Aim To determine cumulative success rate (CSR) of short and ultrashort implants in the posterior maxilla restored with single crowns. Patients and Methods We performed a retrospective study in 65 patients with 139 implants. 46 were ultrashort and 93 short. Implants were placed with a staged approach and restored with single crowns. Success rate, clinical and radiographic outcomes, and crown-to-implant ratio (CIR) were assessed after three years. Statistical analysis was performed by descriptive and inferential statistics. A log-binomial regression model where the main outcome was implant success was achieved. Coefficients and 95% confidence intervals were reported. Analyses were performed with Stata 13.2 for Windows. Results 61.54% of patients were female and mean overall age was 51.9 ± 11.08 years old. Overall CSR was 97.1% (95% CI: 92.4–98.9): 97.9 and 95.1% for short and ultrashort, respectively (P value: 0.33). Four implants failed. Covariates were not associated with CSR (P value > 0.05). Regression model showed coefficients correlated with implant success for ultrashort implants (0.87) and most of covariates but none were statistically significant (P values > 0.05). Conclusions Our results suggest that short and ultrashort implants may be successfully placed and restored with single crowns in the resorbed maxillary molar region.

Peri-implantitis is characterized by inflammation and crestal bone loss in the tissues surrounding implants. Contamination by deleterious bacteria in the peri-implant microenvironment is believed to be a major factor in the etiology of peri-implantitis. Prior to any therapeutic regenerative treatment, adequate decontamination of the peri-implant microenvironment must occur. Herein we present a novel approach to the treatment of peri-implantitis that incorporates the use of a topical desiccant (HYBENX), along with air powder abrasives as a means of decontamination, followed by the application of biphasic calcium sulfate combined with inorganic bovine bone material to augment the intrabony defect. We highlight the case of a 62-year-old man presenting peri-implantitis at two neighboring implants in positions 12 and 13, who underwent access flap surgery, followed by our procedure. After an uneventful 2-year healing period, both implants showed an absence of bleeding on probing, near complete regeneration of the missing bone, probing pocket depth reduction, and clinical attachment gain. While we observed a slight mucosal recession, there was no reduction in keratinized tissue. Based on the results described within, we conclude that the use of HYBENX and air powder abrasives, followed by bone defect grafting, represents a viable option in the treatment of peri-implantitis.

The purpose of this study was to evaluate the esthetic outcome of single-tooth locking taper connection implants placed in the anterior maxilla following a postextractive nonfunctional loading protocol. This preliminary clinical study involving 16 patients evaluated the results of 21 implants placed in areas with high esthetic value. For each implant the pink esthetic score, white esthetic score, cumulative survival rate, and health status of peri-implant tissues were evaluated. The cumulative survival rate was 100% 2 years after prosthetic loading, and the mean total pink esthetic score/white esthetic score was 16.9 ± 1.14 on a maximum value of 20. There was excellent plaque control in all patients, and inflammation indices were within the norm. Within the limits of this study, this immediate nonfunctional loading protocol seems to be a successful procedure esthetically and for the maintenance of peri-implant soft tissues.

