Quintessence International, Pre‑Print

Objective: To evaluate implant and patient characteristics 4 to 8 years after implant installation in a study involving immediate fixed restoration of dental implants. Method and materials: The study was a follow-up of treated generalized chronic periodontitis patients who received immediate restorations on dental implants as part of a previous study. The patients were examined clinically and radiographically at implant placement, 6 months, 1 year, and 4 to 8 years later. Supportive periodontal therapy (SPT), teeth and implant probing pocket depth (TPPD and IPPD), bleeding on probing (BOP [teeth, TBOP; implant, IBOP]), and bone level (BL) measurements around implants were documented. Cases were divided into three groups according to annual SPT rate: 0.00 to 0.99/year (SPT0), 1.00 to 1.99/year (SPT1), 2.00 or more/year (SPT2). Results: Twelve patients, with 26 implants and 242 teeth, were included. The mean ± standard deviation follow-up period was 6.08 ± 1.25 years (range 4.04 to 7.94 years). All implants in the follow-up group were osseointegrated and survived during the follow-up period. The mean number of SPT appointments was 6.17 ± 5.65. A weak negative correlation was found between SPT rate and ΔTPPD (−0.24, P = .0005), whereas a strong negative correlation was found between SPT rate and ΔIPPD (−0.76, P = .0005). Negative correlations were found between SPT rate and ∆TBOP (−0.20, P = .003), and between SPT rate and ∆IBOP (−0.5, P = .009). A moderate correlation was found between SPT rate and ΔBL (0.46, P = .02). Conclusion: SPT has a significant positive effect on PPD, BOP, and on implant BLs in long-term follow-up and should be an essential part of implant therapy. Schlagwörter: dental implants, immediate loading, implant bone level, long-term follow-up, maintenance, periodontitis

Objective: To evaluate the effectiveness of using DentalVibe during injection in comparison with the traditional injection technique, regarding pain and discomfort associated with buccal infiltration anesthesia (BIA) in pediatric patients. Method and materials: This randomized clinical trial included 6- to 12-year-old healthy children currently receiving nonurgent dental treatment on the maxillary arch that required BIA. In the control group, subjects received traditional BIA. In the test group, they received BIA with the aid of DentalVibe. A sample of 30 subjects per group was included. The mean ± SD age of the subjects was 9.18 ± 1.66 years. All the subjects were videotaped, and two trained and calibrated evaluators assessed the children’s behaviors during the injection using the face, legs, activity, cry, consolability (FLACC) scale independently. Immediately after anesthesia administration, the subjects were administered the validated Arabic version of the Wong-Baker FACES scale ranging from 0 to 10. Results: Female subjects showed significantly higher mean FLACC and Wong-Baker FACES scale scores (2.20 ± 1.82 and 2.93 ± 3.05) compared with males (1.08 ± 1.37 and 1.12 ± 2.09) (P = .008 and P = .006, respectively). Multiple regression analysis showed that regardless of age and treatment group, females had significantly higher mean scores on the FLACC (β = 1.63, P = .002) and the Wong-Baker FACES scales (OR = 4.44, P = .004) than males. Conclusion: The use of DentalVibe did not significantly affect pain, discomfort, or time during BIA among pediatric patients compared with the traditional technique. Female children were more likely to report higher pain and discomfort scores during BIA administration regardless of age and anesthesia administration technique. Schlagwörter: children, DentalVibe, local anesthesia, pain, vibration

