The International Journal of Prosthodontics, Pre-Print
DOI: 10.11607/ijp.8750, PubMed ID (PMID): 3798843221. Nov 2023,Pages 1-32, Language: EnglishRamanauskaite, Ausra / Schwarz, Frank
Peri-implant diseases define bacterial-plaque-induced inflammatory conditions affecting implant-surrounding tissues, classified as peri-implant mucositis and peri-implantitis. Peri-implant mucositis characterizes an inflammatory lesion that resides in the soft-tissue compartment, whereas at peri-implantitis sites, the lesions also feature progressive loss of implant-supporting bone. Inflammation resolution of and disease progression arrestment are the main therapeutic endpoints of peri-implant diseases treatment. The present position paper presents the current evidence and clinical recommendations of the European Association for Osseointegration for the treatment of peri-implant diseases. Mechanical biofilm removal along with the reinforcement of patient-administered oral hygiene is considered the standard treatment for managing peri-implant mucositis. It is recommended to assess the outcomes of peri-implant mucositis treatment 2 to 3 months after therapy, and in the absence of treatment success, a repeated intervention should be considered. Peri-implantitis treatment should follow a stepwise treatment approach, starting with a non-surgical treatment, and if not sufficient, followed by the surgical intervention. Surgical peri-implantitis therapies encompass non-reconstructive, reconstructive, and combined treatment modalities. Implantoplasty may be advocated for the treatment of supracrestal peri-implant defects, whereas reconstructive therapy is indicated at peri-implantitis sites featuring intra-osseous defects with a depth of ≥ 3 mm. Adjunctive reconstructive measures may be beneficial in enhancing radiographic defect fill and maintaining postoperative soft-tissue levels, which may have a great impact in aesthetic cases. The adjunctive use of systemic antibiotics during surgical therapy does not seem to improve the clinical outcomes. Regular supportive peri-implant therapy with biofilm removal should be an integral part of the treatment protocol of peri-implant diseases. In the presence of advanced bone loss at implants that do not play a strategic role in masticatory function, implant removal may be immediately considered.
The International Journal of Prosthodontics, Pre-Print
DOI: 10.11607/ijp.8719, PubMed ID (PMID): 3840813326. Feb 2024,Pages 1-20, Language: EnglishLorenz, Jonas / Blume, Maximilian / Schwarz, Frank / Weigl, Paul / Ghanaati, Shahram / Sader, Rober A.
Purpose: Several procedures are performed to achieve optimal esthetic results in single-tooth
implants. However, there is discordance regarding the potential benefit and risks of immediate
implant loading/provisionalization. The aim of this prospective case series is to investigate
the effect of immediate provisionalization of single-tooth implants at healed sites for periimplant
soft-tissue conditions, focusing on papilla formation around single implants.
Materials and Methods: Twelve patients received a total of 12 implants in the incisor, canine
or premolar region of the upper and lower jaw at healed sites with immediate chair-side
provisionalization. Four months later, the temporary crown was replaced by the permanent
crown. After 40±13.1 months, clinical follow-up was conducted, assessing Probing pocket
depth (PPD); Bleeding on Probing(BoP); Mucosal recession (MR) and Width of Keratinized
Mucosa (KM). Papilla index (PI) was determined immediately after implant placement
(baseline), before removing the temporary crown (t1), 4 weeks after insertion of the definitive
crown (t2) and at the final follow-up examination (t3) to evaluate papilla formation and its
change over time. Results: None of the implants were lost. The mean PPD was 2.5±0.39 mm,
BoP of 25% and 3.5 mm of KM were observed at the final follow-up. No implants showed
MR. PI increased in all patients from 1.5±0.45 at baseline to 2.4±0.56 at t1, 2.6±0.47 at t2 and
3.02.6±0 at t3. The increase in PI between t0 and each individual timepoint from t1-t3 showed
statistical significance. Conclusion: The present results indicate the suitability and benefit of
immediate provisionalization to achieve favorable peri-implant soft-tissue conditions and
papilla formation.
