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Literature Update March - April 2011

Clinical Oral Implants Research Vol. 22 No. 3 (March 2011) Vol. 22 No. 4 (April 2011)

Heitz-Mayfield LJA, Salvi GE, Botticelli D, Mombelli A, Faddy M, On Behalf of the Implant Complication

Research Group (ICRG).  Anti-infective treatment of peri-implant mucositis: a randomised controlled clinical trial. Clin Oral Implants Res 2011;22(3):237-241.

Non-surgical mechanical debridement was carried out in 29 patients with peri-implant mucositis at one

implant. The patients then received either 0.5% chlorhexidine gel (test group; 15 patients) or placebo gel (control group; 14 patients). The gel was discontinued after 4 weeks and replaced by routine oral hygiene. Clinical parameters were assessed at baseline and after 1 and 3 months. Mean bleeding on probing (BOP) and probing depth were significantly reduced in both groups after 1 month, with further significant changes up to 3 months, but there were no significant differences between the test and control groups. Complete resolution of BOP was achieved at 38% of test implants. Non-surgical debridement and oral hygiene was therefore effective in treating peri-implant mucositis, but chlorhexidine gel did not significantly enhance the results.


Bornstein MM, Balsiger R, Sendi P, von Arx T. Morphology of the nasopalatine canal and dental implant surgery: a radiographic analysis of 100 consecutive patients using limited cone-beam computed tomography. Clin Oral Implants Res 2011;22(3):295-301.

A total of 100 partially edentulous patients scheduled for CBCT imaging were enrolled. A limited field of view was selected for each CBCT image and slices were analysed with regard to characteristics and dimensions of the nasopalatine canal. Gender had a significant influence on buccal bone plate dimensions, which were greater in males. Maxillary central incisor status and time since loss of central incisors were both independently associated with buccal bone wall measurements. The results indicated decreasing values for buccal bone wall width in patients with missing central incisors and over 1 year since the loss of central incisors. The length of the nasopalatine canal also decreased with increasing age.


Alsabeeha  NHM,  Payne  AGT,  De  Silva  RK,  Thomson  WM.  Mandibular  single-implant  overdentures: preliminary results of a randomised-control trial on early loading with different implant diameters and attachment systems. Clin Oral Implants Res 2011;22(3):330-337.

Single implants were placed in the mandibular midline of 36 edentulous patients, 12 patients received regular Southern implants and ball attachments (control); 12 patients received Southern 8 mm diameter implants and ball attachments; and, 12 patients received regular Neoss implants and Locator attachments. Marginal bone loss, implant stability and implant and prosthodontic success were measured. After 1 year implant success was significantly lower for the regular Southern implants (75%) versus the wide Southern and Neoss implants (both 100%), and implant stability was also significantly lower for the regular Southern implants. Mean marginal bone loss was 0.19 ± 0.39 mm. Prosthodontic success was comparable between the groups, but more maintenance was required for the Locator and standard ball attachments. Single- implant mandibular overdentures were therefore a suitable treatment option for older edentulous patients.


Lang NP, Salvi GE, Huynh-Ba G, Ivanovski S, Donos N, Bosshardt DD.  Early osseointegration to hydrophilic and hydrophobic implant surfaces in humans. Clin Oral Implants Res 2011;22(4):349-356.

Implants (4 mm long and 2.8 mm diameter) with either an SLA or SLActive surface were placed in the

retromolar region in 49 volunteers and retrieved by trephine after 7, 14, 28 and 42 days. Bone debris was present at all surfaces, and a large fraction of the bone matrix increasingly became covered with newly formed bone. Bone formation began in the first week and increased up to 42 days. Bone-to-implant contact was more pronounced with SLActive versus SLA after 2 and 4 weeks, but no significant difference was observed after 42 days.


Bosshardt DD, Salvi GE, Huynh-Ba G, Ivanovski S, Donos N, Lang NP. The role of bone debris in early healing  adjacent  to  hydrophilic  and  hydrophobic  implant  surfaces  in  man.  Clin  Oral  Implants  Res


Implants (4 mm long and 2.8 mm diameter) with either an SLA or SLActive surface were placed in the retromolar region in 28 volunteers and retrieved by trephine after 7, 14, 28 and 42 days. All surfaces were partially coated with bone debris and new bone formation was observed after 7 days. New bone gradually increased over time while fractions of old bone, soft tissue and bone debris gradually decreased. New bone was  higher  with  SLActive  after  2  and  4  weeks,  and  the  change  in  bone  debris:soft  tissue  ratio  was significantly greater with SLActive. The bone debris:soft tissue ratio suggested that bone debris had a significant influence on the initiation of bone deposition.


