No abstract

Background The role of keratinized mucosa in promoting peri‐implant health is controversial, however recent evidence support the use of soft tissue augmentation procedures around dental implants. Soft tissue substitutes have been proposed to replace autogenous connective tissue grafts, therefore the aims of this study are to report clinical and volumetric three‐dimensional changes in mucosal thickness (MT) 1 year after treatment with an acellular dermal matrix (ADM). Methods Soft tissue augmentation was performed at second‐stage surgery in the premolar maxillary area with an ADM. MT was assessed prior to implant placement and 1, 6, and 12 months after treatment. Digital linear and volumetric measurements were recorded at baseline and after 1 and 12 months. Furthermore, clinical parameters (Probing Pocket Depths, Bleeding On Probing, Plaque Index) and marginal bone loss were also recorded. Esthetic outcomes of treatment were evaluated objectively using the Pink Esthetic Score and through patient reported outcomes. Results Twelve patients were enrolled in this prospective study. Post‐hoc analysis of the assessments with Tukey's honestly significant difference adjustment revealed that the MT had increased significantly from baseline to 1 month (P < 0.001), 6 months (P < 0.001) and 12 months (P < 0.001), and remained stable between 6 months and 12 months (P > 0.05). Based on the volumetric evaluation, a shrinkage of 23.31% occurred from 1 month to 12 months (P > 0.05). Conclusions A significant increase in MT was reported after 1 year, with a mean gain of 1.25 mm. Soft tissues were stable, with no statistically significant differences between 6 months and 1 year.

Background Over the years, only few authors have studied the association of systemic conditions with peri‐implantitis. The aim of this study is to detect frequency and severity of peri‐implant diseases among an Italian population of patients affected by metabolic syndrome (MetS). Methods In this cross‐sectional study, patients with at least one dental implant with >5 years of functional loading were screened to evaluate metabolic, periodontal, and peri‐implant status. MetS diagnosis was established in accordance with the National Cholesterol Education Program (NCEP) ATP III criteria, while case definitions of the 2017 World Workshop were adopted for peri‐implant diseases. For each implant, probing depths, mucosal redness, bleeding on probing, suppuration, plaque index, and marginal bone loss were recorded. Multinomial logistic regression analyzed the relationship between sex, diagnosis of MetS, presence of periodontitis, smoking, type of prosthesis, and location of implants and peri‐implant mucositis and peri‐implantitis. Results A total of 183 patients were enrolled: in MetS subjects, peri‐implantitis was detected in 36.9% (n = 31) of implants, and mucositis in 60.7% (n = 51), with an OR of 10.01(P = 0.005) for mucositis and OR 15.26 (P = 0.001) for peri‐implantitis, compared with subjects without MetS, where 26.3% of implants showed peri‐implantitis and 55.5% mucositis. No differences were found for smoking, implant location, sex, and type of prosthetic rehabilitation. Patients with periodontitis showed a higher association with peri‐implant mucositis (OR = 4.33) and peri‐implantitis (OR = 9.00). Conclusion Based on the results of this study, patients affected by MetS showed a greater prevalence of peri‐implant diseases, but further studies are needed to confirm the possibility of this new possible risk indicator.

The aims of this study were to obtain preliminary data and test the clinical efficacy of a novel nonporous dense-polytetrafluoroethylene (d-PTFE) membrane (permamem®, botiss) in alveolar ridge preservation (ARP) procedures with a flapless approach. A traumatic extraction was performed in the premolar maxillary area, and a d-PTFE membrane was used to seal the alveolar cavity: no biomaterial was used to graft the socket and the membrane was left intentionally exposed and stabilized with sutures. The membrane was removed after four weeks and dental implants were placed four months after the procedure. The primary outcome variables were defined as the dimensional changes in the ridge width and height after four months. A total of 15 patients were enrolled in this study. The mean width of the alveolar cavity was 8.9 ± 1.1 mm immediately after tooth extraction, while four months later a mean reduction of 1.75 mm was experienced. A mean vertical reduction of 0.9 ± 0.42 mm on the buccal aspect and 0.6 ± 0.23 mm on the palatal aspect were recorded at implant placement. Within the limitations of this study, the d-PTFE membrane proved to be effective in alveolar ridge preservation, with the outcomes of the regeneration not affected by the complete exposure of this biomaterial.