Introduction and Aim. In case of peri-implantitis, resective surgery is contraindicated for short and ultrashort implants, limiting the treatment options to regenerative surgery or to implant removal. This retrospective case series presents the clinical and radiographic outcomes of a surgical regenerative procedure to treat peri-implantitis around short and ultrashort implants. Materials and Methods. The study is a retrospective evaluation of patients suffering from peri-implantitis and those who underwent access flap surgery, concomitant chemical and mechanical decontamination of implant surface, and bone grafting using a self-hardening mixture of bone substitutes and biphasic calcium sulfate. No membranes were applied to cover the grafting material, and primary tension-free closure was achieved. The retrospective protocol was reviewed and approved by the Ethics Committee for Clinical Sperimentation (CESC) of Verona and Rovigo, Italy (based in the University of Verona) (Prog. 1863CESC. Date of approval: 2018-07-04). Results. 15 patients (17 implants) have been diagnosed with peri-implantitis after a mean follow-up of 24 months after loading. Implant length was between 5 and 8 mm. 8 patients (10 implants) had a history of periodontitis. At baseline, the mean PD (probing pocket dept) at the deepest site was 8.12 mm, with an average mBI (modified bleeding index) of 2.35 and a mean BD (bone defect depth) of 3.04 mm. At the 3-year follow-up, the CSR was 100%, the mean mBI was 0.88 (average reduction: −1.47), the mean PD was 3.35 mm (mean PD reduction: 4.77 mm), and the mean bone defect was reduced by 1.74 mm, with a mean bone fill of 55%. Conclusions. The results of the present case series suggest that if accurate surface decontamination is achieved, high survival rate and good clinical and radiographic results can be obtained after 3 years. However, only the histological examination could confirm the growth of new bone in direct contact with the implant surface or if the grafted material only fills the space left by the peri-implant defect.

The functional and aesthetic restoration of teeth compromised due to aggressive periodontitis presents numerous challenges for the clinician. Horizontal bone loss and soft tissue destruction resulting from periodontitis can impede implant placement and the regeneration of an aesthetically pleasing gingival smile line, often requiring bone augmentation and mucogingival surgery, respectively. Conservative approaches to the treatment of aggressive periodontitis (i.e., treatments that use minimally invasive tools and techniques) have been purported to yield positive outcomes. Here, we report on the treatment and five-year follow-up of patient suffering from aggressive periodontitis using a minimally invasive surgical technique and implant system. By using the methods described herein, we were able to achieve the immediate aesthetic and functional restoration of the maxillary incisors in a case that would otherwise require bone augmentation and extensive mucogingival surgery. This technique represents a conservative and efficacious alternative to the aesthetic and functional replacement of teeth compromised due to aggressive periodontitis.

The replacement of single anterior teeth by means of endosseous implants implies the achievement of success in restoring both aesthetic and function. However, the presence of wide endoperiodontal lesions can lead to horizontal hard and soft tissues defects after tooth extraction, making it impossible to correctly place an implant in the compromised alveolar socket. Vertical augmentation procedures have been proposed to solve these clinical situations, but the amount of new regenerated bone is still not predictable. Furthermore, bone augmentation can be complicated by the presence of adjacent teeth, especially if they bring with them periodontal defects. Therefore, it is used to restore periodontal health of adjacent teeth before making any augmentation procedures and to wait a certain healing period before placing an implant in vertically augmented sites, otherwise risking to obtain a nonsatisfactory aesthetic result. All of these procedures, however, lead to an expansion of treatment time which should affect patient compliance. For this reason, this case report suggests a surgical technique to perform vertical bone augmentation at a single gap left by a central upper incisor while placing an implant and simultaneously to regenerate the periodontal attachment of an adjacent lateral incisor, without compromising the aesthetic result.

Introduction: The purpose was to study any relationship between crown-to-implant ratio and peri-implant bone loss of short, plateau-design, locking taper implants in posterior maxillary areas. Methods: This retrospective clinical study was conducted between May 2013 and September 2013. The sample was composed of patients who had received at least one short implant(5-to-8-mm-long) between January 2009 and December 2011. The outcome variables were implant failure and peri-implant bone loss in relation to crown-to-implant ratio. Analysis of variance (ANOVA) was used to check out correlations between crown-to-implant ratio and peri-implant bone loss. Results: Thirty-six subject who received 79 locking-taper implants were followed for an average of 24 months. Four implants failed, giving a cumulative survival rate (CSR) of 94.9%. The mean crown-to-implant ratio was 2.01. The peri-implant bone loss between prosthetic loading and last recall was 0.21 mm. No statistically significant relationship was observed between increasing crown-implant ratios and marginal bone loss (P = .93). Conclusion: The crown-to-implant ratio, although high, was not associated to increased bone loss. However further studies with longer follow-up are needed to confirm our data.

No abstract