Donos N, Hamlet S, Lang NP, Salvi GE, Huynh-Ba, Bosshardt DD, Ivanovski S.  Gene expression profile of osseointegration of a hydrophilic compared with a hydrophobic microrough implant surface. Clin Oral Implants Res 2011;22(4):365-372.

A total of 18 implants (4 mm long and 2.8 mm diameter) were placed in the retromolar area of nine

volunteers and retrieved by trephine after 4, 7 and 14 days. RNA microarray analysis was then performed on the tissue. No relevant gene categories were over-represented in those expressed at 4 days, but osteogenesis- and angiogenesis-related gene expression was increased with SLActive after 7 days. VEGF signalling remained up-regulated with SLActive after 14 days, while BMP signalling was up-regulated with SLA. Neurogenesis appeared to be influenced by both surfaces. The pro-osteogenic and pro-angiogenic influence of SLActive may be responsible for the osseointegration properties of the surface.


Ivanovski S, Hamlet S, Salvi GE, Huynh-Ba G, Bosshardt DD, Lang NP, Donos N.  Transcriptional profiling of osseointegration in humans. Clin Oral Implants Res 2011;22(4):373-381.

Nine SLActive implants (4 mm long and 2.8 mm diameter) were placed in the retromolar area of nine

volunteers and retrieved by trephine after 4, 7 and 14 days. RNA microarray analysis was performed to identify differences in the transcriptome. The gene expression profile at day 4 was predominantly associated with proliferation and immuno-inflammatory processes. In contrast, the predominant profile after 14 days was associated with skeletogenesis, especially skeletal system development, bone development and ossification. Most changes occurred between 7 and 14 days. Angiogenesis and neurogenesis were also predominant after 14 days. I-κB kinase/NFB kinase signalling was predominant at day 4, while TGF-β/BMP, Wnt and Notch signalling were associated with osteogenesis throughout the study.


Mardas N, D’Aiuto F, Mezzomo L, Arzoumanidi M, Donos N.  Radiographic alveolar bone changes following ridge preservation with two different biomaterials. Clin Oral Implants Res 2011;22(4):416-423.

Alveolar  ridge  preservation  was  performed  in  27  patients,  14  of  whom  were  treated  with  Straumann

BoneCeramic and a collagen membrane (test), and 13 of whom were treated with deproteinised bovine bone mineral and a collagen membrane (control). Standardized periapical x-rays were taken at baseline, tooth extraction and after 16 and 32 weeks, and levels of the alveolar bone crest recorded. Mean mesial alveolar bone height was non-significantly greater in the test group after 32 weeks, while there was no difference in mean distal bone height, and the gain in grey values from baseline to 32 weeks was similar in both groups. Similar alveolar bone changes were therefore observed with both materials.


Schropp L, Stavropoulos A, Gotfredsen E, Wenzel A. Comparison of panoramic and conventional cross- sectional tomography for preoperative selection of implant size. Clin Oral Implants Res 2011;22(4):424-


Panoramic and cross-sectional tomograms were obtained from 121 patients scheduled for single implant treatment; a metal ball was placed in the edentulous area for 70 of the Panoramic tomograms. Implants for each  respective  site  were  calculated  using  four  reference  points  and  appropriate  software,  and  four reference points for the metal ball were manually placed in those panoramic tomograms. Implant lengths and widths were then calculated and the nearest smaller implant size selected. Implant size differed in 89% of cases upon comparison between panoramic and cross-sectional tomograms; length and width differed in

69% and 66% of cases, respectively. The Straumann implant system was significantly less affected by radiographic method then the other two implant systems used.


Brown SDK, Payne AGT.  Immediately restored single implants in the aesthetic zone of the maxilla using a novel design: 1-year report. Clin Oral Implants Res 2011;22(4):444-454.

