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Analysis of Biomarkers and Marginal Bone Loss in Platform-Switched and Nonplatform-Switched Implants: A Randomized Clinical Trial. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2603287. [PMID: 35637753 PMCID: PMC9148225 DOI: 10.1155/2022/2603287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/22/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022]
Abstract
Objectives. To compare the peri-implant crevicular fluid (PICF) biomarker levels, peri-implant status, and marginal bone level (MBL) differences of implants restored with randomly assigned nonplatform-switched (NPS) or platform-switched (PS) abutments. Methods. Ninety-four implants in 27 subjects were included in this study. Receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegerin (OPG), interleukin-1β (IL-1β), monocyte chemotactic protein-1 (MCP-1) levels in PICF, peri-implant health, and the change in the MBL were evaluated at the time of restoration (
) and after 12 months (
). Results. The IL-1β levels decreased and the RANKL, OPG, and MCP-1 levels increased from
to
(
) in both groups. RANKL/OPG ratio at
, MCP-1 levels at
, and the MCP-1 change from
to
were lower in the PS group than in the NPS group (
). MBL change was lower (
mm) in the PS group than that (
mm) in the NPS group at
(
). Peri-implant health status between the study groups was negligible. Conclusion. PS was superior to NPS regarding the preservation of MBL. Higher MCP-1 levels, altered RANKL/OPG ratio, and lower OPG levels in the NPS group could be associated with subclinical peri-implant bone remodeling.
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2
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Abstract
Implant supported dental prostheses are increasingly used in dental practice. The aim of this narrative review is to present the influence of transmucosal surface of prosthetic abutment and implant on peri-implant tissue. The article describes causes of bone loss around the dental implant. Moreover, properties of different materials are compared and discussed. The advantages, disadvantages, and biomechanical concept of different implant-abutment connections are presented. The location of connections in relation to the bone level and the influence of microgap between the abutment and implant are described. Additionally, the implant abutments for cemented and screwed prosthetic restorations are compared. The influence of implant and abutment surface at the transmucosal level on peri-implant soft tissue is discussed. Finally, the biological aspect of abutment-implant connection is analyzed.
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3
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Effects of Vitamin and Amino Acid-Enriched Hyaluronic Acid Gel on the Healing of Oral Mucosa: In Vivo and In Vitro Study. ACTA ACUST UNITED AC 2021; 57:medicina57030285. [PMID: 33803814 PMCID: PMC8003116 DOI: 10.3390/medicina57030285] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 01/06/2023]
Abstract
Background and Objectives: Wound healing is a dynamic process that can be compromised in patients with chronic and metabolic conditions or unhealthy lifestyles. Numerous medical substances designed for topical use, charged with compounds that promote the healing process, have been developed to improve wound healing, especially in compromised subjects. The present study aimed to extend our understanding of the in vivo effects of a hyaluronic acid gel charged with amino acids (HAplus gel, Aminogam gel® Errekappa Euroterapici spa, Milan, Italy) and study the in vitro effects of the same gel charged with additional substances in an attempt to optimize its formulation. Materials and Methods: In a randomized controlled split-mouth clinical and histological trial, HAplus gel was tested on the gingival tissue of the lower third molar post-extraction socket. The gingiva was collected at the time of extraction (T0) and ten days after the extraction (T1) to be histologically analyzed. During the second stage of the study, culture media with HAplus gel and vitamin C and E at different concentrations (TEST) were tested on human gingival fibroblasts and compared to the HAplus-enriched medium (HA-Control). Results: Histological and immunohistochemical analysis of collected gingiva showed higher microvascular density and collagen fibers organized in closely packed and well-oriented bundles in sites treated with HAplus gel. In the in vitro study, all TEST groups showed an increased viability from 24 h to 48 h. After 24 h, the viability percentage in all experimental groups was below 100% of the HA-Control, demonstrating a mild toxicity. After 48 h from seeding, the TEST groups’ viability grew significantly compared to HA-Control. Conclusions: These encouraging preliminary results suggest that the use of HAplus gel enriched with vitamins C and E may be beneficial in patients with conditions that impair soft tissue healing.
