Consensus Report by the Italian Academy of Osseointegration on the Importance of Peri-Implant Soft Tissues.

: The influence of the quantity and quality of peri-implant soft tissue on implant health and long-term maintenance is controversial. This consensus aimed to assess the importance of peri-implant soft tissue by analyzing four aspects: the role of keratinized mucosa (KM), the efficacy of specific collagen matrix, the influence of abutment material, and soft-tissue thickness. : Active members of the Italian Academy of Osseointegration (IAO) participated in the consensus.

Autogenous graft versus collagen matrices for peri-implant soft tissue augmentation. A systematic review and network meta-analysis.

Objective: The primary objective of this review is to compare autogenous soft tissue grafts (connective tissue graft - CTG and free gingival graft-FGG) with different type of matrices (acellular dermal matrix-ADM, xenograft collagen matrix-XCM, volume-stable collagen matrix-VCMX) used to increase peri-implant soft tissues.

Materials And Methods: A search on electronic databases was performed to identify randomized and non-randomized controlled trials (RCTs and CCTs, respectively) with either parallel or split-mouth design, and treating ≥ 10 patients. A network meta-analysis (NMA) was used to compare different matrices.

Do soft tissue augmentation techniques provide stable and favorable peri-implant conditions in the medium and long term? A systematic review.

Objectives: To review the available literature on the medium- and long-term effects of soft tissue augmentation (STA) at implant sites and to explore the effects of the different approaches on clinical-, patient-reported, and health-related parameters.

Materials And Methods: A comprehensive electronic and manual search was performed to identify prospective clinical studies that assessed the medium- and long-term (≥36 months) outcomes following STA, including number of sites maintaining peri-implant health and number of sites developing peri-implant disease, incidence of complications, stability of the clinical, volumetric, and radiographic parameters, and patient-reported outcome measures (PROMs).

Results: Fifteen studies were included in the qualitative analysis.

Antibiotics as Adjunctive Therapy in the Non-Surgical Treatment of Peri-Implantitis: A Systematic Review and Meta-Analysis.

The role of antibiotics as adjunctive therapy in the non-surgical treatment of peri-implantitis is uncertain. The aim of this systematic review of randomized controlled trials was to assess the efficacy of antibiotic therapy, local or systemic, as an adjunctive to the non-surgical therapy of peri-implantitis. Primary outcomes were: implant success rate and complications, changes in radiographic bone level, probing pocket depth (PPD), probing attachment level (PAL), bleeding on probing (BOP) and peri-implantitis resolution.

Clinical efficacy of a new fully piezoelectric technique for third molar root extraction without using manual tools: a clinical randomized controlled study.

Objective: The aim of this randomized controlled clinical study was to evaluate the efficacy of a new technique fully based on the use of a piezoelectric device for third molar root extraction versus the conventional technique based on the use of manual and rotary instruments.

Method And Materials: Patients referred to the hospital of Bolzano for third molar extraction were randomly divided into two groups and treated by two experienced oral surgeons. In the test group all the procedures were performed using piezoelectric instruments and a specially designed piezoelectric lever, whereas in the control group conventional manual and rotary instruments were used.

Clinical efficacy of Lactobacillus reuteri-containing lozenges in the supportive therapy of generalized periodontitis stage III and IV, grade C: 1-year results of a double-blind randomized placebo-controlled pilot study.

Objective: The aim of this 12-month mono-centre double-blind randomized placebo-controlled clinical study was to evaluate the efficacy of Lactobacillus reuteri-containing lozenges during the supportive therapy of generalized periodontitis stage III and IV, grade C (GPIII-IVC) patients.

Material And Methods: Twenty treated GPIII-IVC patients were randomly divided into 2 groups. The test group received two 3-month-long administrations of L.

WITHDRAWN: Interventions for replacing missing teeth: 1- versus 2-stage implant placement.

