Implant survival and complications. The Third EAO consensus conference 2012

Patient-, tooth-, and dentist-related factors influencing long-term tooth retention after resective therapy in an academic setting-a retrospective study

OBJECTIVES

The aim of this study was to evaluate long-term (≥5 years) tooth survival after resective therapy of multi-rooted, periodontally treated teeth and investigate the influence of patient-, tooth-, and dentist-related risk factors on tooth loss.

MATERIALS AND METHODS

A total of 128 patients with root-resected molars were reexamined. Patient-, tooth-, and dentist-related factors were assessed. Tooth survival times were estimated using the Kaplan-Meier method in addition to a Cox proportional hazard frailty model with survival as the dependent outcome to assess an association with predictor variables.

RESULTS

Overall, 100 patients with 130 molars were included. The average postoperative reevaluation period was a 9.62 ± 3.08 year showing an overall survival rate of 56.9% after resective therapy. A cumulative survival rate of 69% (95% CI (61%; 77%)) after 5 years decreasing to 48% (95% CI (35%; 61%)) after 15 years was detected. The median survival time of resected molars was 13.83 years (95% CI (8.75; ∞)). Adherence, smoking, and insurance status were detected to significantly influence the risk for loss of molars after resective therapy.

CONCLUSIONS

Resective periodontal procedures can still be considered an option to retain periodontally compromised molars. In contrast to dentist- and tooth-related factors, patient-related factors impacted significantly upon tooth survival.

CLINICAL RELEVANCE

Periodontally compromised molars could be retained in more than 50% of the cases thus prolonging their life span significantly. This information shall be valuable for clinicians in decision-making, treatment planning, and postoperative management. The weighting of resective therapy to implants especially with regards to the risk of peri-implantitis should be considered.

Peri-implantitis and extracellular matrix antibodies: A case-control study

OBJECTIVE

The aim of this case-control study was to compare patients with a healthy peri-implant environment and patients affected by peri-implantitis, evaluating the occurrence of antibodies to extracellular matrix (ECM) molecules. The authors hypothesized the presence of ECM autoantibodies in serum of peri-implantitis patients.

MATERIALS AND METHODS

Patients were divided into two groups: one with dental implants with a diagnosis of peri-implantitis and one control group with implants classified as being "healthy." Enzyme-linked immunosorbent assay was performed on patients' sera to detect human antibodies to type I, III, IV, and V collagens, laminin, and fibronectin. Fisher exact test was performed to evaluate statistical association, with a significant P < 0.05.

RESULTS

Forty-two patients were enrolled in this study, 27 females (64.28%) and 15 males (35.72%) with a mean age of 53 ± 29.69 years (age range 32-74). The presence of antibodies to CIII was recorded in 6/21 (28.57%) patients of test group, compared to just 2/21 (9.52%) for the control group, showing a statistically significant difference (P < 0.05). Other antibodies tested were found to be not statistically significant or absent.

CONCLUSIONS

Within the limitations of this study, it can be concluded that further studies, with larger sample and different design, are necessary to address the research purpose, evaluating possible associations between anti-ECM antibodies and peri-implantitis.

Patient-centered rehabilitation of single, partial, and complete edentulism with cemented- or screw-retained fixed dental prosthesis: The First Osstem Advanced Dental Implant Research and Education Center Consensus Conference 2017

The aim of this consensus conference was to provide clinical guidelines, based on the available evidence and on the author's daily practice and experience, for general dentistry and dental practitioners to allow them to delivery long-term successful restorations. Three groups of expert clinicians and dental technicians were invited to evaluate all of the scientific literature from 1967 up to March 2017 to identify relevant studies on assigned topics and to prepare in advance narrative/systematic review, written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, to fulfill the consensus statement criteria. The three topics assigned to the three groups were abutment/framework materials and customization (metal vs. metal-free restorations), abutment/framework protocols and designs, and abutment/framework retentions (cemented- vs. screw-retained implant-supported prostheses). All the expert clinicians presented their results, and the lectures were followed by discussions. No significant differences in clinical parameters (marginal bone loss, bleeding on probing, and pocket probing depth) between screw- or cemented-retained were found for single and multiple implant-supported restorations. There is moderate evidence that nonoriginal abutments provide worse mechanical behavior than originals and high evidence that different implant neck designs do not offer any clinical or radiographic advantage. All the participants agreed that it is desirable to connect and remove abutments as few times as possible. There is medium evidence that an adequate platform switching tends to enhance tissue volume and stability in the medium- and long-term follow-up. No statistically significant differences exist between metal and zirconia as a framework material. The authors discussed and all agreed that retrievability and patient's expectation (function and esthetics) should guide the choice of the most adequate technique, component, and material.

A Retrospective Multicenter Study on Short Implants With a Laser-Microgrooved Collar (≤7.5 mm) in Posterior Edentulous Areas: Radiographic and Clinical Results up to 3 to 5 Years

PURPOSE

We aimed to retrospectively evaluate the radiographic and clinical results and the success rate of short implants with a laser-microgrooved collar (≤7.5 mm) placed in the posterior areas after up to 3 to 5 years of function and the possible influence of several variables-such as gender, periodontitis, smoking habit, location, implant stability at placement, and prosthetic fixation design-on implant marginal bone loss (MBL).

MATERIALS AND METHODS

A chart review was used for this multicenter study, which involved 5 private dental clinics. All patients had been treated with short dental implants with a laser-microgrooved collar from January 2012 to December 2015.

RESULTS

A total of 174 patients (99 male and 75 female patients; mean age, 51.6 ± 2.8 years) with 254 implants were evaluated. Seven short implants failed. The cumulative success rate was 97.2%, without a statistically significant difference between implants placed in the posterior maxilla and mandible. The mean MBL was 0.18 ± 0.7 mm at the mesial aspect and 0.19 ± 0.6 mm at the distal aspect. No statistical relationships were found between MBL and gender, periodontitis, smoking habit, location, implant stability at placement, and prosthetic fixation design.

CONCLUSIONS

At the end of the 3- to 5-year follow-up period, short implants with a laser-microgrooved collar (≤7.5 mm) in the posterior areas yielded a relatively high cumulative success rate. The laser-microgrooved collar implant maintained stable marginal bone levels. No investigated variable was statistically associated with MBL.

Development and viability of biofilms grown on experimental abutments mimicking dental implants: An in vivo model

BACKGROUND

To determine whether an experimental abutment mimicking the macro- and microstructure of a dental implant is a suitable method for recovering biofilm, and to describe the features of biofilms formed around such abutments on healthy implants.

