Journal Club Bottom Lines 2024-2025
Minimally invasive non-surgical periodontal therapy of intrabony defects: A prospective multi-centre cohort study
Authors: Mehta J, Montevecchi M, Garcia-Sanchez R, Onabolu O, Liñares A, Eriksson F, Ghezzi C, Donghi C, Lu EM, Nibali L.
DOI: 10.1111/jcpe.13984
Purpose: To evaluate the benefits and factors associated with treatment response of minimally invasive non-surgical therapy (MINST) in intrabony defects.
Conclusions: Clinical and radiographic improvements were found in intrabony defects treated with MINST with minimal treatment time and adverse events. Surgical intervention may still be necessary.
Note: Technique 1st described with pictures comparing MINST and MIST: Ribeiro FV, Casarin RC, Clinical and patient-centered outcomes after minimally invasive non-surgical or surgical approaches for the treatment of intrabony defects: a randomized clinical trial. J Periodontol. 2011 Sep;82(9):1256-66. doi: 10.1902/jop.2011.100680. Epub 2011 Feb 2. PMID: 21284549.
Causes of Implant Failure and Subsequent Removal: A Retrospective Study in a Hospital setting
Authors: Paternò Holtzman L, Solderer A, Malpassi C, Palattella P. (format – last name, first initial)
DOI: 10.11607/jomi.11008
Purpose: This study was done in a hospital setting over a 20 year time span evaluating causes and risk indicators for implant removal. The questions addressed were: “which are the most common causes leading to implant removal? Can risk indicators associated with implant removal be identified?”
Conclusions: Peri-implantitis was the most common cause of removal in this cohort group. Mean marginal bone loss was around 72% at implant removal. This study found no significant association between potential risk factors and peri-implantitis.
The flapless approach with and without enamel matrix derivatives for the treatment of intrabony defects: A randomized controlled clinical trial
Authors: Aimetti M, Stasikelyte M, Mariani GM, Cricenti L, Baima G, Romano F
DOI: 10.1111/jcpe.14028
Purpose: to evaluate the clinical and radiographic outcomes of flapless with and without enamel matrix derivatives (EMD) in treating intrabony defects.
Conclusions: The flapless approach is viable minimally invasive treatment of residual PD ≥6 mm associated with deep intrabony defects. The adjunctive application of EMD to flapless treatment of deep intrabony defects demonstrates improved clinical and radiographic outcomes at 12 months when compared to flapless alone.
Oversized Surgical Preparation of the Implant Site: Systematic Review and Meta-analysis of Preclinical Studies.”
Authors: de Jesus, Rainde Naiara Rezende et al
DOI: 10.11607/jomi.1005
Purpose: to evaluate current evidence on the biomechanical biologic outcomes of oversized surgical implant preparation sites compared to standard or undersized sites in experimental animal models.
Conclusions: This systematic review in the animal model reveals that oversized surgical preparation of implant sites does not provide added benefits in terms of biomechanical and histomorphometric parameters of osseointegration when compared to standard or undersized sites, however it does minimize marginal bone resorption and has better quality bone healing.
Maxillary Sinus Augmentation with Anorganic Bovine Bone Mineral of Different Particle Sizes: A Split-Mouth Study with Histomorphometric, Radiographic, and Clinical Analyses
Authors: Krennmair G, Schwarze UY, Weinländer M, Forstner T, Malek M, Krennmair S.
DOI: 10.11607/jomi.10536
Purpose: To compare results for maxillary sinus augmentation between small and large particles of deproteinized bovine bone mineral (DBBM) as graft material. Background: Small particle size is between 0.25 to 1.0mm, and large particle size is between 1.0 to 2.0mm. Background: Small particle size is between 0.25 to 1.0mm, and large particle size is between 1.0 to 2.0mm.
Conclusions: Key Findings: Radiographically, significant loss of vertical bone height (VBH) of about 10% was observed overtime for both types of graft. Peri-implant marginal bone loss was minimal in both groups (S: 0.52 vs L: 0.48 ) and peri-implant health measures did not differ between implants (S: 87.5%, L:81.2%). Both particle sized DBBM graft are comparable in terms of NB and graft stability. However, Bio-Oss-S exhibited better osteoconductivity.
Systemic antibiotics in the surgical treatment of periimplantitis: A randomized placebo-controlled trial
Authors: Riben Grundström C, Lund B, Kämpe J, Belibasakis GN, Hultin M.
DOI: 10.1111/jcpe.13994.
Purpose: To assess the effectiveness of using adjunctive systemic antibiotics in surgically treated peri-implantitis.
Conclusions: Key Findings: At the 6-month mark, in terms of PD and clinical parameters, there were no significant difference between the three groups. However, group A showed significant improvement compared to group C (97% vs. 76%, p=0.018) in terms of MBL stability. Although surgical treatment can improve clinical parameters for peri-implantitis, adjunctive systemic antibiotics can significantly improve MBL stability. However, caution must be taken for bacterial resistance.
Efficacy and safety of a new heterologous fibrin biopolymer on socket bone healing after tooth extraction: An experimental pre-clinical study
Authors: Bighetti ACC., Cestari TM., Paini S., Pomini KT., Buchaim DV., Ortiz RC., Junior RSF., Barraviera R., Bullen IRFR., Garlet GP., Buchaim RL., de Assis GF.
DOI: 10.1111/jcpe.13992
Purpose: To assess the efficacy of heterologous fibrin biopolymer (HFB) in promoting alveolar bone healing after tooth extraction in rats by qualitative and quantitative analysis.
Conclusions: Key Findings: Reduction of the alveolar ridge was found throughout the study in both groups. Reduction was more pronounced in the BCG than the HFBG. Socket reduction was significantly higher in the BCG (28.3%), compared to the HFBG (14.8%). Use of HFB is a promising biopharmaceutical material for future clinical use. This study has demonstrated an ability to attenuate resorption of the alveolar ridge while simultaneously increasing bone density, reducing inflammation, reducing osteoclastic activity, and supporting bone formation over a longer period of time.
Impact of keratinized mucosa on implant-health related parameters: A 10-year prospective re-analysis study
Authors: Mancini L., Strauss FJ., Lim HC., Tavelli L., Jung RE., Naenni N., Thoma DS.
DOI: 10.1111/cid.13314
Purpose: To investigate whether a lack of keratinized mucosa (KM) affects peri-implant health after 10 years of loading.
Conclusions: Key Findings: For implants lacking KMW, 100% exhibited mucositis. Presence of KMW > 0 mm resulted in a decrease in mucositis prevalence. KMW did not show an association with peri-implantitis at 10 years. Two-piece implants were less likely to present peri-implantitis, were at lower risk of buccal-site BOP, and were associated with less MBL. Increased KMW was significantly associated with less MBL. For each mm of KMW there was a mean of 0.08 mm less resorption. Presence of KMW > 0 reduced the odds of BOP at buccal sites, KMW seems to influence MBL changes, implant systems appear to have an impact on BOP and MBL. There is no substantive evidence that KMW affects peri-implant health over time.
Title Influence of keratinized mucosa width on the resolution of peri-implant mucositis: A prospective cohort study
Authors: Authors Blasi G
DOI: 10.1111/cid.13317
Purpose: This study primarily investigated the relationship between the resolution of peri-implant mucositis and keratinized mucosa (KM) width after mechanical therapy. Furthermore, when examining sites with a wide band of KM (WKM >/= 2mm) compared to sites with a narrow or no band of KM (NKM <2mm), emphasis was placed on identifying variations in the peri-implant microbiome of the respective sites.
Conclusions: mechanical debridement (plaque removal) is the main treatment for peri-implant mucositis; additionally, an adequate band of KT can prevent accumulation of plaque and ultimately, formation of inflammatory mucosal lesions
Donor site wound healing following free gingival graft surgery using platelet rich fibrin: A randomized controlled trial.
Authors: Scott SMH, Lacy JA, Palaiologou AA, Kotsakis GA, Deas DE, Mealey BL.
DOI: 10.1002/JPER.24-0072.
Purpose: The main objective of this study was to compare the effects on healing of the palatal tissue donor site when subject to either platelet-rich fibrin (PRF) or a hemostatic agent. Primarily, pain perception, analgesic use, wound characteristics (color, epithelialization, swelling), bleeding on palpation, and granulation tissue were recorded.
Conclusions: The evidence from the study indicated that palatal wound healing, analgesic use, and pain perception exhibited no difference with comparing those treated with PRF versus those treated with a hemostatic agent as a wound dressing to the palatal donor site.
The facial–coronal ridge crest alterations after single immediate implant placement and provisionalization with thin buccal plate phenotype in anterior maxilla: A radiographic case-series study
Authors: Yi, C et al.
DOI: 10.1111/cid.13280
Purpose: Identify potential landmarks that could predict crestal ridge remodeling after immediate implant placement and provisionalization (IIPP) with thin buccal plate phenotype in the anterior maxilla.
Conclusions: After IIPP, the thin alveolar crest (<1 mm) of the socket lost its curvature and tended to develop a flatter profile due to inconsistent ridge reduction in the middle, mesial, and distal areas, similar to the buccal convexity. The reference line could serve as a potential landmark for predicting the shape of the ridge crest after remodeling
Clinical outcomes and risk factor analysis of dental implants inserted with lateral maxillary sinus floor augmentation: A3- to 8-year retrospective study
Authors: Zhang, L et al.
DOI: 10.1111/jcpe.13947
Purpose: Assess the survival rate of dental implants placed using lateral sinus floor augmentation (LSFA) and determine factors influencing implant survival.
Conclusions: Placing implants in augmented sinuses is a reliable method with a strong long-term survival rate. However, a history of periodontitis without regular SPT increases the risk of implant failure. Additionally, a slight but significant reduction in vertically augmented bone occurs after implant placement using the LSFA technique. These findings underscore the importance of maintenance for patients undergoing LSFA and subsequent implant placement to ensure long-term success.
Immediate single-tooth replacement with acellular dermal matrix allogeneic bone and ossifying collagen scaffold: A case series
Authors: Barack, D., et al.
DOI: N/A
Purpose: This study aims to compare the stability of peri-implant tissues after immediate placement in aesthetic zones in combination with a ribose-based crosslinked ossifying collagen scaffold (OCS) and acellular dermal matrix (ADM).
Conclusions: The conclusion was made that the use of OCS and ADM in immediate implant sites in the aesthetic zone leads to stable and healthy clinical outcomes with long-term satisfaction.
Histologic wound healing in studies using different ridge preservation protocols: A review
Authors: Mealey, BL., et al.
DOI: 10.1002/cap.10281
Purpose: This study aims to review studies done at the Department of Periodontics at UT Health San Antonia (UTHSA) that examined wound healing parameters following extraction and alveolar ridge preservation (ARP).
Conclusions: Key Findings: Is there a difference in healing between the use of mineralized and demineralized freeze-dried bone allograft (FDBA and DFDBA)? A statistically significant difference was seen when DFDBA was used compared to FDBA. Can the use of DFDBA shorten healing time? Implants may be placed earlier when DFDBA is used. What if FDBA and DFDBA are combined? Composite FDBA/DFDBA group resulted in less residual bone (18.2%) compared to the 100% FDBA group (27.0%). How do bovine and porcine xenograft compare? No significant difference was seen. The bovine group: Vital bone = 36.2% and residual graft =20.5% vs porcine group:= 31.3% and 19.5% respectively. There is no significant difference in ridge dimension changes when comparing ARP treatment options with various materials. Ridge preservation is a successful technique. More vital bone can be found at healing sites at longer healing periods. When using allografts for ARP, it is advantageous for it to contain a certain amount of DFDBA for increased vital bone formation, especially if a shorter healing time is desired. Residual graft material can be seen even after 12 months post-ARP.
Is transmucosal healing of an implant as effective as submerged healing when simultaneous guided bone regeneration is performed? A preclinical study
Authors: Park JY, Kwon YH, Song YW, Cha JK, Jung UW, Thoma D, Jung R.
DOI: 10.1111/jcpe.13913
Purpose: To evaluate buccal bone regeneration with guided bone regeneration (GBR) during implant placement with transmucosal healing versus submerged healing
Conclusions: Key Findings: Results : The T-GBR group had highest mean area of mineralized tissue, new regenerated bone, buccal bone thickness, and mean defect resolution. However there was no significant difference compared to S-GBR. In GBR groups, remaining bone graft particles were well integrated within newly formed bone and collagen membrane could not be found. In the control groups, spontaneous new bone formation and defect resolution could be seen, but most of the implant surface in the defect was still exposed. There was no significant difference between transmucosal and submerged implants on bone regeneration at implant sites with guided bone regeneration.
Biological Properties and Medical Applications of Carbonate Apatite: A Systematic Review
Authors: Yotsova R, Peev S.
DOI: 10.3390/pharmaceutics16020291
Purpose: Carbonate apatite is a biomaterial that resembles natural bone. A systematic review was done to discuss the biological properties and medical applications of this material.
Conclusions: Carbonate apatite resembles bone tissue with respect to reactivity. It has excellent biocompatibility, bioresorbabilty, bioactivity, and osteoconductivity, but has poor mechanical properties and high solubility. It has shown superiority over hydroxyapatite and β-TCP as a bone substitute and scaffold material. It can potentially be used as a bioactive coating and/or drug-delivery system.
Risk factors for tooth loss and progression of periodontitis in patients undergoing periodontal maintenance therapy
Authors: Siow DSF, Goh EXJ, Ong MMA, Preshaw PM
DOI: 10.1111/jcpe.13721
Purpose: To evaluate risk factors that may predict tooth loss and periodontal disease progression in periodontitis patients that underwent active periodontal therapy and at least 5 years of maintenance.
Conclusions: Key Findings: he incidence of tooth loss due to periodontitis during maintenance was 0.14 teeth/patient/year. Tooth lost during maintenance regarding severity of periodontitis: Stage IV periodontitis experienced 76.92% (20/26) patients; Stage III experienced 34.04% (40/108). According to this study, stage IV periodontitis is a risk factor for tooth loss. Residual PD ≥5 mm, furcations, and increased in PD and CAL greater than 3 mm after APT are risk factors of disease progression or tooth loss.
A pedicled buccal periosteal flap for the closure of oro-antral fistula.
Authors: Ibrahim, Marwa T et al.
DOI: 10.1186/s12903-024-04217-6
Purpose: To evaluate the effectiveness of the pedicle buccal periosteal flap for closing oroantral fistula and its effect on the vestibular depth
Conclusions: Key Findings: The average size of OAF was 4.7 mm (range: 0 – 9 mm), average size of defect was 8.4 mm (range: 4 – 12 mm), and average duration of fistula was 14.4 weeks (range: 0 – 48 weeks). Pain level at first week postoperative was on average 5.5 (range: 4 – 9) and decreasing to 0 by the fourth week. The buccal pedicle flap can be used to close OAF while maintaining vestibular height , providing tension-free closure and simple management of the mucoperiosteal flap.