Background: Implants may be placed penetrating the oral mucosa (1-stage procedure) or can be completely buried under the oral mucosa (2-stage procedure) during the healing phase of the bone at the implant surface. With a 2-stage procedure the risk of having unwanted loading onto the implants is minimized, but a second minor surgical intervention is needed to connect the healing abutments and more time is needed prior to start the prosthetic phase because of the wound-healing period required in relation to the second surgical intervention.

Objectives: To evaluate whether a 1-stage implant placement procedure is as effective as a 2-stage procedure.

Early loading of maxillary titanium implants with a nanostructured calcium-incorporated surface (Xpeed): 5-year results from a multicentre randomised controlled trial.

Purpose: To evaluate clinical safety and effectiveness of a novel calcium-incorporated titanium implant (Xpeed, MegaGen Implant Co. Limited, Gyeongbuk, South Korea).

Materials And Methods: In total, 60 patients were randomised to receive one to six titanium implants in the maxilla with either calcium-incorporated (Xpeed) or control resorbable blasted media (RBM) surfaces, according to a parallel group design at two centres.

The influence of repeated abutment changes on peri-implant tissue stability: 3-year post-loading results from a multicentre randomised controlled trial.

Purpose: To evaluate the influence of at least three abutment disconnections in conventional loaded implants against placement of a definitive abutment in immediately non-occlusal loaded implants on hard and soft tissue changes. A secondary aim was to evaluate whether the presence of less than 2 mm of keratinised mucosa is associated with increased peri-implant marginal bone loss and soft tissue recessions.

Materials And Methods: Eighty patients requiring one single crown or one fixed partial prosthesis supported by a maximum of three implants were randomised, after implants were placed with more than 35 Ncm, according to a parallel group design to receive definitive abutments that were loaded immediately (definitive abutment or immediate loading group) or transmucosal abutments, which were delayed loaded after 3 months and removed at least three times: 1.

A new multiple anti-infective non-surgical therapy in the treatment of peri-implantitis: a case series.

Background: Peri-implantitis is a frequent disease that may lead to implant loss. The aim of this case series was to evaluate the clinical results of a new non-surgical treatment protocol.

Methods: Fifteen patients with dental implants affected by peri-implantitis were treated with a multiple anti-infective non-surgical treatment (MAINST) which included two steps: 1) supra-gingival decontamination of the lesion and sub-gingival treatment with a controlled-release topical doxycycline; 2) after one week, a session of supra and sub gingival air polishing with Erythritol powder and ultrasonic debridement (where calculus was present) of the whole oral cavity was performed along with a second application of topical doxycycline around the infected implant.

Do repeated changes of abutments have any influence on the stability of peri-implant tissues? One-year post-loading results from a multicentre randomised controlled trial.

Purpose: To evaluate the influence of at least three abutment changes in conventionally loaded implants against placement of a definitive abutment in immediately non-occlusal loaded implants on hard and soft tissue changes.

Materials And Methods: Eighty patients requiring one single crown or one fixed partial prosthesis supported by a maximum of three implants were randomised, after implants were placed with more than 35 Ncm, according to a parallel group design to receive definitive abutments which were loaded immediately (definitive abutment or immediate loading group) or transmucosal abutments. These were delayed loaded after 3 months and were removed at least three times: 1) at impression taking (3 months after implant placement); 2) when checking the zirconium core on titanium abutments at single crowns or the fitting the metal structure at prostheses supported by multiple implants; 3) at delivery of the definitive prostheses (repeated disconnection or conventional loading group).

Dental implants with internal versus external connections: 5-year post-loading results from a pragmatic multicenter randomised controlled trial.

Purpose: To evaluate advantages and disadvantages of identical implants with internal or external connections.

Materials And Methods: One hundred and twenty patients with any type of edentulism (single tooth, partial and total edentulism), requiring one implant-supported prosthesis were randomly allocated in two equal groups to receive either implants with an external connection (EC) or implants of the same type with an internal connection (IC) (EZ Plus, MegaGen Implant, Gyeongbuk, South Korea), at four centres. Due to slight differences in implant design and components, IC implants were platformswitched while EC were not.