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Peri-Implant Tissue Adaptation after Implant Rehabilitation with Shoulderless Abutments with 24 Months of Follow-Up. Case Rep Dent 2021; 2021:6689446. [PMID: 33505732 PMCID: PMC7810531 DOI: 10.1155/2021/6689446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/13/2020] [Accepted: 12/28/2020] [Indexed: 12/13/2022] Open
Abstract
An 11-year-old girl presented with agenesis of the maxillary lateral incisors. Orthodontic treatment was performed to close the midline diastema and create adequate space between the central incisors and canines to replace the missing maxillary lateral incisors on both sides. Two-piece implants were placed, and shoulderless abutments were prepared following the "biologically oriented preparation technique" (BOPT) protocol. The soft tissues were allowed to heal directly on the prosthetic emergence profile of the interim crown restorations after implant exposure. Two months later, the gingival tissue adapted to the prosthetic components in a specular manner. No complications were noted at 24 months. The BOPT protocol, originally described for natural teeth, may be applied to dental implants with shoulderless abutments.
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5
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Serichetaphongse P, Chengprapakorn W, Thongmeearkom S, Pimkhaokham A. Immunohistochemical assessment of the peri-implant soft tissue around different abutment materials: A human study. Clin Implant Dent Relat Res 2020; 22:638-646. [PMID: 32902102 DOI: 10.1111/cid.12942] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 07/24/2020] [Accepted: 08/02/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Soft tissue reaction to dental implant abutments influences the sustainability of restoration. Several abutment materials, such as titanium and gold alloy, have been introduced for strength and esthetic solutions. Zirconia and titanium-base abutments have also become popular in recent years due to high esthetic demands. PURPOSE To investigate the immune cell infiltration into the soft tissue in response to different abutment materials. MATERIALS AND METHODS Twenty dental implants were placed in the posterior regions of 17 patients. Titanium, zirconia, gold alloy, and titanium-base were randomly selected for each patient on the day of surgery. After 8 weeks of healing, the abutments were removed along with 1 mm of peri-implant soft tissue. Immunohistochemical assessment was performed using labeled streptavidin-biotin to identify T cells, B cells, macrophages, plasma cells, and microvascular infiltration. RESULTS Gold alloy demonstrated an overall higher inflammatory cell infiltration and highest number of CD3+ , CD20+ , and CD 68+ cells (P value <.05). The number of plasma cell and new microvascular infiltrations among abutment materials was not significantly different. CONCLUSION Titanium, titanium-base, and zirconia abutments showed comparable infiltration profiles; gold alloy abutments showed the highest B-cell, T cell, and macrophage infiltration. None of the abutment materials caused clinical inflammation; hence, they can be effectively used.
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Affiliation(s)
- Pravej Serichetaphongse
- Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Esthetics Restorative and Implant Dentistry Program, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Wareeratn Chengprapakorn
- Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Esthetics Restorative and Implant Dentistry Program, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sirikarn Thongmeearkom
- Esthetics Restorative and Implant Dentistry Program, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Atiphan Pimkhaokham
- Esthetics Restorative and Implant Dentistry Program, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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6
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Ghinassi B, D’Addazio G, Di Baldassarre A, Femminella B, Di Vincenzo G, Piattelli M, Gaggi G, Sinjari B. Immunohistochemical Results of Soft tissues Around a New Implant Healing-Abutment Surface: A Human Study. J Clin Med 2020; 9:jcm9041009. [PMID: 32252463 PMCID: PMC7230724 DOI: 10.3390/jcm9041009] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 03/29/2020] [Accepted: 04/01/2020] [Indexed: 12/14/2022] Open
Abstract
Although, the high success rate of implant rehabilitation treatment, the biological complications such as bone loss and peri-implantitis are still present. The creation of a coronal biological seal between the implant and the oral tissues seems to be a crucial point on preserving dental implants. The objective of this study was to immunohistochemically analyze the behavior of peri-implant soft tissues around a new implant healing-abutment surface on humans. A total of 30 soft tissue biopsies were collected after a healing period of 30 (±7) days, to analyze the expression of inflammatory (cluster of differentiation 63 (CD63), human neutrophil peptides 1-3 (HPN1-3)) and junctional (E-cadherin, occludin, and β-catenin) markers, on soft tissues around laser treated and machined alternated healing abutments. The evaluation demonstrated the whole area of the soft tissues adherent to the laser treated surface with a regular morphology. While several stress hallmarks in correspondence of machined surfaces were shown such as: a) An irregular, disrupted, and discontinued basal membrane with an increased inflammation evident both the epithelial and connective tissues; b) the absence or defective proper keratinization process of the external layer, and c) damages in the cell to cell interaction. In conclusion, the laser treated surface is preferable to maintain the integrity and functionality of the gingiva epithelium.
