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Literature Update Nov - Dec 2011

Clinical Implant Dentistry and Related Research

Vol. 13 No. 4 (December 2011)

Stoker GT, Wismeijer D.  

Immediate loading of two implants with a mandibular implant-retained overdenture:



a new treatment protocol.



Clin Implant Dent Relat Res 2011;13(4):255-261.


Immediate loading of two bar-splinted SLActive implants with a mandibular overdenture (converted from a conventional denture) was performed in 124 edentulous patients. Resonance frequency analysis (RFA) was performed during the evaluation period to assess implant stability. For an evaluation period of 12-40 months, the implant survival rate was 98.8%; three implants were lost. A significant increase in implant stability was observed during the osseointegration period. Mandibular overdenture relining was necessary in 3% of patients, while 11% of patients required relining of the opposite maxillary denture. Loading of SLActive implants with a mandibular overdenture on the day of implant placement can therefore be successful.



Nissan J, Ghelfan O, Mardinger O, Calderon S, Chaushu G.

Efficacy of cancellous block allograft


augmentation prior to implant placement in the posterior atrophic mandible.




Clin Implant Dent Relat Res





A total of 21 patients with a bony deficiency of at least 3 mm received 29 cancellous allogeneic block grafts;


85 implants were placed after 6 months of healing. After a mean follow-up of 37 months, mean bone block survival was 79.3% and implant survival was 95.3%. Mean bone gains were 5.6 mm horizontally and 4.3 mm vertically. At implant placement, mean bone thickness buccal to the implant neck was 2.5 mm, reducing slightly to 2.3 mm at second-stage surgery. No vertical bone loss was apparent between implant placement


and second-stage surgery. Implant placement following cancellous block allograft was therefore considered to be a suitable treatment.



Cosyn J, Van Aelst L, Collaert B, Persson GR, De Bruyn H.  

The peri-implant sulcus compared with internal




implant  and  suprastructure  components:  a  microbiological  analysis.  Clin  Implant  Dent  Relat  Res





A total of 58 implants placed in the maxillae of eight patients and loaded with screw-retained full-arch prostheses were examined after a mean 9.6 years of loading. Microbiological analysis was performed on gingival fluid samples collected from the peri-implant sulcus, the cotton pellets in the intra-coronal compartment and the abutment screws. Bacterial frequencies and levels were similar between the cotton pellets and the peri-implant sulcus, despite no microbial link between the compartments. However, frequencies and levels were lower for the abutment screws. A high prevalence of numerous species was observed in the peri-implant sulcus, despite no clinical signs of peri-implantitis. The results indicated that the restorative margin was possibly the main pathway for bacterial leakage.



Calandriello R, Tomatis M.  

Immediate occlusal loading of single lower molars using Brånemark System Wide


Platform TiUnite implants: a 5-year follow-up report of a prospective clinical multicenter study.




Clin Implant Dent Relat Res 2011;13(4):311-318.


A total of  33 patients consecutively treated with 40 implants to replace single mandibular molars and


monitored for up to 5 years were evaluated. All implants were immediately loaded in full occlusion at the time of surgery. The cumulative implant success rate was 95.0% (two implants failed) and marginal bone loss was


-1.17 ± 0.90 mm after 5 years. The results indicated that the use of immediately loaded single molar implants was suitable.



Lee D-H, Choi B-H, Jeong S-M, Xuan F, Kim H-R.  

Effects of flapless implant surgery on soft tissue profiles: a


prospective clinical study.




Clin Implant Dent Relat Res 2011;13(4):324-329.


A flapless implant procedure was used to place 76 implants in 44 patients. Marginal peri-implant soft tissue level was measured at 1 week, 1 month and 4 months. The results indicated a mean 0.7 ± 0.3 mm of coronal


soft tissue growth 1 week after surgery, with levels of 0.2 ± 0.2 mm and 0.0 ± 0.3 mm after 1 and 4 months. After 4 months, soft tissue profiles were similar to those immediately before implant placement. Flapless implant surgery can therefore help to maintain the mucosal form around implants.



Clinical Oral Implants Research

Vol. 22 No. 11 (November 2011)



Vol. 22 No. 12 (December 2011)

Serino G, Turri A.  

Outcome of surgical treatment of peri-implantitis: results from a 2-year prospective clinical


study in humans.


Clin Oral Implants Res 2011;22(11):1214-1220.

In 31 patients with signs of peri-implantitis, a surgical procedure based on pocket elimination was performed, with bone contouring and plaque control before and after surgery. Bone loss at implants was recorded at surgery. After 2 years, no signs of peri-implant disease were observed in 48% of subjects, while 77% had no implants with a probing depth ≥ 6 mm associated with bleeding or suppuration. Of 86 implants with an initial diagnosis of peri-implantitis, 42% still showed peri-implant disease after treatment. Peri-implant health was more prevalent at implants with minor initial bone loss (2-4 mm) than those with ≥ 5 mm bone loss, and of 18 implants with ≥ 7 mm bone loss, seven were extracted. The surgical therapy was therefore effective in the majority of subjects, but complete resolution appeared to be dependent on the initial bone loss.


