Aim To compare the effect of recombinant human bone morphogenetic protein‐2 (rhBMP‐2) in an absorbable collagen sponge carrier (ACS) with autogenous bone graft for augmentation of the edentulous atrophic anterior maxilla. Methods Twenty‐four subjects were enrolled in a randomized, controlled, parallel‐group, open‐label clinical trial. Subjects either received rhBMP‐2/ACS (1.5 mg/ml) or particulated autogenous bone harvested from the mandibular retromolar region. A titanium‐mesh was used to provide space and wound stability. A guide was used to standardize clinical recordings using an analogue caliper. Alveolar ridge width was also assessed using cone‐beam computed tomography. Results rhBMP‐2/ACS yielded significantly greater radiographic horizontal bone gain compared with autogenous bone graft at immediate subcrestal levels (1.5 ± 0.7 versus 0.5 ± 0.9 mm; p = 0.01); non‐significant differences were observed at mid‐ (2.9 ± 0.8 versus 2.9 ± 0.9 mm; p = 0.98) and apical (1.7 ± 0.9 versus 1.8 ± 1.1 mm; p = 0.85) crestal levels. No significant differences in clinical horizontal bone gain were observed at 6 months between rhBMP‐2/ACS and autogenous bone graft (3.2 ± 0.9 mm versus 3.7 ± 1.4 mm; p = 0.31). Sixty‐two implants were placed after 6 month of healing with no significant differences between groups for number of implants, implant size, primary stability and survival. Conclusions rhBMP‐2/ACS appears a realistic alternative for augmentation of the edentulous atrophic anterior maxilla.

Our observations suggest that formative biological processes explain bone formation following implantation of rhBMP-2/ACS, whereas remodelling, resorptive/formative processes, characterizes sites receiving ABGs.

Aim:The purpose of this review is to estimate the prevalence of peri-implantitis, as well as to determine possible risk factors associated with its development in patients treated with oral implants.Background: Although implant therapy has been identified as a successful and predictable treatment for partially and fully edentulous patients, complications and failures can occur. Periimplantitis is considered a biologic complication that results in bone loss around implants and may lead to implant treatment failure. Results:A great variation has been observed in the literature regarding the prevalence of peri-implantitis according to the diagnostic criteria used to define peri-implantitis. The prevalence ranges from 4.7 to 43% at implant level, and from 8.9 to ≥ 56% at patient level. Many risk factors that may lead to the establishment and progression of peri-implantitis have been suggested. There is strong evidence that presence and history of periodontitis are potential risk factors for peri-implantitis. Cigarette smoking has not yet been conclusively established as a risk factor for peri-implantitis, although extra care should be taken with dental implant in smokers. Other risk factors, such as diabetes, genetic traits, implant surface roughness and presence of keratinized mucosa still require further investigation. Clinical significance: The knowledge of the real impact of peri-implantitis on the outcome of treatments with oral implants as well as the identification of risk factors associated to this inflammatory condition are essential for the development of supportive maintenance programs and the establishment of prevention protocols. Conclusion: Peri-implantitis is not an uncommon complication following implant therapy. A higher prevalence of peri-implantitis

The present in vitro study evaluated parameters of osteogenesis under the influence of low-level laser therapy (LLLT) at different doses. Osteogenic cells originated from rat calvaria were cultivated in polystyrene plates and exposed to a laser irradiation using an indium-gallium-aluminum phosphide therapeutic laser (InGaAIP), at wavelength of 685 nm, power of 35 mW, 600-μm-diameter optical fiber, and continuous wave. In the attempt of observing the existence of a dose response and its effects, laser irradiation was performed at 25, 77, and 130 J/cm(2) (7, 22, and 37 s, respectively). The following parameters were assessed: growth curve (4, 7, and 11 days), cell viability (24 h), and nodular formation of mineralized matrix (14 days). The results did not show significant differences related to the growth curve (4, 7, and 11 days) and cell viability (24 h). Within 14 days, osteogenic cultures showed nodular areas with well-defined calcified matrix. The total area stained with Alizarin Red did not show any differences between doses of 25 and 130 J/cm(2). However, the percentage of stained area was significantly higher in the 25 J/cm(2) group when compared to the group of 77 J/cm(2) (Kruskal-Wallis test, p < 0.05). It was possible to conclude that the 685-nm laser irradiation (at 25, 77, and 130 J/cm(2)) did not influence cell growth and proliferation, although the extracellular mineralization process may have its pattern altered by the LLLT on osteogenic cell cultures.

No abstract

The aim of this study was to conduct a retrospective evaluation of the survival and success rates of dental implants with acid-etched surfaces after 8-10 years of function. Forty-four patients who received 183 implants 8-10 years ago were evaluated. Clinical examinations were performed around the implants and natural teeth. The following parameters were measured: visible plaque index (VPI), marginal bleeding index (MBI), probing depth (PD), bleeding on probing (BOP) and clinical attachment level (CAL). To considerer an implant as a success case, the following criteria were considered: absence of peri-implant infection and suppuration, absence of implant mobility, absence of persistent pain and dysesthesia and absence of radiolucency around the implant. Overall, 178 implants were categorized as surviving (97.3%), 155 were categorized as successful (84.7%), 5 implants (2.7%) were lost (1 in the maxilla and 4 in the mandible), and 3 implants were not under functional load (2.0 %). 20 implants were diagnosed with peri-implantitis. Thus, the survival rate was 97% and the success rate was 85%. In conclusion, implants with acid-etched surfaces showed high survival and success rates after a period of 8 to 10 years of function. S u r v i v a l / S u c c e s s o f D e n t a l I m p l a n t s w i t h A c i d -E t c h e d S u r f a c e s : A R e t r o s p e c t i v e Evaluation After 8 to 10 Years

This clinical report describes a multidisciplinary approach to treat a patient with edentulism and a severe anatomic defect in the mandible caused by a gunshot injury by using an implant-fixed complete dental prosthesis. An immediate loading interim implant-fixed complete dental prosthesis in the mandible associated with a maxillary removable complete denture prosthesis was initially provided to restore the intermaxillary relation. Nasal floor elevation and maxillary sinus augmentation were subsequently performed to increase the maxillary bone volume. Definitive implant-fixed complete dental prostheses were placed in both arches in order to rehabilitate this initially compromised anatomic condition, which ensured patient satisfaction and improvement in masticatory function and esthetics.

Insufficiently keratinized tissue can be increased surgically by free gingival grafting. The presence or reconstruction of keratinized mucosa around the implant can facilitate restorative procedure and allow the maintenance of an oral hygiene routine without irritation or discomfort to the patient. The aim of this clinical case report is to describe an oral rehabilitation procedure of an edentulous patient with absence of keratinized mucosa in the interforaminal area, using a free gingival graft associated with a mandibular fixed implant-supported prosthesis. The treatment included the manufacturing of a maxillary complete denture and a mandibular fixed implant-supported prosthesis followed by a free gingival graft to increase the width of the mandibular keratinized mucosa. Free gingival graft was obtained from the palate and grafted on the buccal side of interforaminal area. The follow-up of 02 and 12 months after mucogingival surgery showed that the free gingival graft promoted peri-implant health, hygiene, and patient comfort. Clinical Significance. The free gingival graft is an effective treatment in increasing the width of mandibular keratinized mucosa on the buccal side of the interforaminal area and provided an improvement in maintaining the health of peri-implant tissues which allows for better oral hygiene.