A total of 27 patients received single tapered, roughened surface implants (28) in the anterior maxilla.

Provisional screw-retained crowns were placed within 4 h and definitive crowns were placed after 8 weeks. Mean bone gain between surgery and baseline was 0.2 ± 0.75 mm, and bone gain between baseline and 1 year was 0.78 ± 2.45 mm. Mean gain in mid-buccal mucosal margin was 0.2 ± 0.44 mm. The 12° angled prosthodontic platform helped to achieve prosthodontic maintenance and aesthetics of the crowns. The success rate of the crowns was high, with few maintenance issues.



European Journal of Oral Implantology

Vol. 4 No. 1 (March 2011)

Tallarico  M,  Vaccarella  A,  Marzi  GC.   Clinical  and  radiological  outcomes  of  1-  versus  2-stage  implant

placement: 1-year results of a randomised clinical trial. Eur J Oral Implantol 2011;4(1):13-20.

Implants were immediately placed in 47 patients; 29 patients were allocated to 1-stage treatment with 38 implants and 18 patients were allocated to 2-stage treatment with 51 implants. Prosthesis, clinical and implant measurements were assessed at implant loading and after 1 year. Two implants failed in one patient in the 1-stage group versus no failures in the 2-stage group. There were no differences in analgesic consumption, pain score measurements or peri-implant bone level between the groups. The submerged technique is therefore not essential for osseointegration.


Esposito M, Pellegrino G, Pistilli R, Felice P.  Rehabilitation of posterior atrophic edentulous jaws: prostheses supported by 5 mm short implants or by longer implants in augmented bone? One-year results from a pilot randomised clinical trial. Eur J Oral Implantol 2011;4(1):21-30.

The study enrolled 15 patients with bilateral atrophic mandibles (5-7 mm above the mandibular canal) and 15 patients with atrophic maxillae (4.6 mm below maxillary sinus) at 8 mm bone thickness. Patients were randomised to receive 5 mm short implants or ≥ 10 mm long implants in augmented bone. Provisional prostheses  were  placed  after  4  months.  In  five  patients  10  mm  implants  could  not  be  placed  in  the augmented mandibles, so 7 or 8.5 mm long implants were placed instead. Two long implants and one short implant failed, but there was no significant difference in failure or complication rates. Mean bone loss was significantly less with short implants (1.0 mm versus 1.2 mm). Short implants therefore achieve similar results to longer length implants and may be preferable to bone augmentation.


Karaky AEA, Sawair FA, Al-Karadsheh OA, Eimer HA, Algarugly SA, Baqain ZA.  Antibiotic prophylaxis and early dental implant failure: a quasi-random controlled clinical trial. Eur J Oral Implantol 2011;4(1):31-38.

A total of 270 patients treated with dental implants were allocated to one of three antibiotic groups: single

preoperative dose of 2 g amoxicillin (group A); 2 g amoxicillin followed by 500 mg amoxicillin three times/day for 5 days (group B); postoperative amoxicillin with clauvanic acid three times/day for 5 days (group C). Pain, wound  infection,  adverse  event  and  early  implant  failure  were  evaluated.  A  total  of  73  patients  (210 implants), 79 patients (266 implants and 88 patients (290 implants) in groups A, B and C, respectively, adhered to the protocol. Early implant failure rates were 16.4%, 13.9% and 14.8% in groups A, B and C, respectively; the differences were not significant. Postoperative antibiotics may therefore not be necessary.


Cavalcanti R, Oreglia F, Manfredonia MF, Gianserra R, Esposito M.  The influence of smoking on the survival of dental implants: a 5-year pragmatic multicentre retrospective cohort study of 1727 patients. Eur J Oral Implantol 2011;4(1):39-45.

A total of 1727 patients were enrolled at four centres; 549 were smokers and 1178 were non-smokers.

Smokers received a total of 2260 implants and 1292 prostheses non-smokers received a total of 4460 implants and 2583 prostheses. After 5 years, 250 patients (91 smokers and 159 non-smokers) were lost to follow-up. There were 107 implant failures (5.5%) in 75 smokers and 112 implant failures (2.9%) in 105 non- smokers; 90% of failures occurred before implant loading. According to logistic regression, there were no significant differences in prosthesis or early implant failures between the groups, but there were significantly more total failures in smokers versus non-smokers.