Hatano  N,  Yamaguchi  M,  Yaita  T,  Ishibashi  T,  Sennerby L.  

New  approach  for  immediate  prosthetic

rehabilitation of the edentulous mandible with three implants: a retrospective study.


Clin Oral Implants Res



A retrospective analysis was performed in 132 patients who received 396 implants with both machined and oxidized surfaces over an 11-year period. All implants were immediately loaded with a permanent acrylic bridge. The mean follow-up time was 5 years. The implant survival rate was 96.7% for implants and 92.4% for bridges; all implant failures occurred within the first 12 months, and the failure rate was greater for machined surface implants (7% versus 1.2% for oxidized implants). Immediate loading of a fixed bridge on three implants in the mandible is therefore a viable treatment option.


Fromentin O, Lassauzay C, Abi Nader S, Feine J, de Albuquerque RF.

Clinical wear of overdenture ball

attachments after 1, 3 and 8 years.



Clin Oral Implants Res 2011;22(11):1270-1274.

Three groups of ball abutments (69 in total) that were in use for a mean of 12.3, 39 or 95.6 months (groups A, B and C, respectively) in 35 patients were analyzed versus a control group of 10 unused ball abutments. The diameters of the abutments in all three groups were significantly different from those in the control group. Diameters and variations in circularity were not significantly different between abutments in groups B and C. The maximum reduction in diameter was 30 μm, and 90% diameter loss due to wear at the equator was observed in group B. Clinical wear therefore significantly reduced ball abutment diameter, and the maximum wear was found after 3 years.


den Hartog L, Meijer HJA, Stegenga B, Tymstra N, Vissink A, Raghoebar GM.  

Single implants with different

neck designs in the aesthetic zone: a randomized clinical trial.


Clin Oral Implants Res 2011;22(11):1289-



Missing maxillary anterior teeth in 93 patients were replaced using implants with a 1.5 mm smooth neck, moderately rough neck with grooves, or a scalloped moderately rough neck with grooves. The implants were loaded after 3 months and evaluated 6 and 18 months after placement. Significantly greater bone loss was observed in the scalloped group (2.01 ± 0.77 mm) compared to the other two groups (1.19 ± 0.82 mm and

0.9 ± 0.57 mm for the smooth and rough groups, respectively), and significantly greater pocket depths and higher bleeding scores were also observed for the scalloped group. No differences were found for soft tissue levels between the groups. Implant survival rates were 100% for the rough and scalloped implants and 97% for the smooth implants. The scalloped implants therefore showed more marginal bone loss and less favorable clinical outcomes.


Degidi M, Nardi D, Piattelli A.  

One abutment at a time: non-removal of an immediate abutment and its effect

on bone healing around subcrestal tapered implants.



Clin Oral Implants Res 2011;22(11):1303-1307.

Two 3.5 mm diameter tapered implants were placed in each of 24 patients with partial posterior mandibular edentulism  and  immediately  restored  with  a  temporary  restoration  out  of  occlusion.  After  24  weeks, abutments were removed and impressions taken on the implant platform (control; 12 patients) or impressions

were made of the abutments using snap-on copies (test; 12 patients). Final restorations were placed after 6 months, and bone changes were observed after surgery and at 6, 12, 24 and 36 months. No differences in vertical bone healing were observed between the two groups, but there was a small, significant horizontal bone loss in the hard tissue portion over the implant platform between 6 and 12 months in the control group. Non-removal of the immediate abutments therefore reduced horizontal bone remodeling.

Ekfeldt A, Fürst B, Carlsson GE.  

Zirconia abutments for single-tooth implant restorations: a retrospective and

clinical follow-up study.


Clin Oral Implants Res 2011;22(11):1308-1314.

A retrospective evaluation of 185 implants with zirconia abutments in 130 patients was carried out, followed by a clinical examination of 40 restorations with zirconia abutments in place for > 3 years in 25 patients. Restorations were either cemented all-ceramic crowns or screw-retained one-piece restorations. Technical and biological complications were low in both evaluations, and no fractures of all-ceramic crowns were observed. In the clinical examination, no significant differences were observed for soft tissue registrations or marginal bone level between two-piece and one-piece restorations. Good results were therefore obtained for zirconia abutments for single implant crowns.


Vere  J,  Joshi  R.  

Quality  assessment  of  randomised  controlled  trials  of  dental  implant  surgery  and



prosthodontics   published   from   2004   to   2008:   a   systematic   review.   Clin   Oral   Implants   Res



From an initial Medline search of randomized controlled trials of treatment interventions of implant surgery and prosthodontics, a total of 38 met the inclusion criteria. Outcome assessment was blinded in 12 trials (31%), randomization was adequate in 16 trials (42%) and allocation concealment was adequate in seven trials (18%). Only two trials (5%) reported confidence intervals, and a total of 17 different statistical assessments were used in the 38 trials, although inferential statistical analysis was considered appropriate in only 22 trials (57%). Randomized trials in implant surgery and prosthodontics in the time frame examined are therefore poorly reported and provide little unbiased evidence to support clinical decisions.