The significance of vertical platform discrepancies and splinting on marginal bone levels for adjacent dental implants.
Authors: Lin GH, Tran C, Brzyska K, Kan JY, Wang HL, Curtis DA, Kao RT.
DOI: 10.1111/cid.13176.
Purpose: To assess the impact of splinting multiple implants and vertical platform discrepancy (VPD) on the marginal bone loss (MBL) of adjacent implants.
Conclusions: Key Findings: Three splinted adjacent crowns had the most % of implants with MBL ≥ 1 mm (VPD of 1.0mm: 70.00%, VPD of 0.5mm 66.67%), followed by two splinted adjacent crowns (VPD of 1.0mm: 61.11%, VPD of 0.5mm 58.97%). When two or three adjacent crowns of implants are splinted, they have greater occurrence of MBL of ≥1.0mm than non-splinted implant prosthesis. Also, VPD of ≥0.5mm had significant MBL compared to VPD of <0.5mm.
Four-mm-short implants in the rehabilitation of posterior atrophic jaws: A retrospective study on 212 patients with a mean follow-up of 8.02 years.
Authors: Barausse C, Pistilli R, Bonifazi L, Tayeb S, Pellegrino G, Ravidà A, Felice P.
DOI: 10.1111/clr.14349.
Purpose: To retrospectively assess the efficacy of 4mm short implants.
Conclusions: Short implants with 4mm height appear to be an effective option with good survival rate.
Marginal bone changes around platform-switched conical connection implants placed 1 or 2 mm subcrestally: A multicenter crossover randomized controlled trial
Authors: Stacchi C., Lamazza L., Rapani A., Troiano G., Messina M., Antonelli A., Giudice A., Lombardi T.
DOI: 10.1111/cid.13186
Purpose: To analyze marginal bone changes around implants with a platform-switched and conical connection placed 1 to 2 mm subcrestally 1 year after prosthetic loading.
Conclusions: Key Findings: At prosthesis delivery, mean PBL reduction was 0.44 ± 0.30 mm and 0.28 ± 0.32 mm in Test and Control group, respectively. Bone reduction was significantly higher in the test group than control group. After 1-year of loading an additional PBL reduction of 0.05 ± 0.25 mm and 0.18 ± 0.25 were found in the test and control groups, respectively. Bone loss during this period was significantly lower in the test group than control group. Placement 1- or 2-mm subcrestal resulted in similar crestal bone reduction after 1-year of loading. After one year of function, implants placed 2-mm subcrestal had a more coronal bone level relative to the implant platform, with none of the implants with PBL below the implant platform level.
Patient and implant-related risk factors for implant failure of one-stage lateral sinus floor elevation: A 2- to 10-year retrospective study
Authors: Fu M., Ye Y., Pu Rui., Zhu D., Yang G., Jiang Z.
DOI: 10.1111/cid.13380
Purpose: To evaluate survival rate of implants placed in lateral sinus floor elevation (LSFE) sites in a large population with 2–10-year follow-up periods, and to analyze possible risk factors for early and late implant failure.
Conclusions: Key Findings: For early implant failure, RBH ≤ 3 mm was associated with significantly higher rate of failure (OR 7.353). For late implant failure, smoking (HR 13.581, ≤ 3 mm RBH (HR 8.471), and Nobel brand (HR 17.937) was associated with significantly higher risk of failure. Male sex (OR 5.176), narrow ostium diameter ≤ 2.5 mm (OR 4.587), longer IL > 8 mm (OR 4.635), and flat thickening of Schneiderian membrane (OR 5.177) also demonstrated a significantly higher late implant failure rate. Radiographic bone height ≤ 3 mm increased the risk of early and late implant failure. Smoking habit and Nobel brand were additional independent risk factors for late implant failure. Altered sinus physiology (narrower OD, longer IL, and flat thickening of Schneiderian membrane) may represent non-independent risk factors for late implant failure. A cumulative 5-year survival rate of 95.62% was found.
Surgical interventions for the treatment of peri-implantitis.
Authors: Ramanauskaite A, Cafferata EA, Begic A, Schwarz F.
DOI: 10.1111/cid.13162.
Purpose: The purpose of this article is to review and describe various surgical treatments for peri-implantitis.
Conclusions: Access Flap Surgery- This approach allows direct visualization and access to the implant, allowing for decontamination of the implant surface. Several randomized clinical trials (RCTs) found no additional benefits of access flap surgery in conjunction with diode laser/photodynamic therapy when compared to mechanical debridement.
Resective Therapy- The goal of resective therapy is to improve access for adequate oral hygiene by reducing PDs. Implants associated with horizontal bone loss/supracrestal defects are indicated for resective therapy, which can be achieved by apically positioning the soft tissue in the presence or absence of osseous recontouring.
Implantoplasty- This treatment is defined by the alteration of the implant surface with rotary diamond burs/Arkansas stone, to create a smooth implant surface, decreasing the likelihood of contamination of the implant surface.
Reconstructive vs Nonrescontructive- Reconstructive therapy resulted in greater PD reduction/bone fill and less soft-tissue recession; however, reduction in inflammation was similar between those treated with reconstructive vs nonreconstructive therapy.
Conclusion: Combination of mechanical debridement with titanium brushes or lasers, in addition to reconstructive therapy when necessary, resulted in greater PD and bleeding reduction than single treatment alone.
Management of Furcation-Involved Molars: Recommendation for Treatment and Regeneration.
Authors: Rasperini G, Majzoub J, Tavelli L, Limiroli E, Katayama A, Barootchi S, Hill R, Wang HL.
DOI: 10.11607/prd.4341.
Purpose: The purpose of this review was to provide recommendations regarding treatment of furcations associated with molars.
Conclusions: Classification of furcations by identifying vertical and horizontal components were detailed in the following table:
|
Horizontal Class (H) |
Vertical Class (V) |
||
|
A |
B |
C |
|
|
1 |
H: <3mm loss in furcation V: attachment/bone loss to coronal 1/3 |
H: <3mm loss in furcation V: attachment/bone loss to middle 1/3 |
H: <3mm loss in furcation V: attachment/bone loss to apical 1/3 |
|
2 |
H: >/=3mm loss in furcation V: attachment/bone loss to coronal 1/3 |
H: >/=3mm loss in furcation V: attachment/bone loss to middle 1/3 |
H: >/=3mm loss in furcation V: attachment/bone loss to apical 1/3 |
|
3 |
H: through and through bone loss in furcation V: attachment/bone loss to coronal 1/3 |
H: through and through bone loss in furcation V: attachment/bone loss to middle 1/3 |
H: through and through bone loss in furcation V: attachment/bone loss to apical 1/3 |
Class II furcations are mostly ideal for regenerative approaches, as well as Class I with a vertical component. Class CII furcations however are not recommended for regenerative treatment due to the extensive vertical defect (23% 10 year survival rate with maintenance). More severe furcation defects such as Class BIII can be treated with either tunneling (allowing for access for hygiene) or hemisection/root resection. For all class III furcations, the remaining attachment around each root is the driving factor for treatment via hemisection/root amputation or extraction.
Conclusions: Furcation types AI, BI, and BII when the interproximal bone height is coronal to the furcation defect should be assessed and attempted to be treated with regenerative approaches. >/=5mm of horizontal/vertical bone loss, wide divergence of roots, and large vertical component of the defect resulted in poorer/incomplete defect fill. Recession types of RT1/2, at least 2mm of keratinized tissue, and thick tissue result in more predictable regeneration of furcations.
Hard and soft tissue alterations using dual-zone concept versus connective tissue graft at maxillary immediate implant placement: A 1-year randomized clinical and volumetric trial
Authors: Fettouh
DOI: 10.1111/clr.14247
Purpose: To evaluate how the use of CTG vs. dual-zone concept (DZ) at sites with thin labial bone affect the esthetic outcome of immediate implant placement (IIP). Background: Dual-zone concept involves atraumatic tooth removal without flap elevation and placing a bone graft into the residual gap (labial + coronal soft tissue zones) around an immediate fresh-socket anterior implant with a screw-retained provisional restoration which acts as a prosthetic socket seal device (Chu et al. 2012).
Conclusions: Key Findings: here is a statistically significant difference in mean vertical crestal bone changes in the CTG (1.1 ± 0.6 mm) compared to DZ (0.2 ±1.0 mm) meaning more bone loss for CTG group. When comparing the use of CTG and DZ concept with IIP it was found there was less volume reduction horizontally with the CTG group.
Complication, vertical bone gain, volumetric changes after vertical ridge augmentation using customized reinforced PTFE mesh or Ti-mesh. A non-inferiority randomized clinical trial
Authors: Cucchi, et al.
DOI: 10.1111/clr.14350
Purpose: To compare the surgical and healing complications in regards to vertical bone gain, and volumetric bone changes post vertical ridge augmentation using either customized Ti-reinforced d-PTFE mesh or customized CAD/CAM Ti-mesh.
Conclusions: Key Findings: The effective regeneration rate for Ti-mesh group was 87% compared to PTFE group of 90%. From the results it can be concluded that there are comparable if not better results in terms of surgical and healing complications with customized CAD/CAM Ti-meshes with respect to PTFE meshes. There were no significant differences found between the two in vertical bone gain and regeneration rates though the PTFE meshes showed higher values.
A Systematic Approach to Restoring Full Arch Length with Maxillary Fixed Implant Reconstruction: The PATZi Protocol
Authors: Ponnusamy, S et al.
DOI: 10.11607/jomi.10153.
Purpose: To Propose the PATZI protocol for use as a preoperative and intraoperative workflow algorithm that serves as a framework for full-arch maxillary implant surgery and prosthetic rehabilitation.
Conclusions: Full-arch implant reconstruction aims to achieve a consistent outcome; a fixed full-arch prosthetic, despite the wide variations in patient anatomy, habits, and dental conditions. Due to these significant preoperative and intraoperative differences among patients, the PATZi protocol can guide surgeons in consistently delivering successful results and in effectively planning for future treatments.
Peri-implant mucosal enhancement using leukocyte platelet rich fibrin under Sohn’s poncho technique: A randomized controlled clinical trial
Authors: Patnaik, B et al.
DOI: 10.1002/cap.10259
Purpose: The study aims to assess the effectiveness of Sohn’s poncho technique for placing an L-PRF membrane in enhancing peri-implant mucosal thickness. Background: Sohn’s Poncho Technique is a minimally invasive technique that uses autologous membranes like CGF or PRF to promote wound healing in procedures such as GBR. The technique stabilizes these membranes with a healing abutment, avoiding the need for a full-thickness flap or periosteal incision. The membranes are resorbed over four weeks, encouraging soft tissue growth, which eliminates the need for primary wound closure and reduces postoperative pain.
Conclusions: Key Findings: The test group showed significantly greater mucosal thickness at buccal, crestal, and lingual (average of 3.8 ± 0.4 mm v/s 2.3 ± 0.4 mm) sites compared to the control group. Regarding the width of keratinized mucosa, the test group showed a consistent increase over time, while the control group experienced a slight decline after 4 weeks (3.6 ± 0.6 mmm v/s 2.7 ± 0.3 mm). The Sohn’s poncho technique, when used with L-PRF, can potentially improve peri-implant mucosal thickness and increase the width of keratinized mucosa.
How to Prevent and Manage Postoperative Complications in Maxillary Sinus Augmentation Using the Lateral Approach: A Review
Authors: Valentini P.
DOI: 10.11607/jomi.10145
Purpose: to outline risk factor and indicators associated with postoperative complications in sinus augmentation procedures.
Conclusions: Sinus augmentation via lateral window technique (LWT) is a safe and predictable procedure. Careful risk assessment and working with an ENT who is familiar with the LWT is advised to avoid and manage complications.
Risk factors for the failure of re-implanted dental implants: A 20-year retrospective study
Authors: Kim CM., et al.
DOI: 10.1002/JPER.24-0198
Purpose: to address the gaps in the research on re-implantation by analyzing failed implants, the survival of re-implanted cases, and identifying risk factors contributing to refailure.
Conclusions: Key Findings: The second-placed implants had a cumulative 1-year survival rate of 88.1%. No significant associations were found between the surgical sites, use of submerged or non-submerged implants, cover screw exposure, simultaneous GBR during the re-implantation, prosthesis type, surgeon experience, and reimplantation failure occurrence. Risk factors for failure of second-time-placed implants are smoking, implant surface, and timing of re-implantation. Analysis of previous failure factors is necessary and modifiable risk factors should be controlled. Smoking cessation, relatively safe SLA surface implants and re-implantation after sufficient healing time of 4 or more months are recommended.
The impact of collagen membrane fixation protocols on volume stability in horizontal ridge augmentation in the aesthetic area: A retrospective study
Authors: A retrospective study. Zhang S, Wang Y, Wang Q, Li J, Wang F, Li Z, Cui J, Zhang
DOI: 10.1111/cid.13393
Purpose: This retrospective study evaluated volume stability of different membrane fixation protocols in horizontal ridge augmentation in the aesthetic area. Membrane without fixation, fixation with absorbable sutures, fixation with titanium pins, and fixation with both pins and absorbable sutures were evaluated.
Conclusions: Key Findings: orizontal bone thickness was less after 6 months of bone healing regardless of the collagen membrane fixation used. There was higher bone loss in group 1 than in the other groups showing that membrane fixation reduces horizontal bone loss GBR with membrane fixation demonstrated superior volume stability. No differences were found when comparing pins to sutures. However, when used it in combination there was higher volume stability.
Change in clinical parameters after subgingival instrumentation for the treatment of periodontitis and timing of periodontal re-evaluation: A systematic review and meta-analysis
Authors: Paternò Holtzman, Lucrezia et al
DOI: 10.1111/jcpe.13985
Purpose: To assess clinical parameters after subgingival instrumentation when treating periodontitis and determine the best timing for periodontal re-evaluation in periodontitis patients treated with subgingival instrumentation.
Conclusions: Key Findings: The mean PD reduction for all pockets was 1.16 mm in the first 1-2 months after treatment, and 0.25 additional reduction between 1-2 and 3-4 months. For initial deep sites (≥6 mm), the mean PD reduction at 1-2 months was 3.4 mm, with additional 0.97 mm reduction at 3-4 months. The change in clinical parameters after subgingival instrumentation for treating periodontitis shows that majority of PD reduction for all sites take place within the first 2 months. There is also clinically significant PD reduction at 3-4 months after treatment that can decrease the number of sites needing additional treatment. Waiting 3-4 months or longer before re-evaluating for surgery may show improved clinical parameters, but better designed studies needed to confirm or reject this notion.