Evaluation of resistance against bacterial microleakage of a new conical implant-abutment connection versus conventional connections: an in vitro study.

The aim of the present in vitro study was to evaluate bacterial microleakage from inside to outside the implant-abutment assembly in a new design of internal conical connection compared to eight different internal connections. The design of this connection should prevent or limit microbiologic leakage into the surrounding implant tissue, that could contribute to infections without bone loss (mucositis) or with bone loss (peri-implantits). In order to investigate bacterial microleakage, the inner part of each system was inoculated with an Escherichia coli suspension.

Prevalence of Peri-implantitis in Medically Compromised Patients and Smokers: A Systematic Review.

Purpose: To verify whether the diversity of systemic medical conditions and smoking act as biologic associated factors for peri-implantitis.

Materials And Methods: The PICO question was: "In patients with osseointegrated dental implants, does the presence of smoking habits or a compromised medical status influence the occurrence of peri-implantitis compared with the presence of good general health?" Smoking and systemic conditions such as type 2 diabetes mellitus, cardiovascular diseases, rheumatoid arthritis, lung diseases, obesity, cancer, deep depression, and osteoporosis were screened. Selection criteria included at least 10 patients per condition, 1 year of follow-up after implant loading, and strict cutoff levels (probing pocket depth [PPD], bleeding on probing [BOP] and/or pus, marginal bone loss) to define peri-implantitis.

Dental implants with internal versus external connections: 1-year post-loading results from a pragmatic multicenter randomised controlled trial.

Purpose: To evaluate advantages and disadvantages of identical implants with internal or external connections.

Materials And Methods: Two hundred patients with any type of edentulism (single tooth, partial and total edentulism) requiring one implant-supported prosthesis were randomly allocated in two equal groups to receive either implants with an external connection (EC) or implants of the same type but with an internal connection (IC) (EZ Plus, MegaGen Implant, Gyeongbuk, South Korea) at seven centres. Due to slight differences in implant design/components, IC implants were platform switched while EC were not.

The Microbiologic Profile Associated with Peri-Implantitis in Humans: A Systematic Review.

Purpose: To qualitatively investigate the microbiologic profile in peri-implantitis by systematically reviewing the published literature on peri-implant infection.

Materials And Methods: Searches of the US National Institutes of Health free digital archives of the biomedical and life sciences journal literature (PubMed) and The Cochrane Library of the Cochrane Collaboration (CENTRAL), as well as a hand search of other literature, were conducted to identify articles potentially relevant for the review. Randomized clinical trials, prospective cohort studies, longitudinal studies, case-control studies, and cross-sectional studies in humans reporting microbiologic findings in patients with diagnosed peri-implantitis were considered eligible for this review.

Safety and effectiveness of early loaded maxillary titanium implants with a novel nanostructured calcium-incorporated surface (Xpeed): 3-year results from a pilot multicenter randomised controlled trial.

Purpose: To evaluate clinical safety and effectiveness of a novel calcium-incorporated titanium implant surface (Xpeed, MegaGen Implant Co., Gyeongbuk, South Korea).

Materials And Methods: Sixty patients were randomised to receive one to six implants in the maxilla with either calcium-incorporated (Xpeed) or control resorbable blasted media (RBM) surfaces, according to a parallel group design at two centres.

The effectiveness of a resorbable bone substitute with a resorbable membrane in the treatment of periodontal infrabony defect - A multicenter randomised controlled trial.

Purpose: To evaluate the effectiveness of a bone substitute covered with a resorbable membrane versus open flap debridement for the treatment of periodontal infrabony defects.