Objectives: Recent data show that teeth prepared with horizontal finishing lines supporting crowns and fixed partial dentures present more periodontal disorders than untreated control teeth. Several studies have shown that NitrAdine (bonyf) induces a significant reduction of dental biofilm. The aim of this study was to demonstrate that 10-day use of PerioTabs (bonyf), a NitrAdine-based gingiva brushing solution, is effective in treating gingival inflammation of prosthodontic patients. Method and materials: Forty-nine subjects were instructed to brush their teeth, gingivae, and prostheses with the PerioTabs solution for 10 days (treatment group) and 49 with any toothpaste (control group). The initial and 11-day Plaque Index and Bleeding Index were recorded. A five-point Likert scale was used to evaluate the level of patient satisfaction. The Shapiro-Wilk statistical test was used to compare the results for the two groups. Results: Highly significant differences between the treatment and control group (P < .001) for the Plaque Index and Bleeding Index resulted. The treatment group patients’ satisfaction was high: 31 (63.3%) reported the highest level, 5, on the Likert scale, and 18 (36.7%) declared they were satisfied (level 4). Conclusions: The use of a NitrAdine-based gingiva brushing solution (PerioTabs) was effective in reducing the gingival inflammation in periodontally affected patients treated with fixed partial dentures. Clinical relevance: The NitrAdine-based gingiva brushing solution (PerioTabs) was highly accepted by the patients and seems to be a promising alternative to the solutions widely used. Schlagwörter: Bleeding Index, fixed prostheses, inflammation, NitrAdine, periodontal disease, periodontitis, PerioTabs, Plaque Index

Objectives: This systematic review aimed to evaluate the clinical and radiographic outcomes of coronal and partial pulpotomies in mature permanent molars with cariously exposed vital pulp. Method and materials: The protocol of the current review was registered in the PROSPERO database (CRD 42020190785). Articles published between January 1980 and June 2020 were searched in eight different online databases and six textbooks according to PRISMA guidelines. Eleven studies were included in the analysis of 1-year success rates, whereas five studies were included in the analyses of 2-year and > 2-year success rates for coronal pulpotomy. Two studies were included in the analyses of the 1-year and 2-year success rates for partial pulpotomy. The clinical and radiographic success rates were estimated using the DerSimonian-Laird random effect method. The risks of bias were evaluated using Cochrane RoB 2, ROBINS-I, and Newcastle-Ottawa scale assessment tools. Evidence levels were determined using the Oxford Centre for Evidence-Based Medicine (OCEBM) recommendation tool. The success rates using different pulp capping medicaments and restorative materials were analyzed using meta-regression analysis. Results: The clinical and radiographic success rates of coronal pulpotomy ranged between 92.2% and 99.4%, whilst for partial pulpotomy, the success rates ranged between 78.2% and 80.6%. Different pulp capping medicaments and restorative materials showed no significant effect on the success rates of coronal pulpotomy, but the former significantly (P < .05) affected the success rates of partial pulpotomy. Conclusion: Coronal and partial pulpotomies demonstrated a high success rate in treating cariously exposed vital pulp of mature permanent molars. Further well-designed studies with longer follow-up periods are required to validate these findings. Schlagwörter: meta-analysis, permanent molar, pulp capping medicament, pulpotomy, systematic review

Raloxifene is a selective estrogen receptor modulator (SERM) that is used to manage osteoporosis in women. Because of its tissue selectivity, raloxifene has fewer side effects than estrogen therapy; however, raloxifene-associated osteonecrosis of the jaw (ONJ) has recently been reported. While most of the reported cases were treated with antiresorptive therapy in addition to raloxifene, ONJ can also occur with the isolated use of raloxifene. This report presents a case where there was no prior exposure to bisphosphonates, in which the patient incidentally had florid cemento-osseous dysplasia (FCOD). Raloxifene-associated ONJ has never been reported before in a patient with FCOD. It is unclear whether the presence of FCOD increases the risk of ONJ. Case report: Clinical and radiographic findings regarding an African-American patient with FCOD and raloxifene-induced ONJ are described. The patient underwent a battery of investigations and surgical debridement of the area in question. She has remained disease free in the 2 years following the treatment. Conclusions: The aim of this report is to shed some light on a serious complication of raloxifene, a medication that is increasingly encountered in dental practices. Dental practitioners should use this knowledge to increase their awareness of possible ONJ development after the use of raloxifene. Brief recommendations and guidance in general dental practice for management of patients on raloxifene are also presented. Schlagwörter: CBCT, inflammation, medication-related osteonecrosis of the jaw (MRONJ), multidetector computed tomography (MDCT), panoramic radiography, raloxifene