Maló P, de Araújo Nobre M, Lopes A.  Short implants in posterior jaws. A prospective 1-year study. Eur J Oral Implantol 2011;4(1):47-53.

A total of 127 patients received 217 short implants (7 mm) to support 165 prostheses. Final prostheses were

generally delivered after 6 months. Three patients (five implants) were lost to follow-up and 10 implants failed in six patients, giving a success rate of 95%. Mean peri-implant marginal bone resorption after 1 year was

1.27 ± 0.67 mm. Good success rates were therefore achieved, indicating that 7 mm short implants may be a viable treatment alternative.



Implant Dentistry

Vol. 20 No. 1 (February 2011)

Simonpieri A, Choukroun J, Del Corso M, Sammartino G, Ehrenfest DMD. Simultaneous sinus-lift and implantation using microthreaded implants and leukocyte- and platelet-rich fibrin as sole grafting material: a

six-year experience. Implant Dent 2011;20(1):2-12.

A total of 20 patients received 23 lateral sinus elevations with simultaneous implant placement with Astra Tech implants (19 implants in seven patients) or Intra-Lock implants (33 implants in 13 patients). Leukocyte and  platelet-rich  fibrin  (L-PRF)  membranes  were  used  to  cover  the  Schneiderian  membrane  and  the subsinus cavity was filled up with L-PRF clots. All implants were clinically stable after 6 months. The minimum follow-up time was 2 years and the maximum was 6 years. No implants were lost and substantial vertical bone gain (mean 10.4 ± 1.2 mm) was achieved. L-PRF was therefore a suitable filling material and may be a reliable option.



International Journal of Oral and Maxillofacial Implants

Vol. 26 No. 1 (January/February 2011)

Strietzel FP, Karmon B, Lorean A, Fischer PP.  Implant-prosthetic rehabilitation of the edentulous maxilla and mandible with immediately loaded implants: preliminary data from a retrospective study, considering time of

implantation. Int J Oral Maxillofac Implants 2011;26(1):139-147.

A total of 25 patients with 283 immediately loaded implants were retrospectively evaluated. Various parameters were assessed, including clinical and radiographic status of peri-implant soft and hard tissue, and prosthesis function. For a maximum observation period of 120 months, the implant survival rate was

99.6% (one implant failure), while the implant and patient success rates were 98.2% and 88%, respectively. The implant site or time of placement were not associated with lack of success, but there was a significant association between success and implant length ≤ 10 mm. Immediate loading in the edentulous maxilla or mandible is therefore a reliable treatment option.


Wolfinger GJ, Balshi TJ, Wulc DA, Balshi SF.  A retrospective analysis of 125 single molar crowns supported by two implants: long-term follow-up from 3 to 12 years. Int J Oral Maxillofac Implants 2011;26(1):148-153. A total of 105 patients who received 250 implants in 125 molar sites were retrospectively evaluated; patients with a follow-up time from 3 to 12 years were selected. There were five failures, giving a cumulative survival rate of 98%. Porcelain fracture occurred in 5.6%, prosthetic screw loosening occurred in 5.6% and there was one abutment screw loosening. The placement of two implants to support a single molar crown appears to reduce rotational forces that can create stress on a single implant. The technique also demonstrated fewer complications than single implant-supported molar crowns.


Conrad HJ, Jung J, Barczak M, Basu S, Seong W-J.  Retrospective cohort study of the predictors of implant failure in the posterior maxilla. Int J Oral Maxillofac Implants 2011;26(1):154-162.

Patients  who  received  504  maxillary  posterior  implants  were  retrospectively  evaluated  according  to

continuous and categorical variables. For a mean follow-up period of 35.7 months, the overall survival rate was 93.2%. Age of the patient at implant surgery and time between tooth extraction and implant surgery were significantly associated with implant failure. Categorical variables associated with implant failure were ASA status, implant proximity, residual bone crest height, implant diameter, sinus augmentation technique and sinus graft material. Implants placed in inadequate crestal bone requiring sinus augmentation were significantly associated with implant failure.


Sohn D-S, Bae M-S, Heo J-U, Park J-S, Yea S-H, Romanos GE. Retrospective multicenter analysis of immediate provisionalization using one-piece narrow-diameter (3.0-mm) implants. Int J Oral Maxillofac Implants 2011;26(1):163-168.

