BackgroundA sufficient amount of bone is essential to ensure long-term stability of dental implants. To support the bone regeneration process, different techniques and materials are available. It has been questioned whether these techniques and materials may compromise implant survival compared to pristine bone. To properly answer this question, long-term stability up to 20.2 years after insertion of implants placed in augmented or non-augmented sites was retrospectively analysed.MethodsRetrospective analysis included 10,158 implants from 3095 patients in three private practices who underwent implant therapy with or without bone augmentation procedures. Different graft materials and membranes were used for augmentation. If necessary, the graft was stabilised using a titanium mesh. Implant survival was evaluated analysing explantation rates and Kaplan-Meier survival curves in augmented or non-augmented sites. In additional subgroup analyses, augmentation procedures, graft materials and membranes were compared applying descriptive statistics.ResultsThe observation period varied from the day of implantation up to 20.2 years after implant insertion. The overall implant survival was 95.5% (augmented sites 96.33%; native sites 94.27%). Comparison of Kaplan-Meier survival curves revealed significantly better survival of implants in augmented sites (p = 0.0025). When comparing different augmentation procedures, the best results were found for bone condensing followed by lateral augmentation. Graft materials were used in 58.2%, membranes in 36.6% of all implant sites. The most often used graft materials were a deproteinized bovine bone mineral (53.0%) and autogenous bone particles (32.5%). Both provided the best results and showed a significantly better implant survival compared to no graft material using the Kaplan-Meier method (p = 0.0104 and p < 0.0001). A native collagen membrane was used most often (74.0% of the membrane sites) and provided the best results regarding implant survival in the log-rank test.ConclusionsThe retrospective analysis shows that implants inserted in augmented or native bone demonstrate similar implant survival under the conditions of private practice compared to prospective studies. To establish a broad base of support, further well-designed clinical trials are necessary.
Piercing, i.e. perforation of skin or mucous membranes in order to attach mostly metallic jewelery as well as multicolored skin tattooing have become more popular than ever before and a considerable number of (young) people practise these methods of body art which are supposed to increase the individuality. But there is a lot of side effects, among them especially infections. The most important bacteria cultivated from such patients are Staphylococcus aureus, group A streptococci and Pseudomonas aeruginosa. Viruses which can be transmitted by piercing or tattooing are especially hepatitis B virus and hepatitis C virus. Besides local bacterial infections also systemic infections (sepsis, endocarditis) occur. The main aspects of diagnostics, therapy and prevention are discussed.
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