Objective: To analyze the loss of abutment teeth for double crown-retained removable partial dentures (DC-RPDs) compared to clasp-retained removable partial dentures (C-RPDs). Method and materials: A search was conducted in the Ovid MEDLINE, Embase, Web of Science databases, and a manual search. The search was conducted based on the PICO framework with inclusion and exclusion criteria. After extracting the data of selected studies, a meta-analysis was performed to estimate abutment loss with 95% confidence interval (CI). The statistical significance was defined as P < .05, and the heterogeneity of the data was assessed based on the chi-squared test and I2 statistics. Risk of bias assessment was conducted using Cochrane Risk of Bias tool and Newcastle-Ottawa Scale. Results: A total of 4,692 records were identified from electronic databases and 38 studies were included for quantitative synthesis of 3,393 subjects with 13,552 abutment teeth. A total of 1,226 abutment teeth were lost with > 4,016 RPDs. Seven studies were compounded for > 668 C-RPDs (mean follow-up time ≤ 5 years) and six studies for 893 C-RPDs (mean follow-up time > 5 years), where the estimates of abutment loss were 5% (95% CI 2% to 8%) and 8% (95% CI 5% to 13%), respectively. The data were not significantly different (P = .1), and were heterogenous between the studies (τ2 ≥ 0.34, I2 ≥ 87.38%). Thirteen studies were compounded for 1,223 DC-RPDs (mean follow-up time ≤ 5 years) and eight studies for 1,033 DC-RPDs (mean follow-up time > 5 years), where the estimates of abutment loss were 6% (95% CI 5% to 8%) and 12% (95% CI 8% to 18%), respectively. The data were heterogenous (τ2 ≥ 0.17, I2 ≥ 75.86%), and were significantly different between the studies (P = .005). Overall, C-RPDs were not significantly different from DC-RPDs in abutment loss (P ≥ .3). A significant predictor for abutment loss was follow-up time with DC-RPDs (P = .005), where the risk of abutment loss per year was 18% (P = .0001). In contrast, follow-up time was not a significant factor for C-RPDs (P = .1). None of the included studies were at high risk of bias. Conclusion: Within the limitations of the current systematic review and meta-analysis, abutment loss was not significantly different between C-RPDs and DC-RPDs. A significant predictor was follow-up time for DC-RPDs, whereas this factor was not significant for C-RPDs. Further research is needed to investigate critical factors for abutment loss with RPDs. Schlagwörter: abutment loss, clasp-retained removable partial denture, conical crown-retained removable partial denture, double crown-retained removable partial denture, telescopic crown-retained removable partial denture

Objective: The aim was to evaluate the efficacy of periodontal regenerative therapy using enamel matrix derivatives (EMDs) in aggressive periodontitis patients, and to determine the contribution of maintenance via periodic supportive periodontal treatment. Method and materials: In total, 28 patients were evaluated, comprising 74 intrabony sites. In 50 sites EMD gel was applied, and in 24 sites EMD was combined with deproteinized bovine xenograft. Patients were assigned to a supportive periodontal treatment program; 18 patients fulfilled the program, defined as the well-maintained (WM) group; 10 did not comply, defined as the nonmaintained (NM) group. Probing depth (PD), clinical attachment level (CAL), and radiographic bone level (BL) were recorded. Data were compared presurgically (T0), 6 months postsurgery (T1), and 3 to 10 years posttreatment (T2). Results: Both surgical modalities achieved similar PD reduction, CAL gain, and BL gain, maintained over time. T1 to T2 showed a mean gain/loss of 0.21 ± 0.5 mm and 0.04 ± 1.1 mm, and −0.65 ± 3.0 mm and −0.73 ± 3.0 mm for PD and CAL, respectively, at the WM/NM groups, respectively. BL gain was 21.6% and 11.5% for the WM/NM groups, respectively (P < .05). The courses of the PD, CAL, and BL differed between the WM and NM groups during the observation periods (P < .05). Conclusion: Periodontal regeneration via EMD with/without the combination of deproteinized bovine xenograft can be maintained in aggressive periodontitis cases. It appears that periodic supportive periodontal treatment is a determinant factor in achieving this task. Schlagwörter: aggressive periodontitis, clinical attachment level, enamel matrix derivative (EMD), probing depth, regenerative therapy, supportive periodontal treatment

