Background Soft tissue stability is crucial to obtain and maintain optimal esthetic results. Purpose This study aimed to investigate, over 5 years, the soft tissue response using a conical abutment together with the “one‐abutment one‐time” (OA‐OT) protocol in the restoration of implants inserted in the anterior esthetic area. Material and Methods From January 2011 to January 2012, all consecutive patients requiring an implant n the maxillary area between canines were enrolled. After submerged healing and osseointegration, a definitive abutment with a provisional crown was inserted. After 1 month, the definitive crown was delivered (Tdef). Analog impressions were taken before tooth extraction (T0), at implant insertion Timpl, and Tdef, and at 12 months (T1) and 60 months (T5). Casts were scanned and superimposed using a dedicated software. Differences in vertical height of soft tissue margins between the digitized model casts were calculated and paired sample t test was conducted to compare results. To detect the potential role of biotype, groups (thick vs. thin) were compared by analysis of variance with general linear model. Results Twenty‐five patients were enrolled. Three patients dropped out. At the 60‐month, 22 patients (12 men and 10 women with mean age of 68.3 ± 11 years) concluded the study follow‐up. Horizontal changes demonstrated gain of 1.06 mm at Timpl, 0.94 mm at Tdef, 0.92 mm at T1 and 0.97 mm at T5 compared to T0. Vertical changes demonstrated gain of 0.84 mm at Timpl, 0.11 mm at Tdef, 0.29 mm at T1 and 0.59 mm at T5 compared to T0. The analysis of variance showed a significant better performance of thick biotype in soft tissue horizontal width (P = .022). No statistical differences were noticed for vertical width (P = .111). Conclusions The use of a conical abutment together with the OA‐OT approach allowed longitudinal stable soft tissue dimensions.

Aim The aim of the present study was to evaluate the efficacy on the healing of mechanical decontamination of infected implant surfaces performed with a titanium brush. Methods Mandibular premolars and first molars were extracted bilaterally in six dogs. After 3 months, two unsubmerged implants were installed on both sides of the mandible. Three months later, peri‐implantitis was induced with ligatures for 3 months and then removed. After 1 month, surgical mechanical decontamination of the surfaces was performed either with a rotatory titanium brush or gauzes soaked in saline. Five month later, biopsies were retrieved. Evaluations on X‐rays taken of the mesiodistal plane and on histological slides prepared in a buccal‐lingual plane were performed. Results After the induction of peri‐implantitis, a mean marginal bone loss of 2.6 ± 0.6 mm and 1.9 ± 1.0 mm was observed in the brush and gauze groups by X‐ray, respectively. Five months after treatment, a mean gain of marginal bone of 0.6 mm was obtained in both groups. The mean closures of the vertical and horizontal defects were 0.6 mm and 0.6 mm for the brush group, and 0.8 mm and 0.5 mm for the gauze group, respectively. Histologically, a loss of attachment at the buccal aspect of 2.2 ± 0.9 mm in the brush group and of 2.3 ± 0.5 mm in the gauze group was found. No statistically‐significant differences were found after the treatment. Conclusions Mechanical implant surface decontamination performed with a rotatory titanium brush resulted in a marginal bone level gain, yielding a low content of inflammatory infiltrate close to the marginal bone.

Results showed that the OA-OT approach allow to obtain stable bone levels.

ObjectivesTo evaluate histomorphometrically the healing at implants installed with standard or very low insertion torque valuesMaterial and methodsTwelve volunteer patients were recruited, and two screw-shaped titanium devices were installed in the distal segments of the mandible using insertion torque values of either < 10 Ncm or ~ 30 Ncm. The implants were left to heal in a non-submerged fashion. After 8 weeks, biopsies were retrieved, and ground sections were prepared for histological evaluation.ResultsHistological slides from 11 patients were available for (n = 11). The new bone in contact with the implant surface was 39.3 ± 18.5% and 49.4 ± 9.4% at the < 10 and ~ 30 Ncm sites, respectively. Considering the pre-existing old bone, the total mineralized bone was 46.8 ± 22.1% at the < 10 Ncm sites and 57.0 ± 14.1% at the ~ 30 Ncm. No statistically significant differences were found.New bone density and total mineralized bone density were 36.6 ± 8.1% and 53.0 ± 13.5% at the < 10 Ncm sites and 35.9 ± 10.0% and 52.2 ± 16.0% at the ~ 30 Ncm sites, respectively. No statistically significant differences were disclosed.ConclusionFrom the data of the present study, it can be concluded that a trend of higher osseointegration was observed at the ~ 30 Ncm compared to the < 10 Ncm torque group. Nevertheless, it can be concluded that an implant installed with a very low torque may achieve a good integration.Trial registrationClinicalTrials.gov NCT04017156; trial retrospectively registered on 12 July 2019.

This study investigated the influence of professional mechanical tooth cleaning (PMTC) pastes on the surface texture of different subject materials. Methods: Two one-step PMTC pastes, Clinpro Cleaning Paste for PMTC (CP) and PRG Pro-Care Gel (PG), and multiple-step PMTC pastes, Merssage Regular (MR), Merssagge Fine (MF), and Merssage Plus (MP), were used. For comparison, PMTC was performed using distilled water without paste (DW). The subjected materials used were bovine enamel (ENA) and dentin (DEN), a resin composite (FSU), and lithium disilicate (IEC). The prepared specimens were polished using a #2000-grit silicon carbide paper. PMTC was performed using a brush at 1,000 rpm for 15 s. Results: The surface roughness (Ra) values of the specimens before and after PMTC were measured by laser scanning microscopy. The Knoop hardness number (KHN) of the subjected material was obtained. The types of PMTC pastes and subject materials had a significant influence on the Ra values and KHN. For the majority of subject materials, the descending order of Ra values after PMTC was MR > MF > CP > PG > MP > DW. The descending order of KHN of the materials was IEC > ENA > FSU > DEN. Conclusion:Although one-step PMTC pastes appeared to be effective, it is important to consider the subject material during PMTC.