Materials And Methods: Ninety-seven patients with one infrabony defect, which was 3 mm or deeper and at least 2 mm wide were randomly allocated either to grafting with a bone substitute covered with a resorbable barrier (BG group) or open flap debridement (OFD group) according to a parallel group design in five European centres. Blinded outcome measures assessed tooth loss, complications, patient's satisfaction with treatment and aesthetics, changes in probing attachment levels (PAL), probing pocket depths (PPD), gingival recessions (REC), radiographic bone levels (RAD) on standardised periapical radiographs, plaque index (PI) and marginal bleeding index (MBI).

A Prospective Longitudinal Study on Implant Prosthetic Rehabilitation in Controlled HIV-Positive Patients with 1-Year Follow-Up: The Role of CD4+ Level, Smoking Habits, and Oral Hygiene.

Background: A recent study showed that implant-prosthetic rehabilitation in well-controlled HIV patients gave slightly worse results than in an healthy population, and failures were all linked to infection.

Purpose: The aim of this study was to examine the associations between the success of implant-prosthetic treatment and systemic CD4+ level, smoking habits, and oral hygiene.

Materials And Methods: This mono-centric study included HIV patients with a stable disease and good oral hygiene requiring implant rehabilitation.

Systematic review of some prosthetic risk factors for periimplantitis.

Statement Of Problem: The recent literature underlines a correlation between plaque and the development of periimplantitis but neglects the importance of the prosthetic factors.

Purpose: The purpose of this systematic review was to appraise the available literature to evaluate the role played by cement excess and misfitting components on the development of periimplantitis.

Material And Methods: An electronic search restricted to the English language was performed in PubMed, Embase, and the Cochrane Register up to September 1, 2014, based on a selected search algorithm.

Do repeated changes of abutments have any influence on the stability of peri-implant tissues? Four-month post-loading preliminary results from a multicentre randomised controlled trial.

Purpose: To evaluate the influence of at least three abutment changes against the placement of a definitive abutment, which was no longer removed, on hard and soft tissue changes, and to compare the clinical outcomes of immediate non-occlusal loading versus conventional loading.

Materials And Methods: Eighty patients requiring one single crown or one fixed partial prosthesis supported by a maximum of three implants were randomised, after implants were placed with more than 35 Ncm, according to a parallel group design to receive definitive abutments which were loaded immediately (definitive abutment or immediate loading group) or transmucosal abutments which experienced delayed loading after 3 months and were removed at least three times: 1) during the making of the impression (3 months after implant placement); 2) when checking the zirconium core of titanium abutments at single crowns or the fitting of the metal structure at prostheses supported by multiple implants; 3) at delivery of the definitive prostheses (repeated disconnection or conventional loading group). Patients were treated in four centres and each patient contributed to the study with only one prosthesis followed for 4 months after initial loading.

Implant Prosthetic Rehabilitation in Controlled HIV-Positive Patients: A Prospective Longitudinal Study with 1-Year Follow-Up.

Purpose: The clinical trial aimed to evaluate the survival of implant-prosthetic rehabilitation in controlled HIV-positive patients.

Materials And Methods: This mono-centric study included HIV patients with a stable disease, requiring implant rehabilitation, with good oral hygiene. Each patient received at least one dental implant.

The adjunctive use of light-activated disinfection (LAD) with FotoSan is ineffective in the treatment of peri-implantitis: 1-year results from a multicentre pragmatic randomised controlled trial.

Purpose: To evaluate possible benefits of the adjunctive use of light-activated disinfection (LAD) in the treatment of peri-implantitis.

Materials And Methods: A total of 80 patients with at least one implant affected by peri-implantitis defined as at least 3 mm of bone loss on baseline radiographs in the presence of signs of infection (pus exudation and/or soft tissue swelling and/or soft tissue redness) were non-surgically or surgically treated for peri-implantitis and 50% of them were randomly allocated to receive an additional LAD treatment (FotoSan) according to a parallel group design at four different centres. Only one implant per patient was considered.