MATERIAL AND METHODS

Experimental abutments were used in 15 patients without peri-implant diseases. After 14 days' absence of dental hygiene in this area, the abutments were retrieved and analyzed through confocal laser scanning microscopy and scanning electron microscopy. The biofilm formation on the surface of the first 5 abutments was determined by a fluorescence-staining method using SYTO9 nucleic acid stain. In order to study the biofilm's coverage and vitality, 10 additional abutments were assessed using live & dead bacterial viability. Descriptive and bivariate analyses of the data were performed.

RESULTS

A global plaque coverage of the abutments was observed in all cases. The submucosal area of the abutment was mostly covered with biofilm (over 21%). Moreover, significant differences between supra- and subgingival locations were detected.

CONCLUSIONS

This in vivo experimental model allows detailed observation of the extensive plaque growth found on exposed experimental abutments mimicking dental implants when hygiene measures are absent. The biofilm coverage is significantly higher in the supragingival zone than in the subgingival portion.

Metal Nanoparticles Released from Dental Implant Surfaces: Potential Contribution to Chronic Inflammation and Peri-Implant Bone Loss

Peri-implantitis is an inflammatory disease affecting tissues surrounding dental implants. Although it represents a common complication of dental implant treatments, the underlying mechanisms have not yet been fully described. The aim of this study is to identify the role of titanium nanoparticles released form the implants on the chronic inflammation and bone lysis in the surrounding tissue. We analyzed the in vitro effect of titanium (Ti) particle exposure on mesenchymal stem cells (MSCs) and fibroblasts (FU), evaluating cell proliferation by MTT test and the generation of reactive oxygen species (ROS). Subsequently, in vivo analysis of peri-implant Ti particle distribution, histological, and molecular analyses were performed. Ti particles led to a time-dependent decrease in cell viability and increase in ROS production in both MSCs and FU. Tissue analyses revealed presence of oxidative stress, high extracellular and intracellular Ti levels and imbalanced bone turnover. High expression of ZFP467 and the presence of adipose-like tissue suggested dysregulation of the MSC population; alterations in vessel morphology were identified. The results suggest that Ti particles may induce the production of high ROS levels, recruiting abnormal quantity of neutrophils able to produce high level of metalloproteinase. This induces the degradation of collagen fibers. These events may influence MSC commitment, with an imbalance of bone regeneration.

Randomized Controlled Trials in Implant Dentistry: Assessment of the Last 20 Years of Contribution and Research Network Analysis

The aim of this study was to evaluate the characteristics of randomized controlled trials (RCTs) regarding implant-supported single tooth or fixed partial dentures. We performed searches (PubMed/MEDLINE and Web of Science) to identify all RCTs published from 1996 to 2016 and assessed publication details, study characteristics, international collaboration networks, and characteristics related to the implant-supported treatment. Two reviewers independently screened the titles/abstracts and selected full texts. A total of 122 RCTs were included, and most of the authors were from Europe (72%). Most trials did not report a trial registering number (89.9%) or sample size calculation (58.2%). The use of the CONSORT Statement increased over the past 9 years. Trials were mostly conducted at universities (54.9%), and only 13.1% compared 2 or more implant brands. Loading protocol was the most prevalent main comparison among the included studies, and most of the RCTs did not clearly report whether they excluded patients with known risk factors. The studies reviewed here presented different methodological and publication characteristics, and many did not show aspects aligned with current research practices.

The effect of implant prosthesis complications on patient satisfaction

STATEMENT OF PROBLEM

How complications regarding implant prostheses affect patient satisfaction and oral health-related quality of life (OHRQoL) is unclear.

PURPOSE

The purpose of this retrospective study was to compare patient satisfaction with implant restorations in patients with or without a history of complications. These data were used to determine whether implant prosthesis complications affected self-reported OHRQoL.

MATERIAL AND METHODS

Data were gathered from 176 edentulous and partially dentate patients who had received implant prostheses consisting of implant-supported crowns, implant-supported overdentures, and screw-retained fixed dental prostheses (FDPs) in predoctoral and postdoctoral clinics between January 1, 2010, and December 31, 2014. Demographics and complications were self-reported by means of a survey. Patients rated their OHRQoL using the Quality of Life with Implant-Prostheses (QoLIP-10) questionnaire. Means were compared by using a 1-way ANOVA to compare the variables of prosthesis complications, sociodemographic data, and patient satisfaction. Significantly different variables were further evaluated using a post hoc Tukey-Kramer Honestly Significant Different (HSD) test (α=.05).

RESULTS

Statistically significant differences in patient satisfaction were found related to prosthesis complications, gender, and marital status. The most common complication for implant-supported crowns was screw loosening. For implant-supported overdentures and screw-retained FDPs, the most common complication was repair of the prosthesis. Those who had experienced complications reported lower OHRQoL scores than those who had not. Women and widows/widowers overall reported lower OHRQoL scores. The OHRQoL scores of women with and without prosthesis complications were not statistically different (P=.073). No significant differences were found relative to age (P=.937) or education (P=.302). Patients without complications with implant-supported crowns reported the lowest satisfaction because of oral hygiene difficulties. The lowest satisfaction in patients with complications of implant-supported overdentures and screw-retained FDPs was related to worry/concern because of problems with the implant prosthesis.

CONCLUSIONS

The results of this survey suggest that patients who experience complications with an implant prosthesis report a lower OHRQoL score than those who do not. Future studies are needed to evaluate patient satisfaction by comparing prosthesis complications with and without implants to determine whether patients who have had complications with implant prostheses are more satisfied than those who have experienced complications with conventional prostheses.

Therapeutic alternatives for addressing pink esthetic complications in single-tooth implants: A proposal for a clinical decision tree

OBJECTIVE

Esthetic complications in implant therapy today represent a clinical challenge, when the aim is to overcome the sequelae and obtain a pleasing result. The current scientific literature about this topic is scarce and often based on case reports and the personal opinions of clinicians.

CLINICAL CONSIDERATIONS

The aim of this article is to introduce a decision tree for diagnosis and treatment of complications, focusing on the pink esthetic of single-tooth implants and based on three diagnostic pillars (3D implant position, peri-implant hard-tissue anatomy, and peri-implant soft-tissue anatomy). Different shortcomings have been identified for each of the three diagnostic areas.