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Affiliation(s)
- Barbara Ghinassi
- Department of Medicine and Aging Sciences, University "G.d’Annunzio" of Chieti-Pescara, 66100 Chieti, Italy; (B.G.); (A.D.B.); (G.G.)
| | - Gianmaria D’Addazio
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (B.F.); (M.P.)
| | - Angela Di Baldassarre
- Department of Medicine and Aging Sciences, University "G.d’Annunzio" of Chieti-Pescara, 66100 Chieti, Italy; (B.G.); (A.D.B.); (G.G.)
| | - Beatrice Femminella
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (B.F.); (M.P.)
| | - Giorgio Di Vincenzo
- Department of Periodontics & Implant Dentistry, New York University, E 40th St #508, New York, NY 10016, USA;
| | - Maurizio Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (B.F.); (M.P.)
| | - Giulia Gaggi
- Department of Medicine and Aging Sciences, University "G.d’Annunzio" of Chieti-Pescara, 66100 Chieti, Italy; (B.G.); (A.D.B.); (G.G.)
| | - Bruna Sinjari
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (B.F.); (M.P.)
- Correspondence: ; Tel.: +39-392-27471479
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7
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Influence of the implant-abutment connection on the ratio between height and thickness of tissues at the buccal zenith: a randomized controlled trial on 188 implants placed in 104 patients. BMC Oral Health 2020; 20:53. [PMID: 32066431 PMCID: PMC7027242 DOI: 10.1186/s12903-020-1037-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/06/2020] [Indexed: 02/06/2023] Open
Abstract
Background To compare tissue response to two implant systems, featuring internal hexed connections with different designs. Methods Patients enrolled in this randomized controlled trial were assigned to two groups. In Group 1, patients were treated with implants with a 5° conical internal hexed connection (Anyridge®, MegaGen, South Korea). In Group 2, patients were treated with implants with an internal hexed connection (Core®, Kristal, Italy). After implant placement and a provisionalisation period of 12 months, impressions were taken, stone casts were poured and digitised with a desktop scanner (D700®, 3Shape, Copenhagen, Denmark). In a digital environment, for each fixture, two values were collected at the buccal zenith: the height of the peri-implant mucosa (mucosal height; MH), calculated from the vestibular shoulder of the implant analogue to the upper gingival margin of the supra-implant tissue; and the width of the peri-implant mucosa (mucosal thickness; MT), calculated from the vestibular shoulder of the analogue to the external mucosa point perpendicular to the implant major axis. The mean and standard deviation for MH and MT, as well as their ratios, were calculated for each group; the sectors in which the implants were placed were also considered. Finally, correlation between MH, MT, connection type and sector was assessed by Pearson’s correlation coefficient, with significance level set at 0.05, and a confidence interval (CI) set at 95%. Results Data deriving from 188 implants placed in 104 patients were evaluated. The mean MH values were 3.32 (± 0.12) and 2.70 (± 0.16) mm for Groups 1 and 2, respectively. The mean MT values were 4.37 (± 0.16) and 3.93 (± 0.18) mm for Groups 1 and 2, respectively. Group 1 showed higher MH and MT values and a better ratio (1.50 ± 0.88) than Group 2 (1.81 ± 1.20). The MH, MT and MH/MT ratio were significantly influenced both by sector (p = 0.015) and group (p = 0.047). Conclusions Within the limits of this study, the 5° connection implants supported a more extended tissue height and thickness at the buccal zenith, and a better ratio between them. Trial registration This study was retrospectively registered in Clinicaltrials.gov, with number NCT04160689, dated 13/11/2019.