Assessment of bone defect morphology for the adjunctive use of bone grafting combined with enamel matrix derivative: A 3-year cohort study
Authors: Matsuura, Takanori et al
DOI: 10.1002/JPER.23-0538
Purpose: to evaluate the features of intrabony defects, like defect angle and number of bony walls, in terms of additional benefits of enamel matrix derivative (EMD) with or without bone grafting.
Conclusions: Since DA and RBD reduction are inversely related, it is suggested that bone graft may compensate for the negative effect, in which EMD and autogenous bone grafting significantly reduced intrabony defects when DA ≥40°, independent of the number of bony walls. When DA was <30°, there was no significant difference when using EMD with or without bone graft.
A multi-centre randomized controlled trial comparing connective tissue graft with collagen matrix to increase soft tissue thickness at the buccal aspect of single implants: 3-Year results.
Authors: Surdiacourt L, Christiaens V, De Bruyckere T, De Buyser S, Eghbali A, Vervaeke S, Younes F, Cosyn J.
DOI: 10.1111/jcpe.13975.
Purpose: To analyze the difference between connective tissue graft (CTG) and collagen matrix (CMX) for increasing the buccal soft tissue thickness of a single implant site.
Conclusions: Key Findings: At T1, due to CMX graft being thicker than CTG, the estimated mean difference favored the test group. At later time points T2, T3, and T4, the estimated mean difference favored the control group. ( n terms of MBL and midfacial recession the results favored the control group significatively at least in one time point. CTG is more effective than CMX in terms of improving BSP and lessening MBL.
Ten-Year Follow-Up of Oral Implants in Bone With Limited Bucco-Oral Dimensions: A Prospective Case Series.
Authors: Alami M, Ntovas N, Penne G, Teughels W, Quirynen M, Castro A, Temmerman A.
DOI: 10.1111/jcpe.14063
Purpose: To assess implants placed in ridges with narrow bucco-oral width.
Conclusions: Key Findings: In terms of soft tissue analysis sites with keratinized but non-attached tissue had significantly higher BOP score and Peri-mucositis, compared to sites with attached tissues. Overall, implants had 100% survival rate at 10-year mark. Even with a narrow alveolar ridge, an implant may survive for at least 10 years.
Effect of suturing in root coverage via coronally advanced flaps: A systematic review
Authors: Ariceta A., Chambrone L., Stuhr S., Couso-Queiruga E.
DOI: 10.1002/cap.10312
Purpose: To analyze the literature to assess the influence of the suturing technique and material usage on mean percentage root coverage (%MRC) for single tooth gingival recession defects treated using the coronally advanced flap for root coverage.
Conclusions: Key Findings: For studies using sling and single interrupted sutures, MRC was 70.2%. For the three studies using single interrupted sutures alone, MRC was 74.1%. MRC for studies using silk sutures was 68.3%, ePTFE only was 37%, polyglactin910 was 76.6%, and nylon was 74.8%. Mean root coverage did not differ significantly whether single interrupted sutures were used alone or in combination with sling sutures. Sites treated with polyglactin910 or nylon sutures exhibited higher %MRC. The use of 5-0 suture diameter demonstrated the highest %MRC.
Histological and immunohistochemical soft-tissue response to cylindrical and concave abutments: Multicenter randomized clinical trial
Authors: Camacho-Alonso F., Mira Bernabeu JC., Sanchez J., Buendia AJ., Mercado-Diaz AM., Perez-Sayans M., Jardon-Perez A., Martin JMS., Montero J., Gomez-Polo C., Quispe-Lopez N., Penarrocha-Oltra D.
DOI: 10.1002/JPER.24-0250
Purpose: To assess the influence of abutment shape (cylindrical vs concave) on peri-implant soft tissue via histological and immunohistochemical analyses.
Conclusions: Key Findings: Inflammatory intensity and vascular proliferation were significantly lower in the peri-implant soft tissue surrounding concave abutments compared to cylindrical. ( Concave abutments presented significantly greater peri-implant tissue height, linked to an extended barrier epithelium, compared to cylindrical abutments in thick tissue phenotype. This enhances soft tissue sealing, promoting a greater percentage of transversely oriented collagen fibers. The concave design also reduced chronic inflammatory exudate with T and B cells, minimizing risk of chronic inflammation.
Preloading peri-implant crestal bone loss: A retrospective study of incidence and related factors.
Authors: Vilela N, Gurgel BCV, Bruzos C, Duarte WR, da Silva HDP, Pannuti CM, Duarte PM.
DOI: 10.1002/JPER.24-0028.
Purpose: The purpose of this study was to determine the incidence of pre-loading creastal bone loss (PLCBL), the time between implant placement and uncovery or abutment/prosthesis placement, and to note the factors associated with PLCBL.
Conclusions: Key Findings: Average PLCBL at mesial and distal sites were 1.2mm and 1.3mm respectively. This study concluded that incidences for PLCBL >/=0.5 was 24.4% and for PLCBL >/=1.5mm was 10.5%. Factors such as male gender, penicillin allergy, diabetes, bone-level platform connection, supracrestal placement, anterior location were all associated with increased risk of PLCBL. Previously grafting at sites however, seemed to have a protective role in PLCBL.
Alveolar ridge preservation versus early implant placement in single non-molar sites: A systematic review and meta-analysis.
Authors: Atieh MA, Shah M, Hakam A, AlAli F, Aboushakra I, Alsabeeha NHM
DOI: 10.1111/clr.14314.
Purpose: The purpose of this systematic review was to investigate the radiographic, clinical, and patient reported outcomes of alveolar ridge preservation (ARP) of non-molar teeth compared to early implant placement (EIP).
Conclusions: N/A
Effects of hard- and/or soft-tissue grafting with early implant placement: Histomorphometric outcomes of an exploratory study in canines
Authors: Hyun-Chang Lim, et al.
DOI: 10.1111/clr.14320
Purpose: This study aims to examine how early implant placement protocol effects hard and soft tissue augmentation.
Conclusions: Key Findings: The group with the largest total tissue thickness at 16 weeks was GBR +CTG group, (1.74 mm at implant shoulder+1 and 1.94 mm at implant shoulder). This group also had the most favorable level of marginal mucosa and presence of mineralized tissue at the coronal level. When comparing the results of CTG alone vs. GBR alone at 16 weeks CTG demonstrated a larger thickness. The combination of both GBR with CTG resulted in the best outcomes in regard to tissue thickness when combined with early implant placement.
Enhanced periodontal tissue healing via vascular endothelial growth factor expression following low-level erbium-doped: yttrium, aluminum, and garnet laser irradiation: In vitro and in vivo studies.
Authors: Takemura, et al.
DOI: 10.1002/JPER.23-0458
Purpose: This study aimed to investigate the changes in periodontal tissue regeneration, angiogenesis, and healing both in vivo and vitro using low-level erbium doped: yttrium, aluminum, and garnet (Er:YAG) lasers.
Conclusions: Via TRPV1 the results suggest that Er:YAG laser can promote periodontal tissue healing by means of increased angiogenesis and endothelial cell function. Angiogenesis is improved via upregulation of VEGF secretion, proliferation, and tube formation of endothelial cells.
Maxillary sinus membrane perforation rate utilizing osseodensification-mediated transcrestal sinus floor elevation: A multicenter clinical study
Authors: Mazor, Z et al.
DOI: 10.1111/cid.13368
Purpose: This study looked at how often the membrane gets damaged during transcrestal sinus floor elevation (TSFE) when using osseodensification (OD) burs. It also aimed to find out what factors might increase the risk of this happening.
Conclusions: Key Findings: Sinus membrane perforations occurred in 49 sites (7.31%), confirmed by direct observation. Using OD instrumentation for TSFE results in a low rate of membrane perforation. However, severe posterior maxillary atrophy was identified as a significant risk factor for increasing the likelihood of membrane perforation during the procedure.
The efficacy of reconstructive therapy in the surgical management of peri-implantitis: A 3-year follow-up of a randomized clinical trial.
Authors: Renvert, S et al.
DOI: 10.1111/jcpe.14049
Purpose: To find out if guided bone regeneration (GBR) can help heal bone loss in peri-implantitis better than open flap debridement (OFD) after 36 months.
Conclusions: Key Findings: The composite treatment success rate was higher in the TG (46.2%) compared to CG (20%), though this difference did not reach statistical significance (p = .053). PROs, including satisfaction, showed no significant difference between the groups, with satisfaction reaching 100% in TG and 92% in CG at 36 months. At 36 months, both GBR and OFD treatments maintained the results achieved at 1 year in patients who received SPT. GBR led to greater RDF and a higher overall treatment success rate compared to OFD. However, there were no significant differences between the two groups in clinical parameters or PROs.
Clinical efficacy of two vertical soft tissue augmentation techniques for peri-implant crestal bone level stability: A randomized clinical trial
Authors: Puisys A, et al.
DOI: 10.1111/cid.13365
Purpose: to assess the efficacy of peri-implant soft tissue augmentation via acellular dermal matrix (ADM) grafting compared to the use of short healing abutments to expand the soft tissue through the tenting technique (TT).
Conclusions: Key Findings: Both groups were comparably effective at increasing STH with an average increase of 1.6 +/- 0.5mm in the ADM group and 1.8 +/- 0.4mm in the TT group. A small but insignificant PPD increase was seen at the distal aspects in both groups while BOP and PI were low. Both ADM graft and TT are effective in augmenting STH and maintaining crestal bone levels around implants. TT offers the added benefits of maintaining crestal bone stability at the mesial aspect, but also has higher risk of post-surgical complications.
Influence of repeated implant-abutment manipulation on the prevalence of peri-implant diseases in complete arch restorations. A retrospective analysis.
Authors: Krebs M., et al.
DOI: 10.1111/cid.13381
Purpose: to evaluates the effects of abutment manipulation by comparing one-abutment-one time (OAOT) vs. conventional multiple abutment replacements (AR) on peri-implant disease prevalence.
Conclusions: Key Findings: Healthy peri-implant tissues were seen in 94.4% of OAOT and 0% of the AR group patients, with a 5.6% and 88.9% diagnosis of peri-implantitis and 0% and 22.2% diagnosis of peri-implant mucositis respectively. The one-abutment one-time treatment concept leads to lower peri-implant disease prevalence.
A Narrative Review on Oral Mucosa Biomechanics and Clinical Implications of Periodontal and Implant-Related Regenerative Procedures.
Authors: Rodriguez A, Mohamed M, AlHachache S, Kripfgans O, Chan HL
DOI: 10.11607/prd.6786
Purpose: This systematic review looked to evaluate the difference between attached mucosa (AM) and lining mucosa (LM), compare their biomechanical properties, and to relate flap tension to wound stability.
Conclusions: Presurgical evaluation of the tissue should be done and modifications in techniques, materials, and flap designs should be considered to increase wound stability.
Clinical Indications and Outcomes of Sinus Floor Augmentation With Bone Substitutes: An Evidence-Based Review.
Authors: Saleh MHA, Sabri H, Di Pietro N, Comuzzi L, Geurs NC, Bou Semaan L, Piattelli A
DOI: 10.1111/cid.13400
Purpose: To provide a comprehensive review on bone graft materials used during sinus floor elevation evaluating the histologic and clinical results and give clinical recommendations.
Conclusions: Biomaterial selection and formulation have a crucial role in SFE outcomes. There should be considerations for resorption rates and material consistency.
Simplified Subperiosteal Sling Suture for Connective Tissue Graft Stabilization in Root Coverage and Phenotype Modification
Authors: Do, Jonathan H
DOI: 10.11607/prd.6843
Purpose: To describe the simplified subperiosteal sling (SPS) suture to stabilize the connective tissue graft (CTG) during soft tissue augmentation with vestibular incisional subperiosteal tunnel access (VISTA) in single or multiple tooth sites.
Conclusions: The simplified SPS suture is an improved SPS suture that significantly reduces intraoperative complications and has improved CTG stabilization when treating single and multiple gingival recession defects.
Do Recombinant, Purified, and Concentrated Growth Factors Enhance the Regenerative Potential of Particulate Bone Graft Substitutes in Maxillary Sinus Floor Augmentation? A Systematic Review and Meta-analysis
Authors: Mendes, Vivian Viveiros et al
DOI: 10.11607/jomi.10553
Purpose: To evaluate recombinant, purified, and concentrated growth factors effect on new bone formation, residual graft material, and fibrous tissue ratio in maxillary sinus floor augmentation.
Conclusions: Select growth factors when used supplementary to bone grafting during maxillary sinus floor augmentation may enhance new bone formation and graft turnover.
Soft-Tissue Phenotype as a Risk Indicator of Peri-Implantitis and Peri-Implant Soft-Tissue Dehiscence-A Cross-Sectional Study.
Authors: Isler SC, Romandini M, Akca G, Bakirarar B, Unsal B, Romanos G, Sculean A.
DOI: 10.1111/jcpe.14059.
Purpose: To examine the relationship between components of peri-implant phenotype when peri-implantitis and peri-implant soft tissue dehiscence (PISTD) are present.
Conclusions: Considering the confounding variables, lack of PIKM-W and short vestibulum depth were associated with presence of peri-implantitis and PISTD, while deficient attached mucosa was only linked to peri-implantitis, and thin mucosa was only linked to PISTD. In terms of inflammatory biomarkers, lack of PIKM-W was associated with disrupted inflammatory response and upregulated soft-tissue remodeling.
Endoscopic Re-Instrumentation of Intrabony Defect-Associated Deep Residual Periodontal Pockets Is Non-Inferior to Papilla Preservation Flap Surgery: A Randomized Trial.
Authors: Ho KD, Ho KR, Pelekos G, Leung WK, Tonetti MS.
DOI: 10.1111/jcpe.14075.
Purpose: To compare the effectiveness of endoscopic-assisted subgingival debridement (EASD) against papilla-preservation flap surgery (PPFS) for addressing residual pockets from intrabony defects.
Conclusions: EASD is comparable to PPFS in terms of managing residual pockets.
Submerged vs Nonsubmerged Reconstructive Approach for Surgical Treatment of Peri-implantitis: Reanalysis of Two Prospective Clinical Studies
Authors: Wen SC., Sabri H., Dastouri E., Huang WX., Barootchi S., Wang HL
DOI: 10.11607/jomi.10560
Purpose: To compare submerged and non-submerged approaches for peri-implantitis reconstructive treatments. Factors relevant to disease resolution and bone augmentation outcomes were also explored.