CONCLUSIONS

Following this tree, the article proposes treatment alternatives including soft- and hard-tissue reconstruction, implant submergence, orthodontic extrusion, and implant extraction in order to help clinicians establish a logical therapeutic sequence.

CLINICAL SIGNIFICANCE

Guidelines for adequate diagnosis and management of single implant-supported restorations with compromised esthetics is mandatory when attempt to overcome shortcoming in the pink esthetic result.

Evaluation of Biological Response of STRO-1/c-Kit Enriched Human Dental Pulp Stem Cells to Titanium Surfaces Treated with Two Different Cleaning Systems

Peri-implantitis-an infection caused by bacterial deposition of biofilm-is a common complication in dentistry which may lead to implant loss. Several decontamination procedures have been investigated to identify the optimal approach being capable to remove the bacterial biofilm without modifying the implant surface properties. Our study evaluated whether two different systems-Ni-Ti Brushes (Brush) and Air-Polishing with 40 µm bicarbonate powder (Bic40)-might alter the physical/chemical features of two different titanium surfaces-machined (MCH) and Ca⁺⁺ nanostructured (NCA)-and whether these decontamination systems may affect the biological properties of human STRO-1⁺/c-Kit⁺ dental pulp stem cells (hDPSCs) as well as the bacterial ability to produce biofilm. Cell morphology, proliferation and stemness markers were analysed in hDPSCs grown on both surfaces, before and after the decontamination treatments. Our findings highlighted that Bic40 treatment either maintained the surface characteristics of both implants and allowed hDPSCs to proliferate and preserve their stemness properties. Moreover, Bic40 treatment proved effective in removing bacterial biofilm from both titanium surfaces and consistently limited the biofilm re-growth. In conclusion, our data suggest that Bic40 treatment may operatively clean smooth and rough surfaces without altering their properties and, consequently, offer favourable conditions for reparative cells to hold their biological properties.

Frequency of infraposition and missing contact points in implant-supported restorations within natural dentitions over time: A systematic review with meta-analysis

OBJECTIVES

The aim of this systematic review was to assess clinical evidence on adverse effects of osseointegrated implants placed among natural teeth of a residual dentition.

METHODS

Seven databases were searched without restrictions up to January 2018 for clinical studies on implant infraposition (IIP) or proximal contact point (PCP) loss to the adjacent teeth. After duplicate selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of odds ratios (OR) or mean differences (MD) and their 95% confidence intervals (CI) were performed, followed by meta-regression and sensitivity analyses.

RESULTS

A total of 27 nonrandomized studies with 1,572 patients (mean age 42.2 years/51.2% female) followed up to 18.5 years after implant placement were included. The pooled %prevalence of IIP was 50.5% (nine studies; 95% CI = 26.3-74.5%), and the pooled IIP extent was 0.58 mm (six studies; 95% CI = 0.33-0.83 mm), while IIP > 1 mm was seen for 20.8% of placed implants (five studies; 95% CI = 8.3-37.1%), and male patients were less prone to IIP than female patients (three studies; OR = 0.30; 95% CI = 0.10-0.88; p = 0.03). The pooled %prevalence of PCP loss was 46.3% (nine studies; 95% CI = 32.3-60.6%), with increase through observation time (two studies; OR = 1.09; 95% CI = 1.03-1.16; p = 0.004) and predilection for mesial PCPs (five studies; OR = 2.25; 95% CI = 1.06-4.77; p = 0.03). However, the quality of evidence was very low due to bias.

CONCLUSIONS

Patients and doctors need to be aware that long-term adverse effects of dental implants among natural teeth can be observed in terms of IIP and PCP loss to the adjacent teeth.

Retrospective cohort study of 4,591 dental implants: Analysis of risk indicators for bone loss and prevalence of peri-implant mucositis and peri-implantitis

Background

Due to the risk of peri‐implantitis, following dental implant placement, this study aimed to evaluate risk indicators associated with marginal bone loss from a retrospective open cohort study of 4,591 dental implants, placed in private practice, with 5‐ to 10‐year follow‐up. Furthermore, the prevalence of mucositis and peri‐implantitis among the study cohort was evaluated, comparing strict versus relaxed criteria for bleeding on probing.

Methods

Periapical radiographs were used to evaluate changes in crestal bone level. Peri‐implant soft tissue was evaluated using an ordinal mucosal index in comparison with the conventional binary threshold for bleeding (i.e., present or not). Periodontal probing depth was not evaluated. Linear mixed models were used to evaluate bone level over time, and other risk indicators, at the patient and implant level.

Results

Risk indicators found to have a significant impact on bone level included: autoimmune disease, heavy smoking, bisphosphonate therapy, implant location, diameter and design, and the presence of a bone defect at site of implantation. The prevalence of mucositis at the implant level was 38.6% versus 14.2% at 6 to 7 years, when using strict versus relaxed criteria, respectively. The prevalence of peri‐implantitis after 6 to 7 years was 4.7% and 3.6% when using strict versus relaxed criteria, respectively.

Conclusions

The results of this study identify several risk factors associated with bone loss. Furthermore, the prevalence of mucositis and peri‐implantitis was shown to be lower at both the implant and the patient when using strict versus relaxed criteria based on the assessment of oral health surrounding dental implants.

[A review of peri-implant microbiology]

Dental implants represent the majority of treatment strategies used to replace missing teeth. However, peri-implant diseases caused by disturbance in peri-implant microbiological balance are among the reasons for implant failure. Since the 1980s, peri-implant microorganisms have been a hot research topic in dental microbiology. The bacterial ecology between the disease and health largely differs, which directly or indirectly increases the risk of peri-implant diseases. Accordingly, the determination of the 'core microbiome' of peri-implantitis and peri-implant mucositis is a key point of recent research.

The impact of implant abutment surface treatment with TiO2 on peri-implant levels of angiogenesis and bone-related markers: a randomized clinical trial

The goal of this randomized, blinded, split-mouth controlled clinical trial was to assess the influence of abutment surface treatment on tissue healing. Fifteen patients received two implants distributed randomly to two groups: test (TiO₂ abutment surface), control (standard abutment surface). Levels of epidermal growth factor (EGF), bone morphogenetic protein 9 (BMP-9), endothelin 1 (ET-1), fibroblast growth factor (FGF), placental growth factor (PlGF), and vascular endothelial growth factor (VEGF) were quantified in the peri-implant fluid after 3, 14, 30, and 60 days. Inter-group comparisons indicated higher levels of EGF, BMP-9, ET-1, FGF, and PlGF in the test group after 30days (P<0.05). PlGF levels were also higher in the test group after 60 days. In the test group, intra-group analysis revealed different levels of ET-1 and FGF between days 3 and 30, and days 3 and 60 (P<0.05); furthermore, VEGF levels were significantly higher on day 60 than on day 3 (P <0.05). In the control group, intra-group analysis demonstrated significantly different levels of ET-1, FGF, and PlGF between days 3 and 60 and of PlGF between days 14 and 60 (P<0.05). In conclusion, abutment surfaces treated with TiO₂ influenced the levels of angiogenesis and bone-related markers.