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8
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Forna N, Agop-Forna D. Esthetic aspects in implant-prosthetic rehabilitation. Med Pharm Rep 2019; 92:S6-S13. [PMID: 31989103 PMCID: PMC6978930 DOI: 10.15386/mpr-1515] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 09/02/2019] [Indexed: 12/12/2022] Open
Abstract
The esthetic component is critical for the successful outcome and patients’ satisfaction regarding the implant-prosthetic therapy. The esthetic outcome success depends mostly on the optimization of the algorithms specific to the pro-implant and implant stage as well as to the designing and technological execution of the future prosthetic restoration. A proper planning of optimal facial esthetics must involve a multidisciplinary approach with inclusion of periodontists, orthodontists, oral surgeons and implantology specialists. The dental practitioner must consider various factors that influence the esthetic outcome (tooth position, root position of the adjacent teeth, biotype of the periodontium, tooth shape, smile line, implant site anatomy, implant positioning). Also, some factors (anatomical limits of the implant site, periodontal status, occlusal parameters), which can alter the final esthetic result, must be assessed prior to planning the esthetic parameters of the future prosthetic restoration. The esthetic outcome can be improved by using new digital technologies based on software applications for assessment of clinical and biological indices of the prosthetic field, virtual planning of implants positioning and design projection of future prosthetic restoration.
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Affiliation(s)
- Norina Forna
- Department Implantology, Removable Restorations, Dental Medical Faculty, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Doriana Agop-Forna
- Department of Oral Surgery, Dental Medical Faculty, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
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9
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Messias A, Rocha S, Wagner W, Wiltfang J, Moergel M, Behrens E, Nicolau P, Guerra F. Peri-implant marginal bone loss reduction with platform-switching components: 5-Year post-loading results of an equivalence randomized clinical trial. J Clin Periodontol 2019; 46:678-687. [PMID: 31025365 PMCID: PMC6594132 DOI: 10.1111/jcpe.13119] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/28/2019] [Accepted: 04/23/2019] [Indexed: 11/26/2022]
Abstract
AIM To compare the clinical performance and marginal bone levels of implants restored with platform-switching (PS) or platform-matching (PM) abutments. MATERIALS AND METHODS Adult patients missing two or more adjacent teeth in the posterior mandible received 2-4 CAMLOG SCREW-LINE implants and were randomly allocated to the PM or PS group, receiving the corresponding prosthetic components from surgery onwards. Implants were conventionally loaded with single cemented crowns. Patients were followed annually for 5 years. Outcome measures were marginal bone level changes, implant survival, performance of the prosthetic components and clinical parameters plaque index, sulcus bleeding index and pocket probing depth. RESULTS Thirty-three patients received 72 implants in the PM group, and thirty-five patients received 74 implants in the PS group. Sixty patients attended the final appointment, 31 had received PS components and 29 had received PM components with 65 and 63 implants, respectively. Global survival rate was 96.6% with no differences between groups (p = 0.647). After 5 years of functional loading, PS restored implants presented 0.23mm (95% CI: [0.03, 0.43], p = 0.025) lower marginal bone level changes. The two groups were declared non-equivalent. CONCLUSION Patients requiring implant supported restorations in healed bounded or free end edentulous gaps of the mandible benefit from the use of PS components in terms of peri-implant marginal bone level maintenance, though it may not be clinically noticeable.