Thirty-six  patients  treated  with  62  one-piece  narrow  implants  to  support  maxillary  (8  implants)  and

mandibular (54 implants) incisors were retrospectively evaluated. Definitive prostheses were placed after 3 months in the mandible and after 5 months in the maxilla; these were fixed partial prostheses (44 implants) or single crowns (18 implants). For a follow-up period of up to 33 months, the implant survival rate was 100% and the mean marginal bone loss at 12 months was 0.53 ± 0.37 mm. One-piece narrow diameter implants supporting maxillary or mandibular incisors are therefore a reliable treatment option.


Pieri F, Aldini NN, Marchetti C, Corinaldesi G.  Influence of implant-abutment interface design on bone and soft tissue levels around immediately placed and restored single-tooth implants: a randomized controlled clinical trial. Int J Oral Maxillofac Implants 2011;26(1):169-178.

The study enrolled 40 patients requiring single maxillary premolar replacement. Implants were immediately placed and restored after tooth extraction, either with platform-switched (test) or matching diameter (control) abutments. Provisional crowns were placed within 24 hours and definitive crowns were placed after 4 months. Periodontal, clinical and radiographic parameters were measured after 4 and 12 months. there was one implant failure in the control group and none in the test group. No significant differences were observed between the groups for periodontal parameters, soft tissue level or papilla height, but marginal bone loss was significantly greater in the control group.


Kan JYK, Rungcharassaeng K, Lozada JL, Zimmerman G.  Facial gingival tissue stability following immediate placement and provisionalization of maxillary anterior single implants: a 2- to 8-year follow-up. Int J Oral Maxillofac Implants 2011;26(1):179-187.

In 35 patients who received immediately placed and provisionalised implants in the aesthetic zone, clinical

and radiographic parameters were evaluated at pre-surgery, immediately after provisionalisation, 1-year post-surgery and at the latest follow-up. The mean follow-up time was 4 years, and all implants were still in place. Marginal bone level changes were significantly greater after the latest follow-up compared to after 1 year, but the mean papilla level changes were significantly smaller after the latest follow-up compared to after 1 year. Smaller changes in facial gingival levels were observed where there was a thick gingival biotype. The procedure therefore led to favourable success rates and tissue level responses.


Akoglu B, Uçankale M, Özkan Y, Kulak-Özkan Y.  Five-year treatment outcomes with three brands of implants supporting mandibular overdentures. Int J Oral Maxillofac Implants 2011;26(1):188-194.

Each of 36 patients received two implants in the intraforaminal region; the implant systems used were

Straumann, Zimmer Dental SwissPlus and Astra Tech (24 of each). Implants were loaded following osseointegration, and clinical, radiographic and patient satisfaction parameters were assessed. There were no implant failures, but probing depth values were significantly higher for Astra implants than the other groups, and the mean marginal bone loss was significantly lower for Straumann implants than for the other groups. Mandibular denture fracture and dislodged female attachments were the most common prosthetic complications.


Lópey-Cedrún  JL.   Implant  rehabilitation  of  the  edentulous  posterior  atrophic  mandible:  the  sandwich osteotomy revisited. Int J Oral Maxillofac Implants 2011;26(1):195-202.

Retrospective data were analysed from 23 patients with 30 sites of posterior mandibular atrophy treated with

sandwich osteotomy and a block of autologous or allogeneic bone. Mean gain in bone height was 5.3 mm and the follow-up time ranged from 12 to 93 months. A total of 65 implants were placed, with implants ≥ 10 mm placed in 90.8% of sites. Interpositional sandwich osteotomy is therefore a successful technique for the treatment of moderate to severe posterior mandibular atrophy.


International Journal of Periodontics and Restorative Dentistry

Vol. 31 No. 1 (January/February 2011)

Grunder U.  Crestal ridge width changes when placing implants at the time of tooth extraction with and

without soft tissue augmentation after a healing period of 6 months: report of 24 consecutive cases. Int J Oral Periodontics Restorative Dent 2011;31(1):9-17.