Laser microtextured titanium implant surfaces reduce in vitro and in situ oral biofilm formation

INTRODUCTION

Micro- or nano-topography can both provide antimicrobial properties and improve osseointegration of dental implant titanium surfaces. Laser treatment is one of the best surface microtexturing techniques. The aim of this study was to evaluate in vitro and in situ biofilm formation on a laser-treated titanium surface, comparing it with two conventional surfaces, machined and grit-blasted.

METHODS

For the in vitro experiment, an oral microcosm biofilm model was developed on the surface of titanium disks and reference human enamel using a bioreactor for 48 h. For the in situ experiment, titanium implants with laser-treated, machined and grit-blasted surfaces were mounted on intraoral trays and worn by ten volunteers for 48 h. Biofilm formation was quantitatively evaluated, and surfaces were analyzed using confocal laser scanning microscopy, scanning electron microscopy and energy-dispersive X-ray spectroscopy.

RESULTS–IN VITRO STUDY

Biofilm structures with a prevalence of viable cells covered most of the machined, grit-blasted and human enamel surfaces, whereas less dense biofilm structures with non-confluent microcolonies were observed on the laser-treated titanium. Laser-treated titanium showed the lowest biofilm formation, where microorganisms colonized the edges of the laser-created pits, with very few or no biofilm formation observed inside the pits.

RESULTS–IN SITU STUDY

The biofilm formation pattern observed was similar to that in the in vitro experiment. Confocal laser scanning microscopy showed complete coverage of the implant threads, with mostly viable cells in grit-blasted and machined specimens. Unexpectedly, laser-treated specimens showed few dead microbial cells colonizing the bottom of the threads, while an intense colonization was found on the threading sides.

CONCLUSION

This data suggests that laser-created microtopography can reduce biofilm formation, with a maximum effect when the surface is blasted orthogonally by the laser beam. In this sense the orientation of the laser beam seems to be relevant for the biological interaction with biofilms.

Microbial Leakage at Morse Taper Conometric Prosthetic Connection: An In Vitro Investigation

OBJECTIVE

To evaluate in vitro the sealing capability at the prosthetic connection interface of 2 conometric systems.

MATERIALS AND METHODS

Two conometric systems with the same design and different material were used, for a total of 24 samples. Each sample was assembled by a tapered abutment and respective coping. In group A, the copings were made of gold, whereas in group B they were made of PEEK. Three μL of mix bacterial suspension (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Fusobacterium nucleatum species) was inoculated into the abutment screw hole, and the coping was inserted on the abutment. Samples were immersed into culture tubes and incubated for 24, 48, and 72 hours into anaerobic conditions. Visual evaluation of turbidity was performed at each time point. Qualitative-quantitative assessment using real-time polymerase chain reaction was performed at 72 hours. Any difference between the groups was checked by means of Fisher exact test.

RESULTS

Microbial leakage occurred in both groups, and there was no statistically significant difference between groups. Microbial concentration resulted in a presence inferior to 1 × 10 copies/μL in all positive assemblies.

CONCLUSIONS

Because of the low bacterial count, it can be concluded that a minimal bacterial infiltration may be allowed by conometric interfaces for prosthetic connection.

The effect of single tooth implant restorations on the survival, morbidity, pulpal, and periapical health of adjacent teeth: A chart review

PURPOSE

To determine whether the placement and restoration of a single tooth posterior implant affects the survival, morbidity, pulpal, and periapical health of adjacent natural teeth.

MATERIALS AND METHODS

A retrospective chart review identified patients who received single posterior tooth implants between August 2004 and July 2015 at the UNC SOD and met the study inclusion criteria. Preoperative and postoperative records were reviewed; survival and changes in coronal, pulpal, and periapical status of teeth adjacent to the implant and contralateral tooth were recorded. Dichotomous survival, restoration, and retreatment outcomes were analyzed using conditional logistic regression with patient as strata and implant versus control as the predictor. Exact odds ratio estimates and the 95% confidence intervals were obtained for the relationship of implant versus control side and outcomes.

RESULTS

Five hundred and fifty-five sites with follow-up time averaging 5 years ± 30.8 months were reviewed. Teeth adjacent to implants had 1.75 (95% CI: 1.17, 2.64) times the odds of restorative retreatments as compared to controls (P = .005). On the implant side, 48 adjacent teeth (4.5%) were more heavily restored at follow up, while 84 (7.9%) experienced retreatment with comparable number of surfaces restored. On the contralateral side, 54 adjacent teeth (5.0%) were more heavily restored, and 56 (5.2%) experienced comparable levels of retreatment. In addition, 17 (1.7%) implant adjacent teeth required root canal treatment, compared to 12 (1.2%) on the contralateral side; 1 implant adjacent tooth required root canal retreatment. Forty-two teeth (3.8%) adjacent to implants were lost, compared to 35 (3.2%) adjacent to natural teeth.

CONCLUSIONS

The incidence for restorative retreatment was significantly higher on teeth adjacent to implant restorations as compared to the contralateral controls. There were no significant differences in the survival, morbidity, pulpal, or periapical health of teeth adjacent to single tooth implants compared to those adjacent to the contralateral natural tooth.

Peri-implantitis: A Comprehensive Overview of Systematic Reviews

The objective of this systematic review was to perform a comprehensive overview of systematic reviews and meta-analyses pertaining to peri-implantitis in humans, including the prevalence and incidence, the diagnostic findings, microbial findings, effects of systemic diseases, and treatment of peri-implantitis. Electronic databases were searched for systematic reviews and meta-analyses of peri-implantitis. In view of the limitations of the included systematic reviews, the outcome of this overview suggested that (1) occurrence of peri-implantitis was higher in patients with periodontitis, in patients who smoke, and after 5 years of implant function; (2) the microbial profile of peri-implantitis was different from periodontitis; (3) risk for peri-implantitis was higher in patients with uncontrolled diabetes and cardiovascular disease; (4) there was no strong evidence to suggest the most effective treatment intervention for peri-implantitis, although most peri-implantitis treatments can produce successful outcomes; and (5) postimplant maintenance may be crucial in patients with a high risk of peri-implantitis.