Objective: This study aimed to examine and compare the anti-caries effects of slightly acidic 1% NaF-HF gel when applied once or twice (7-day or 6-month interval) to mandibular first molars in 6- to 7-year-old children. Method and materials: This was a 1-year, multi-arm, placebo-controlled, double-blind, parallel-group randomized trial. In total, 1,077 schoolchildren from eight primary schools were allocated to one of the four study groups (group 1, single application; group 2, two applications with a 7-day interval; group 3, two applications with a 6-month interval; group 4, placebo control). The occlusal surfaces of permanent mandibular first molars were examined by three calibrated examiners who were blind to the group allocation at baseline and the end of the study. Caries reduction and prevented fraction was assessed. Results: A total of 986 children completed the study. There was a statistically significant difference in the mean D1MFT increment across the groups (P < .001). The mean D1MFT increment was 0.37 in group 1 (single application), 0.18 in group 2 (two applications with a 7-day interval), 0.21 in group 3 (two applications with a 6-month interval), and 0.56 in the control group. The mean D2MFT increments (0.22 in group 1, 0.06 in group 2, 0.18 in group 3, and 0.50 in the control group) also showed a statistically significant difference across the groups (P < .001). Conclusion: Subacidic 1% NaF-HF gel exerts a high preventive effect on caries (more than 40%) when applied twice at a 7-day interval in 6- to 7-year-old schoolchildren who do not use fluoride toothpaste in areas where drinking water is not fluoridated. Schlagwörter: anti-caries effect, caries, fluoride, randomized controlled trial, subacidic NaF-HF gel

Oral squamous cell carcinoma (OSCC) is an extremely rare occurrence during pregnancy. OSCC accounts for less than 2% of all malignancies in pregnant women, with an average mortality rate of 36%. Understanding the features of this tumor during pregnancy is important; however, the paucity of reports in the literature makes this challenging. Case presentation: The following is a case presentation of a woman who was diagnosed with SCC of the tongue (TSCC) at 13 weeks gestation. The article also provides a review of the literature of TSCC affecting pregnant women aged 30 years and under. Conclusion: Although OSCC in young women of reproductive age is rare, recent literature suggests an increased risk for this age group. The rarity of OSCC in pregnancy may potentially lead to low clinical index of suspicion, misdiagnosis, and delay in treatment. Additionally, treatment modalities, prognosis, and the long-term impact on the developing fetus are not well established, due to rarity of OSCC in pregnancy. Further studies to identify specific etiologic factors are needed to establish the association of OSCC with pregnancy, aid in prevention, and improve treatment and outcome. Schlagwörter: etiopathogenesis, oral squamous cell carcinoma, pregnancy, tongue, young patients