Implants were placed in the anterior maxilla of 24 patients at the time of tooth extraction; in 12 patients a

subepithelial tissue graft was placed using the tunnel technique, and 12 patients were treated without raising a flap. In the non-grafted group, a mean loss of labial volume of 1.063 mm was observed, compared to a gain of 0.34 mm in the grafted group. A soft tissue graft at the time of immediate implant placement is therefore an effective technique.


Di Felice R, D’Amario M, De Dominicis A, Garocchio S, D’Arcangelo C, Giannoni M.  Immediate placement of

Bone Level Straumann implants: a case series. Int J Oral Periodontics Restorative Dent 2011;31(1):57-


Successful immediate implant placement in fresh extraction sites has been demonstrated, together with early loading. Immediate placement in the maxilla or mandible and early loading with Straumann Bone Level implants with the SLActive surface was evaluated in this study.



Journal of Clinical Periodontology

Vol. 38 No. 3 (March 2011) Vol. 38 No.4 (April 2011)

Koldsland OD, Scheie AA, Aass AM.  The association between selected risk indicators and severity of peri-

implantitis using mixed model analyses. J Clin Periodontol 2011;38(3):285-292.

Clinical and radiographic examination was performed in 109 patients. The mean time of implants in function was 8.4 years. The relationship between possible risk indicators and detectable peri-implantitis and overt peri-implantitis was then assessed. Location in the maxilla was identified as a risk factor for detectable peri- implantitis, while male gender and history of periodontitis were identified as risk factors for overt peri- implantitis.


Gallucci GO, Grütter L, Chuang S-K, Belser UC.  Dimensional changes of peri-implant soft tissue over 2 years with single-implant crowns in the anterior maxilla. J Clin Periodontol 2011;38(3):293-299.

A total of 20 patients received single implants in the anterior maxilla with either all-ceramic or porcelain-

fused-to-metal crowns. Clinical parameters were evaluated at baseline, crown placement, 1 year and 2 years. No significant differences were observed for distance from implant shoulder to marginal peri-implant mucosa (DIM), papilla height (PH), keratinized mucosa (KM), crestal bone level (CBL), plaque score (PS) or bleeding score (BS), with the exception of distal CBL to the adjacent tooth. Mid-facial DIM increased to crown placement and remained stable thereafter, while mesial and distal DIM significantly increased to crown placement and showed stability after 2 years.


Cortellini P, Tonetti MS. Clinical and radiographic outcomes of the modified minimally invasive surgical technique with and without regenerative materials: a randomized-controlled trial in intra-bony defects. J Clin Periodontol 2011;38(4):365-373.

Isolated intra-bony defects in each of 45 patients were accessed using a modified minimally invasive surgical

technique (M-MIST) and assigned to three groups: M-MIST alone or in combination with EMD or EMD plus bone mineral-derived xenograft. Differences in probing depth reduction, clinical attachment level gain and bone fill were significant between baseline and 1 year. Radiographic bone fill of the intrabony component was similar in the three groups, indicating that M-MIST resulted in significant improvements.


Enkling N, Jöhren P, Klimberg T, Mericske-Stern R, Jervøe-Strom-P-M, Bayer S, Gülden N, Jepsen S.  Open or submerged healing of implants with platform switching: a randomized, controlled clinical trial. J Clin Periodontol 2011;38(4):374-384.

Each of 21 patients received two platform-switched implants, assigned to either open or submerged healing.

Radiographs were taken at implant surgery, before re-entry, after crown mounting and 1 and 2 years post- surgery. Implant-bone-level changes were assessed and bacterial samples from the inner cavities of the implants were analysed. Mean implant-bone-level changes were -0.47 ± 0.46 mm and -0.54 ± 0.38 mm for open and submerged healing, respectively, after 2 years, with no significant differences between the groups at any time point. Bacterial contamination was significantly dependent on time but not healing mode.


Raes F, Cosyn J, Crommelinck E, Coessens P, De Bruyn H. Immediate and conventional single implant treatment in the anterior maxilla: 1-year results of a case series on hard and soft tissue response and aesthetics. J Clin Periodontol 2011;38(4):385-394.