Mertens C, Steveling HG.  

Early and immediate loading of titanium implants with fluoride-modified surfaces:


results of 5-year prospective study.


Clin Oral Implants Res 2011;22(12):1354-1360.

A total of 49 implants were placed in the maxillae and mandibles of 17 patients and loaded either immediately or after a mean of 9.56 weeks. Full follow-up after 5 years was possible in 15 patients with 42 implants. The implant survival rate was 97% (one implant failure), while the mean bone loss was 0.1 ± 0.4 mm, with no significant difference between implants loaded immediately or after a mean of 9.56 weeks. Healthy peri- implant soft tissue was observed in the majority of cases, with plaque in 6.2% of cases and signs of inflammation in 4.2% of cases. High success and survival reates were therefore observed after 5 years.


Vilhjálmsson V, Klock KS, Størksen K, Bårdsen A.  

Aesthetics of implant-supported single anterior maxillary


 c r owns    evaluated    by    obj ec tive    indic es    and    par tic ipants ’    per c eptions .    Clin   Oral   Implants   Res



This study evaluated 50 subjects with implant-supported crowns to replace upper anterior teeth. Evaluation was performed using the pink esthetic score (PES), implant crown esthetics index (ICAI), modified ICAI and the Californian Dental Association (CDA) index. Satisfaction with crowns and adjacent soft tissue were rated by the participants. Crown form, color and adjacent mucosa were satisfactory for 88%, 84% and 72% of participants, respectively. There was a significant correlation between PES and ICAI and modified ICAI, and there was a significant correlation between the modified ICAI and satisfaction with crown form and color, and between the sum of participants’ responses to questions about crown form and color and adjacent mucosa form and color. Good aesthetic outcomes were therefore obtained.


Calvo-Guirado JL, Gómez-Moreno G, López-Mari L, Guardia J, Negri B, Martínez-González JM.  

Crestal bone


loss  evaluation  in  Osseotite  expanded  platform  implants:  a  5-year  study.  Clin  Oral  Implants  Res



A total of 64 platform-switched implants were placed in fresh extraction sockets in the maxillae of 64 patients, with immediate provisional restorations and final screwed restorations after 15 days. Primary stability was recorded, and mesial and distal bone heights were measured after 1, 3 6, 9, 12, 24 and 36 and 60 months. Mean mesial and distal bone loss was 0.08 ± 0.42 mm and 0.14 ± 0.56 mm, and the mean implant stability, as measured by resonance frequency analysis, was 72.5 ± 3.1. The overall survival rate was 97.1%.

Rismanchian M, Fazel A, Rakhshan V, Eblaghian G. One-year clinical and radiographic assessment of

fluoride-enhanced implants on immediate non-functional loading in posterior maxilla and mandible: a pilot

prospective clinical series study.



Clin Oral Implants Res 2011;22(12):1440-1445.

Implants were placed in the posterior maxillae and mandibles of 10 patients. Temporary prostheses were placed out of occlusion and replaced with permanent prostheses after 13 weeks. Implant stability and clinical and radiographic evaluations were performed at placement and after 3, 6 and 12 months. All implants survived and there was no significant change in plaque or bleeding indices or pocket probing depth over time; however, there was a significant increase in implant stability between implant placement and 1 year. Mean crestal bone loss was 0.4 ± 0.55 mm, 0.48 ± 0.37 mm and 0.48 ± 0.21 mm at 3, 6 and 12 months, respectively; the change was not significant.



European Journal of Oral Implantology
Vol. 4 No. 3 (October 2011)

Cannizzaro G, Felice P, Leone M, Checci V, Esposito M.  Flapless versus open flap implant surgery in partially

edentulous patients subjected to immediate loading: 1-year results from a split-mouth randomised controlled


Eur J Oral Implantol 2011;4(3):177-188.

Implants were placed in a split-mouth design in 40 patients either with or without flap elevation (67 and 76 implants, respectively). Single crowns or metal-ceramic FPDs were placed after 2 months. Four flaps were raised in the flapless group to control bur direction, and one hemorrhage and one buccal bone fracture occurred in the raised flap group. Primary stability was not reached for four implants, which were immediately replaced  by implants  with  a  larger  diameter. There  were  two  implant failures  in  each  group,  and  no differences in complications, ISQ values, marginal bone levels or prosthetic failures between the groups; however, operation time was significantly lower in the flapless group, and the procedure was associated with less pain, swelling and analgesic consumption, and was the procedure preferred by patients.


