Background Clinical data on the restorative designs affecting the early progression of peri‐implantitis are scarce. The aim of this retrospective study was to evaluate the influence of several restorative factors (e.g., restoration emergence angle, and internal screw length/diameter) on the marginal bone loss around implants with peri‐implantitis. Methods Implants diagnosed with peri‐implantitis having 1‐ (T1) and 2‐year (T2) follow‐ups were included. In addition, within 6 months pre‐diagnosis (Tb), all cases required to have full documentation in which no evidence of peri‐implantitis was not indicated. Changes in marginal bone levels (MBLs) from Tb to T1 and from T1 to T2 were evaluated. The effect of several variables on MBLs changes was assessed via univariate and multivariate generalized estimating equations. Results Eighty‐three bone‐level implants from 65 patients were selected. The mean follow‐up before peri‐implantitis diagnosis was 99.47 ± 47.93 months. The radiographic mean marginal bone loss was 1.52 ± 1.33 mm (Tb to T1) and 0.58 ± 0.52 mm (T1 to T2). Restoration emergence angle and frequency of maintenance visits significantly affected MBLs from Tb to T1. Besides, 66.3% of the included implants’ bone levels were in a zone within 1 mm of the apical end of the internal screw at T1 and remained in this zone during the second follow‐up year. Conclusions Significant marginal bone loss occurred in the early post‐diagnosis period of peri‐implantitis, which could be affected by the restoration emergence angle. Peri‐implant MBLs were frequently located in a zone within 1 mm of the apical end of the internal screw.

The objective of this study was to compare postsurgical outcomes of resective treatment for peri-implantitis with and without implant surface modification (implantoplasty [IP]). This was accomplished by a retrospective analysis with data from patients with ≥1 implant who were surgically treated for peri-implantitis by resective therapy. Patients were divided into 2 groups regarding treatment approach: IP (test) and no IP (control). Retrospective data were obtained after implant placement (T0) and the day of peri-implantitis surgical treatment (T1). Patients were then recalled (≥1 y after T1) for clinical and radiographic examination (T2). The findings were conclusive. A total of 41 patients (68 implants; mean ± SD follow-up, 41.6 ± 24.4 mo) were included in this study. The survival rate at the implant level was 90% in the test group and 81.6% in the control group ( P > 0.05). Multilevel regression analysis showed that the probability of implant failure was influenced by marginal bone loss (MBL) at T1 and not surgical modality. For example, peri-implantitis defects ≥50% and 25% to 50% MBL were 18.6 and 8.86 times more likely to lose the implant, respectively, when compared with <25% MBL. Nonetheless, MBL changes were similar in the test and control groups ( P = 0.592). Similarly, changes in bleeding on probing, probing pocket depth, and suppuration at T2 did not differ between groups ( P > 0.05). Multilevel regression analysis indicated that clinical improvement of these parameters was influenced by the number of supportive peri-implant therapy visits ( P < 0.01). The results demonstrate little difference between the procedures. Regardless of the implant surface modification (IP) being performed or not, the survival rate of implants treated for peri-implantitis was primarily influenced by the amount of bone loss at the time of treatment. Other clinical parameters (MBL, probing pocket depth, bleeding on probing, suppuration) were influenced by the frequency of supportive peri-implant therapy visits and not by the IP procedure (ClinicalTrials.gov NCT04259840).

Aim To assess the impact of keratinized mucosa (KM) width around dental implants on surgical therapeutic outcomes when treating peri‐implantitis. Material and Methods Surgically treated peri‐implantitis implants were divided into two groups (KM width < 2 mm and ≥2 mm). Retrospective data were obtained after implant placement (T0) and the day of peri‐implantitis surgical treatment (T1). Patients were later recruited (≥1 year after T1) for clinical and radiographic examination (T2). Outcomes were analysed using generalized estimating equation (GEE) models. Results A total of 40 patients (68 implants) (average follow‐up: 52.4 ± 30.5 months) were included in this study. From T0 to T1, no differences were found between KM groups in terms of peri‐implant probing depths (PPD) and bleeding on probing (BOP). However, sites with <2 mm KM exhibited significantly higher suppuration (SUP) and lower marginal bone level (MBL) (p > .01). Between T1 and T2, no major differences were noted on PPD reduction, BOP and MBL changes between the two groups. GEE modelling demonstrated that MBL severity prior to surgical therapy was a better predictor for implant survival than KM width. Conclusion Surgical outcome in treating peri‐implantitis was influenced by the severity of bone loss present at the time of treatment and not by the presence of KM at the time of treatment.