Bone grafting for alveolar ridge reconstruction. Review of 166 cases

Objective:

to investigate the predictive factors of failure in bone grafts for alveolar ridge augmentation and implant surgery.

Methods:

we reviewed the charts of 166 patients operated between 1995 and 2014. A total of 248 grafting procedures were performed. We submitted the data to the binomial test at 5% significance.

Results:

grafts to gain width of the alveolar ridge (65.32%) were more frequent than sinus lifting (p<0.0001) and the number of grafts to the posterior maxilla (48.8%) was greater than in other regions (p<0.01); 6.04% of the grafts were lost. The losses in anterior (p<0.0309) and posterior (p<0.0132) maxilla were higher than in the mandible. There were 269 ​​implants installed in the grafted areas, of which only 4.83% were lost. The number of implants lost (4.51%) in areas of onlay grafts was not statistically higher than those placed after sinus lifting (2.63%, p<0.2424). Losses were greater in the anterior (53.85%) and posterior (38.46%) maxilla than in the mandible (p<0.031). Regarding patients' age, 76.92% of the lost grafts (p<0.006) and 80% of the lost implants (p<0.001) were installed in patients over 40 years.

Conclusion:

failure rate was higher both for grafts and dental implants in the maxilla and in patients over 40 years of age.

Objetivo:

investigar os fatores preditivos de falhas em enxertos ósseos para aumento do rebordo alveolar e cirurgia de implantes.

Métodos:

os prontuários de 166 pacientes, operados entre 1995 e 2014, foram revistos. Um total de 248 enxertos foi realizado. Os dados foram submetidos ao teste binomial a 5% de significância.

Resultados:

os enxertos para ganho em espessura do rebordo alveolar (65,32%) foram mais frequentes do que levantamentos de seio maxilar (p<0,0001) e o número de enxertos para a região posterior da maxila (48,8%) foi maior do que em outras regiões (p<0,01). Foram perdidos 6,04% dos enxertos. As perdas em maxila anterior (p<0,0132) e posterior (p<0,0309) foram maiores do que na mandíbula. Foram instalados 269 implantes nas áreas enxertadas e apenas 4,83% perdidos. O número de implantes perdidos (4,51%) em áreas de enxertos em bloco não foi estatisticamente maior do que na área de seios maxilares enxertados (2,63%) (p<0,2424). As perdas foram maiores na região anterior (53,85%) e posterior (38,46%) da maxila em relação a mandíbula (p<0,031) e, 76,92% dos enxertos (p<0,006) e 80% dos implantes perdidos (p<0,001), foram instalados em pacientes com mais de 40 anos de idade.

Conclusão:

maior taxa de falhas foi observada para enxertos e implantes dentários realizados em maxila e em pacientes com mais de 40 anos de idade.

Five-Year Survival of Short Single-Tooth Implants (6 mm): A Randomized Controlled Clinical Trial

The aim of the present study was to evaluate whether 6-mm dental implants in the posterior segments of either jaw perform equally well in terms of clinical and radiographic outcomes when compared with 10-mm implants after 5 y of loading. Patients with single-tooth gaps in the posterior area who were scheduled for implant therapy were randomly assigned to a group receiving either a 6- or 10-mm implant. After a healing period of 10 wk, implants were loaded with a screw-retained single crown and followed up at yearly intervals. Of 96 patients, 86 could be recalled after 5 y. The implant survival rates amounted to 91% (95% confidence interval: 0.836 to 0.998) for the 6-mm group and 100% for the 10-mm group ( P = 0.036). Median crown-to-implant (C/I) ratios were 1.75 (interquartile range [IQR], 1.50 to 1.90) for the 6-mm group and 1.04 (IQR, 0.95 to 1.15) for the 10-mm group, whereas the median marginal bone levels measured −0.29 mm (IQR, −0.92 to 0.23) for the 6-mm group and −0.15 mm (IQR: −0.93 – 0.41) for the 10-mm group after 5 y. The C/I ratio turned out to be statistically significant ( P < 0.001), whereas marginal bone levels showed no significant difference between the groups. The 6-mm implants exhibited significantly lower survival rates than the 10-mm implants over 5 y, whereas there was no difference between upper and lower jaws in terms of survival ( P = 0.58). Lost implants did not show any sign of marginal bone loss or peri-implant infection previous to loss of osseointegration. High C/I ratio and implant length had no significant effect on marginal bone level changes or technical and biological complications (German Clinical Trials Registry: DRKS00006290).

Should implants be considered for patients with periodontal disease?

Dental implants are seen as a good option for replacing missing teeth. The success and survival rates for implants are very high. Concerns are developing about the problem of peri-implantitis. The reports of its prevalence vary but it is noted that the presence of periodontal disease is a risk factor. The issue of peri-implantitis was raised in the House of Lords in 2014. Complaints relating to implants is on the rise with the General Dental Council. Placement of implants in patients with periodontal disease is not a treatment that should be done without a full periodontal assessment and stabilisation of periodontal disease first. This review considers the risk of placing implants in patients with aggressive and chronic periodontitis.

Antibiotic prescription for the prevention and treatment of postoperative complications after routine dental implant placement. A cross-sectional study performed in Spain

Background

As there are no established guidelines for antibiotic prescription after dental implant placement a study was made to determine the current prescribing habits of several groups of practitioners regarding antibiotics to prevent and/or treat postoperative complications — early failures and infections — in relation to routine dental implant placement.

Material and Methods

An electronic survey was sent to postgraduate students and professionals with experience in routine dental implant placement who practice in Spain. The questions asked were related to whether antibiotics were routinely prescribed either pre- or postoperatively to prevent and/or treat postoperative complications during routine dental implant placement, and, if so, what antibiotics, dosage, frequency, and duration were used. Descriptive and bivariate analyses of the data were performed.

