Present findings showed that implants placed with higher insertion torque in mandible led to greater bone resorption and mucosal recession than that registered for implants placed with a regular IT. Moreover, sites with a thick buccal bone wall (≥1 mm) showed smaller recession at the facial soft tissue level after 3 years.

Background Consistent bone changes occur after tooth removal, often compromising the success of implants placed within the socket left to natural healing The long‐term effect of ridge preservation on implant outcomes is still unclear. Purpose The aim of the study was to assess success and survival rates of implants placed in extraction sockets, with spontaneous healing, or grafted with cortical porcine bone, or collagenated corticocancellous porcine bone. Materials and methods Ninety patients in need for a single premolar/molar tooth extraction and an implant treatment were selected for the present study. Patients were randomly distributed among 3 groups: sites that healed naturally (ctrl), or sites that received ridge preservation with either cortical (cort) or collagenated corticocancellous porcine bone (coll). Three months after, all the experimental sites were reentered to insert implants. Marginal bone levels were recorded; soft tissues were analyzed and summarized with the Pink Esthetic Score (PES). Forty‐two patients out of 90 (initial cohort study) completed the entire follow‐up of 4 years. Results Cumulative survival and success rates for all implants were 100% at a 4‐year evaluation. Mean marginal bone loss (MBL) was 1.14 ± 0.23 mm in the cort group, 1.13 ± 0.29 mm in the coll group, and 1.92 ± 0.07 mm in the ctrl group. There were no significant differences between the 2 grafting materials but MBL was significantly greater in the nongrafted sites (P value < .001). The PES resulted significantly better (9.42 ± 0.75) for the cort group than for the coll group (8.53 ± 1.18) and ctrl group (6.07 ± 1.89) at 4‐year evaluation. Conclusions Ridge preservation was more effective than natural healing in preserving marginal bone and in achieving better esthetic outcomes around implants 4 years after placement. The cortical porcine bone showed better clinical outcomes than collagenated corticocancellous porcine bone.

Peri-implantitis is an infectiousinflammatory process affecting soft and hard tissues surrounding osteointegrated dental implants, and it is always preceded by untreated implant mucositis. Clinically, periimplantitis is associated with bleeding, suppuration, and progressive loss of the implant supporting bone. 1 The prevalence of peri-implant mucositis and peri-implantitis is reported to range from 19% to 65% and 1% to 47%, respectively. 2 The inconsistency of literature when describing periimplantitis makes it difficult to define univocal criteria of diagnosis. In occasion of the 2016 consensus meeting on peri-implantitis in Rome, it was stated that it is impossible to define periimplantitis as a unique entity with precise etiology. 3 According to the authors, the best way to diagnose periimplantitis was to assess a progressive marginal bone loss in several radiographs taken during the follow-up. This finding could be integrated by the positivity to bleeding on probing and to probing depth $6 mm. However, those factors, if taken alone, are poor predictors of disease. It is accepted that the main causative factor for peri-implantitis is the presence of pathogenous bacteria, but its clinical course might depend on other modifying factorsdpositive anamnesis for periodontitis, smoking habits, systemic conditions, and prosthesis fallacy. 4,5 The bacterial flora associated to peri-implantitis was found to be similar to that of periodontitis, consisting mainly of gram-negative anaerobes. 6 Therefore, the mechanical disruption of the biofilm and the reduction of the oral bacterial load account for the avant-garde of the army against

The cumulative survival rate was of 94.6% at 7-year visit. The mean MBL was -0.6 ± 0.49 mm at baseline and 1 ± 0.2 mm after 7 years. The FST Level was 0.4 ± 0.69 mm at baseline and 0.02 ± 0.70 mm at the 7-year follow-up. The Width of Keratinazed Gingiva was 3.8 ± 0.47 mm at baseline and 3.1 ± 0.42 mm at 7-year follow-up. Implants placed immediately after tooth extraction and immediately restored showed predictable clinical outcomes in this prospective study.