Conclusions: A fully submerged healing approach for peri-implantitis reconstructive therapy yields significantly improved clinical and radiographic outcomes. A reported 1.5 mm more PDR, 0.9 mm more DF, and 1.9 mm more RDF than non-submerged healing was reported when compared to non-submerged healing.
Current Emerging Concepts on the Pathogenesis of Periimplant Diseases: A Narrative Review
Authors: Guarnieri R., Testarelli L., Galindo-Moreno P., Fabbro MD., Testori T.
DOI: 10.11607/jomi.10723
Purpose: To describe emerging evidence on etiologic factors and pathophysiologic mechanisms involved in peri-implant inflammatory diseases.
Conclusions: Key Findings: Results: Peri-implant mucositis and peri-implantitis is characterized as inflammatory reactions in the tissues surrounding an implant. The etiology for peri-implant mucositis (PIM) is the accumulation of a biofilm around the implant, while peri-implantitis (PI) is characterized by an inflammatory process encompassing both soft tissue inflammatory and progressive loss of supporting bone exceeding physiologic remodeling. Therefore, it is reasonable to conclude bacteria is necessary but not sufficient for development of PI. Peri-implant conditions – Marginal bone loss: However, regardless of the initial source of MBL, early bone loss exceeding thresholds of 0.5-1 mm have been demonstrated as a predictor of long-term peri-implant pathology and risk of peri-implantitis. Several studies have demonstrated a distinction in the immune response with M1-polarized (pro-inflammatory) monocytes being more present in disease peri-implant tissues than disease periodontal tissues. A more robust immune response may occur which results in more advanced tissue destruction. an aseptic immunologic response initiation rather than an infectious one. This response may often precede and precipitate bacterial-related marginal bone loss. Peri-implant conditions – Peri-implant mucositis The key criterion for PIM is inflammation in the peri-implant mucosa in the absence of onging peri-implant bone loss. Peri-implant conditions – Peri-implantitis: I t is most likely that peri-implant diseases are influence by the presence of alloplastic materials where the interaction between the bacterial plaque and Ti may lead to alterations in the Ti surface, where bacterial attachment and growth is promoted on the corroded surface. Therapeutic implications: The authors of this paper advocate for comparing a history of retroalveolar radiographs (periapicals and bitewings) for assessing peri-implant disease. While antibiotics and decontamination may temporarily alleviate the disease, it’s important to always address the root etiology of the disease PIM and PI have classically been defined as inflammatory conditions associated with a microbial challenge. However, emerging evidence has demonstrated several etiologic factors, often iatrogenic, which are important to recognize and include in the treatment of PI disease if found. A growing body of evidence is also suggesting peri-implant inflammatory conditions may be connected to aseptic reactions associated with an immunologic response. More research is needed to better understand the inflammatory mechanisms occurring around dental implants.
Immediate implant placement combining socket seal abutment and peri-implant socket filling: A prospective case series.
Authors: Lilet, R., Desiron, M., Finelle, G., Lecloux, G., Seidel, L., & Lambert, F.
DOI: 10.1111/clr.13852.
Purpose: The purpose of this article is to investigate the effects of CAD-CAM fabricated socket seal abutment (SSA) in conjunction with immediate implant placement and peri-implant socket filling (PISF) on soft and hard tissue remodeling in posterior sites.
Conclusions: Key Findings: 11 molar and 9 premolar teeth were replaced in the study. 20% of patients (4 patients) experienced complications regarding postop infection and peri-implantitis (in one case)—these patients were not prescribed antibiotics immediately following the surgery. The overall implant survival rate was 95%, with 20% of patients (those who were not prescribed antibiotics) facing complications. The protocol of immediate implant placement with DBBM and SSA is an effective way to maintain peri-implant hard and soft tissue dimensions.
Does Injectable Platelet-Rich Fibrin Combined With Autogenous Demineralized Dentine Enhance Alveolar Ridge Preservation? A Randomized Controlled Trial.
Authors: Amer O, Shemais N, Fawzy El-Sayed K, Saleh HA, Darhous M.
DOI: 10.1111/clr.14372
Purpose: The purpose of this article was to primarily investigate the effect of injectable platelet rich fibrin (i-PRF) in conjunction with autogenous demineralized dentin graft (ADDG) for alveolar ridge preservation (ARP) on buccolingual ridge width, in addition to examining socket bone heights, pain, keratinized tissue width (KTW), chair time, patient satisfaction, and histology of the new osseous tissue.
Conclusions: Key Findings: Overall, no significant differences in ridge width occurred with reductions of 1.8+/-1.35mm and 1.71+/-1.08mm for the ADDG and ADDG+i-PRF groups respectively. Comparing ADDG and ADDG+i-PRF, mineralized osseous tissue was 40.1% and 33.8% and remaining graft particles was 0.6% and 1.15% respectively. Use of ADDG with or without i-PRF for ARP allow for effective grafting of extraction sockets. Some advantages of the addition of i-PRF include lower pain, easier handling, and improved KTW following extraction.
A randomized controlled trial comparing guided bone regeneration to connective tissue graft to re-establish buccal convexity at dental implant sites: Three-year results
Authors: Bouckaert, et al.
DOI: 10.1111/clr.13906
Purpose: To compare GBR to CTG as a means to increase buccal soft tissue profile around a single implant site with minor horizontal alveolar defects at three-year follow-up.
Conclusions: Key Findings: It was found that the augmented area may not be fully stable even at 1-3 years post-op since buccal bone loss present during this entire period. 0.93mm or 28% of the augmented area was lost at 1 year, and 1.66mm or 50% loss at 3 years. At the three year time point it was concluded by the authors that there is no significant difference between GBR and CTG in relation to the linear increase in buccal soft tissue profile. Various clinical factors should therefore be taken into account to make this decision including anatomy of the defect, procedure invasiveness, and material selection.
Clinical outcomes of using operating microscope for alveolar ridge preservation: A randomized controlled trial
Authors: Sirinirund, et al.
DOI: 10.1002/JPER.24-0081
Purpose: To compare the wound healing and crestal bone quality after the use of operating microscope (OM) for extraction and alveolar ridge augmentation (ARP) in comparison to dental loupes (DL).
Conclusions: Key Findings: The test group had only two sites with tissue remnants compared to 10 sites in the control group after socket debridement was done. The authors concluded that using the operating microscope there were significantly better soft tissue healing results with better closure at 2 and 4 weeks. There was also less remnants at time of extraction. The authors attribute these differences found to the increased magnification and light allowing for better visualization. Using the microscope may also offer higher surgical precision resulting in better tissue handling and thus decreased trauma as noted by better early closure of the extraction sites. No differences were noted in the core biopsies or CBCT evaluations.
Interproximal contact loss at implant sites: a retrospective clinical study with a 10- year follow- up
Authors: Gasser, T et al.
DOI: 10.1111/clr.13908
Purpose: To evaluate the incidence and extent of interproximal contact loss (ICL) between implant restorations and adjacent teeth after a 10-year follow-up.
Conclusions: Key Findings: ICL was observed in 50% of implant sites, with open interproximal contacts (1.64mm) with mesial contact points more prone to ICL (Relative Risk (RR) 1.79) than distal ones. ICL occurred in 50% of implant sites over 10 years, with a higher risk at mesial contact points and in multi-unit restorations compared to single crowns and distal points. ICL was linked to an increase in PD, while BOP, MBL, and PCR remained stable and unaffected by ICL.
Timing of soft tissue augmentation around implants: A clinical review and decision tree
Authors: Mancini, L et al.
DOI: n/a
Purpose: To provide recommendations to guide clinicians on effective timing for soft tissue augmentation procedures.
Conclusions: The timing of STA around implants is essential for optimal outcomes. The most recommended time points are before/after implant placement and at the healing abutment connection, as these stages are supported by evidence and are more predictable, though they require clinical experience. STA at implant placement (immediate/delayed) and after final restoration is more challenging, with less predictable results and demands greater surgical expertise.
Do postoperative antibiotics influence one-year peri-implant crestal bone remodelling and morbidity? A double-blinded randomized clinical trial.
Authors: Durand R, et al.
DOI: 10.1111/clr.13832
Purpose: to assess after one year the effect of postoperative antibiotics on peri-implant crestal bone remodeling, morbidity, and postoperative pain.
Conclusions: Postoperative antibiotics after implant placement do not have any influence on the crestal bone levels and morbidities. To prevent complications and minimize the risk of antibacterial resistance, a single pre-operative dose of antibiotics 1 hour prior to the surgery may suffice.
One-Piece Versus Two-Piece Abutments for Single Crowns in the Esthetic Zone: A Clinical Trial
Authors: Pascoal, A., et al.
DOI: 10.1111/clr.14370
Purpose: to compare two-piece (TP) titanium/zirconia abutments with the one-piece (OP) titanium prefabricated abutments in terms of esthetics, patient satisfaction, and quality of life.
Conclusions: In implant crowns restored with metal-free single crowns, prefabricated one-piece titanium abutments and two-piece customized titanium/zirconia abutments have equivalent results in terms of esthetics, quality of life and satisfaction. The steps in tissue conditioning and final crown insertion are important in improving outcomes. PES values might have been affected by the soft and hard tissue grafting procedures that were done prior to implant placement, leading to improved esthetic results even in patients with thin phenotypes.
A multi-centre randomized controlled trial on alveolar ridge preservation with immediate or delayed implant placement: Need for soft-tissue augmentation.
Authors: Cosyn J, Seyssens L, De Bruyckere T, De Buyser S, Djurkin A, Eghbali A, Lasserre JF, Tudts M, Younes F, Toma S
DOI: 10.1111/jcpe.13911
Purpose: To assess whether immediate implant placement or delayed implant placement will affect need for soft tissue augmentation and to identify risk factors for horizontal and vertical soft tissue loss. It is hypothesized that immediate placement reduces the need for soft tissue augmentation due to the support of the mucosa from provisional implant crowns.
Conclusions: Key Findings: It was determined that 24.1% of the test group and 35.7% of the control group needed soft tissue augmentation. Soft tissue augmentation was required more frequently for delayed implant placement but the result was not statistically significant. Patients with thin buccal soft tissues, with buccal bone dehiscence and treated with a delayed approach had more soft tissue loss based on the soft tissue changes found in the study.
Systemic Antibiotic Prophylaxis Adjunctive to Surgical Reconstructive Peri-Implantitis Treatment: A Retrospective Study.
Authors: Ramanauskaite A, Saltzer I, Padhye N, Begic A, Obreja K, Dahmer I, Schwarz F.
DOI: 10.1111/cid.13429
Purpose: To evaluate if oral systemic antibiotics after surgical reconstructive peri-implantitis treatment had any clinical efficacy
Conclusions: Key Findings: At 12 months, the mean probing depth reduction was 1.74mm for the no antibiotics group, 1.91 for the pre-op antibiotics group, and 1.13 for the post-op antibiotics group. This study did not find there was an additional clinical benefit of oral systemic antibiotics with reconstructive peri-implantitis treatment. However, it did show a tendency toward a higher disease resolution suggesting that clinical benefits may depend on the severity of the disease.
A 30-year retrospective cohort outcome study of periodontal treatment of stages III and IV patients in a private practice
Authors: Fardal, Øystein et al
DOI: 10.1111/jcpe.13877
Purpose: To study patients with stage III and IV periodontitis over 30 years in private practice.
Conclusions: Majority of stage III and IV periodontitis patients can be successfully treated and maintained for over 30 years, with the initial 10-15 years showing the most stable period. Tooth loss and prognostic factors affect patients differently, as some patients who have same characteristics and treatment ended up losing more teeth.
Airflowing as an adjunctive treatment for periodontitis: A randomized controlled trial
Authors: Alsuwaidi, Salem et al
DOI: 10.1002/JPER.24-0099
Purpose: To compare outcomes of subgingival instrumentation (SI) with erythritol airflowing (EAF) to SI alone when treating periodontitis.
Conclusions: Key Findings: There were 32 patients included in the study, 16 in each group. SI with EAF and SI alone both significantly reduced FMBS, FMPS, PD, and percent of sites with PD ≥5 mm at 3 and 6 months. The use of EAF in addition to SI did not provide significant improvement in clinical outcomes over 6 months. Patients found short-term physiological improvement in quality of life with EAF.
Wide Restorative Emergence Angle Increases Marginal Bone Loss and Impairs Integrity of the Junctional Epithelium of the Implant Supracrestal Complex: A Preclinical Study.
Authors: Strauss FJ, Park JY, Lee JS, Schiavon L, Smirani R, Hitz S, Chantler JGM, Mattheos N, Jung R, Bosshardt D, Cha JK, Thoma D.
DOI: 10.1111/jcpe.14070
Purpose: To evaluate the impact of the emergence angle on initial marginal bone loss (MBL) and the supracrestal soft tissue surrounding dental implants in dogs.
Conclusions: Wide restorative angles lead to greater marginal bone loss (MBL) and compromise the integrity of the junctional epithelium around implant sites. Conversely, narrow restorative angles help reduce MBL and promote the formation of a continuous junctional epithelium, minimizing mucosal inflammation. Thus, maintaining a restorative angle as narrow as clinically feasible (< 40°) is advisable.
Extended Platelet-Rich Fibrin as a Membrane for Lateral Window Sinus Lifts: A Case Series.
Authors: Estrin NE, Basma H, Espinoza AR, Pinto MAC, Pikos MA, Miron RJ.
DOI: 10.1111/cid.13427
Purpose: To examine the reliability and safety of extended PRF (e-PRF) membrane to cover lateral window in sinus augmentation. Background: e-PRF extends the typical resorption time of 2 weeks of PRF to 4-6months.
Conclusions: Key Findings: Background: e-PRF extends the typical resorption time of 2 weeks of PRF to 4-6months. A total of 31 implants were placed. 100% of the implants survived with no complications. The follow-up period ranged from 6 to 18 months (mean 10.8 months). The average RBH was 4.3mm and average bone gain was 8.0mm (3.9mm to 13.2mm). The e-PRF membrane demonstrated reliability in terms of covering sinus opening during lateral window sinus lift procedure.
The Anatomy of the Mandibular Incisive Canal and Its Influence in Implant Therapy: A Scoping Review
Authors: Peña-Cardelles JF., Markovic J., Alanezi A., Hamilton A., Gallucci GO., Lanis A.
DOI: 10.11607/prd.6826
Purpose: To describe the mandibular incisive nerve anatomy related to potential interferences in implant therapy. Study undertaken because it is unclear whether damage to the mandibular incisive nerve (MIN) is associated with any morbidities.