Results

Two hundred and forty-seven responses were obtained. Preventively, 17 respondents (6.9%) prescribed antibiotics only preoperatively (95% confidence interval (CI): 3.7 to 10.0%), 100 (40.5%) preferred to give them exclusively during the postoperative period (95%CI 34.4 to 46.6%) and 94 practitioners (38.1%) prescribed antibiotics both pre- and post-operatively (95%CI 32.0 to 44.1%). The most common preoperative regime was amoxicillin 2 g given orally 1 hour before the procedure (21.6%, n = 24) following amoxicillin 750 mg given orally 1 day prior to surgery (21.6%, n = 24). The most common routine postoperative regime was amoxicillin 750 mg given orally for 7 days (34.0%, n = 66). To treat postoperative infections during the osseointegration period, 233 respondents (93.2%) prescribed antibiotics (95%CI 91.4 to 97.2%). The most common regime used was amoxicillin and potassium clavulanate 875/125 mg, given orally for 7 days (51.9%, n = 121).

Conclusions

There is no consensus among dental clinicians regarding antibiotic use during routine dental implant placement to prevent postoperative complications and/or early failures. Moreover, the most commonly-prescribed regimes differ from that recommend in the latest published studies.

Key words:Antibiotics, dental implants, oral implantology, complications, postoperative wound infection, early failure.

Effects of d-valine on periodontal or peri-implant pathogens: Porphyromonas gingivalis biofilm

BACKGROUND

When presented with a surface or an interface, bacteria often grow as biofilms in which cells are held together by an extracellular matrix. Biofilm formation on implants is an initiating factor for their failure. Porphyromonas gingivalis is the primary etiologic bacteria of initiation and progression of periodontal disease. This microorganism is also the risk factor of many systemic diseases, such as cardiovascular disease, diabetes, and pulmonary infection. To date, no medication that can remove such biofilm has been accepted for clinical use. D-valine (D-val) can reportedly inhibit the formation of biofilm and/or trigger the scattering of mature biofilm. Accordingly, this study investigated the effects of d-val on single-species P. gingivalis biofilms in vitro.

METHODS

P. gingivalis grown in brain heart infusion culture with or without d-val was inoculated in 24- or 96-well plates. After incubation for 72 hours, biomass via crystal violet staining, extracellular polysaccharide production by biofilms, and scanning electron microscopy (SEM) were used to determine the d-val concentration that can effectively prevent P. gingivalis biofilm formation.

RESULTS

Experimental results showed that d-val effectively inhibited biofilm formation at concentrations ≥50 mM (mMol/L), and that d-val inhibition increased with increased concentration. Moreover, at high concentrations, the bacterial form changed from the normal baseball form into a rodlike shape. d-val also notably affected extracellular polysaccharide production by P. gingivalis.

CONCLUSIONS

d-val can inhibit P. gingivalis biofilm formation, and high concentrations can affect bacterial morphology.

Assessment of Survival Rate of Dental Implants in Patients with Bruxism: A 5-year Retrospective Study

Background:

Dental implants are associated with failure such as early or late failure. Systemic conditions such as diabetes, hypertension, and bruxism affect the success rate. The present study was conducted to assess complications in dental implants in bruxism patients.

Materials and Methods:

This 5-year retrospective study was conducted on 450 patients (640 dental implants) who received implants during the period and followed up for 5 years from June 2010 to June 2016. Among these patients, 124 had bruxism habit. Dental radiographs or patients' recalled records were evaluated for the presence of complications such as fracture of implant, fracture of ceramic, screw loosening, screw fracture, and decementation of unit.

Results:

In 240 males and 210 females, 380 implants and 260 implants were inserted, respectively. The difference was statistically nonsignificant (P = 0.1). A total of 145 screw-type and 130 cemented-type fixations had complications. The difference was statistically nonsignificant (P = 0.5). Complications were seen in single crown (45), partial prostheses (125), and complete prostheses (105). The difference was statistically significant (P = 0.012). The common complication was fracture of ceramic (70) in cemented-type fixation and fracture of ceramic (85) in screw-type fixation. The difference was statistically significant (P = 0.01). Forty-two single crowns showed decementation, 85 partial prostheses had fracture of ceramic/porcelain, and 50 complete prostheses showed fracture of ceramic/porcelain. The failure rate was 42.9%. Survival rate of dental implants in males with bruxism habit was 90% after 1 year, 87% after 2 years, 85% after 3 years, 75% after 4 years, and 72% after 5 years. Survival rate of dental implants in females with bruxism habit was 92% after 1 year, 90% after 2 years, 85% after 3 years, 75% after 4 years, and 70% after 5 years. The difference among genders was statistically nonsignificant (P = 0.21).

Conclusion:

Bruxism is a parafunctional habit which affects the survival rate of dental implants. There is requirement to follow certain specific protocols in bruxism patients to prevent the developing complications.

The periodontal pocket

Periodontal disease is synonymous with the presence of periodontal pockets, and very often the clinical success of periodontal therapy is based on periodontal pocket depth reduction. Therefore, in the fields of periodontology and implant dentistry, significant research effort has been placed on the etiopathogenesis, diagnosis and treatment of periodontal/peri-implant disease and as a consequence on pocket pathology. In this volume of Periodontology 2000, the in-depth reviews include topics ranging from preclinical models, anatomy and structure of tissues, and molecular and bacterial components, to treatments of pockets around teeth and implants. These reviews aim to provide the readers with current and future perspectives on the different areas of research into the periodontal pocket.

Plaque accumulation on titanium disks with different surface treatments: an in vivo investigation

Implants with rough surfaces are today widely used. It has been speculated that rough surfaces (Ra > 0.2 μm) provide a better "substrate" for retention and accumulation of plaque in terms of area, thickness and colony-forming unit that can eventually lead to peri mucositis and/or peri-implantitis. The aim of this investigation was to evaluate in vivo the plaque accumulation after 48 h on three implant surfaces with different treatments. For this investigation, we used 21 sterilized titanium disks, with a diameter of 8mm and a thickness of 3 mm, provided by the manufacturer: 7 with machined surface, as smooth control, 7 with HA grit sandblasted RBM surface and 7 with Ca⁺⁺ incorporated in titanium Xpeed surface. One disk for each surface treatment was characterized at time 0 by SEM and AFM to study, respectively, the surface morphology and roughness. The other 18 disks were mounted randomly on three upper acrylic bites in a buccal lateral position, worn for 48 h by three volunteer students for plaque accumulation. After 48 h each disk was removed and analyzed qualitatively and quantitatively by an independent operator, not involved into the study, in order to avoid bias. Data collected were statistically analyzed by one-way ANOVA. The qualitative analysis showed no differences in terms of total plaque accumulation between the surfaces. Data from quantitative analysis using Anova Test showed no significance between all groups. In this in vivo investigation all the surfaces studied promoted plaque formation. The degree of surface roughness seems not to be a critical factor for plaque accumulation.