International Journal of Periodontics & Restorative Dentistry, Pre-Print
DOI: 10.11607/prd.6756, PubMed ID (PMID): 3765597231. Aug 2023,Pages 1-23, Language: EnglishBianchini, Marco Aurélio / Kuhlkamp, Lucas de Freitas / Schwarz, Frank / Galarraga-Vinueza, Maria Elisa
Objectives: The aim of the present case series is to exhibit the long-term clinical and radiographic outcomes of resective surgery with adjunctive implantoplasty over a 6-to-11-year follow-up. Materials and Methods: Four patients presenting 4 implants diagnosed with peri-implantitis according a to an established case definition were included in the present case series. Subjects underwent resective surgery, a modified implantoplasty approach, and implant surface decontamination. Clinical and radiographic outcomes such as bleeding on probing (BOP), suppuration on probing (SoP), probing depth (PD), marginal recession (MR), modified plaque index (mPI), and marginal bone levels (MBL) were recorded over a long-term following surgical therapy. Results: Over 6-to-11-year follow-up, mean BOP, PD, and SoP scores amounted to 17 ±24%, 2.5 ±1.26 mm, and 0%, respectively. BOP scores were reduced in 17%, PD values in 2.5mm, and SoP scores in 100%. Radiographic analysis revealed a mean radiographic bone gain of 3.1 ± 1.84 mm. Peri-implant marginal bone loss surface area decreased by 5.7±3.77mm2 over the long-term follow-up. Conclusion: Resective therapy with adjunctive implantoplasty promoted favorable clinical and radiographic outcomes at peri-implantitis treated sites over a long-term period. Clinical Relevance: Diverse surgical approaches such as resective, reconstructive, and combined therapy have been proposed towards peri-implantitis treatment. A resective surgical approach with an adjunctive “modified” implantoplasty refers to the modification of the implant body into a constricted area to mimic a “waist” silhouette. This modified technique conforms an adequate concave smooth area that may favor the outcomes of resective surgical therapy for soft tissue adaptation, biofilm control, and possible peri-implant bone gain over the long term.
Implantologie, 3/2023
Pages 257-266, Language: GermanKallab, Sandra / Schwarz, Frank / Becker, Jürgen / Brunello, Giulia
Implantate aus Zirkoniumdioxid erweisen sich als vielversprechende Alternative zu herkömmlichen Titanimplantaten. Eine 9-Jahres-Follow-up-Nachuntersuchung einer prospektiven klinischen Beobachtungsstudie dieser Arbeitsgruppe liefert weitere Daten zum Langzeiterfolg von Zirkoniumdioxid-Implantaten, welche in diesem Beitrag unter Bewertung der aktuell verfügbaren Literatur zusammenfassend dargestellt werden sollen.
Manuskripteingang: 15.08.2023, Annahme: 22.08.2023
Keywords: Zirkoniumdioxid-Implantate, Langzeitstudien, Titanimplantate, periimplantäre Mukositis, Periimplantitis
Parodontologie, 2/2023
Pages 199-205, Language: GermanObreja, Karina / Schliephake, Carla / Lermen, Yanislava / Steffen, Björn / Aldiri, Talal / Petsos, Hari / Schwarz, Frank
Gingivawucherung entpuppt sich als leukämische ZellinfiltrationAnzeichen einer Leukämie können sich in der Mundhöhle manifestieren. Deshalb kann die oralmedizinische Untersuchung eine essenzielle Bedeutung bei der Früherkennung hämatologischer Erkrankungen haben und den Ausgangspunkt für die Diagnose darstellen. Der vorliegende Fall zeigt, wie die Abklärung eines auffälligen Gingivabefunds zur Diagnose „akute myeloische Leukämie“ führte.
Manuskripteingang: 18.10.2021, Annahme: 18.11.2021
Originalpublikation: Obreja et al. (Zahnärztl Mitt 2022;112:220−225). Mit freundlicher Genehmigung des Deutschen Ärzteverlags.
Keywords: akute myeloische Leukämie, Gingivawucherung, orale Manifestationen, leukozytäres Manifestrat
Implantologie, 2/2023
Pages 111, Language: GermanSchwarz, Frank
Implantologie, 2/2023
Pages 115-119, Language: GermanSchwarz, Frank
Falldefinitionen und TherapiezieleEine systematische Literaturübersicht und Bewertung von 80 Publikationen, einschließlich 55 randomisierter kontrollierter Studien und 7 klinischer Kontrollstudien, hat zu einer Neubewertung der Wirksamkeit von alternativen und adjuvanten Methoden zur nichtchirurgischen Therapie von periimplantärer Mukositis und Periimplantitis sowie der chirurgischen Therapie von Periimplantitis geführt. Diese Ergebnisse wurden verwendet, um die S3-Leitlinie zur „Behandlung von periimplantären Infektionen an Zahnimplantaten“ (Registernummer 083-023, V 2.0, Stand 02.12.2022) zu aktualisieren. In diesem Beitrag sollen die diagnostischen Kriterien für periimplantäre Infektionen sowie die Therapieziele unter Berücksichtigung klinischer und radiologischer Parameter dargestellt werden.