Objective: This study examined the impact of early biofilm on the tooth surface, during the assessment of initial enamel erosion using swept-source optical coherence tomography (SS-OCT). Method and materials: Forty-five enamel windows of 2 × 4 mm2 were prepared on 23 extracted human teeth. The specimens were exposed to citric acid (pH 3.2) for 30 minutes and randomly divided into three groups (n = 15): Group 1, no biofilm; Group 2, 1-day-old biofilm; and Group 3, 3-day-old biofilm. Specimens in Groups 2 and 3 were inoculated with oral bacteria (Streptococcus sanguinis, Streptococcus mitis, and Actinomyces naeslundii) to produce early laboratory-cultivated biofilms for 1 and 3 days respectively. Surface microhardness (SMH) measurements were taken at pre- (t1) and post-erosion (t2); and SS-OCT scans were done at t1, t2, and post-biofilm cultivation (t3). Integrated reflectivity (IR) of the tooth-air interface (IRsurface) and enamel (IRenamel) were computed from the mean A-scans. Statistical analysis was performed using paired t tests and one-way ANOVA (α = .05). Results: A significant increase in IRenamel was observed at t2 (P < .05). At t3, IRsurface between Group 1 (control) and Group 2 (P = .012) as well as Group 3 (P = .001) were significantly different. Significant variances in IRenamel were perceived between t2 and t3 for Groups 2 and 3 but not for Group 1. Conclusion: As early biofilm affected SS-OCT assessment of initial enamel erosion, they should be removed from the tooth surface prior to OCT procedures. Schlagwörter: assessment, biofilm, detection, enamel erosion, initial erosion, optical coherence tomography

Objectives: The aim of this retrospective study was to evaluate the effect of vertical soft tissue thickness (STT) on crestal bone loss (CBL) of early loaded implants after 1 and 5 years. Method and materials: Forty-four tapered implants with platform switching and conical connection were placed in the posterior mandible and maxilla to rehabilitate edentulous sites. STT at implant sites was divided into two groups: thin (n = 21, mean STT = 2.0 ± 0.3 mm) and thick (n = 23, mean STT = 3.0 ± 0.8 mm). The implants were loaded after 6 to 8 weeks. Survival and success rates and CBL were measured after 1 and 5 years. Results: The survival and success rates at 1 and 5 years were 100% and 97.8%, respectively. At the 1-year follow-up, the CBL of the thin and thick gingival groups was 0.96 ± 0.49 and 0.55 ± 0.41 mm, respectively; the difference was statistically significant (P = .004). At 5 years, the CBL of the thin and thick gingiva groups increased to 1.12 ± 0.84 and 0.65 ± 0.69 mm, respectively; the difference was not statistically significant (P = .052). Conclusion: At 1 year, the CBL was more pronounced at sites with a thin gingiva; at 5 years the difference between the groups was not statisically significantly different. Within the limitations of this study, early loading of implants with platform switched and conical connection was safe. Schlagwörter: crestal bone loss, dental implants, early loading, platform switching, soft tissue thickness

Objectives: The prevalence of "dental anxiety" (DA) is often underestimated and numerous diagnostic methods are available for dental practitioners. It is difficult to differentiate between a dental phobia requiring an interdisciplinary approach and DA, which can be managed by dental practitioners alone. The appropriate use of diagnostic tools is key for the successful management of highly anxious and/or phobic patients. The aim was to provide a guideline to recognize dental fear and to differentiate DA from patients who are highly anxious or even have a phobia. Data sources: In total, 8,929 articles that were selected for the development of the German guidelines for "Dental anxiety in adults" in PubMed, Web of Science, Embase, and MedPilot were filtered for diagnosis of DA disorder. The focus for this review was on the use of scales to measure DA levels. The methods and tools used in the 51 reviewed articles to assess DA levels were evaluated in terms of their practicability and suitability in daily practice to differentiate between phobia (ie, DA disorder) and nonpathologic anxiety. In addition, the internal consistency (Cronbach alpha) of the questionnaires/tools was determined. Conclusion: All identified DA questionnaires validated in the German language had an acceptable to excellent internal consistency (0.7 to 0.986). The only validated questionnaire-free method was galvanic skin reaction measurement. For the assessment of DA and diagnosis of a DA disorder in adults, the survey by means of any suitable questionnaire or even several questionnaires in combination with a behavioral observation of the patient is currently the method of choice. Schlagwörter: dental anxiety, dental phobia, diagnosis, probability, scale