The role of immediate provisional restorations on implants with a hydrophilic surface: A randomised, single-blind controlled clinical trial

OBJECTIVES

To compare the radiographic bone changes, clinical parameters and aesthetic outcomes of immediately provisionalised and conventionally restored implants at 12- and 24-months post-implant placement.

MATERIAL AND METHODS

In 24 patients, 24 bone level implants with a hydrophilic (SLActive) surface were placed in healed sites and they were either immediately provisionalised with a non-occluding temporary crown (test group) or left without a crown (control group). In both groups, the definitive restoration was placed 16 weeks after implant placement. Clinical and radiographic parameters were calculated at 12- and 24-months post-implant placement, together with implant success/survival rates according to three different sets of criteria. The aesthetic outcome was evaluated through the Papilla Fill Index and the Pink Aesthetic Score.

RESULTS

The mean marginal bone loss at 1 year was -0.73 mm (SD 0.83 mm) in the test group and -0.22 mm (SD 0.46 mm) in the control group (p > .05). Whilst 100% survival rate and positive aesthetic outcomes were recorded in both groups, three patients of the test group did not fulfil all success criteria.

CONCLUSIONS

Immediate provisionalisation may represent a viable option for the replacement of single missing teeth, with radiographic, clinical and aesthetic results comparable to those of conventionally loaded implants at 2 years of follow-up.

In Vitro Laser Treatment Platform Construction with Dental Implant Thread Surface on Bacterial Adhesion for Peri-Implantitis

This study constructs a standard in vitro laser treatment platform with dental implant thread surface on bacterial adhesion for peri-implantitis at different tooth positions. The standard clinical adult tooth jaw model was scanned to construct the digital model with 6 mm bone loss depth on behalf of serious peri-implantitis at the incisor, first premolar, and first molar. A cylindrical suite connected to the implant and each tooth root in the jaw model was designed as one experimental unit set to allow the suite to be replaced for individual bacterial adhesion. The digital peri-implantitis and suite models were exported to fulfill the physical model using ABS material in a 3D printer. A 3 mm diameter specimen implant on bacterial adhesion against Escherichia coli was performed for gram-negative bacteria. An Er:YAG laser, working with a chisel type glass tip, was moved from the buccal across the implant thread to the lingual for about 30 seconds per sample to verify the in vitro laser treatment platform. The result showed that the sterilization rate can reach 99.3% and the jaw model was not damaged after laser irradiation testing. This study concluded that using integrated image processing, reverse engineering, CAD system, and a 3D printer to construct a peri-implantitis model replacing the implant on bacterial adhesion and acceptable sterilization rate proved the feasibility of the proposed laser treatment platform.

What do sales data tell us about implant survival?

Objective

The aim of this study was to evaluate the influence of implant diameter, length and shape on a surrogate parameter of implant survival; i.e. the implant return rate in a big data analysis.

Materials and methods

A retrospective study was conducted and the factors influencing the success rates of 69,377 sold implants over a seven-year period were evaluated. The osseointegration program of a reseller provides reliable data of a single country. Implant loss rates were investigated using logistic regression models and regressed by implant type, diameter, and length.

Results

The return rate of 69,377 sold implants was 2.78% and comparable to implant loss rates in previous published prospective studies as its surrogate parameter. A total of 80% of implant returns had occurred within 157 days, and an additional 15% within 750.25 days. Diameters of 3.8 to 5.0mm showed the lowest return rates with its bottom in the 4.3mm implant whilst 6.0mm implants had significantly higher return rates. In comparison to the most sold implant length (13mm) shorter implants showed significantly higher early return rates.

Conclusions

The study provides evidence that in cases of standard indications and sufficient bone, the use of screw typed dental implants with 3.8 or 4.3 diameter and 11 or 13 mm length shows the lowest implant return rates. Other implants may be selected only in specific indications.

Postoperative Infections After Dental Implant Placement: Prevalence, Clinical Features, and Treatment

PURPOSE

To determine the prevalence and describe the clinical features and treatment of patients with early infections after implant placement.

MATERIALS AND METHODS

A retrospective cohort study was performed. Postoperative infections were defined as the presence of purulent drainage and/or increasing pain and swelling in the operated area before prosthetic loading. Patient-based infection prevalences and 95% confidence intervals for implant were determined. Patients who healed, were followed up to determine implant survival and success rates.

RESULTS

Three hundred thirty-seven participants (1273 implants) were included. Twenty-two postoperative infections were recorded (6.5% of the patients and 1.7% of the implants). These complications were usually diagnosed within the first month, and in 17 cases (77.3%) surgical treatment was performed because of antibiotic therapy failure. Twelve implants (54.6%) in 12 patients (54.6%) failed before prosthetic loading. The survival and success rates of the infected loaded implants were 80% and 50%, respectively, with a mean follow-up of 42.9 months (SD of 10.2 months).

CONCLUSION

Four to 10% of patients receiving dental implants develop postoperative infections. This complication is important because applied treatments are usually ineffective and two-thirds of the infected implants fail, most before prosthetic loading.

Evaluation of the Alteration of Occlusal Distribution in Unilateral Free-End and Intermediate Missing Cases

The present study aimed to evaluate the effect of implant prostheses on the occlusal force and area as well as the distribution of occlusal loading in unilateral free-end and intermediate missing cases. Fourteen healthy subjects (7 free-end missing cases in the first and second molars and 7 intermediate missing cases in the first molar region) were included. Six months after the implant prosthesis was placed, an occlusal evaluation was performed with or without the implant superstructure by using Dental Prescale film and an occluder device. In free-end missing cases, the total occlusal force and area, implant-side occlusal force and area, and implant-side occlusal force and area of the residual natural teeth were significantly affected by the implant prostheses. In intermediate missing cases, the implant-side occlusal force of the residual natural teeth was significantly affected by the implant prostheses. In free-end missing cases, the proportions of implant-side occlusal force, non–implant-side occlusal force, and implant-side occlusal force of the residual natural teeth relative to the total occlusal force were significantly affected by the implant prostheses. In the intermediate missing cases, the proportion of the implant-side occlusal force of the residual natural teeth relative to the total occlusal force was significantly affected by the implant prostheses. The proportion of the occlusal area was also significantly affected. In free-end missing cases, implant prostheses significantly increased the occlusal force and area, which resulted in the proper occlusal distribution. In intermediate missing cases, an implant prosthesis may only improve the same-side occlusal loading of the natural teeth.