Felice P, Soardi E, Pellegrino G, Pistilli R, Marchetti C, Gessaroli M, Esposito M.  Treatment of the atrophic

edentulous maxilla: short implants versus bone augmentation for placing longer implants. Five months post-

loading results of a pilot randomised controlled trial.



Eur J Oral Implantol 2011;4(3):191-202.

Each of 28 patients with atrophic edentulous maxillae received either 4-8 short implants (15 patients) or autogenous bone grafting for the placement of 11.5 mm implants (13 patients). Acrylic prostheses or bar- retained overdentures were placed after 4 months, and patients were followed up for 5 months after loading. One sinus lift procedure failed, although short implants could still be placed. Two implant failures occurred in the short implant group and one occurred in the augmented group. Complications were significantly greater in the augmented group (eight in five patients, compared to no complications in the short implants group). All patients were satisfied with treatment, but short implants may be a cheaper and faster alternative to longer implants in augmented bone.


Cannizzaro G, Felice P, Soardi E, Ferri V, Leone M, Esposito M.  Immediate loading of 2 (all-on-2) versus 4

(all-on-4) implants placed with a flapless technique supporting mandibular cross-arch fixed prostheses:

preliminary results from a pilot randomised controlled trial.


Eur J Oral Implantol 2011;4(3):205-217.

Either two or four implants were placed in 60 patients (30 patients in each group), and complications and implant and prosthesis failures were recorded. There were no implant failures or drop-outs after 4 months. Four biomechanical complications occurred in the all-on-four group compared to one in the all-on-two group; the difference was not significant. Two implants can therefore successfully be used to support immediately loaded mandibular cross-arch FPDs.


Maló P, Nobre M de A, Lopes A. The rehabilitation of completely edentulous maxillae with different degrees of

resorption with four or more immediately loaded implants: a 5-year retrospective study and a new





Eur J Oral Implantol 2011;4(3):227-243.

A total of 995 implants were placed in 221 patients with edentulous maxillae where bone was available to the first molar (group 1), second premolar (group 2), first premolar (group 3) or canine (group 4). After 5 years, there were eighteen patient drop-outs and three prostheses lost due to implant failure, giving a prosthesis survival rate of 98.6%. The implant survival rate was 88.7% at the patient level (41 implants lost in 25 patients) and 95.8% at the implant level. Patient-specific survival per group was 78.6%, 89.3%, 92.4% and

91.7% for groups 1, 2, 3 and 4, respectively. There were 129 biological complications (129 implants) in 66 patients (30%) and 170 mechanical complications (170 implants) in 71 patients (38%). Smoking and bruxism

were identified as risk factors for biological and mechanical complications, respectively. Rehabilitation of the edentulous maxilla with four or more implants is therefore a viable treatment option.


Gillot L,  Noharet R,  Buti J,  Cannas B.  

A  retrospective cohort study of  105  patients rehabilitated with

immediately loaded mandibular cross-arch bridges in combination with immediate implant placement.




Eur J Oral Implantol 2011;4(3):247-253.

In the mandibles of 105 patients, the remaining teeth were extracted and four to six implants were placed

(448 in total) in healed sites (266 implants) or fresh extraction sockets (182 implants). Provisional prostheses were immediately loaded and the patients followed up after 4 months, when definitive fixed prostheses were placed. The implant survival rate after 4 months was 98.2%; eight implants were lost in eight patients, four each in healed and extraction sites. There was no significant difference between the groups. High implant and prosthetic survival rates were therefore obtained with immediate implant placement and loading.


Hansen EJ, Schou S, Harder F, Hjorting-Hansen E.  

Outcome of implant therapy involving localised lateral

alveolar ridge and/or sinus floor augmentation: a clinical and radiographic retrospective 1-year study.




Eur J Oral Implantol 2011;4(3):257-267.

In  47  consecutively  treated  patients,  82  regions  were  augmented  and  151  implants  were  placed

approximately 6.5 months after grafting. Block or particulate grafts (16% and 30%), or a combination of both (54%), were used. Most grafted areas were covered by an e-PTFE membrane (71%) or a resorbable collagen membrane (13%). Complications were noted in eight patients after bone harvesting, and membrane exposure occurred only with e-PTFE membranes. Prosthesis survival was 99% and implant survival in sinus lift, lateral augmentation and combined sinus lift/lateral augmentation was 91%, 97% and 100%, respectively, with mean peri-implant bone loss of 0.60 mm, 0.31 mm and 0.41 mm, respectively. There were no instances of technical complications.



Implant Dentistry

Vol. 20 No. 5 (October 2011)

Engelke W, Deccó EA, Cura AC, Ruscio ML.

Immediate loading of freestanding implants using cortical


satellite implants: 3-year results of an ongoing prospective study.


Implant Dent 2011;20(5):341-344.