Objective: Calcified carotid artery atheroma (CCAA) detected by panoramic radiographs has been suggested as an accurate biomarker for cerebrovascular accidents (CVAs). However, there has not been agreement on the relationship between CCAA and risk for stroke or other CVA. Method and materials: The question asked was, "Are patients with CCAA detected on panoramic radiographs more likely to get a stroke or CVA in the future compared to those who do not have CCAA and, further, would Doppler ultrasonography of the neck obtained secondary to panoramic radiography in suspected individuals add value to this association with stroke or CVA?" This meta-analysis was conducted by searching PubMed, Ovid Medline, Dentistry & Oral Sciences Source, CINAHL, Web of Science, Google Scholar, and ClinicalTrials.gov. Six studies that met the inclusion criteria were included in the final analysis; three used panoramic radiography and the rest used panoramic radiography and ultrasonography. Multiple random effect meta-analyses were conducted using RevMan 5.2 software. Conclusion: Evidence from this meta-analysis shows that although detection of CCAA via panoramic radiography to predict risk for stroke may be comparable to Doppler ultrasonography, risk prediction is somewhat more significant when diagnostic confirmation is made using Doppler ultrasonography than panoramic radiography alone. Clinical implications: Because stroke risk assessment is complicated and comprises many additional systemic factors beyond calcification of the carotid artery, CVA prediction is more reliable when Doppler ultrasonography is used after panoramic radiography. Managing hypertension, diabetes, and smoking habit are far more important in risk management of patients with CCAA detection on panoramic radiography. Schlagwörter: calcified carotid artery atheroma, cerebrovascular accident, Doppler ultrasonography, panoramic radiography, risk assessment, stroke

Objectives: Adequate gingival thickness provides a stable base for appropriate oral hygiene maintenance and mucogingival lesion prevention. The study aim was to assess attached gingiva thickness in relation to its width, probing depth, crowding, and tooth position in the arch during the early transitional dentition phase. Method and materials: A cross-sectional study in 193 children aged 7 years with healthy mucogingival complex was conducted, and PIROP ultrasonic biometer measurement of gingival thickness of mandibular incisors was applied. To compare qualitative variables across different dentition groups, chi-square test or Fisher exact test were used, and for quantitative variables Kruskal-Wallis test plus post-hoc analysis (Dunn test). Spearman correlation coefficient was used to correlate gingival thickness with width of attached gingiva, as well as Kruskal-Wallis test and post-hoc analysis to assess the relationship between gingival thickness and tooth position in the arch, type of incisor, and eruption phase. Results: The mean gingival thickness value was less than 1 mm in all incisor type groups. The thinnest gingiva was noticed at permanent newly erupted incisors (0.72 ± 0.36; P < .001). Thickness of attached gingiva positively correlated with its width and with probing depth (r = 0.164, P < .001). Gingival thickness was significantly thinner at incisors positioned labially. No correlation of attached gingiva thickness with transitional crowding in mandibular incisor segment was observed. Conclusions: The results revealed thin gingiva at mandibular incisors in white children during the early transitional dentition phase. Objective, ultrasound measurements were used for the first time in a pediatric population, and the device was simple and well tolerated. Schlagwörter: attached gingiva, gingival thickness, permanent dentition, primary dentition, ultrasonic measurements

Objective: This study aimed to compare the clinical outcomes in dental prophylaxis between rubber cup polishing and an air polishing system using erythritol powder, with or without prior dental plaque disclosure. Method and materials: In this single-blind, randomized, controlled, split-mouth clinical trial, healthy participants with full-mouth plaque score ≥ 60% were recruited. Quadrants in each participant were randomly assigned to four treatment groups: air polishing with prior plaque disclosure; air polishing without plaque disclosure; rubber cup polishing with prior plaque disclosure; or rubber cup polishing without plaque disclosure. Plaque scores and treatment time for each quadrant were recorded. Posttreatment satisfaction questionnaires for both the participants and operators were also completed. Results: In total, 88 participants consisting of 42 men and 46 women (mean age 23.1 ± 2.0 years) were recruited. Air polishing with prior plaque disclosure had significantly lower posttreatment marginal mean plaque score (21.7 ± 17.5%) compared to air polishing (33.5 ± 23.4%) or rubber cup polishing (34.5 ± 19.7%) without prior plaque disclosure (P < .001). Marginal mean treatment time for air polishing (325 seconds; SE = 10 seconds) was significantly shorter compared to rubber cup polishing (407 seconds; SE = 15 seconds) (P < .001). Both the participants and operators preferred air polishing over rubber cup polishing (P < .001). Conclusion: Prior plaque disclosure enhanced the effectiveness of plaque removal. Air polishing exhibited better treatment efficiency than rubber cup polishing and was the patients' and clinicians' preferred treatment modality. Schlagwörter: air polishing, biofilm, dental prophylaxis, periodontal disease, rubber cup

