The aim of current split-mouth study was to compare the implant treatment outcomes of hybrid-surface implants (minimally rough implant collar and moderately rough body) with moderately rough implants after 5 years in patients with a bar-supported mandibular overdenture. Fully edentulous patients were enrolled, and each patient received two implants: one moderately rough and one hybrid-surface implant. A total of 18 patients with 36 implants attended the 5-year recall, and the implant survival rate was 100%. The 5-year evaluation showed no significant difference in crestal bone loss or peri-implant health between the hybrid and moderately rough implants.

Partial-thickness double pedicle flap and connective tissue graft (CTG) is a procedure to treat single gingival recession in the anterior mandible. However, long-term data have not been reported. Patients who had been treated by the same periodontist in a private practice in Belgium between 2002 and 2009 were invited to return for a clinical examination in 2017. Seventeen patients (15 females, 2 males; mean age: 34.6 years) with a total of 23 treated single recessions were reexamined after 8 to 15 years of follow-up. Between 1 and 8 to 15 years of follow-up, mean and complete root coverage did not differ and amounted to 75% and 44% at study termination, respectively (P = .204). The esthetic outcome was mediocre, given a final mean root coverage esthetic score of 6.52. The Mucosal Scarring Index demonstrated a significant reduction in scarring between 1 and 8 to 15 years of follow-up; however, 31% of the cases still demonstrated some scarring in the end. Patients were less critical than clinicians, as they expressed high esthetic (mean: 81) and low scarring (mean 14) scores on visual analog scales. Partial-thickness double pedicle flap and CTG is an effective root-coverage procedure. However, alternative techniques may need to be considered for esthetically demanding patients.

Purpose: The aim of this study was to compare clinical and radiographic bone level assessments to intra-surgical bone level registration around implants with peri-implantitis and to identify the clinical variables rendering peri-implant bone level assessment accuracy. Materials and methods: The study sample included 50 implants with peri-implantitis in 23 patients. Registration methods included probing of the vertical distance between the implant/abutment interface and the bottom of the pocket (= VPD), intraoral radiography, bone sounding without flap elevation and intra-surgically assessed interproximal bone level. The latter was considered the true bone level (gold standard). Twenty clinicians evaluated all radiographs. Results: VPD and intraoral radiography resulted in a significant underestimation of the true bone level by 1.0 mm (95% CI: 0.495-1.585; P < 0.001) and 2.3 mm (95% CI: 1.650-2.980; P < 0.013) respectively. Bone sounding without flap elevation did not differ significantly from the true bone level (mean difference 0.2 mm; 95% CI: -0.775 - 0.335; P = 0.429). Duplicate magnification registration of 50 implants resulted in excellent intra- and inter-rater reliability (ICC intra ≤ 0.99; ICC inter = 0.964; P < 0.001). Radiographic underestimation was significantly affected by defect depth (P < 0.001). Variation among clinicians was substantial (mean underestimation range 1.1 mm to 3.8 mm); however, clinical experience had no impact on radiographic underestimation (P = 0.796). Conclusions: Bone sounding without flap elevation was the best predictor of peri-implant bone level, whereas intraoral radiography was the most inferior. Consequently, peri-implantitis may be under-diagnosed if examination is only based on radiographs. Keywords: bone defect, clinical experience, implant, intraoral radiography, peri-implantitis Conflict-of-interest statement: Prof Hugo De Bruyn is associated with education and research collaboration agreements with Dentsply Sirona and Southern Implants, on behalf of Ghent Universit

Purpose: To compare the 2-year survival and peri-implant bone loss of implants with and without a fluoride modification under immediate loading conditions in completely edentulous mandibles. Materials and Methods: A total of 125 Osseospeed implants (test group) were placed in 25 patients requiring a fixed rehabilitation. Implants were loaded immediately (baseline) with a provisional screw-retained prosthesis. Implant survival and bone level changes were analyzed at 3, 12, and 24 months. Results were compared with the outcome of 25 previously treated patients with immediately loaded TiOblast implants using the same treatment protocol (control group). Results: Implant survival was 100% for both groups. After 3, 12, and 24 months, the mean bone loss for the control group was 0.60, 0.81, and 0.84 mm on the patient level and 0.60, 0.80, and 0.86 mm on the implant level. For the test group, a mean bone loss of 0.14, 0.11, and 0.11 mm was for the patient; and 0.14, 0.11, and 0.11 mm with the implant as statistical unit after 3, 12, and 24 months, respectively. No statistically significant differences were observed comparing peri-implant bone loss at 3 months with 12 and 24 months in both groups, but the control group showed more peri-implant bone loss compared with the test-group (P < .001). Moreover, the control group showed an increasing interquartile range over time, suggesting that not every implant is reaching steady-state bone levels. Conclusions: Immediate loading of implants placed in the completely edentulous mandible is a successful treatment option with high survival rates and limited bone loss after 2 years. However, initial crestal bone preservation significantly benefits from fluoride modification.