Each of 20 patients received two free-standing implants that were stabilized during healing using cortical satellite implants. The implants were immediately loaded with ball-attached mandibular overdentures and the cortical satellite implants were removed after 3 months. After 3 years, implant survival was 100%, and the mean Periotest, bone resorption and pocket probing depth values were -5.89, 0.51 mm and 2.60 mm, respectively. Immediate loading of free-standing implants stabilized by satellite implants can therefore be successful.


Sohn D-S, Heo J-U, Kwak D-H, Kim D-E, Kim J-M, Moon J-W, Lee J-H, Park I-S.  

Bone regeneration in the

maxillary sinus using an autologous fibrin-rich block with concentrated growth factors alone.



Implant Dent




Sixty-one sinus grafts were performed using the lateral window approach, and following sinus membrane elevation a total of 113 implants were placed simultaneously with fibrin-rich blocks containing concentrated growth factors. The bony window was then replaced and sinus augmentation was verified. New bone was observed along all the implants by radiography and cone-beam computed tomography. After a mean of 10 months, the implant success rate was 98.2% and there were no significant post-operative complications. The use of fibrin-rich blocks may therefore be a suitable sinus augmentation procedure.


International Journal of Oral and Maxillofacial Implants

Vol. 26 No. 5 (September/October 2011)

Yuan YC-C, Shyamsunder N, Barão VAR, Lee DJ, Sukotjo C.  

Publication bias in five dental implant journals:


an observation from 2005 to 2009.



Int J Oral Maxillofac Implants 2011;26(5):1024-1032.

Articles published in five major dental implant journals between 2005 and 2009 were reviewed for potential publication bias according to various criteria. A total of 1,503 articles met the inclusion criteria from an initial total of 2,085. Positive outcomes were reported by 1,226 publications, compared to 160 reporting negative outcomes and 117 reporting neutral outcomes. Positive outcomes were significantly more likely in funded animal studies, in vitro studies and studies from Asia, but industry-funded studies showed the lowest frequency of positive outcomes compared to studies funded in other ways.


Krennmair  G,   Seemann  R,   Weinländer  M,   Wegscheider  W,   Piehslinger  E.   




rehabilitation   of   anterior   partial   edentulism:   a   clinical   review.   Int   J   Oral   Maxillofac   Implants




Patients with maxillary or mandibular partial edentulism and who received two implants supporting a four-unit FPD between 2002 and 2006 were retrospectively analyzed. Implant survival rates, peri-implant conditions, and incidence and type of prosthodontic maintenance were evaluated. Patient subjective satisfaction was also assessed. After a mean of 56.2 ± 10.3 months, 36 patients with 72 implants were available for assessment. Implant survival and success was 100%, and good peri-implant conditions were observed. Maxillary cementation and mandibular rebasing were the most common prosthodontics maintenance procedures (12% and 18.2%, respectively), and the patient satisfaction sore was high, with slightly better results for maxillary versus mandibular FPDs.


Fuster-Torres MÁ, Peñarrocha-Diago M, Peñarrocha-Oltra D, Peñarrocha-Diago M.  Relationships between

bone density values from cone beam computed tomography, maximum insertion torque, and resonance

frequency analysis at implant placement: a pilot study.



Int J Oral Maxillofac Implants 2011;26(5):1051-




Partially and fully edentulous patients who received implants between 2007 and 2008 were retrospectively evaluated, including insertion torque and implant stability, and bone densities were calculated from cone beam CT scans. A total of 82 implants were placed, and the mean insertion torque and bone density were

42.4 ± 4 Ncm and 623 ± 209 HU, respectively, and there was a significant difference in bone density between the maxilla and mandible. A significant relationship was found between bone density and insertion torque for implants in the anterior mandible, and between bone density and implant stability for men. Bone density measurements may therefore be a useful diagnostic tool.


Urdaneta RA, Daher S, Leary J, Emanuel K, Chuang S-K.

Factors associated with crestal bone gain on

single-tooth locking-taper implants: the effect of nonsteroidal anti-inflammatory drugs.




Int J Oral Maxillofac Implants 2011;26(5):1063-1078.

A total of 326 implants in 81 patients were evaluated for a mean of 70.7 months. Bone gain was observed at

81 implants in 46 patients and was associated with type of opposing structure, type of restoration, HA coating, implant size, and daily intake of non-steroidal anti-inflammatory drugs (NSAIDs). Implants were significantly more likely to gain bone if NSAIDs were taken daily, but this effect was limited to HA-coated implants.



Lin I-C, Gonzalez AM, Chang H-J, Kao S-Y, Chen T-W. A 5-year follow-up of 80 implants in 44 patients

placed immediately after the lateral trap-door window procedure to accomplish maxillary sinus elevation


without bone grafting.





Int J Oral Maxillofac Implants 2011;26(5):1079-1086.


