Different implant placement depths do not influence crestal bone changes. Soft tissue behavior is not influenced by different implant placement depths or by the amount of keratinized tissue.

AimTo evaluate techniques for assessing soft tissue alterations at implant sites and compare the traditionally utilized methods to the newer three‐dimensional technologies emerging in the literature.Materials and MethodsA comprehensive search was performed to identify interventional studies reporting on volumetric changes at implant sites following different treatments.ResultsSeventy‐five articles were included the following: 30 used transgingival piercing alone, one utilized calliper, six with ultrasonography, six on cone‐beam computed tomography, and 32 utilized optical scanning and digital technologies. Optical scanning‐based digital technologies were the only approach that provided ‘volumetric changes,’ reported as volumetric variation in mm3, or the mean distance between the surfaces/mean thickness of the reconstructed volume. High variability in the digital analysis and definition of the region of interest was observed. All the other methods reported volume variation as linear dimensional changes at different apico‐coronal levels. No studies compared volumetric changes with different approaches.ConclusionsDespite the emergence of optical scanning‐based digital technologies for evaluating volumetric changes, a high degree of variation exists in the executed workflow, which renders the comparison of study results not feasible. Establishment of universal guidelines could allow for volumetric comparisons among different studies and treatments.

Objectives The aim of the present study was to explore the feasibility of ultrasonography (US) for clinical imaging of peri‐implant tissues. Material and Methods Patients with ≥1 implant, a cone‐beam computed tomography (CBCT) scan, an US scan, and clinical photographs taken during the surgery were included. The crestal bone thickness (CBT) and facial bone level (FBL) were measured on both US and CBCT modalities, and direct FBL measurements were also made on clinical images. US measurements were compared with CBCT and direct readings. Results A total of eight implants from four patients were included. For FBL measurements, US and direct (r2 = 0.95) as well as US and CBCT (r2 = 0.85) were highly correlated, whereas CBCT correlated satisfactorily with the direct reading (r2 = 0.75). In one implant without facial bone, CBCT was not able to measure CBT and FBL accurately. The estimated bias for CBT readings was 0.17 ± 0.23 mm (p = .10) between US and CBCT. US blood flow imaging was successfully recorded and showed a wide dynamic range among patients with different degrees of clinical inflammation. Conclusion US is a feasible method to evaluate peri‐implant facial crestal bone dimensions. Additional US features, for example, functional blood flow imaging, may be useful to estimate the extent and severity of inflammation.

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).

Objectives This randomized clinical trial analyzed the long‐term (5‐year) crestal bone changes and soft tissue dimensions surrounding implants with an internal tapered connection placed in the anterior mandibular region at different depths (equi‐ and subcrestal). Materials and methods Eleven edentulous patients were randomly divided in a split‐mouth design: 28 equicrestal implants (G1) and 27 subcrestal (1–3 mm) implants (G2). Five implants were placed per patient. All implants were immediately loaded. Standardized intraoral radiographs were used to evaluate crestal bone (CB) changes. Patients were assessed immediately, 4, 8, and 60 months after implant placement. The correlation between vertical mucosal thickness (VMT) and soft tissue recession was analyzed. Sub‐group analysis was also performed to evaluate the correlation between VMT and CB loss. Rank‐based ANOVA was used for comparison between groups (α = .05). Results Fifty‐five implants (G1 = 28 and G2 = 27) were assessed. Implant and prosthetic survival rate were 100%. Subcrestal positioning resulted in less CB loss (−0.80 mm) when compared to equicrestal position (−0.99 mm), although the difference was not statistically significant (p > .05). Significant CB loss was found within the G1 and G2 groups at two different measurement times (T4 and T60) (p < .05). Implant placement depths and VMT had no effect on soft tissue recession (p > .05). Conclusions There was no statistically significant difference in CB changes between subcrestal and equicrestal implant positioning; however, subcrestal position resulted in higher bone levels. Neither mucosal recession nor vertical mucosa thickness was influenced by different implant placement depths.

Objectives The primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures (PROMs) compared to conventional impression (CI) techniques, taking into account the size of the scanned area. The secondary aim was to verify the effectiveness of IOS procedures based on available prosthodontic outcomes. Materials and methods Electronic and manual literature searches were performed to collect evidence concerning the outcomes of IOS and CI performed during the treatment of partially and complete edentulous patients for tooth- or implant-supported restorations. Qualitative analysis was conducted to evaluate the time efficiency and PROMs produced by the two different techniques. Clinical prosthodontic outcomes were analyzed among the included studies when available. Results Seventeen studies (9 randomized controlled trials and 8 prospective clinical studies) were selected for qualitative synthesis. The 17 included studies provided data from 430 IOS and 370 CI performed in 437 patients. A total of 7 different IOS systems and their various updated versions were used for digital impressions. The results demonstrated that IOS was overall faster than CI independent of whether quadrant or complete-arch scanning was utilized, regardless of the nature of the restoration (tooth or implant supported). IOS was generally preferred over CI regardless of the size of the scanned area and nature of the restoration (tooth- or implant-supported). Similar prosthodontic outcomes were reported for workflows implementing CI and IOS. Conclusions Within the limitations of this systematic review, IOS is faster than CI, independent of whether a quadrant or complete arch scan is conducted. IOS can improve the patient experience measured by overall preference and comfort and is able to provide reliable prosthodontic outcomes. Clinical relevance Reduced procedure working time associated with the use of IOS can improve clinical efficiency and the patient experience during impression procedures. Patient-reported outcome measures (PROMs) are an essential component of evidence-based dental practice as they allow the evaluation of therapeutic modalities from the perspective of the patient. IOS is generally preferred by patients over conventional impressions. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-04157-3.

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.

Background: Root resection has been considered a viable treatment option for molars with furcation defects. However, need of a multidisciplinary approach could potentially deem this procedure less successful. The aim of the present article was to determine survival rates of root resection procedure and reasons for failure in an academic setting.Methods: Patient-related demographic data, medical history information, and relevant data pertaining to the root-resected teeth performed from January 1990 to September 2017 were reviewed through electronic and paper chart. Survival rates were analyzed using Kaplan-Meier estimate. Association between the reasons for failure and independent variables was established by a Pearson Chi-squared and Kruskal-Wallis test.Results: A total of 85 patients with an average follow-up of 5 ± 4.3 years (range: 1 to 16.8 years) were included in the present article. A total of 47 molar teeth treated with root resection remained as part of the dentition (55.3%) and 38 (44.7%) failed. The mean survival time with the Kaplan-Mayer analysis was 109.9 months (9.1 years).Fracture (39.5%), caries (26.3%), and periodontal disease (23.7%) were the most common causes for failure. Interestingly, the majority of failures occurred in the first 4 years after therapy (n = 31; 81.5% of all failures). Conclusions:Root resection therapy remains a treatment solution for molars with furcation defects. In an academic setting, >50% of teeth remained functional after 9 years of root resection therapy. K E Y W O R D Sfurcation lesions and treatment, periapical diseases, periodontal surgery, periodontitis, prognosis, tooth loss, tooth root