Immediate implant surgery was performed (either with a flap or flapless procedure) in 16 patients and conventional implant surgery /with standard flap elevation) was performed in 23 patients. Cemented acrylic crowns were used for all implants. Aesthetic outcomes were evaluated after 1 year. One implant failed in the immediate group. Mean bone level after 1 year from the implant-abutment interface was 0.85 mm and 0.65 mm for immediate and conventional implants, respectively. A small loss of distal papillae was observed in the conventional group, with a tendency for re-growth. In the immediate group, midfacial soft tissue remained stable over time. Midfacial recession was significantly reduced with flapless surgery. Acceptable aesthetics were observed in 68%, while 8% showed an almost perfect outcome and 24% were aesthetic failures.



Journal of Oral Implantology

Vol. 37 No. 1 (February 2011)

Romanos GE, Froum S, Costa-Martins S, Meitner S, Tarnow DP.  Implant periapical lesions: etiology and

treatment options. J Oral Implantol 2011;37(1):53-63.

Several symptoms have been reported and several aetiologies proposed for implant periapical lesions. Implant periapical lesions reported in the literature are reviewed and possible treatment options presented, based on diagnosis, cause of tooth extraction, location, time of implant placement, implant surface and treatment approach. The topics discussed in this review include the implant surface, excessive implant torque, poor bone quality, cortical bone perforation or thinning, excessive load and implant placement in infected maxillary sinus. The authors suggest that areas around endodontically compromised teeth should be evaluated carefully before implant placement.


Journal of Periodontology

Vol. 82 No. 2 (February 2011) Vol. 82 No. 3 (March 2011)

Barone A, Orlando B, Tonelli P, Covani U.  Survival rate for implants placed in the posterior maxilla with and

without sinus augmentation: a comparative cohort study. J Periodontol 2011;82(2):219-226.

A total of 105 patients requiring implants in the posterior maxilla were enrolled; sinus augmentation were performed according to the two-stage technique where required. A total of 393 implants were placed, 201 of which were placed after preliminary sinus grafting in 41 patients, while 192 implants were placed in pristine bone in 64 patients (control). The implant survival rate was significantly greater for implants placed in pristine bone (96.4% versus 86.1%).


Koutouzis T, Fetner M, Fetner A, Lundgren T. Retrospective evaluation of crestal bone changes around implants with reduced abutment diameter placed non-submerged and at subcrestal positions: the effect of bone grafting at implant placement. J Periodontol 2011;82(2):234-242.

Records were retrospectively reviewed for 50 patients with dental implants placed with a xenograft and 50 patients with dental implants placed without graft material. The degree of subcrestal positioning, changes in hard tissue height and detection of hard tissue on the implant platform were evaluated. No significant differences in mean marginal hard tissue loss was observed between the groups (0.11 ± 0.30 mm and 0.08 ±

0.22 mm for the grafted and non-grafted groups, respectively). Hard tissue on the implant platform was detected at 69% of the grafted implants and 77% of then non-grafted implants. Grafting of the remaining osseous defect therefore had no significant influence.


Buser D, Wittneben J, Bornstein MM, Grütter L, Chappuis V, Belser UC.  Stability of contour augmentation and  esthetic  outcomes  of  implant-supported  single  crowns  in  the  esthetic  zone:  3-year  results  of  a prospective study with early implant placement postextraction. J Periodontol 2011;82(3):342-349.

A total of 20 patients received implant-supported crowns in the aesthetic zone, and clinical radiologic and aesthetic parameters were recorded for 3 years follow-up. All implants were successfully osseointegrated and stable, with good peri-implant soft tissues after 3 years. Good results were obtained for the pink and white aesthetic scores, with white aesthetic scores being slightly superior. Mean crestal bone loss was 0.18 mm after 3 years; bone loss from 0.5 to 1.0 mm was observed at only two implants, one of which showed minor recession of the facial mucosa (< 1 mm).

Borges FL, Dias RO, Piattelli A, Onuma T, Cardoso LAG, Salomão M, Scarano A, Ayub E, Shibli JA. Simultaneous sinus membrane elevation and dental implant placement without bone graft: a 6-month follow- up study. J Periodontol 2011;82(3):403-412.