A total of 80 implants placed with a sinus elevation trap-door procedure without bone grafting in 44 patients were followed for 5 years after prosthesis delivery. No sinusitis or complications leading to implant loss were observed. Mean residual bone height was 5.06 ± 1.51 mm, and the average gained bone height was 7.24 ±


1.83 mm after 2 years and 7.44 ± 1.94 mm after 5 years. Implant survival was 100% and the mean peri- implant bone loss was 1.3 ± 0.3 mm and 2.1 ± 0.5 mm at 2 and 5 years, respectively. New bone formation and good implant survival were therefore confirmed.



Stimmelmayr M, Stangl M, Edelhoff D, Beuer F.  

Clinical prospective study of a modified technique to extend


the keratinized gingiva around implants in combination with ridge augmentation: one-year results.





Int J Oral Maxillofac Implants 2011;26(5):1094-1101.


Implants were placed in mandibles in combination with free gingival grafts (FGGs); implants were either


placed with ridge augmentation with FGGs at the time of uncovering (group 1), or were placed after ridge augmentation, with FGGs performed at placement (group 2). The widths of keratinized local gingiva (KLG), FGG, buccal keratinized gingiva (BKT) and lingual keratinized gingiva (LKT) were measured after 4 weeks, 3 months and 1 year. Mean KLG was 3.00 mm in group 1 and 2.75 mm in group 2, while mean width of BKT after 1 year was 3.70 mm in group 1 and 3.30 mm in group 2. Significantly more LKT atrophy was observed in group 1 compared to group 2 (0.35 mm versus 0.05 mm after 1 year). Ridge augmentation and FGG therefore resulted in stable extension of keratinized gingiva around implants.



Annibali S, Bignozzi I, Iacovazzi L, La Monaca G, Cristalli MP.  

Immediate, early, and late implant placement in


first molar sites: a retrospective case series.





Int J Oral Maxillofac Implants 2011;26(5):1108-1122.


Data were analyzed for 47 patients with 57 immediate, early or conventional implants and clinical parameters were evaluated after a mean of 38.84 ± 16.14 months, 32.91 ± 18.49 months or 42.66 ± 12.41 months for the immediate, early and  conventional groups, respectively. Implant survival was 100% for all groups, but success rates were 95.0%, 91.7% and 100% for immediate, early and conventional implants, respectively, but there were no differences in marginal bone loss between the groups. Only thin gingival biotype was found to slightly affect the outcome variables. Early placement should therefore be considered if conditions are unfavorable for immediate placement.






International Journal of Periodontics and Restorative Dentistry


Vol. 31 No. 5 (September/October 2011)

Neiva R, Pagni G, Duarte F, Park CH, Yi E, Holman LA, Giannobile WV.

Analysis of tissue neogenesis in



extraction sockets treated with guided bone regeneration: clinical, histologic, and micro-CT results.





Int J Periodontics Restorative Dent 2011;31(5):457-469.


Hopeless maxillary premolars were  extracted in  10  patients and  the  sockets covered with a  collagen


membrane. Surgical re-entry was performed after 12 weeks and biopsies were taken prior to implant placement and analyzed. Mean bucco-palatal and mesio-distal bone regeneration were 7.7 mm and 4.6 mm, respectively, while the mean vertical bone gain was 10.9 mm. There was a mean apical shift in crestal bone at the center of the socket of 2.1 mm. the mean percentage of vital bone was 45.87 ± 12.35%. Adequate bone formation for implant placement was therefore observed as early as 12 weeks after tooth extraction.



Orsini G, Stacchi C, Visintini E, Di Iorio D, Putignano A, Breschi L, Di Lenarda R.

Clinical and histologic


evaluation of fresh frozen human bone grafts for horizontal reconstruction of maxillary alveolar ridges.





Int J Periodontics Restorative Dent 2011;31(5):535-544.


Fresh frozen bone grafts were used in 10 patients for the treatment of maxillary horizontal defects prior to


implant placement. The mean thickness of the maxillary alveolar ridge increased from 2.3 ± 0.4 mm at baseline to 6.8 ± 0.5 mm after 5 months, and the mean percentage of bone was 57.5 ± 24.7%. All subsequently placed implants were successful after 2 years.



Mazzocco F, Nart J, Cheung WS, Griffin TJ.  

Prospective evaluation of the use of motorized ridge expanders


in guided bone regeneration for future implant sites.





Int J Periodontics Restorative Dent 2011;31(5):547-






Bone augmentation was performed with lateral ridge augmentation on one side of the jaw and motorized ridge expanders on the other in eight patients with bilateral ridge deformities. Implants were placed 6 months after augmentation. Significant augmentation was achieved with both techniques, with no significant differences between the techniques. With motorized ridge expanders, the amount of expansion was negatively correlated with the thickness of cancellous bone, but was not affected by the thickness of the cortical plate. The use of motorized ridge expanders was therefore as effective as lateral ridge augmentation for the augmentation of atrophic ridges.





Journal of Clinical Periodontology

Vol. 38 No. 11 (November 2011)




Vol. 38 No. 12 (December 2011)

Buhlin K, Mäntylä P, Paju S, Peltola JS, Nieminen MS, Sinisalo J, Pussinen PJ.  