Purpose: The number of clinical reports giving detailed information on clinical outcomes with guided surgery is rather scarce despite its large-scale introduction over the last decade. The aim of this report was to determine implant survival and success in terms of peri-implant bone loss and evaluate whether smoking affects the outcome. Materials and Methods: A total of 26 cases with a partially or totally edentulous maxilla were selected for implant treatment using the Facilitate software system (Astra Tech). In totally edentulous cases, six fluoride-modified OsseoSpeed implants (Astra Tech) were inserted. Immediately after implantation, abutments were screwed onto the implants. Within 8 hours, a provisional screw-retained fiber-reinforced acrylic fixed dental prosthesis was screwed on the abutments. For the partial cases, the surgical guide rested on the remaining teeth and implants were not immediately loaded. Results: In total 13 out of 114 implants were lost within 12 months after surgery, resulting in 88.6% survival at 1 year. Twelve of those failures occurred in smokers, leading to 69.2% implant survival compared to 98.7% in nonsmokers. Implants were lost in 7 out of 26 (26.9%) patients; only 1 out of 17 nonsmokers (5.9%) compared to 6 out of 9 (66.7%) smokers lost one or more implants. In total, 38.5% of the subjects with a full immediately loaded fixed dental prosthesis experienced implant failures compared with 15.4% of the partially delayed loaded cases. The overall mean bone loss based on all implants was 0.47 mm (SD, 0.94). Mean bone loss was 0.36 mm for nonsmokers and 0.62 mm for smokers. Conclusions: On the basis of the current case control study, it is tempting to suggest that smoking is an exclusion factor when placing implants using stereolithographic guided surgery in conjunction with immediate loading. There is still not enough scientific evidence to show if this method is as safe and predictable as the traditional method. Keywords: dental implants, stereolithography, guided surgery, smoking, clinical outcome

Purpose: To compare survival and peri-implant bone loss around immediately loaded surface-enhanced implants in the maxilla supporting single crowns (SCs), fixed partial dentures (FPDs), and fixed full-arch dentures (FFDs). Materials and Methods: The study included all subjects referred for implant treatment in the maxilla followed by immediate loading between November 2004 and 2007 with at least 2 years of follow-up. Smokers were excluded. Implant survival and bone loss were assessed by a calibrated external examiner who compared digital periapical radiographs taken during recall visits with baseline radiographs (day of loading = day after implant placement). An implant was considered successful when bone loss did not exceed 1 mm. Survival of implants supporting SCs, FPDs, and FFDs was compared using the log-rank test. A linear mixedeffect model analysis was used to evaluate bone loss because of clustering of implants in patients. Results: Three hundred six implants were placed in 55 patients (31 women, 24 men; mean age, 57.5 ± 11.4 years; range, 19 to 77 years) and followed for a mean of 35 ± 10.2 months (range, 24 to 58 months). One implant failed, resulting in an overall survival rate of 99.7% on the implant level and 98.2% on the patient level. No statistically significant differences were observed in the survival rates for SCs (100%), FPDs (98%), and FFDs (100%). The overall mean bone loss was 0.27 ± 0.37 mm (range, 0.00 to 2.55 mm) and was not influenced by the prosthetic reconstruction. Conclusion: Immediate loading of fluoride-modified implants in the maxilla is a predictable and reliable treatment option with high survival rates and limited peri-implant bone loss after 2 years. No statistically significant differences were found between implants supporting SCs, FPDs, and FFDs. Keywords: bone loss, dental implant, immediate loading, implant survival