Conclusions: Key Findings: Mandibular incisive canal ( MIC ) has been demonstrated to only be found in 2.7% of panoramic radiographs yet has a detection rate of 100% by CBCT analysis in another study. Regarding damage to the MIN, one study found that at least 44% of implant placements passed through the MIN. Evidence for MIN damage due to implant placement is likely present in the literature. More studies are necessary to assess MIN damage, understand clinical relevance, associated morbidities. Due to different anatomical presentations, CBCT analysis assessing for MIC is recommended to prevent complications during implant placement in the anterior mandible.
Effect of immediate all-digital restoration of single posterior implants: The SafetyCrown concept on patient-reported outcome measures, accuracy, and treatment time—A randomized clinical trial
Authors: Waltenberger L., Reich S., Zwahlen M., Wolfart S.
DOI: 10.1111/cid.13374
Purpose: To assess the effect of a digital immediate restoration workflow on dental patient-reported outcome (dPRO), such as patient satisfaction and perception of healing, compared to the conventional restorative protocol. Feasibility of the treatment concept, implant accuracy, and treatment duration were also assessed.
Conclusions: Implants were successfully placed in healed sites and restored with a definitive abutment and provisional crown in 21/23 cases (91.3%). OHRQoL measures were not significantly different in the healing period whether patients received an immediate restoration or not. Overall satisfaction was high in both groups. Patients who received the immediate restoration deemed the workflow more of an advantage and more important than subjects in the control group. The process increased chair time, however need for a second-stage surgery and impression making was eliminated in the process.
Retrospective Study on 57 Direct Interproximal Restorations with Supracrestal Tissue Attachment Violation: Follow-ups Between 10 and 23 Years.
Authors: Pradella S, Morellini C, Formentini D, Del Fabbro M.
DOI: 10.11607/prd.6778.
Purpose: The purpose of this study is to investigate a minimally invasive approach to treating severely decayed teeth, whose restorative margin potentially violates the supracrestal tissue attachment (STA). Furthermore, a 10 year examination of vertical bone loss following treatment was included.
Conclusions: The average bone loss was very limited at 0.46mm, indicating that bone levels can remain stable if proper isolation, adhesion, and restorative protocols are performed—regardless of violation of the STA. Therefore, in sites with deep restorative margins, bone recession and surgery may be avoided.
Sinus Bone Graft Stability and Implant Survival Following Transalveolar Sinus Floor Elevation in Severely Atrophic Maxilla: A Retrospective Study With 5-8 Years of Follow-Up.
Authors: Mao Y, Shen Y, Dai J, Lu T, Wu Y, Shi Y, He F.
DOI: 10.1111/clr.14392.
Purpose: The purpose of this study was to investigate the effectiveness and viability of grafting with transalveolar sinus floor elevation (TSFE), in terms of bone gain, at atrophic maxillary sites. Furthermore, implant survival factors were also examined.
Conclusions: Overall, TSFE is a viable and effective method of sinus augmentation in the atrophic maxilla. When RBH was 4-6mm, implant survival rates of 98% were present with favorable medium and long term results. In areas when RBH was <4mm, implant survival rates were significantly reduced at 88%. In terms of endo-sinus bone gain, positive correlations with first molar sites, SFE elevation methods, and implant length were noted.
Alveolar Ridge Regeneration With Open Versus Closed Healing in Damaged Extraction Sockets: A Preclinical In Vivo Study
Authors: Choi, et al.
DOI: 10.1111/clr.14376
Purpose: The purpose of this paper to compare alveolar ridge preservation (ARP) procedures in damaged extraction sockets with open versus closed healing of the soft and hard tissue in dogs.
Conclusions: Key Findings: Ridge reduction was similar with 18.2% ± 2.4% in the open group compared to 15.7% ± 3.1% in the closed group. The vertical ridge changes in the buccal and lingual areas between the open group and closed group were not significant (0.196 and 0.028mm vs. 0.226 and 0.037mm) respectively. When comparing the open vs. the closed healing approaches for ARP in extraction sockets with damaged buccal walls there was similar ridge dimensions and new bone formation. The areas in which the open technique did provide better results was that of less reduction of buccal bone crest and wider keratinized tissue width after open healing.
Performance and Strength Characteristics of Suture Knots in Periodontal Microsurgery: An In Vitro Study
Authors: Ariceta, et al.
DOI: 10.11607/prd.6899
Purpose: The goal of the study was to investigate the tension required to cause knot failure (untying or breaking) with various diameters of suture.
Conclusions: Key Findings: The ANOVA test found that the type of knot significantly affected the final tension for 7/0 and 8/0 but not 6/0 sutures. When comparing the 2x2x2 and 2=2=2 knots to the 1x1x1 and 1=1=1 they exhibited 0.4N higher tension when using 7.0 suture and 0.3N when using 8/0 suture. Knots tied with 2=2/2×2 and 1=1=1/1x1x1 ended up being secure. It was found that additional throws beyond this did not increase knot security. The authors noted that decreasing suture size results in reduced tensile strength.
Impact of Glycine Powder Air- Abrasive Debridement on Peri- Implant Mucositis: A Randomized Control Trial of Clinical, Microbial, and Immunological Changes
Authors: Partido B, et al.
DOI: 10.1111/clr.14361.
Purpose: To evaluate the efficacy of glycine powder in reducing clinical inflammation and reestablishing host-microbial balance.
Conclusions: Key Findings: Glycine therapy also resulted in sustained reductions in mucosal inflammation and more pronounced improvements in microbiome diversity, including a reduction in pathogens like Fusobacterium nucleatum , from 1 week to 6 months. Additionally, glycine treatment significantly decreased pro-inflammatory markers (IL-1β, IL-2, IL-6, RANTES, VEGF) and increased anti-inflammatory IL-10 levels for up to 3 months, while ultrasonic therapy showed less pronounced and shorter-lasting effects. Glycine therapy demonstrated more consistent and prolonged benefits across clinical, microbiological, and inflammatory outcomes compared to ultrasonic debridement, inducing earlier and more sustained changes in host-microbial interactions. However, the effects of both therapies were maintained for a maximum of 3 months.
Long-term treatment outcomes of single maxillary buccal peri-implant soft tissue dehiscences: A 10-year prospective study
Authors: Roccuzzo A. et al.
DOI: 10.1111/cid.13273
Purpose: To evaluate the results over 10 years of surgically treated shallow, isolated peri-implant soft tissue dehiscences (PSTD) at single-tissue level implant treated via minimally invasive split-thickness flap with connective tissue grafting from the tuberosity area.
Conclusions: Key Findings: Mean dehiscence coverage at 10-years was 89.6% ± 17.1%, with complete coverage in 58.3% of cases. The outcomes showed that the proposed surgical technique is a simple and reliable treatment option to treat the single maxillary PSTDs in selected cases. Over the long term, patients demonstrated stability in clinical parameters and high aesthetic satisfaction, highlighting the efficacy of the surgical and maintenance protocols.
Ten-year follow-up after peri-implantitis treatment using resective surgery: A case report.
Authors: César Neto, J.B., et. al.
DOI: 10.1002/cap.10310
Purpose: report the clinical and radiographic outcomes of a peri-implantitis case treated with i surgical treatment via access flap, implantoplasty, minor osteotomy, prosthetic modifications, and maintenance over a 10-year follow-up period.
Conclusions: Key Findings: All implants were radiographically stable over time with an average BOP of 17.5% at the last follow up. Favourable long-term clinical and radiographic results can be obtained in the treatment of peri-implantitis with a combined approach of implantoplasty and prosthesis replacement and/or recontouring to allow for adequate oral hygiene.
The Impact of Membrane Stabilization for Alveolar Ridge Preservation in Periodontally Compromised Extraction Sockets: A Non-Inferiority Randomized Controlled Trial
Authors: Lee, S.J., et al.
DOI: 10.1111/jcpe.14092
Purpose: Primarily assess the effect of membrane stabilization with sutures on alveolar ridge preservation (ARP) outcomes in periodontally compromised extraction sites and secondarily assess alveolar ridge dimensional changes, wound healing, patient reported and histomorphometric outcomes.
Conclusions: Key Findings: Both groubs received DBBM-C; Bio-oss collagen and a collagen membrane (NBCM; Bio-Gide). Test group had membrane stabilization sutures whereas controls did not. NSD between soft tissue height shrinkage in the control (-2.20+/-18.22mm) and test (-3.30+/-7.76mm) groups. NSD between the ratio of open wound area at 10d in the control (29.30%+/-10.88%) and test (27.94%+/-12.84%) groups. Membrane fixation had no significant influence on wound closure. In periodontally compromised extraction sockets, ARP with membrane stabilization does not lead to inferior results in terms of soft tissue contour changes, compared to no membrane fixation.
Endoscopic Re-Instrumentation of Intrabony Defect-Associated Deep Residual Periodontal Pockets Is Non-Inferior to Papilla Preservation Flap Surgery: A Randomized Trial
Authors: Ho KD, Ho KR, Pelekos G, Leung WK, Tonetti MS
DOI: 10.1111/jcpe.14075
Purpose: To test whether endoscopy-assisted non-surgical debridement (EASD) is not inferior to papilla preservation access flap surgery (PPFS) for residual, non-responding pockets in intrabony defects in terms of clinical and radiographic measurements with CAL being the primary outcome measured.
Conclusions: Key Findings: The EASD group had a 2.0mm change in CAL and the PPFS had a 1.8mm change. There was a difference of 0.3mm between groups which was within the 1mm non-inferiority margin. No differences were found in pocket resolution or radiographic bone healing between the groups. EASD is a promising alternative and is not inferior to PPFS.
Horizontal Guided Bone Regeneration: L-PRF Bone-Block Vs A Mixture of Autogenous Bone with Deproteinized Bovine Bone Mineral. A Split-Mouth RCT Study with 25 Months Follow-Up.
Authors: Dhondt RAL, Quirynen M, Lahoud P, Cortellini S, Temmerman A
DOI: 10.11607/jomi.11095
Purpose: To evaluate the difference in horizontal guided bone regeneration outcomes of two different bone grafting materials (L-PRF bone block and a combination of 50% autogenous bone with 50% DBBM).
Conclusions: Key Findings: No significant differences were found in horizontal bone width gain between both groups at any time point. More bone volume was lost at higher crestal levels post implant placement. 48.8% of horizontal bone width gain obtained at one level on the implant was lost by 25 months after GBR while 46.2% was lost in the control sites. The implant survival implant rate was 100% at 16 months for both groups. No significant differences were found between the two groups, but significant resorption of grafted material within 25 months was found in both.
Periodontal Probing Depth Trajectory in 10 Years of Follow-Up as Associated With Tooth Loss
Authors: Meisel, Peter et al
DOI: 10.1111/jcpe.14117
Purpose: To determine if baseline probing depth (PD) ranking position changes after 10 years to ranked PD outcomes, and if this change can be used to determine tooth loss and prognosis.
Conclusions: Key Findings: PD and CAL worsened over time and patients lost an average of 1.5 teeth. Few patients saw major changes to ranking positions (worsening or improvement). Measuring PD is a predictable, quick, and easy to determine periodontal disease progression and tooth loss prognosis. However, these results are based on a certain population and cannot be generalized.
The Use of Enamel Matrix Derivative to Modulate Wound Healing of Peri-implant Soft Tissues
Authors: Cardaropoli, Daniele et al.
DOI: 10.11607/prd.6573
Purpose: To determine if enamel matrix derivative (EMD) can improve early phase of soft tissue healing around one-staged implants.
Conclusions: Key Findings: Test group showed significant reduction in BOP between 6 weeks and 1 year, while control group had continuous BOP percentage. There was no significant difference in terms of marginal bone levels when comparing test and control. With the limited data, this study supports the use of EMD during implant placement to improve and speed up soft tissue wound healing.
Bone Regeneration After Sinus Floor Elevation in an Intact Sinus or a Sinus With Prior Large Membrane Perforation: A Preclinical Study Using a Rabbit Sinus Model.
Authors: Lee S, Chung JH, Thoma DS, Jung RE, Jung UW, Shin SY, Lim HC.
DOI: 10.1111/jcpe.14108.
Purpose: To evaluate bone regeneration after sinus floor elevation (SFE), comparing sites with and without previous perforation in the sinus in rabbits.
Conclusions: Key Findings: All perforation s w ere addressed by using collagen matrix (Genoss). Histomorphometric analysis revealed that at both 2- and 4-weeks healing period, the extent of new bone formation showed no significant difference between Group SFE + Perf and Group SFE. Prior SMP (large) sites yield new bone formation comparable to sites without SMP after SFE surgery. Thus, a large perforation of the sinus membrane followed by an 8-week healing period does not jeopardize new bone formation following SFE.
Incidence of Gingival Recessions in Adolescent Orthodontic Patients Treated With Fixed Appliances and Lingual Retainer.
Authors: Celis B, Sanz-Esporrin J, Verdasco C, Yañez-Vico RM, Martin C.
DOI: 10.1111/jcpe.14097
Purpose: To evaluate development of gingival recession (GR) in orthodontic patients
Conclusions: Key Findings: Of 177 total patients, 89 patients received orthodontic treatment with a mean duration of 2.24 years and a mean retention period of 5.54 years and the remaining 88 patients did not receive orthodontic treatment. Although both groups exhibited similar periodontal parameters, the untreated group had significantly lower PI than exposed group. The untreated group had 0 patients with recession. However, at T2 or at the completion ortho treatment had 10 patients (11.24%) with recession. After 5 years post ortho treatment, the exposed group had 60 patients (67.42%) with recession. The deepest recession in terms of depth was 0.89mm. Within the limitation of the study, orthodontic treatment and lingual retainers for post treatment may increase development of small gingival recession.
Impact of Vertical Inter-Implant Distance in Two Adjacent Single-Unit Posterior Implants: A Retrospective Cohort Study With 1–8 Years of Follow-Up
Authors: Gao J., Yang Y., Yang X., Tang X., Qu Y., Wu Y., Xiang L., Man Y.
DOI: 10.1111/jcpe.14094
Purpose: To investigate the impact of vertical inter-implant distances (VIDs) on long-term survival, peri-implant conditions, and complications of two adjacent single-unit implants.
Conclusions: Key Findings: Variations in vertical and horizontal inter-implant distances did not lead to significant differences in implant survival rates, peri-implant conditions, complication-free survival rates, or radiological outcomes with posterior bone-level implants. This suggests VID > 2 mm may be acceptable for two adjacent single-unit implants when considering clinical decision making. s Despite platform discrepancies, maintaining a minimum abutment height of 2 mm is crucial for maintaining space for the supracrestal tissues. 3) Platform switching creates additional space for two adjacent single-unit implants, creating more space for tissue to sustain an inflammatory infiltrate and reduce the inflammatory reaction, thereby reducing early bone loss around implants. Overall, the role of the biologic width (supracrestal tissue) and implant design appears to be more critical than spacing of implants horizontally or vertically. A vertical inter-implant distance > 2 mm between adjacent single-unit posterior bone-level implants may be considered acceptable based on study findings.