Periodontitis is associated


with angiographically verified coronary artery disease. J Clin Periodontol 2011;38(11):1007-1014. Periodontal examination was carried out on 506 patients undergoing coronary angiography, and panoramic radiographs were taken. Stable coronary artery disease (CAD) was found in 184 patients and acute coronary syndrome (ACS) was observed in 169 patients, while 123 patients had no significant CAD. Stable CAD and ACS were both significantly associated with 8-17 missing teeth and more than seven teeth with probing depth


≥ 6 mm. In addition, severe alveolar bone loss was significantly associated with ACS. Poor periodontal health, including missing teeth, inflammation and bone loss, therefore appeared to be associated with coronary artery





Franchini R, Petri A, Migliario M, Rimondini L.  

Poor oral hygiene and gingivitis are associated with obesity and


overweight status in paediatric subjects.





J Clin Periodontol 2011;38(11):1021-1028.


A total of 98 obese/overweight or normal weight subjects aged between 10 and 17 years were clinically and periodontally examined. Obese/overweight subjects showed significantly higher anthropometric measurements than normal weight subjects and a worse attitude towards oral hygiene. The gingival index was found to have a significant effect on obesity status, and gingivitis appeared to be dependent on insulin resistance and bad oral hygiene. The gingivitis was therefore thought to be due to a combination of metabolic and inflammatory profiles and neglect towards oral hygiene.



Saito A, Ota K, Hosaka Y, Akamatsu M, Hayakawa H, Fukaya C, Ida A, Fujinami K, Sugito H, Nakagawa T.

Potential impact of surgical periodontal therapy on oral health-related quality of life in patients with


periodontitis: a pilot study.





J Clin Periodontol 2011;38(12):1115-1121.


Twenty-one patients with moderate to severe periodontitis received periodontal surgery after initial periodontal therapy and were assessed using the Oral Health-Related Quality of Life Model for Dental Hygiene (OHRQL) at baseline, at least 3 weeks after initial therapy and 3-4 months after surgery. A progressive improvement in periodontal parameters was observed during periodontal therapy, and there was a significant improvement in OHRQL score from baseline to after initial therapy, but no significant improvement was observed between after initial therapy and after surgery.



Moslemi  N,  Jazi  MM,  Haghighati  F,  Morovati  SP,  Jamali  R.  

Acellular  dermal  matrix  allograft  versus


subepithelial connective tissue graft in treatment of gingival recessions: a 5-year randomized clinical study.





J Clin Periodontol 2011;38(12):1122-1129.


Subepithelial connective tissue graft or acellular dermal matrix allograft were used for the treatment of Miller


class I/II gingival recessions in 16 patients. Clinical parameters were measured at baseline and after 6 months and 5 years. A significant improvement in all parameters was seen in both groups at 6 months, but


there were significant relapses in complete root coverage, recession depth and recession width in both groups after 5 years, and greater relapses were observed in patients with a horizontal toothbrushing habit. The 5-year outcomes were similar for both treatments.



Svensson KG, Trulsson M.

Impaired force control during food holding and biting in subjects with tooth- or


implant-supported fixed prostheses.





J Clin Periodontol 2011;38(12):1137-1146.


Contact and biting forces were evaluated in 10 subjects for holding and splitting food with different degrees of hardness (peanuts and biscuits) between opposing central incisors with natural teeth, or tooth-supported or implant-supported bridges. Hold force was significantly higher and more variable in the implant-supported group. Split force was higher for peanuts in all three groups. For natural teeth, there was a significantly higher rate of force increase when splitting peanuts compared to biscuits, but there was no such difference for the other two groups. The results indicated that there needs to be adequate sensory information from the periodontal mechanoreceptors for normal control of biting and contact forces.



Faggion CM Jr, Giannakopoulos NN, Listl S.  Risk of bias of animal studies on regenerative procedures for

periodontal and peri-implant bone defects – a systematic review. J Clin Periodontol 2011;38(12):1154-1160. Electronic and hand searching was performed for animal studies from 1998-2000 and 2008-2010 on periodontal and peri-implant defects to assess changes in risk of bias based on a check list. A total of 107 studies were included. The risk of bias was found to be unclear in most of the studies, due to poor reporting of the check list items; the accuracy of treatment effect estimates was therefore difficult to determine.









Journal of Oral Implantology





Vol. 37 No. 5 (October 2011)


Mumcu E, Bilhan H, Cekici A.


Marginal bone loss around implants supporting fixed restorations.




J Oral




Implantol 2011;37(5):549-558.


A total of 36 patients who received 126 implants to support cemented, fixed restorations were recalled at 6,


12, 24 and36 months after loading and comparative bone level measurements assessed. No excessive bone loss, peri-implant inflammation of implant failure was observed after 36 months. In addition, there was no significant relationship between marginal bone loss or implant diameter or length, but bone loss was influenced by age, gender and the presence of cantilevers. The results indicated that short and/or narrow implants may be preferred over cantilever extensions in cases of limited anatomic conditions.