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Affiliation(s)
- Ana Messias
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Salomão Rocha
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Wilfried Wagner
- Medical Center of Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Jörg Wiltfang
- Schleswig-Holstein University Hospital, University of Kiel, Kiel, Germany
| | - Maximilian Moergel
- Medical Center of Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Eleonore Behrens
- Schleswig-Holstein University Hospital, University of Kiel, Kiel, Germany
| | - Pedro Nicolau
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Fernando Guerra
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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10
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Teixeira MKS, de Moraes Rego MR, da Silva MFT, Lourenço EJV, Figueredo CM, Telles DM. Bacterial Profile and Radiographic Analysis Around Osseointegrated Implants With Morse Taper and External Hexagon Connections: Split-Mouth Model. J ORAL IMPLANTOL 2019; 45:469-473. [PMID: 31536433 DOI: 10.1563/aaid-joi-d-18-00222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this clinical study was to evaluate bacterial colonization, marginal bone loss, and optical alveolar density in implants with Morse taper (MT) and external hexagon (EH) connections. Thirty-five implants were installed in 7 patients (mean age: 65.8 ± 6.7 years). Implants were divided into 2 groups, according to platform design: G1 - MT, installed 2mm infra-osseous and G2 - EH, positioned according to Branemark protocol. Patients were evaluated at baseline (T0), 21 days (T1), 3 months (T2), 6 months (T3), and 12 months (T4) after installations. Bone loss and alveolar density were evaluated by standardized periapical radiographs and bacterial profile with checkerboard DNA-DNA hybridization. Statistical analyses were performed using SPSS 23.0. To present the results, boxplots and a line graph of mean were used. P-values ≤ .05 were statistically significant. After 3 months, alveolar bone loss was significantly higher in the G2 (T2-T0: P = .006; T3-T0: P = .003; and T4-T0: P = .005). No significant differences between G1 and G2 groups were observed for optical alveolar density. Microbiological analysis showed similar profiles between studied groups; however, there were significantly higher counts of Tannerella forsythia (P = .048), Campylobacter showae (P = .038), and Actinomyces naeslundii (P = .027) in G1 after 12 months. Based on the results of this study, it can be concluded that there was less peri-implant bone loss in MT compared to EH connections, but microbiological profile did not seem to influence bone changes.
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Affiliation(s)
- Mayla Kezy Silva Teixeira
- Department of Prosthodontics, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | | | - Eduardo José Veras Lourenço
- Department of Prosthodontics, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Carlos Marcelo Figueredo
- Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil.,School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia
| | - Daniel Moraes Telles
- Department of Prosthodontics, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
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11
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Cabanes-Gumbau G, Pascual-Moscardó A, Peñarrocha-Oltra D, García-Mira B, Aizcorbe-Vicente J, Peñarrocha-Diago MA. Volumetric variation of peri-implant soft tissues in convergent collar implants and crowns using the biologically oriented preparation technique (BOPT). Med Oral Patol Oral Cir Bucal 2019; 24:e643-e651. [PMID: 31422410 PMCID: PMC6764706 DOI: 10.4317/medoral.22946] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/20/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND To evaluate the changes in the peri-implant soft tissues of convergent collar implants with biologically oriented preparation technique (BOPT) crowns, 10 months after loading. MATERIAL AND METHODS A pilot study was carried out from January 2016 to October 2017 involving 14 patients with one or two implants in the posterior mandibular sector. A total of 32 convergent collar implants were placed using a non-submerged protocol. Three months later the provisional cemented crowns were fitted using the BOPT approach with the finish line 1-1.5 mm below the gingival margin, simulating coronal emergence of a natural tooth. The soft tissue changes were measured with an intraoral scanner at two different timepoints: a) on the day of provisionalization, before prosthetic loading; and b) 10 months later without the provisional prosthesis. The STL files were superimposed and the soft tissue changes were recorded using a color scale with measurement of the volumetric changes in mm3. RESULTS A mean increase in peri-implant mucosal volume of 64.7 mm3 was observed in 29 implants. The zones with the greatest increase in soft tissue volume were the papillae of implants with adjacent teeth and the peri-implant buccal margin. Three implants showed a mean decrease in soft tissue volume of -25.1 mm3. CONCLUSIONS The fitting and design of crowns using the biologically oriented preparation technique (BOPT) over convergent collar implants affords a significant increase in peri-implant soft tissue volume both at the level of the papillae and in the buccal margin.
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Affiliation(s)
- G Cabanes-Gumbau
- Departamento de Estomatología, Universitat de València, C/ Gascó Oliag 1, 46010 - Valencia (Spain),
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12
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The Effect of Tapered Abutments on Marginal Bone Level: A Retrospective Cohort Study. J Clin Med 2019; 8:jcm8091305. [PMID: 31450607 PMCID: PMC6780335 DOI: 10.3390/jcm8091305] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/17/2019] [Accepted: 08/20/2019] [Indexed: 01/16/2023] Open
Abstract
Background: Early peri-implant bone loss has been associated to long-term implant-prosthetic failure. Different technical, surgical, and prosthetic techniques have been introduced to enhance the clinical outcome of dental implants in terms of crestal bone preservation. The aim of the present cohort study was to observe the mean marginal bone level around two-part implants with gingivally tapered abutments one year after loading. Methods: Mean marginal bone levels and change were computed following radiological calibration and linear measurement on standardized radiographs. Results: Twenty patients who met the inclusion criterion of having at least one implant with the tapered prosthetic connection were included in the study. The cumulative implant success rate was 100%, the average bone loss was −0.18 ± 0.72 mm, with the final bone level sitting above the implant platform most of the time (+1.16 ± 0.91 mm). Conclusion: The results of this cohort study suggested that implants with tapered abutments perform successfully one year after loading and that they are associated with excellent marginal bone preservation, thus suggesting that implant-connection macro-geometry might have a crucial role in dictating peri-implant bone levels.
