March 2014, Volume 35, Issue 3
Published by AEGIS Communications
Long term analysis of osseointegrated implants in non-smoker patients with a previous history of periodontitis
This study evaluated long-term clinical and radiographic parameters of osseointegrated implants in non-smoker patients with a previous history of chronic periodontitis. A total of 54 screw-type implants with a moderately roughened surface and internal hexagonal implant–abutment connection were placed according to a two-phase protocol, and 40 reference teeth were analyzed at baseline and after 5 and 10 years. Pocket probing depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP) were analyzed. Radiographic peri-implant bone level was measured on the mesial and distal surfaces. The prevalence of peri-implantitis and the survival rate of the implants were assessed at the patient and implant levels. In implants, the CAL at 5 years was 0.3 mm higher, and at 10 years 1.2 mm higher in comparison to baseline. The corresponding data for the reference teeth were 0 mm and 0.5 mm, respectively. Multilevel testing showed statistical difference for PPD between implants and teeth over time. After 10 years, the mean mesial bone loss was 0.63 ± 0.26 mm, and the mean distal bone loss was 0.56 ± 0.25. Survival rates were 100% and 92.3% for the implants in the maxilla and the mandible, respectively.
Dental implants placed by undergraduate students: clinical outcomes and patients’/students’ perceptions
Implant dentistry in undergraduate education is predominantly theoretical or prosthetics oriented. Clinical experience with implant surgery could provide students a better understanding of alternatives for tooth replacements. This study describes an implant dentistry program for undergraduate students that included surgical implant placement. It presents the clinical outcomes of the program, patients’ satisfaction, and students’ attitudes/perceptions and reflects on barriers and problems encountered during implementation. Thirty-six students placed one implant each for a single tooth replacement after radiographic assessment and pre-surgical planning. One-stage surgery was performed under one-to-one supervision. Crowns were cemented on individual abutments 3 to 6 months later. Crestal bone loss was assessed radiographically immediately after surgery, at crown placement, and after 1 year of loading. Of the 36 implants placed in 27 patients, two (5.6%) failed prior to loading; mean bone loss from time of surgery to crown placement was 1.41 mm and remained unchanged thereafter, reflecting implant success. The authors concluded that implant placement by undergraduate students resulted in acceptable clinical outcome parameters. These findings support the further development of clinical implant education in undergraduate dental curricula.
A systematic review and meta-analysis of the effect of various laser wavelengths in the treatment of peri-implantitis
This systematic review addressed the question: “Is laser therapy as a monotherapy, or as an adjunctive therapy, an efficacious treatment modality for patients with peri-implantitis?” The PubMed database of the US National Library of medicine and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched up to June 2013, yielding 137 titles and abstracts. Narrative synthesis of the results revealed that non-surgical laser treatment with a single application of either an Er:YAG (2,940 nm) laser or a diode laser (660 nm) in combination with a phenothiazine chloride dye is efficient in controlling inflammation around treated implants for at least 6 months following intervention, while it has a mild effect on reduction in probing depth (PD) and gain in clinical attachment level (CAL). There is limited information regarding the clinical application of CO2 laser (10.6 µm) in the surgical treatment of peri-implantitis, however its use may be promising. Based on the limited currently available information, any superiority of laser treatment in comparison to conventional treatment of peri-implantitis could not be identified. It was concluded that non-surgical laser therapy may be investigated as phase I therapy for the treatment of peri-implantitis. Future research should emphasize detailed description of the specific laser characteristics and power settings in clinical studies.