Chung S, Rungcharassaeng K, Kan JYK, Roe P, Lozada JL.

Immediate single tooth replacement with


subepithelial connective tissue graft using platform switching implants: a case series.





J Oral Implantol






Facial gingival stability following immediate single implant placement with subepithelial connective tissue graft was assessed in 10 patients. Clinical and radiographic analysis was performed before surgery, at placement and after 3, 6 and 12 months. Nine implants remained osseointegrated after 12 months, with a mean marginal bone loss of -0.31 mm and a mean change in facial gingival level of -0.05 mm. Over 50% of papilla fill was found at 89% of sites after 12 months. Good success and peri-implant tissue response can therefore be obtained with immediate implant placement and simultaneous subepithelial connective tissue graft.









Journal of Periodontology


Vol. 82 No. 10 (October 2011)




Vol. 82 No. 11 (November 2011)

Zupnik J, Kim S-W, Ravens D, Karimbux N, Guze K.  

Factors associated with dental implant survival: a 4-year



retrospective analysis.




J Periodontol 2011;82(10):1390-1395.


A cohort of patients treated by periodontology residents with 341 rough-surfaced implants between 2003 and


2006 were retrospectively evaluated and the data analyzed by multimodel analyses to determine failure rates and any factors that may be involved in implant failure. The odds ratios for implant failures were highest for


male patients and patients with diabetes. The success rate for periodontology residents over the treatment period was 96.48%. Implant success rates were within acceptable standards and confirmed previously identified factors for implant failure.



McGuire MK, Scheyer ET, Nevins ML, Neiva R, Cochran DL, Mellonig JT, Giannobile WV, Bates D.  Living

cellular construct for increasing the width of keratinized gingiva: results from a randomized, within-patient,


controlled trial.





J Periodontol 2011;82(10):1414-1423.


Either living cellular construct or free gingival graft were applied in 96 patients for regeneration of the


keratinized gingiva. After 6 months, living cellular construct regenerated ≥ 2 mm of keratinized gingiva in


95.3% of patients, but more keratinized gingiva was regenerated by free gingival graft. Keratinized gingiva of


≥ 1 mm was achieved in all patients with living cellular construct by 6 months, and this treatment was preferred by more patients. Both treatments were well tolerated, with typical adverse events for this type of periodontal surgery.



Mazzocco F, Comuzzi L, Stefani R, Milan Y, Favero G, Stellini E.  

Coronally advanced flap combined with a




subepithelial  connective  tissue  graft  using  full-  or  partial-thickness  flap  reflection.  J  Periodontol






Miller  class  I  or  II  defects  at  52  teeth  in  20  patients were  treated with  coronally advanced flap  and subepithelial connective tissue graft using either full- or partial-thickness flap reflection (25 and 27 teeth). Periodontal parameters were measured at baseline and after 6 months. With full-thickness flap reflection, mean root coverage was 97%, while for partial thickness flap reflection it was 95%. No significant differences in reduction in gingival recession, gain in keratinized tissue or probing depth were found between the two groups, indicating that the type of flap reflection did not appear to have an influence.



Koutouzis T, Koutouzis G, Tomasi C, Lundgren T.  

Immediate loading of implants placed with the osteotome


technique: one-year prospective case series.





J Periodontol 2011;82(11):1556-1562.


Single implant placement was performed in 18 patients using a modified placement procedure with under- preparation of the implant bed with an osteotome technique; the implants were immediately loaded. Follow-up


clinical examinations were performed after 2 weeks and 6 and 12 months, with radiographic analyses at 6 and 12 months. Of 20 implants, only four showed an insertion torque > 35 Ncm. One implant failed and was removed after 3 months. Mean marginal bone loss was -0.09 mm at 6 months and -0.19 mm at 12 months. Immediately loaded implants placed with an osteotome technique therefore did not present a high insertion torque.



Sgolastra F, Petrucci A, Gatto R, Giannoni M, Monaco A.  

Long-term efficacy of subantimicrobial-dose


doxycycline as an adjunctive treatment to scaling and root planing: a systematic review and meta-analysis.





J Periodontol 2011;82(11):1570-1581.


A literature search was conducted for studies indicating evidence for the effectiveness of doxycycline as an


adjunctive treatment to scaling and root planing in chronic periodontitis. Periodontal parameters and gingival crevicular fluid levels were assessed at baseline and follow-up. Only three randomized placebo-controlled trials met the inclusion criteria; all had similar treatment designs, dosing regimens and post-treatment follow- up periods. All investigated clinical parameters were significantly in favor of scaling and root planing plus

doxycycline compared to scaling and root planing plus placebo. The long-term effectiveness of the treatment therefore appeared to be supported.

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