Retrospective study on the clinical and radiographic outcomes of 2.8 mm diameter implants supporting fixed prostheses up to 11 years
Authors: Xu L., Ma Y., Du X., Qing Y., Cao Y., Sun X., Jacobs R., Song K.
DOI: 10.1111/cid.13395
Purpose: To evaluate the implant survival rate, implant and prosthetic failure, MBL, and complications associated with narrow diameter implants (NDIs) placed in the last decade in a clinic.
Conclusions: The NDI presented in this study has exhibited 98.15% survival, demonstrating long-term maintenance over 10 years. This may represent a flexible restorative plan when limited dimensions of bone are present. Background: The 2.8 mm narrow diameter implant has a Morse taper connection which eliminates the need for a central screw. Saving this screw retention space allows for great fracture strength and marginal fit. The prosthetic system also has flexible abutment choices with 4 anges and 4 abutment heights.
Impact of Two Flap Advancement Techniques and Periosteal Suturing on Graft Displacement During Guided Bone Regeneration
Authors: Clemens Raabe, Emilio A. Cafferata, Emilio Couso-Queiruga, Vivianne Chappuis, Ausra Ramanauskaite, Frank Schwarz
DOI: 10.1111/cid.13434.
Purpose: The purpose of this study was to investigate the effects of full-thickness flaps with modified periosteal releasing incisions (MPRI) compared to combination flaps utilizing the mucosal detachment technique (MDT) either with or without periosteal sutures (PS) on graft material thickness (GMT) following primary closure of guided bone regeneration (GBR) sites. Furthermore, PS and soft tissue qualities and their effects on graft displacement were also evaluated.
Conclusions: Overall, significant graft displacement occurs with both MPRI and MDT techniques, with significantly less graft displacement when utilizing PS. Both MPRI and MDT were both effective techniques for flap advancement, with no influence by characteristics of soft tissues.
Excess cement and peri-implant disease: A cross-sectional clinical endoscopic study.
Authors: Montevecchi M, Valeriani L, Salvadori MF, Stefanini M, Zucchelli G
DOI: 10.1002/JPER.24-0510.
Purpose: The primary purpose of this study was to use a dental endoscope to investigate submucosal residual cement in patients affected by peri-implant disease. Secondarily, to explore the relationship between the severity of the pathology and the extension of the residual cement.
Conclusions: Key Findings: A total of 46 patients were included in the study, with 80.4% of implants (37 out of 46 implants) presenting with cement residue. Significantly more residual cement was found in the maxillary arch and in mild periodontitis cases. Overall, the findings of this study indicate that there is an association between residual cement and peri-implant diseases, with the most apical location of the cement influencing the presence of peri-implantitis.
Maxillary Sinus Elevation Difficulty Score with Lateral Wall Technique
Authors: Testori, et al.
DOI: 10.11607/jomi.8034
Purpose: To present a new pre-surgical maxillary sinus floor elevation difficulty (MSED) score based on comprehensive patient and surgical related factors including extraoral findings, anatomical factors, and possible influence of surgeon’s experience.
Conclusions: Key Findings: Results : Anatomy-Related Risk Factors Sinus membrane thickness Lum et al. found that patients who experienced membrane perforation during sinus floor elevation had a thinner membrane compared to patients who did not (0.84mm vs 2.65mm). CBCT tends to overestimate 2.5 membrane thickness compared with histologic findings. According to Shanbhag et al, increased membrane thickness (>5mm) is positively associated with a higher risk of ostium obstruction, which is a contraindication of sinus floor augmentation. Presence of sinus septum The presence of sinus septum is associated with increased incidence of membrane laceration during lateral sinus elevation. The average frequency ranges from 28.4% to 44.8%. The presence of septa was found to be related to the thinning of the sinus membrane, which may account for higher perforation rate (Cakur et al.). Direction of sinus septa The frequency of septa orientation in a mediolateral direction (transverse) is between 59.2% and 87.6% with fewer patients presenting with septa running in the anteroposterior (sagittal) direction Height of sinus septa A radiographic study found that septa located in anterior and middle region are significantly higher than septa in the posterior region. Through the difficulty score outlined in it is now possible to assess the complexity of lateral sinus augmentation systematically and comprehensively. This can then be used to better know the risk of possible complications intraoperatively.
Microgap Formation in Conical Implant-Abutment Connections Under Oblique Loading: Influence of Cone Angle Mismatch Through Finite Element Analysis
Authors: Gantier-Takano, et al.
DOI: 10.1111/cid.13436
Purpose: The study aims to investigate the resistance to microgap formation of various conical implant-abutment connection (IAC) dental implants under oblique loads in accordance to the ISO standard of testing. The study also looked into the ISO specifications on outcomes and the effect of deviations from this.
Conclusions: The IAC design and cone angle mismatch significantly influenced microgap formation, with some designs showing zero gaps even when the oblique load reached 400 N. The non-ISO adaptor increased gap formation in IACs B and C. In order to enhance stability and sealing capacity under high loads of force, the taper angle and cone height in IAC is of the utmost importance. The creation of a mismatch (or platform switch) of the implant and abutment creates a better seal.
Osseodensification technique in crestal maxillary sinus elevation—A narrative review
Authors: Gaspar et al.
DOI: 10.1111/cid.13399
Purpose: to discuss advances in surgical drilling techniques such as Osseodensification (OD) designed to enhance patient outcomes in implant dentistry.
Conclusions: The success of implant treatment depends on multiple factors, including patient health, surgical technique, implant design, osteotomy preparation, and prosthetic reconstruction. OD burs have proven to be a safe and predictable option for transcrestal SFE. However, cases with severe posterior maxillary atrophy (RBH ≤3 mm) pose a higher risk of membrane perforation. It is important to note that the reviewed studies focused exclusively on the first patented OD system, and results may not be directly applicable to other OD drilling systems.
Zirconia Barriers in Bone Regeneration Procedures: A Scoping Review
Authors: Uriarte, X. et al.
DOI: 10.1111/clr.14404
Purpose: To assess the progress and current use of zirconia barriers in bone augmentation procedures for adult patients in the maxillofacial region.
Conclusions: The use of zirconia barriers in guided bone regeneration is a relatively new technique without an established manufacturing protocol. While results show promising bone formation and reduced surgical time, complication rates remain high. Due to the limited sample sizes and short follow-ups in current studies, further research with control groups and longer observation periods is needed for more reliable conclusions.
Impact of Implant Mesiodistal Distance on Peri-Implant Bone Loss: A Cross-Sectional Retrospective Study.
Authors: Liu, W., et. al.
DOI: 10.1111/cid.13442
Purpose: To assess the validity of previously proposed mesiodistal distance requirements between multiple posterior implants and offer a measurable criterion for implant prognosis. Background: Previously proposed Mesiodistal algorithm by authors for multiple implant placement recommends 4-4.6mm between implant and canine, 7-7.4mm, 8-8.5mm, and 9-9.5mm inter-implant/tooth distance from the first premolar to the second molar respectively.
Conclusions: Key Findings: Implants placed according to the algorithm had significantly less MBL. Placing implants according to the proposed mesiodistal algorithm is conducive to preserving the bone level. Inter-implant distance has a more significant impact than smoking on MBL.
Antimicrobial Effect and Cytocompatibility After Using Different Decontamination Methods on Titanium Implant Surfaces: An In Vitro Study.
Authors: Alonso-Español, A., et al.
DOI: 10.1111/clr.14410
Purpose: Assess the efficiency of implant decontamination with Curcumin (CUR), Xanthohumol (XN), and GalvoSurge electrolye current (GS) in terms of antimicrobial and biofilm reduction potential as well as their cytocompatibility.
Conclusions: 2D and 3D in vitro models all showed that implant surface decontamination with CUR, XN, GS, and CHX lead to SSD compared to the negative control. CUR and XN are the most cytocompatible with the greatest antimicrobial effect, while GS displayed a “bubble shaped effect” antibiofilm activity, impaired hGF cell morphology and integrity, and compromised cytocompatibility. CHX exhibited antimicrobial properties but did not reduce biofilm biomass, while cytocompatibility was altered.
Tissue Perfusion and Biomarkers Assessment Following Root Coverage Procedures.
Authors: Tavelli L, Nguyen T, Rodriguez MV, Mancini L, Giannobile WV, Barootchi S
DOI: 10.1111/jre.13374
Purpose: Tissue perfusion changes and wound healing biomarker levels were assessed after root coverage procedures with coronally advanced flaps with xenogeneic collagen matrix that was loaded with a recombinant human platelet-derived growth factor-BB (rhPDGF) or a placebo. This study was a secondary analysis of a previous clinical trial assessing the clinical and volumetric outcome of collagen matrix with rhPDGF or a placebo with a coronally advanced flap.
Conclusions: At 2 weeks when the collagen matrix was treated with rhPDGF, the tissue perfusion at the level of the collagen matrix was found to be higher in terms of mean perfusion relief intensity, mean perfusion relief area, mean flow intensity, and total flow intensity. Time to recover was shorter when high levels of PDGF-BB were found.
Comparison of Ultrasonography, CBCT, Transgingival Probing, Colour-Coded and Periodontal Probe Transparency With Histological Gingival Thickness: A Diagnostic Accuracy Study Revisiting Thick Versus Thin Gingiva.
Authors: Sabri H, Nava P, Hazrati P, Alrmali A, Galindo-Fernandez P, Saleh MHA, Calatrava J, Barootchi S, Tavelli L, Wang HL
DOI: 10.1111/jcpe.14139
Purpose: To evaluate the reliability of multiple methods assessing gingival thickness compared with the gold standard histological assessment.
Conclusions: Key Findings: The gingival thickness was assessed first by a CBCT. An ultrasound scan was then done 2mm apical to the free gingival margin. Probe transparency was assessed with a stainless-steel probe then color-coded probes. Transgingival probing was then done with a no.25 endodontic spreader with a rubber stopper 2mm below the gingival margin. Mean gingival thickness from histological samples was 1.34mm, from ultrasound scan was 1.25mm, from CBCT was 1.13mm, and from transgingival probing was 1.51mm. All methods demonstrated diagnostic accuracy for quantifying gingival thickness. Transgingival probing showed a slight overestimation while ultrasonography and CBCT showed a slight underestimation. Stainless steel and colored probes showed excellent agreement with colored probes being slightly more accurate. A new cut-off threshold of 1.18mm to discern thin from thick gingiva was suggested based on the histologic gingival thickness and probe visibility.
Evaluation of circulating IgG antibodies against Porphyromonas gingivalis or its gingipains as serological markers of periodontitis and carriage of the bacterium.
Authors: Massarenti, Laura et al.
DOI: 10.1002/JPER.23-0766
Purpose: to evaluate serological biomarkers of P. gingivalis to determination of periodontal status in patients.
Conclusions: Key Findings: Serum IgG antibodies against whole bacteria P. gingivalis and fragments were significantly higher in patients with stage II, III, IV periodontitis when compared to healthy controls. The levels of gingipains did not significantly differ between periodontitis and health controls. E. Coli and C. ochracea did not significantly differ between periodontitis and health controls, however stage III or IV periodontitis patients had lower levels of E. coli. Serum IgG antibodies against whole or fragmented P. gingivalis may be a moderately good serological biomarker for periodontitis and oral carriage of P.G.
Early periodontal wound healing after chlorhexidine rinsing: a randomized clinical trial
Authors: Graziani, Filippo et al.
DOI: 10.1007/s00784-024-05643-0
Purpose: To assess wound healing after periodontal surgery using minimally invasive surgical technique and single flap approach with papilla preservation flap when using chlorhexidine-based mouth rinses
Conclusions: Key Findings: Thirty-three patients completed the study. Abbreviations: chlorhexidine (CHX) anti-discoloration system (ADS) and 0.2% hyaluronic acid (HA). Significantly higher rate of complete healing in the CHX + ADS + HA group (90.91%) versus CHX + ADS (63.64%) and control (36.36%). Bleeding and plaque were significantly lower with CHX. CHX + HA and CHX were more effective in early wound healing. The addition of hyaluronic acid was observed to increase primary closure. Need more studies to confirm HA on cell migration and differentiation during healing period.
Do soft tissue augmentation techniques provide stable and favorable peri-implant conditions in the medium and long term? A systematic review.
Authors: Stefanini M, Barootchi S, Sangiorgi M, Pispero A, Grusovin MG, Mancini L, Zucchelli G, Tavelli L.
DOI: 10.1111/clr.14150.
Purpose: To assess peri-implant soft tissue augmentation (STA) in the medium to long term (>= 36mo) follow up period. Different types of STA such as bilaminar technique (CTG), Apically Positioned Flap (APF) were considered.
Conclusions: Implant sites that receive STA show high survival rate and lower occurrence of peri-implantitis in the medium- to long-term. Also, STA sites exhibit soft tissue margin stability.
Accuracy of Ionizing-Radiation-Based and Non-Ionizing Imaging Assessments for the Diagnosis of Periodontitis: Systematic Review and Meta-Analysis.
Authors: Discepoli N, De Rubertis I, Wasielewski C, Troiano G, Carra MC.
DOI: 10.1111/jcpe.14137.
Purpose: To update current understanding of diagnostic accuracy of 2D radiograph to evaluate periodontitis and to evaluate alternative diagnostic methods (i.e., CBCT, MRI, ultrasound imaging)
Conclusions: Key Findings: Diagnostic accuracy of traditional 2D radiograph exhibited a sensitivity value that ranged from 30% to 70%; specificity value range from 70% to >90%. Generally, 2D radiographs underestimated the lesions observed. Reliability increased when lesions were more advanced (i.e., Grades II/III furcation). Traditional 2D radiographs are useful for diagnosing periodontal disease and defects. However, CBCT has proven to be superior for assessing FI and intrabony defects. USG and MRI are promising non-ionizing devices for diagnosing periodontal conditions.
Twenty-five years of recombinant human growth factors rhPDGF-BB and rhBMP-2 in oral hard and soft tissue regeneration
Authors: Galarraga-Vinueza ME., Barootchi S., Nevins ML., Nevins M., Miron RJ., Tavelli L.