Objective: Achieving high levels of primary implant stability is considered to be desirable, despite some studies warning of the risk of bone damage. It was the goal of this observational clinical study to compare two current bone level implant systems with respect to primary and secondary stability. Method and materials: Data on bone quality, insertion torque, implant stability at insertion and after healing, as well as number of implants lost during healing were obtained from two centers either placing BLT (Bone Level Tapered, Straumann) or Nobel Parallel CC (Nobel Biocare) implants. Statistical analysis was based on Spearman rank correlation tests, analysis of variance, and t tests with the level of significance set at α = .05. Results: A total of 312 BLT and 92 Nobel Parallel CC implants were placed. Ten BLT and two Nobel Parallel CC implants failed resulting in survival rates of 96.79% and 97.83%, respectively. Mean insertion torque recorded in the different bone classes showed large standard deviations, and only torque values for BLT implants recorded in type 3 bone differed significantly from type 2 bone and type 1 bone (P = .024). For BLT implants, bone quality and insertion torque correlated (Spearman rho = −.3326; P = .0023) as did ISQ at insertion (Spearman rho = −.2241; P = .0429). Implant diameter significantly affected primary (P = .0013) and secondary (P = .0050) stability of Nobel Parallel CC implants while for BLT implants a significant effect was only seen for secondary stability (P = .0000). Bone quality had a significant effect on implant insertion torque for BLT implants (P = .0059). Bone quality had no general effect on ISQ changes during healing but 3.3-mm BLT implants showed significantly (P = .0005) lower stability after healing. Conclusion: Huge variation with respect to primary and secondary stability seems to exist among similar looking implant systems clinically used for identical indications. Schlagwörter: bone quality, implant design, insertion torque, primary stability, resonance frequency analysis

Objective: This study analyzed two xenogenous biomaterials based on deproteinized bovine bone mineral applied for maxillary sinus elevation. Method and materials: Fourteen patients were submitted to maxillary sinus augmentation with one of the following biomaterials: Criteria Lumina Bone Porous (test group) or Geistlich Bio-Oss (control group), both of large granules (1 to 2 mm). After 6 months, trephine biopsies were collected at the time of implant placement: 27 samples (11 patients) in the test group; 7 samples (3 patients) in the control group. Biopsies were analyzed by descriptive histology and histomorphometry, in which the percentages of newly formed bone, residual biomaterial particles, and connective tissue were evaluated. Results: Histomorphometry showed means for test and control groups, respectively, of 32.41% ± 9.42% and 26.59% ± 4.88% for newly formed bone, 22.89% ± 4.58% and 25.00% ± 4.81% for residual biomaterial, and 44.70% ± 9.54% and 48.41% ± 3.36% for connective tissue. There were no differences between groups (P > .05). Conclusion: This study concluded that Criteria Lumina Bone Porous presented similar histologic and histomorphometric characteristics to Geistlich Bio-Oss 6 months after sinus elevation surgery, identifying the tested biomaterial as an interesting alternative for bone augmentation in the maxillary sinus. Schlagwörter: biomaterials, bone grafting, bone substitutes, clinical study, histomorphometry, maxillary sinus elevation