Aim:We retrospectively explored effects of smoking on tooth loss due to periodontitis (TLP) in long-term compliant patients. Materials and Methods:Chart data were collected from 258 patients undergoing post-non-surgical periodontal treatment (mean 2.24 visits/year) for 10-47.5 (mean 24.2) years. Patients were categorized as: (1) never smokers, (2) former smokers, (3) current light smokers (<10 cigarettes/day) and ( 4) current heavy smokers (≥10 cigarettes/day).Results: Of 6,590 teeth present at baseline (mean 25.6 teeth/patient), 264 teeth were lost due to periodontitis, corresponding to 0.03, 0.05, 0.08 and 0.11 TLP annually among never smokers, former smokers, current light smokers and current heavy smokers, respectively. A tooth from a current heavy smoker had 4.4-fold, 2.7-fold and 2.6-fold greater risk of TLP than a tooth from a never smoker, a current light smoker and a former smoker, respectively. Both heavy and light former smokers needed washout periods of approximately 15 years to reach the TLP risk level of never smokers. The TLP risk decreased by 6%/year of smoking cessation.Conclusions: It took almost 15 years of smoking cessation for the risk of TLP among former smokers to reach the level of never smokers. Hence, the 2018 periodontitis grading system should consider the impact of the "washout" period on former smokers.

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Background: Accurate implant placement is essential in reducing post-treatment complications and in ensuring a successful treatment outcome. Purpose: To compare the accuracy of fully-guided static computer-assisted implant surgery (s-CAIS) using partially-and fully-digital workflows. Materials and methods: Electronic and manual literature searches were performed to collect evidence concerning the accuracy of fully-guided s-CAIS procedures utilizing tooth-supported guides. Quantitative analysis was conducted to evaluate the accuracy of partially-and fully-digital workflows, and survival rates and complications were qualitatively analyzed. Results: Thirteen studies, including 6 randomized controlled trials and 7 prospective clinical studies, were selected for quantitative and qualitative synthesis. A total of 669 implants in 325 patients using s-CAIS were available for review. Meta-analysis of the accuracy revealed a total mean angular deviation of 2.68 (95% CI: 2.32-3.03); mean global coronal deviation of 1.03 mm (95% CI: 0.88-1.18 mm); mean global apical deviation of 1.33 mm (95% CI: 1.17-1.50 mm); and mean depth deviation of 0.59 mm (95% CI: 0.46-0.70 mm). Minimal differences were found between the two different workflows. Few complications were reported, and survival rates were between 97.8% to 100% (range of follow-up: 12 to 24 months) in the available studies. Conclusion: Similar accuracy is obtained when implants are placed in partially edentulous patients using fully-guided s-CAIS, independently of the workflow utilized.

Purpose: To evaluate the accuracy of static computer-assisted implant surgery (sCAIS) for tooth-supported free-end dental implantation with the aid/and without the aid of fixation pins to secure the surgical template through comparison between planned, 3D printed guide position and placement implant position. Materials and Methods: Thirty-two duplicated maxillary resin models were used in the present in vitro study. Digital planning was performed and fabrication of a surgical template that allowed implant placement on the distal extension edentulous site of the model (maxillary left side). A first optical scan was performed after fitting the surgical template on the model to assess the deviation at the surgical guide level. After placing implants in the model using the surgical guide, scan bodies were attached to the implants, and a second scan was performed to record the position of placed implants. The digital representations were later superimposed to the pre-operative scan and measurements of implant deviations were performed. Global (coronal and apical), horizontal (coronal and apical), depth and angular deviations were recorded between planned implant position, guide position, and placement implant position. Three-way ANOVA was used to compare implant location (#13, 14, and 15), fixation pin (with or without pin), and guide comparison (planned, guided, and placement). Results: Final implant placement based on the digital plan and based on the 3D printed guide were very similar except for depth deviation. Use of fixation pin had a statistically significant effect on the depth and angular deviation. Overall, without fixation pins and based on guide versus placement, mean global coronal (0.88 ± 0.36 mm), horizontal coronal (0.55 ± 0.32 mm), and apical (1.44 ± 0.75 mm), and angular deviations (4.28 ± 2.01°) were similar to deviations with fixation pins: mean global coronal (0.88 ± 0.36 mm); horizontal coronal (0.67 ± 0.22 mm) and apical (1.60 ± 0.69 mm); and angular deviations (4.53 ± 2.04°). Horizontal apical without pins (1.63 ± 0.69 mm) and with fixation pins (1.72 ± 0.70 mm) was statistically significant (p = 0.044). Depth deviation without pins (-0.5 ± 0.5 mm) and with fixation pins (-0.16 ± 0.62 mm) was also statistically significant (p = 0.005). Further analysis demonstrated that the final sleeve position on the 3D printed guide was on average 0.5 mm more coronal than the digital plan. Conclusions: The use of surgical guides with or without fixation pins can provide clinically acceptable outcomes in terms of accuracy in implant position. There was a statistically significant difference in the accuracy of implant position when utilizing fixation pins only for horizontal apical and depth deviation. Additionally, a statistically significant difference between the planned and the 3D printed surgical guide when considering the sleeve position was detected.