DOI: 10.1111/prd.12522
Purpose: Review the applications, clinical, and patient-reported outcomes of rhBMPs and rhPDGF-BB for oral tissue regeneration over the last 25 years to gain insight to prosthetic factors influencing peri-implant bone level. Recombinant human bone morphogenetic proteins (rhBMPs): Historical background and biological properties Large bone defects are often a challenging clinical situation due to complications of graft exposure, necrosis, insufficient graft vascularization, and post-op infections. These procedures are also technique sensitive and autogenous bone availability may be limited. Due to these limitations and the known molecular signaling pathways crucial to bone regeneration, bone morphogenic proteins (BMPs) have been used to enhance osteogenic and osteoinductive potential for the regeneration of large grafted areas. BMPs are pleiotropic morphogens capable of recruitment, proliferation, and differentiation of mesenchymal calls into osteoblasts. This molecule was discovered in the 1960s. A multitude of studies have demonstrated the capability of rhBMP-2 for regenerating de novo bone horizontal ridge augmentation, sinus floor elevation, ridge preservation, and peri-implant bone augmentation. Some studies have also highlighted complications when using this growth factor, such as increased risk of ankylosis. Clinical applications of rhBMPs in bone regeneration Horizontal and vertical ridge augmentation often requires invasive procedures involving autogenous block grafts. This approach increases surgical time and patient morbidity. The application of grown factors such as BMP-2 may be utilized to avoid these unattractive sequelae of autogenous grafting and ease surgical technique. However, use of BMP-2 is not without complications, as erythema and edema are common findings after augmentation with using rhBMP-2. Difference in de novo bone formation can be expected depending on what concentration of BMP-2 is used. One study has demonstrated 1.5 mg/mL resulted in signification higher bone formation. Different carriers have been studied for use of BMP-2. However, one study demonstrated collagen sponge soaked in BMP-2 resulted in similar dimensional changes to beta-tricalcium phosphate and hydroxyapatite particles after ridge preservation. For sinus floor elevation, a meta-analysis has demonstrated that use of rhBMP-2 results in similar clinical and histometric outcomes compared to conventional sinus floor elevation. Some studies have demonstrated the selected carrier for BMP-2 may be sensitive when used in sinus floor elevation, as variable outcomes have been found depending on what carrier is used. No significant adverse effects have been found when utilizing BMP-2 in maxillary sinus augmentation. Preclinical studies have also highlighted BMP-2 as a potential strategy to achieve re-osseointegration. Human clinical studies have demonstrated that enhanced bone maturation can be found around implants when utilizing BMP-2. However, this finding could not be corroborated in the long-term. Future studies should further evaluate the use of BMPs at peri-implantitis bone defects. Current recommendations for clinical applications of BMPs Several systematic reviews have been inconclusive regarding clinical and radiographic benefit to use of BMPs. However, it has been highlighted that BMPs enhance histological outcomes, increase wound healing processes with increased vascularity and de novo bone, favor earlier implant loading, and exhibit superior bone regeneration development. For this reason, use of rhBMPs may be considered for patients with compromised bone healing capacity, in the presence of limited donor bone, fasting healing is required, or when large defects are involved. An additional limitation of rhBMP is its high cost. Recombinant human platelet-derived growth factor-BB (rhPDGF-BB) Historical background and biological properties PDGF is a molecule that was initially observed in platelets, although many other calls can release this growth factor. This molecule interacts with different cell types, especially mesenchymal cells and is a potent mitogen for fibroblasts and osteoblasts. PDGF receptors are found in alveolar bone and the periodontal ligament cells. The isoform PDGF-BB was found to be the most potent isoform to promote responses in periodontal ligament cells. Trials utilizing the molecule were first introduced in the late 1980s. One human study compared use of PDGF-BB gel to open flap debridement (OFD) in infrabony and furcation defects. This study demonstrated rhPDGF-BB to be safe at high dose and resulted in greater bone fill compared to OFD alone. Vertical bone gain at 9 months was 2.8 mm compared to 0.75 mm with OFD and mean defect fill was 42.3% at 9 mo compared to 18.5 % with OFD. Clinical applications of rhPDGF-BB in oral tissue regeneration A recent review highlighted 63 studies up until June 2019 on the use of rhPDGF-BB in oral tissue regeneration procedures. These included bone augmentation, infrabony and furcation defects, root coverage procedures, alveolar ridge preservation, and sinus floor elevation. Several studies have demonstrated increased clinical attachment level gains and defect fill with additional use of PDGF-BB. Several authors have also reported using the growth factor off-label with other bone graft carriers. With limited studies compared PDGF-BB with different scaffolds, there is no consensus for which carrier is best. However, freeze-dried bone allograft and demineralized freeze-dried bone allograft are often used. One recent systematic review compared PDGF-BB to other biologic agents. The study found that rhPDGF-BB was the agent which exhibited the largest effect size for clinical attachment level gain, pocket reduction, less gingival recession, and radiographic linear bone gain. It also highlighted that bone graft carrier may have a significant role in outcomes of infrabony defects, where allogenic bone displayed the highest treatment effects for clinical attachment gain and radiographic bone gain, while xenogeneic bone had the largest effect for probing reduction and stability of the gingival margin. Furthermore, there was no benefit found to adding a barrier membrane to the regenerative approach in combination with a biologic agent. This supports that barrier membranes may jeopardize the angiogenic, cell recruitment, and wound healing capacities of biologics. Use of PDGF-BB in root coverage was first published in 2006 via a GTR approach. This study and further studies have found probing depth reduction greater with use of PDGF. Evidence of periodontal regeneration has also been found to be higher with the use of PDGF-BB. However, by following these studies long-term (5-years), it was found that sites treated by connective tissue graft had better long-term stability compared to the sites which received GTR with PDGF. This highlights the importance of phenotype modification in root coverage procedures, where this modification may be more important for stability of the gingival margin than regenerating the lost periodontium and buccal bone. Thin tissue is more prone to recede in the presence of inflammation and traumatic tooth brushing, regardless of the situation of the underlying bone. For this reason, more recent studies have evaluated soft tissue matrices acting as the scaffold for PDGF to better increase tissue thickness. In very challenging cases, the addition of PDGF to a connective tissue graft (CTG) may by indicated. However, in most cases the use of a CTG alone is sufficient. A recent study compared Fibrogide soaked in saline vs PDGF. After 6 months, greater mean root coverage, frequency of complete root coverage, and esthetic outcomes. Tissue volume was also found to be greater with PDGF, which may be due to less graft shrinkage experienced after a more robust vascularization of the graft occurred. In alveolar ridge preservation, use of rhPDGF-BB may promote faster wound healing and earlier bone remodeling. Most studies report less residual graft material and increased vital bone formation. A study does exist which demonstrated superior buccolingual width with use of PDGF. Current guidelines only suggest use of biologics in challenging and compromised extraction sockets. In horizontal and vertical ridge augmentation, most current studies are case reports or series. rhPDGF-BB has been utilized with autograft, allograft, beta-tricalcium phosphate, anorganic bovine bone, xenogeneic bone block, or a combination of bone grafts. No complications have been reports and its use can be considered safe. Reports often include study sites which do not utilize a barrier membrane. The favorable outcomes highlight the periosteum as a crucial source for osteoprogenitor cells and drawback of barrier membranes to limit blood supply and chemotaxis to the bone graft for bone regeneration. Advantages of using rhPDGF-BB in sinus floor augmentation may include up to double the vital bone formation. This could enable earlier implant placement following sinus augmentation. Few studies currently involve rhPDGF-BB in peri-implant tissue reconstruction. Current studies show better maintained bone volume. Its use may be indicated in challenging clinical situation with large bone or mucosa deficiencies. Current recommendation for clinical applications of rhPDGF-BB Robust evidence exists to support the safety and benefits of rhPDGF-BB in periodontal regeneration and treatment of gingival recessions. Applications in peri-implant tissues has also been demonstrated to be safe, yet a limited number of studies precludes definitive recommendations. Nevertheless, the growth factor may enhance osteogenesis for implant site development and should be considered strongly in complex and large bone defects. Future direction: The future of periodontal therapy is without a doubt in the direction in minimal invasiveness. In this vein, treatment outcomes should be increasingly geared towards patient satisfaction and should consider the entire treatment process to reduce chair time, patient morbidity, and adjustments to their lives while healing. One significant component to achieve these therapeutic goals is certainly the application of biologics and nonautogenous grafting substitutes.
Conclusions: rhBMPs and rhPDGF-BB has been studied over the past 25 years and are highlighted as safe to use. While more evidence is necessary to support rhBMPs for bone regenerative procedures, a robust body of evidence exists to support the application of rhPDGF-BB for periodontal regeneration and root coverage procedures.
Combined Effect of Abutment Height and Restoration Emergence Angle on Peri-Implant Bone Loss Progression: A Retrospective Analysis
Authors: Misch J., Abu-Reyal S., Lohana D., Mandil O., Saleh MHA., Li J., Wang HL., Ravidà A.
DOI: 10.1111/clr.14408
Purpose: To investigate the impact of abutment height on peri-implant bone response to various restoration emergence angles (REA) and transmucosal abutment height (TmAH) around bone-level implants.
Conclusions: REA ≥ 30 appears to only have significant influence on MBL when TmAH is large. Small TmAH had the greatest influence on experiencing MBL, where short/narrow implants experienced an odds ratio of 4.19 for peri-implantitis compared to long/wide, and for every 1 mm increase in TmAH the prevalence of. MBL > 0 mm decreased by 37%.
The effect of lingual orthodontic appliances in the dimensional reduction of labial gingival recession and root prominence caused by the wire syndrome in the anterior mandible: a multicenter study.
Authors: Schmid JQ, Katsaros C, Sculean A, Galletti C, Bettenhäuser-Hartung L, Janssens Y
DOI: 10.3290/j.qi.b5984435.
Purpose: The aim of this article was to investigate the effects on facial gingival recession and root prominence (ROP) reductions that orthodontic treatment with completely customized lingual appliances (CCLA) has following wire syndrome of the mandibular anterior teeth. Wire syndrome (WS) is defined as undesirable tooth movements following placement of a fixed retainer, that can manifest as gingival recession.
Conclusions: Key Findings: R ecession surface (RS), depth (RD), and width (RW) were recorded at baseline and at the end of treatment. From baseline to post treatment, RD reduced from 3.91 to 2.04mm, RW reduced from 1.97 to 1.27mm, and ROP reduced by 1.15mm. Overall, RD reduced by 44.9%, RW reduced by 35.6%, and RS reduced by 61.4%. All reductions were statistically significant. Root prominence following and facial gingival recession resulting from wire syndrome can be corrected with CCLA by applying torque to the roots of mandibular incisors.
Customized Bone Regeneration—A Retrospective Clinical Follow-Up Study of the Aesthetic Outcome.
Authors: Seiler, M., Kämmerer, P.W. and Hartmann, A.
DOI: 10.1111/clr.14425.
Purpose: The purpose of this study was to investigate the aesthetic outcomes in terms of soft tissue following a customized bone regeneration (CBR) technique.
Conclusions: Key Findings: Group A, crestal incisions without vertical releasing incisions, resulted in significantly higher PES scores. Group A also resulted in significantly improved MBL for both mesial sites (0.30+/-0.60mm) and distal sites (0.27+/-0.46mm). The use of customized bone regeneration (CBR) techniques can result in aesthetic results in treatment of complex defects. In terms of incision design, crestal incisions without vertical releasing incisions result in the most aesthetic results and most long-term bone volume.
Decision Tree for the Treatment of Multiple Gingival Recession Defects When Utilizing MCAT or MCAF Based on Evidence and Clinical Experience
Authors: Aroca et al.
DOI: 10.11607/prd.7290
Purpose: The aim of this study is to compare Multiple coronally advanced flap (MCAF) vs. Modified coronally advanced tunnel technique (MCAT) iwith respect to relevant anatomical factors that must be considered. A decision tree was then made to guide clinicians when making these evaluations prior to surgery. Introduction: In the decision-making process, step one is to evaluate the interdental clinical attachment loss (CAL). Then the KT lateral to the recession defect (LKT) is assessed. The height, size, and coronal width of the interdental papillae is observed when the LKT is insufficient. Soft tissue phenotype is also used in the classification.
Conclusions: In order to have an easier time elevating the surgical papilla via tunnel technique it is beneficial to have a large amount of LKT. When considering MCAF the papilla dimensions must be taken into account because a larger papilla allows for better coronal stabilization and increased vascular bed. Including gingival phenotype is necessary to determine if CTG is necessary or not to reduce the amount of tissue harvested.
Effect of initial bone morphology on alveolar bone remodeling following molar extraction: A retrospective study
Authors: Lin et al.
DOI: 10.1002/JPER.24-0342
Purpose: To evaluate the initial morphology of molar extraction sockets to see how the dimensional changes of the alveolar bone are affected.
Conclusions: Key Findings: After molar extraction significant resorption was seen of the alveolar bone both vertically (Central alveolar height, Buccal height, and Lingual height decreased by 1.87mm, 2.62 mm, and 1.07mm, respectively) and horizontally (HW 1mm from crest, HW 3mm from crest, and HW 5mm from crest decreased by 5.18 mm, 2.88 mm, and 1.68 mm, respectively). Remodeling of the alveolar bone is greatly affected by the initial morphology. Loss is greater in the horizontal direction > vertical. There are many factors of the initial morphology that play a role including furcation involvement, number of bony wall defects, number of roots, relative bone loss, height difference between B-L.
Avoiding errors and complications related to immediate implant placement in the esthetic area with a mucogingival approach
Authors: Stefanini, M et al.
DOI: 10.1111/prd.12491
Purpose: The purpose of this review is to present a mucogingival approach for fully guided immediate implant placement and provisionalization with buccal flap elevation in the esthetic area as an alternative to the flapless approach to overcome some of the limitations for immediate tooth replacement in cases that lack the pristine conditions once considered essential.
Conclusions: Immediate implant placement in the esthetic zone requires a thorough evaluation of tissue morphology. Digital planning and guided placement optimize positioning. When flapless placement is not feasible, raising a buccal flap can facilitate implant insertion and tissue management. This approach integrates bone and soft tissue augmentation, recession correction, and provisionalization, enhancing esthetic and functional outcomes.
Treatment of teeth with insufficient clinical crowns. Long-term clinical outcomes of a Minimally invasive Crown Lengthening Approach: A Retrospective Analysis
Authors: Cortellini, P, et al.
DOI: 10.13607/prd.6992
Purpose: To evaluate the incidence of complications and the long-term survival rate of teeth with severely compromised clinical crowns treated with minimally invasive crown lengthening (MICL).
Conclusions: This long-term retrospective analysis shows high tooth survival and low complication rates for MICL-treated teeth. Findings support the preservation of periodontal health with intrasulcular CMs, which does not damage the supracrestal attachment apparatus is possible.