Objective: The purpose of this clinical study was to determine if skin tone and tooth color had the same influence on smile attractiveness. Materials and Methods:A woman's smile photograph was digitally manipulated to create a range of images with varying colors. The skin shade was modified to create four tones (p1: light, p2: light medium, p3: medium dark, p4: dark) using the L'Oreal True Illusion shade as a guide. The tooth shade was modified in four different tones: A1, A2, A3, A4 using the VITAPAN Classical shade guide to produce 16 images. A sample of 328 participants rated each image for attractiveness by means of a visual analog scale (VAS). Comparison among groups was performed with a 2-way ANOVA adjusted for multiple comparisons with the Bonferroni test (α = .05).Results: Image (p3-a1) showed the highest VAS values, while image (p1-a4) obtained the lowest, (Bonferroni Test: a1 vs a2, a3, a4 P < .001; p3 vs p1, p2, p4 P < .001).Analysis performed for age, sex, level of education, and laypeople/dentists were not statistically significant (P > .05). Conclusions:Variations in tooth and skin tone can significantly influence the perception of smile attractiveness. In the tested conditions, a brighter tooth shade significantly affected the attractiveness of the smile independently from skin tone.Clinical Significance: Understanding patient and dentist perception of the attractiveness of a smile with the important role-played by skin tone, may help clinicians to better identify teeth shade, helping delivery of tailored prostheses and esthetic restorations. K E Y W O R D S chroma, esthetics, skin tone, smile attractiveness, tooth color, value

Objectives The aims of this retrospective study were to report data on the prevalence of retrograde peri-implantitis (RPI) in a single-center in a 20-year observation period and to evaluate implant survival after surgical treatment. Materials and methods A retrospective cohort study was conducted screening all patients who underwent implant treatment in a private practice. Patients were enrolled if they had one or more implants showing a radiolucency around the implant apex, without implant mobility. Furthermore, clinical symptoms of RPI and days from symptoms’ appearance after implant placement were also collected, as well as periodontal and endodontic status of nearby teeth. All patients were treated with the same surgical approach: antibiotic therapy, mechanical curettage, chemical decontamination and xenograft application. Results Out of the 1749 implants placed, only 6 implants were classified as affected by RPI, with a prevalence of 0.34%. Clinical symptoms of RPI (pain, swelling, dull percussion or fistula presence) varied among patients and were reported after a mean period of 51.83 ± 52.43 days. Conclusions RPI was successfully treated with surgical curettage and bone substitute application and all implants are still in place after a mean follow-up of 8.83 ± 5.34 years. Clinical relevance Bacteria from teeth with failed endodontic treatment or residual lesions might be reactivated by drilling for implant osteotomy, with subsequent colonization of the implant apex and possible failure before prosthetic loading. Therefore, it might be recommended to take a periapical x-ray at implant placement and after 6–8 weeks in order to intercept RPI before prostheses delivery.

No abstract

There is a lack of evidence in the attitude and prescribing practice of implantologists in dental implant post-operative assessment; therefore, the aims of this cross-sectional study were to investigate these habits and the knowledge about radiographic aspect of retrograde peri-implantitis (RPI) among Italian implantologists. A questionnaire was sent via email to dentists randomly selected from the register of implantology and oral surgery societies. It included three questions: the preferred X-ray after implant placement, the timing of post-operative assessment and the knowledge of the RPI radiographic representation. A final sample of 434 implantologists was included in the study. The majority of them (84.3%) perform a periapical X-ray as control radiograph and picked the correct radiographic representation of RPI (74.3%), without statistically significant differences (p > 0.05) for sex, age, years of working practice and number of implants placed per year. Just 47.7% of dentists perform a control radiograph at prostheses delivery, to establish a proper baseline. A statistically significant difference (p < 0.05) was detectable only for the number of implants placed per year, with dentists placing > 80 implants selecting the correct choice. To the best of authors’ knowledge, this is the first study to report data on attitude of implantologists in radiographic imaging after implant placement.