In 15 patients, bilateral sinus membrane elevation and simultaneous implant placement was performed, either with autogenous bone graft (control) or without graft material (test). Abutments were placed after 6 months and implant stability, bone gain and implant protrusion into the sinus were recorded. One implant was lost in the test group, giving implant success rates of 96.4% and 100% for the test and control groups, respectively. Radiographic new bone was observed, with no significant difference between the groups. Resonance frequency (implant stability) was significantly lower for control compared to baseline, but the values were similar after 6 months. There was a significant positive correlation between protruded implant/bone length and implant survival/sinusitis.


Aykol G, Baser U, Maden I, Kazak Z, Onan U, Tanrikulu-Kucuk S, Ademoglu E, Issever H, Yalcin F.  The effect  of  low-level  laser  therapy  as  an  adjunct  to  non-surgical  periodontal  treatment.  J  Periodontol


Non-surgical periodontal therapy was performed in 36 patients, half of whom also received adjunctive low- level laser therapy on the first, second and seventh days (test group). The test and control groups were also divided according to smokers and non-smokers. Gingival crevicular fluid samples and clinical parameters were assessed in all patients at baseline and after 1, 3 and 6 months. Sulcus bleeding, clinical attachment level and probing depth improvements were significantly greater in the laser group versus the control group, and significant improvements were seen in smokers versus non-smokers. There was a significant decrease in TGF-β1 levels and ratio of MMP-1 to tissue inhibitor MMP-1 in both groups at all time points, while bFGF levels decreased in the first month and increased thereafter. No significant differences were found between the groups.


Quintessence International

Vol. 42 No. 2 (February 2011) Vol. 42 No. 3 (March 2011) Vol. 42 No. 4 (April 2011)

Bachhav  VC,  Aras  MA.   Zirconia-based  fixed  partial  dentures:  a  clinical  review.  Quintessence  Int


Y-TZP has recently been added to the ceramics used in all-ceramic restoration systems, crowns and FPDs, and has especially been used in aesthetic and stress-bearing areas due to its physical properties, biocompatibility and aesthetic outcomes. Such systems have therefore been considered as alternatives to metal-ceramic restorations. The relevant features are discussed in this review, with an emphasis on clinical survival and recommendations for use.


Eccellente T, Piombino M, Piattelli A, D’Alimonte E, Perrotti V, Iezzi G.  Immediate loading of dental implants in the edentulous maxilla. Quintessence Int 2011;42(2):281-289.

In 45 patients with an edentulous maxilla, 180 implants were placed to support removable prostheses on

prefabricated conical crowns in the denture base supported by conical implant abutments immediately after surgery During the observation period, two implants were removed due to lack of osseointegration, one was removed due to peri-implantitis and one was removed due to fracture: the implant and prosthesis survival rates were 97.7% and 100%, respectively. Healthy peri-implant tissue was observed in all cases after a mean observation period of 26.7 months. The method was therefore shown to be suitable for rehabilitation of the edentulous maxilla.


Vered Y, Zini A, Mann J, Kolog H, Steinberg D, Zambon JJ, Haraszthy VI, DeVizio W, Sreenivasan P.  Teeth and   implant   surroundings:   clinical   health   indices   and   biological   parameters.   Quintessence   Int


Clinical and microbiological assessments of implants and contralateral natural teeth were performed in 83 patients and compared. Results showed that the plaque score and total bacterial cell count were significantly higher at teeth than implants; significantly higher number so of oral bacteria, both aerobic and anaerobic, were also observed in the plaque samples from natural teeth. For both teeth and implants, the numbers of anaerobic bacteria were significantly higher than the number of aerobic bacteria.


Jaiswal  G,  Deo  V,  Bhongade  M,  Jaiswal  S.   Serum  alkaline  phosphatase:  a  potential  marker  in  the progression of periodontal disease in cirrhosis patients. Quintessence Int 2011;42(2):345-348.

Oral health index, gingival index and clinical attachment level were assessed in 30 patients with liver

cirrhosis  and  with  or  without  periodontitis.  Alveolar  bone  height  and  alkaline  phosphatase  were  also assessed. Alveolar bone loss, mean clinical attachment level and serum alkaline phosphatase were all significantly greater in the periodontitis group. Bone loss, clinical attachment level and serum alkaline phosphatase were also significantly higher in older cirrhosis patients. A strong correlation was therefore suggested between periodontal breakdown and serum alkaline phosphatase in patients with liver cirrhosis.

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