Wound healing dynamics, morbidity, and complications of palatal soft-tissue harvesting
Authors: Tavelli, L., et. al.
DOI: 10.1111/prd.12466
Purpose: Review palatal wound healing following soft tissue harvesting and assess the effects of adjunctive biologic and photobiomodulation agents. Additionally, review errors and complications in harvesting technique and methods to minimize morbidity.
Conclusions: Most complications after palatal harvesting are not severe, but might have a negative impact on the patient’s quality of life and willingness to receive further surgical treatments. Graft height, residual flap thickness, and intraoperative trauma are some factors that affect postoperative discomfort, while the harvesting protocol has no impact on it. The use of hemostatic agents and wound healing enhancers has been supported in the literature. Agents such as cyanoacrylate tissue adhesive alone or with a collagen sponge, platelet concentrates, hyaluronic acid, photobiomodulation, and ozone therapy have all been shown to reduce patient morbidity. FGG harvested from the palate or tuberosity as opposed to the conventional CTG harvesting techniques is supported, along with proper management of the donor site.
Probing Depth Reduction Following Peri-Implantitis Treatment: A Systematic Review and Component Network Meta-Analysis
Authors: Liu, Y. C., et al.
DOI: 10.1111/cid.70010
Purpose: to use component network meta-analysis (CNMA) for comparing the efficacy of surgical and non-surgical treatments of peri-implantitis in terms of PD reduction as well as identifying the best treatment combination components.
Conclusions: Key Findings: Treatment regimens that included bone grafts and membranes led to greater PD reduction than non-surgical treatments. Antibiotics showed a larger effect size in non-surgical treatment while implantoplasty has uncertain size effects in PD reduction. Irrigation was the least effective in non-surgical treatment but showed effectiveness in surgical treatment. Using antibiotics as adjunct to non-surgical treatment leads to greater PD reduction compared to non-surgical treatment alone. In surgical treatments, patient-specific factors like defect morphology and disease severity have made it challenging to identify a single best treatment modality and personalized approaches should be used. With the large number of treatment regimens, no future trial can directly compare them and validating the current CNMA results will require an unrealistic number of clinical trials. There is insufficient evidence to identify ideal surgical and non-surgical regimens in treating peri-implantitis, therefore careful interpretation of the current study findings should be made.
The Tunneled Coronally Advanced Flap for Vertical Soft Tissue Reconstruction and Papilla Augmentation at Implant Sites (verTCAF).
Authors: Tavelli L, Akhondi S, Vinueza MEG, Mancini L, Lanis A, Barootchi S.
DOI: 10.11607/prd.7619
Purpose: To explain the rationale and principles of tunneled coronally advanced flap (TCAF) and it’s use in vertical soft tissue reconstruction (verTCAF) around implants with deficient papilla or peri-implant soft tissue deficiencies (PSTD)
Conclusions: verTCAF with CTG had promising outcomes with a significant improvement in patient reported esthetics, substantial root coverage and papilla gain, and significant increase in peri-implant soft tissue phenotype parameters.
The Last Molar-Entire Pad Preservation Technique (L-EPPT) as a Regenerative Surgical Approach for Combined Distal Intrabony Defects and Furcation Involvement: Case Reports
Authors: Kawanabe D, Ryutaro K
DOI: 10.11607/prd.7024
Purpose: To present the last molar-entire pad preservation technique (L-EPPT) in periodontal regenerative therapy. The rationale of the L-EPPT is to preserve the tissue of the most distal molar and achieve primary closure to maintain blood supply and avoid biomaterial leakage.
Conclusions: Key Findings: After the first 3 weeks, complete wound closure was still present and no complications were observed. Patients reported minimal discomfort and pain with limited need for analgesics. L-EPPT may improve clinical results of periodontal regenerative therapy when using EMD and bone graft.
Stackable Guides and Immediate Full-Arch Loading: A Retrospective Cohort Study of 43 Edentulous Arches- The STAGE Study
Authors: Levy-Bohbot, A et al.
DOI: 10.11607/jomi.10998
Purpose: To evaluate the advantages and disadvantages of stackable guided implant surgery, using the guides for bone reduction and fully guided implant placement, and immediate implant loading
Conclusions: Key Findings: Twenty-two maxillary and 21 mandibular arches were rehabilitated with a total of 284 implants. After 4 months, 10 implants (3.5%) did not osseointegrate , and were replaced. The overall success rate was 96.5%. After 1 year, the prosthetic success rate was 100% and all patients progressed to final prosthesis. This study supports stackable guided implant surgery and immediate implant loading in patients that require grafting or not. Long-term studies needed.
Electrolytic Surface Decontamination in the Reconstructive Therapy of Peri-implantitis: Single-Center Outcomes.
Authors: Monje A, Pons R, Peña P.
DOI: 10.11607/prd.7151.
Purpose: To compare the effectiveness of electrolytic method (test group) to hydrogen peroxide (control) as adjunctive decontamination agent to address peri-implantitis.
Conclusions: Key Findings: In terms of disease resolution (i.e., lack of BOP/SOP, PD<5mm, no progressive radiographic bone loss), the control group yielded 75% and test group yielded 90.9%, which was not significantly different. The study has demonstrated that the method of GalvoSurge is an effective adjunctive agent to decontaminate peri-implantitis sites with an 91% disease resolution rate. However, the result was not significantly different from using hydrogen peroxide as an adjunctive agent.
Genetic Biomarkers for Periodontal Diseases: A Systematic Review.
Authors: Dommisch H, Hoedke D, Lu EM, Schäfer A, Richter G, Kang J, Nibali L.
DOI: 10.1111/jcpe.14149.
Purpose: To assess genetic diagnostic tests for periodontal diseases.
Conclusions: Key Findings: Diagnostic studies related to gingivitis investigated cytokine genes (IL1, IL6, IL10, MMP). Statistically speaking, some studies revealed significant association between the genotypes and presence of gingivitis, but no studies reported any information regarding diagnostic accuracy. Regarding disease progression, studies revealed statistically significant associations between cytokine genes and disease progression, but no studies revealed any data on diagnostic accuracy. Current genetic biomarker tests cannot reliably distinguish different stages of periodontal disease. Considering that periodontal disease is polygenic disease with systemic component, diagnostic accuracy may increase in value when multiple genotypes are considered together.
Xenograft Combined with a Mixture of Polynucleotides and Hyaluronic Acid (PN-HA) for Horizontal Alveolar Bone Regeneration: Clinical and Histologic Assessments in a Case Series
Authors: Beretta M., Manfredini M., Bruna Dellavia CP., Pellegrini G., Maiorana C., Paolo Poli P.
DOI: 10.11607/prd.7042
Purpose: To investigate the use of polynucleotides (PNs) mixed with hyaluronic acid (HA) in a gel form to promote bone regeneration in horizontal alveolar ridge defects.
Conclusions: The present study supports the use of PN-HA-based gel mixed with xenogeneic bone graft as a grafting option for horizontal bone regeneration.
Comparison Between Conventional and Artificial Intelligence-Assisted Setup for Digital Implant Planning: Accuracy, Time-Efficiency, and User Experience
Authors: Ntovas P., Marchand L., Schnappauf A., Finkelman M., Revilla-Leon M., Att W.
DOI: 10.1111/clr.14382
Purpose: To investigate the accuracy and time efficiency of conventional manual and automatic artificial intelligence-driven approached for segmentation of the mandibular canal and registration of radiographic data sets with intraoral model scan data.
Conclusions: Preoperative segmentation of the mandibular canal and registration of the CBCT scan to the intraoral scan with AI-assistance was a valid approach for virtual implant planning. The approach led to a similar or better accuracy compared to manual workflows and provides greater efficiency for all users. All operations should be verified by the clinician and refined when necessary.
Title Identifying Undiagnosed Diabetes and Prediabetes in the Dental Setting in an Asian Population-A Clinical Risk Model.
Authors: Chee HK, Abbas F, van Winkelhoff AJ, Tjakkes GH, Htoon HM, Li H, de Waal Y, Vissink A, Seneviratne CJ.
DOI: 10.1111/jcpe.14090.
Purpose: The purpose of this study was to determine the prevalence of prediabetes and undiagnosed diabetes in those patients receiving tertiary dental care in Singapore. Furthermore, an attempt was made to create a model used for identification of patients at risk of developing diabetes.
Conclusions: DM and prediabetes are conditions able to be identified using chairside HbA1c collection, followed by referral to a physician. Furthermore, family history of diabetes, smoking, BMI, presence of advanced periodontitis are all factors that can place an individual at higher risk of hyperglycemia, and dentists should advise these patients to seek a definitive diagnosis.
The adjunctive effect of a titanium brush in implant surface decontamination at peri-implantitis surgical regenerative interventions: A randomized controlled clinical trial.
Authors: de Tapia B, Valles C, Ribeiro-Amaral T, Mor C, Herrera D, Sanz M, Nart J.
DOI: 10.1111/jcpe.13095.
Purpose: The purpose of this study was to investigate the radiographic and clinical results of the use of titanium brushes in addition to standard implant decontamination procedures prior to reconstructive peri-implantitis treatment, typically involving the use of ultrasonics and 3% H2O2.
Conclusions: Overall, both control and test (with or without the use of titanium brushes) resulted in equally effective results in terms of reducing probing depth, radiographic bone fill, and treatment success.
Performance of the Implant Disease Risk Assessment in Predicting Peri-Implantitis: A Retrospective Study
Authors: Vilela, et al.
DOI: 10.1111/clr.14390
Purpose: Aimed to assess the ability of the implant disease risk assessment (IDRA) to predict peri-implantitis
Conclusions: Key Findings: An online tool was used to calculate the IDRA score. The eight vectors included were: 1. BOP%, 2. PD ≥ 5 mm, 3. Prosthesis features (cleanable, poor fit with supra-mucosal restoration margins, poor fit with submucosal restoration margins/excess of cement, or not cleanable), 4. BL/Age, 5. Periodontitis susceptibility (stage 1–4 and grade A–C), 6. SPT (compliant, in a recall interval ≤ 5 months, in a recall interval of 6 months, casual attender, or no SPT), 7. Restorative margin – bone crest (≤ 1.5 mm or > 1.5 mm for bone level implants), 8. History of periodontitis. There is a good sensitivity but a low specificity and discriminatory capacity of the IDRA as a tool. The two most effective predictors for peri-implantitis were “number of sites with PD ≥ 5 mm” and “distance from RM to BC”. IDRA shows promise but modifications are necessary to better the predictive accuracy.
Tenting Screw Technique for Horizontal Alveolar Bone Augmentation in the Anterior Maxilla: A 1- to 5-Year Retrospective Study
Authors: Wang, et al.
DOI: 10.1111/clr.14428
Purpose: To look at outcomes at 1 and 5 years for conventional guided bone regeneration (GBR) vs. GBR with tenting screws (TS) technique in conjunction with implant placement.
Conclusions: In terms of per-implant soft tissue healing, esthetics, and patient satisfaction using the tenting screw technique for GBR in cases of an atrophic ridge the results are comparable to conventional GBR with even superior bone augmentation outcomes.
Maxillary Sinus Grafting Complications: Diagnosis, Management, Patient Outcomes, and Role of Multidisciplinary Care
Authors: Saibene, A. et al.
DOI: 10.1111/cid.13420
Purpose: Maxillary sinus grafting (MSG) is a common, reliable procedure for rehabilitating the atrophic maxilla. Sinonasal complications are a key concern, especially in patients with preexisting sinus issues or anatomical variations. A multidisciplinary approach, often involving ENT specialists, is essential for identifying risks and managing complications effectively. The purpose was to show how working together as a team helps prevent and manage problems, leading to better results both, short- and long- terms.
Conclusions: Sinonasal complications after MSG are uncommon but can be serious. ENT evaluation helps identify risk. Interdisciplinary care improves outcomes. Accurate diagnosis and early management are critical. Conservative treatment is often enough, but surgery may be needed for severe cases. More research is needed on how graft material, membrane type, and technique affect complication rates.
Treatment Options for the Management of the Postextraction Socket: Report From the First Giuseppe Cardaropoli Foundation Consensus Conference
Authors: Cardaropoli, D. et al.
DOI: 10.1111/jre.13385
Purpose: To provide specific clinical recommendations for treatment planning after tooth extraction and before implant placement, with a focus on common clinical scenarios and post-extraction socket classifications in the aesthetic zone.
Conclusions: Key Findings: Results : Classification of Extraction Sockets A classification system that considers socket anatomy and soft tissue dimensions divides post-extraction sockets into four classes based on clinical and radiographic assessment: Class I: Intact socket with favorable conditions. Ia: Thick gingival phenotype Ib: Thin gingival phenotype Class II: Intact socket, but with limitations for ideal implant positioning and stability. Class III: Partially compromised socket with 20–50% buccal bone resorption. Class IV: Severely compromised socket with unfavorable conditions. Treatment Options for each are presented. Treatment planning for post-extraction sites requires careful assessment of: Socket integrity, available bone volume, buccal bone condition and gingival phenotype. With proper case selection, immediate placement with immediate restoration is a reliable option for intact sites. Early placement is preferred for thin phenotypes or compromised sockets. For severely compromised cases, staged augmentation with delayed placement is recommended.
Does Implant Placement Below the Ridge Reduce Crestal Bone Loss? A Split-Mouth Randomized Controlled Clinical Trial.
Authors: Altieri, F., et. al.
DOI: 10.11607/jomi.10947
Purpose: to review the crestal bone loss (CBL) at 2, 12, 36 and 60 months after implant placement equicrestally compared to 2mm subcrestal.
Conclusions: Key Findings: he average CBL between T0 and T4 was 0.81+/- 0.40mm (0.1-1.6mm range) for the equicrestal group compared to 0.87+/-0.41mm (0.2-2mm range) in the subcrestal group. Overall bone levels stayed coronal in the equicrestal group compared to the subcrestal group. Less CBL is seen in equicrestally placed implants, however it is not clinically significant. Subcrestal placement is recommended to reduce the risk of implant rough surface exposure.
Guided transpositional bone blocks in esthetic zone: Surgical technique and case report
Authors: Ye, M. F., et al.
DOI: doi.org/10.1002/cap.10352
Purpose: Review the advantages of using surgical guides to harvest bone blocks in complex maxillary bone atrophy cases, aiming to create only a single surgical site and reduce patient morbidity.
Conclusions: Horizontal bone defects in the anterior maxilla can be augmented via transpositional bone blocks, from an intraoral source, reducing morbidity, and leading to both functional stability and esthetic results. The surgical guide offers accuracy in harvesting and implant placement.