Association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars: a long-term follow-up clinical and radiographic analysis

Purpose

The aim of this retrospective study was to determine the association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars, using data collected during from 2002 to 2015.

Methods

Traumatic occlusion in the adjacent premolars was assessed by examining clinical parameters (bleeding on probing, probing pocket depth, fremitus, and tooth mobility) and radiographic parameters (loss of supporting bone and widening of the periodontal ligament space) over a mean follow-up of 5 years. Clinical factors (gender, age, implant type, maxillary or mandibular position, opposing teeth, and duration of functional loading) were evaluated statistically in order to characterize the relationship between implants in the posterior region and traumatic occlusion in the adjacent premolars.

Results

The study inclusion criteria were met by 283 patients, who had received 347 implants in the posterior region. The incidence of traumatic occlusion in the adjacent premolars was significantly higher for splinted implants (P=0.004), implants in the maxillary region (P<0.001), and when implants were present in the opposing teeth (P<0.001). The other clinical factors of gender, age, and duration of functional loading were not significantly associated with traumatic occlusion.

Conclusions

This study found that the risk of traumatic occlusion in the adjacent premolars increased when splinted implants were placed in the maxillary molar region and when the teeth opposing an implant also contained implants.

Outcomes of implant therapy in patients with a history of aggressive periodontitis. A systematic review and meta-analysis

OBJECTIVE

To investigate the outcomes of implant therapy in partially dentate patients treated for aggressive periodontitis (GAgP) in comparison to periodontally healthy (HP) and patients treated for chronic periodontitis (CP) utilizing radiographic and clinical parameters.

MATERIAL AND METHODS

An electronic search of databases, supplemented by hand searching, was conducted to identify relevant clinical studies. Sequential screenings at the title, abstract and full-text levels were performed independently and in duplicate. A random effects meta-analysis was conducted and bias corrected bootstrap 95 % confidence intervals were estimated for group comparisons.

RESULTS

The search strategy revealed a total of 899 results. After title screening, abstract scanning, and full-text reading, seven articles fulfilled the inclusion criteria. The 3-year survival rate for CP and HP patients was 100 % while in GAgP subjects, the respective value was 97.98 %; this difference being statistically significant. The 3-year mean marginal bone loss (MBL) was 1.07 mm for the GAgP group, 0.47 mm for the CP group, and 0.69 mm for the HP group. A significant difference between the GAgP and CP groups was identified (p < 0.05). The weighted mean differences of MBL concerning the above groups were also calculated and examined for statistical significance in both 1 and 3 years.

CONCLUSIONS

The 3-year survival rate and peri-implant marginal bone loss was found statistically significantly lower in GAgP subjects (SR 97.98 % vs 100 %) in comparison to HP and CP individuals.

CLINICAL RELEVANCE

The outcome of implant therapy in terms of survival rate and marginal bone loss is considered very important for the clinician in decision making when placing implants in patients with a history of aggressive periodontitis.

Long-term effects of vertical bone augmentation: a systematic review

Extraction, periodontitis, or trauma can cause a reduction on the alveolar ridge. This could result in an insufficient alveolar bone width and height. Different techniques of vertical bone augmentation are described in literature. However, nowadays there is not enough evidence against lateral augmentation procedures to verify if these techniques are stable over a long period of time.

Epidemiology of Sjögren's Syndrome-from an Oral Perspective

Oral symptoms are among the most distressing manifestations for patients with Sjögren's syndrome (SS). The feeling of dry mouth is unpleasant, and hyposalivation may contribute to difficulty in speaking, chewing and swallowing and reduced quality of life. Reduced salivary flow increases the risk for dental caries and problems with prosthetic replacement. It seems that SS is not as frequently occurring as previously anticipated. Population-based prevalence studies on primary SS in Europe, conducted on large background populations and in accordance with the AECG criteria, reported of a prevalence of 1-9 cases per 10,000 people. This gives a combined prevalence of nearly 39/100,000 (~0.04 %). The cause of Sjögren's syndrome is even now not fully understood, and the treatment of oral symptoms is still mostly palliative. Hopefully, useful information will appear from the new methods that are now available for genome wide association studies, epigenetics, DNA methylation studies, and proteomics. Similarly, this is anticipated for the immunological side of the story. The interferon signature, the interferon γ/interferon α mRNA ratio, and CXCL13 are among the proposed biomarkers of active disease. In this review, we provide an update on oral aspects of Sjögren's syndrome with emphasis on the latest publications on these topics.

Intricate Assessment and Evaluation of Effect of Bruxism on Long-term Survival and Failure of Dental Implants: A Comparative Study

INTRODUCTION

Dental implants are one of the common lines of treatment used for the treatment of missing tooth. Various risk factors are responsible for the failure of the dental implants and occurrence of postoperative complications. Bruxism is one such factor responsible for the failure of the dental implants. The actual relation between bruxism and dental implants is a subject of long-term controversy. Hence, we carried out this retrospective analysis to assess the complications occurring in dental implants in patients with and without bruxism.

MATERIALS AND METHODS

The present study included 1100 patients which were treated for rehabilitation by dental implant procedure at 21 dental offices of Ghaziabad (India) from 2004 to 2014. Analyzing the clinical records of the patients along with assessing the photographs of the patients was done for confirming the diagnosis of bruxism. Clinical re-evaluation of the patients, who came back for follow-up, was done to confirm the diagnosis of bruxism. Systemic questionnaires as used by previous workers were used to evaluate the patients about the self-conscience of the condition. Estimation of the mechanical complications was done only in those cases which occurred on the surfaces of the restoration of the dental implants. All the results were analyzed by Statistical Package for Social Sciences (SPSS) software. Student's t-test and Pearson's chi-square test were used to evaluate the level of significance.

RESULTS

In both bruxer and non-bruxers, maximum number of dental implants was placed in anterior maxillary region. Significant difference was obtained while comparing the two groups for dimensions of the dental implants used. On comparing the total implant failed cases between bruxers and non-bruxers group, statistically significant result was obtained. Statistically significant difference was obtained while comparing the two study groups based on the health parameters, namely hypertension, diabetes, and smoking habit.

CONCLUSION

Success of dental implant is significantly affected by bruxism. Special attention is required in such patients while doing treatment planning.

CLINICAL SIGNIFICANCE

For the long-term clinical success and survival of dental implants in patients, special emphasis should be given on the patient's deleterious oral habits, such as bruxism as in long run, they influence the stability of dental implants.