Background Resolution and prevention of peri‐implant mucositis are a key in preventing peri‐implantitis. This case–control study aims to assess the modifying effect of a deep mucosal tunnel (DMT) on the induction and resolution phases of experimental peri‐implant mucositis. Methods Nineteen subjects with a tissue level implant were assigned to cases (DMT, depth ≥3 mm) or controls (shallow mucosal tunnel ≤1 mm, SMT). Subjects underwent a standard experimental peri‐implant mucositis protocol characterized by an oral hygiene optimization phase, a 3‐week induction phase using an acrylic stent to prevent self‐performed oral hygiene at the experimental implant, and a 3 + 2 weeks resolution phase. Modified plaque (mPI), gingival index (mGI) and peri‐implant sulcus fluid IL‐1β concentrations were measured over time. Differences between DMT and SMT were assessed with the Mann–Whitney test. Results Modified plaque index and mGI increased in parallel during the induction phase. After resumption of oral hygiene practice, mPI and mGI resolved towards baseline values in the SMT group. In DMT, mPI and mGI values diverged: plaque resolved but resolution of inflammation was delayed and of smaller magnitude during the first 3 weeks after resumption of oral hygiene. IL‐1β concentrations were significantly higher in DMT at 21 days (end of induction) and during the resolution phase corroborating the clinical findings. Removal of the crown and submucosal professional cleaning were needed to revert mGI to baseline values in DMT implants. Conclusions The depth of the mucosal tunnel modifies the resolution of experimental peri‐implant mucositis at transmucosal implants. This observation raises important questions on the effectiveness of self‐performed oral hygiene in cases where implants are placed deeper and the ability to resolve mucositis and effectively prevent peri‐implantitis in such situations.

Dental neglect is widespread in Hong Kong, particularly neglect of professional dental care. Socio-demographic disparities in dental neglect were apparent. Dental neglect is associated with self-reported oral health status including how oral health impacts on life quality. These findings have implications in understanding the impact of dental neglect.

Background Few studies have looked at professional assessment or patient perception of aesthetics after root coverage procedures. The addition of connective tissue grafts (CTG) seems to improve aesthetic outcomes. The objective of this a priori analysis was to compare aesthetics after addition of CTG or a collagen matrix (CMX) to coronally advanced flap (CAF). Methods Two independent, trained and calibrated assessors analysed baseline and 6‐month post‐operative Images from 183 subjects with 475 recessions from a previously reported multicentre multinational randomized clinical trial. The root coverage aesthetic score (RES) was assessed in its five constituent components after assessing the suitability of images blindly with regard to treatment assignment and centre. Data were analysed at the tooth and subject level. Results One hundred and fifty‐five subjects (81 CTG) and 393 teeth (207 CTG) were included in the analysis. CTG control subjects had higher total RES scores (mean adjusted difference of 1.3 ± 0.8 RES units, p = 0.002). Analyses of RES subcomponents showed that the CTG group had higher scores in terms of gingival margin position but that better marginal tissue contour (OR 3.0, 95% CI 1.2–7.7) and soft tissue texture (OR 3.3, 95% CI 1.9–5.8) was observed for the CMX group. No significant differences were observed for mucogingival alignment and gingival colour. Conclusion Better overall RES scores were observed for the CTG group. Better marginal tissue texture and marginal contour were observed in the CMX group. More research and development is needed to optimize materials to be used in conjunction with CAF to improve root coverage without negatively affecting tissue texture and marginal contour.

Aims To investigate the effect of defect morphology, bone thickness and examiner experience on the accuracy to detect the presence, the type and the depth of peri‐implant defects with digital periapical radiographs (PAs) and cone beam computed tomography (CBCT) in an in vitro model. Methods Thirty six implants were placed in fresh porcine rib bone with different types of standardized defects while sites with no defect served as control. Fourteen masked examiners evaluated 324 PAs and 108 CBCT images. The presence and type of defect, the location of the bottom of the defect and the location of first bone‐to‐implant contact were recorded. The sensitivity, specificity, accuracy, positive and negative predictive values were calculated for each type of defect using actual measurements as the gold standard. Results The diagnostic accuracy for PAs was affected by defect morphology, exposure time, thickness of bone walls and the level of experience of the examiner. The overall diagnostic accuracy of CBCT was high (>96%) for all types of defects. Conclusion Cone beam computed tomography showed better diagnostic accuracy in the detection of peri‐implant defects, this can be attributed to the fact that CBCT seems to be less affected by variables that contribute to the poorer performance of PAs.