Manuskripteingang: 14.04.2023, Annahme: 19.04.2023
Keywords: periimplantäre Erkrankungen, periimplantäre Mukositis, Periimplantitis
Implantologie, 2/2023
Pages 165-176, Language: GermanSchwarz, Frank / Ramanauskaite, Ausra
Nicht rekonstruktive, rekonstruktive und kombinierte VerfahrenEine systematische Literaturübersicht und Bewertung von 24 Publikationen, einschließlich 15 randomisierter kontrollierter Studien und 3 klinisch kontrollierter Studien, hat zu einer Neubewertung der Wirksamkeit der chirurgischen Therapie der Periimplantitis geführt. Diese Ergebnisse wurden verwendet, um die S3-Leitlinie zur „Behandlung von periimplantären Infektionen an Zahnimplantaten“ (Registernummer 083-023, V 2.0, Stand: 02.12.2022) zu aktualisieren. In diesem Beitrag sollen die nicht rekonstruktiven, rekonstruktiven und kombinierten Verfahren für die chirurgische Therapie der Periimplantitis dargestellt werden.
Manuskripteingang: 14.04.2023, Annahme: 20.04.2023
Keywords: periimplantäre Erkrankungen, Periimplantitis, chirurgische Therapie, rekonstruktive Therapie, Implantatplastik
Implantologie, 1/2023
Pages 79-85, Language: GermanParvini, Puria / Treitz, Caroline / Schwarz, Frank / Sader, Robert / Obreja, Karina
Autotransplantation impaktierter Eckzähne im OberkieferDie autogene Zahntransplantation gilt heute als anerkannte Alternative zum implantologischen und prothetischen Zahnersatz sowie zum kieferorthopädischen Lückenschluss. Als erfolgreiche Zahntransplantate haben sich Weisheitszähne, Prämolaren, Milcheckzähne sowie verlagerte Eckzähne bewährt. Sie können auf biologische Art und Weise fehlende oder auch nicht erhaltungsfähige Zähne ersetzen. Gerade beim Patienten mit nicht abgeschlossenem Kieferwachstum birgt die autogene Zahntransplantation Vorteile im Hinblick auf den Knochen- und Weichgewebeerhalt in der Wachstumsphase. Wichtig für die Erfolgsprognose sind vor allem die klinische und radiologische Diagnostik sowie die chirurgische Planung.
Manuskripteingang: 20.01.2023, Annahme: 26.01.2023
Keywords: Dystopie, Eckzahn, Transplantation
International Journal of Periodontics & Restorative Dentistry, 5/2022
DOI: 10.11607/prd.5942Pages 665-673, Language: EnglishObreja, Karina / Begić, Amira / Trimpou, Georgia / Galarraga-Vinueza, Maria Elisa / Balaban, Ümniye / Schwarz, Frank / Parvini, Puria
Immediate implant placement with immediate restoration in the esthetic zone is a standardized protocol that aims to satisfy the patient with an immediate, esthetic rehabilitation. This study evaluated clinical and esthetic outcomes following immediate implant placement and provisionalization over a medium- to long-term period. A total of 57 implants in 44 patients were included in the present cross-sectional study, with a follow-up period of 3.97 ± 2.03 years. Surgical and prosthetic treatments were performed according to a standardized protocol. Clinical outcomes (modified Plaque Index, bleeding on probing, probing depth [PD], keratinized mucosa, mucosal recession [MR], and pink esthetic score [PES]) were evaluated during follow-up. Peri-implant tissue health was assessed based on the established case definitions. The mean PES value at the final control examination (mean PES follow-up time: 3.79 ± 1.85 years) was 12.06, the mean PD was 2.52 ± 0.88 mm, and mean MR was 0.03 ± 0.13 mm. No suppuration, pain, or implant or prosthetic failures were reported. The prevalence rates of mucositis and peri-implantitis were 45.5% and 0%, respectively. Immediate implant placement and restoration was associated with peri-implant tissue stability and esthetics over medium- and long-term follow-up periods.