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13
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Souza AB, Alshihri A, Kämmerer PW, Araújo MG, Gallucci GO. Histological and micro-CT analysis of peri-implant soft and hard tissue healing on implants with different healing abutments configurations. Clin Oral Implants Res 2018; 29:1007-1015. [PMID: 30246409 DOI: 10.1111/clr.13367] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 07/12/2018] [Accepted: 08/09/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The aim of this study was to assess the effect of different abutment configurations on peri-implant soft and hard tissue healing. MATERIALS AND METHODS Two-piece dental implants, 3.5 mm in diameter and 8 mm in length, were placed in four beagle dogs. Two different transmucosal healing abutment configurations were randomly selected: one with a wide emergence profile (WE) (45° angulation with implant long axis) and the other with a narrow emergence profile (NE) (15° angulation with implant long axis). After four months of healing, the animals were sacrificed. Micro-CT scans were taken for mesio-distal analysis; subsequently, the biopsies were prepared for bucco-lingual histometric analyses. Several measurements were taken using the following reference points: marginal mucosal level (MML), apical barrier epithelium (aBE), implant shoulder (IS), marginal bone crest (BC), and first bone-to-implant contact (fBIC). RESULTS In the micro-CT analysis, the distance from IS-fBIC was 1.11 ± 0.66 mm for WE and 0.12 ± 0.21 mm for NE (p = 0.004). The IS-BC of WE was -0.54 ± 0.80 mm, whereas NE presented 0.76 ± 0.48 mm (p = 0.002). The histometric analysis showed that both groups presented comparable dimensions of peri-implant biologic width (p > 0.05). However, in the distance from IS to BC, the WE showed a mean distance of -0.66 ± 0.78 mm while NE was 0.06 ± 0.42 mm (p = 0.039); the IS to fBIC was 0.89 ± 0.68 mm for WE while NE was 0.30 ± 0.30 mm (p = 0.041). CONCLUSION The design of the transmucosal component can influence the establishment of the peri-implant biologic width. The flat and wide emergence profile induced an apical displacement of the peri-implant biologic width and more bone loss.
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Affiliation(s)
- André Barbisan Souza
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts
| | - AbdulMonem Alshihri
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts.,Department of Prosthodontics and Biomaterial Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Peer W Kämmerer
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Centre Rostock, Germany
| | - Maurício G Araújo
- Department of Dentistry, State University of Maringá, Paraná, Brazil
| | - German O Gallucci
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts
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Various Surface Treatments to Implant Provisional Restorations and Their Effect on Epithelial Cell Adhesion: A Comparative In Vitro Study. IMPLANT DENT 2017; 26:12-23. [PMID: 28114240 DOI: 10.1097/id.0000000000000538] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE AND OBJECTIVE The aim of this in vitro study was to investigate the ability of epithelial cells to attach to or proliferate on various mechanical or chemical surface treatments of an implant provisional material. MATERIALS AND METHODS Polyethyl methacrylate discs 10 mm in diameter and ∼0.2 to 0.75 mm in width were used in the study. Experimental discs were treated with either a mechanical (pumice, varnish for shine, or high polishing) or a chemical agent (alcohol, chlorhexidine, or steam) to provide cleaning and/or polishing. Using primary human epidermal keratinocytes, experiments were performed to test the adhesion or proliferation of cells on the discs with various surface treatments. RESULTS Scanning electron microscope analysis, rhodamine staining, and cell counting using a hemocytometer corroborated all findings and illustrated that the highest cell adhesion was found to be in the smooth surface treatment groups and the poorest adhesion was found to be in the rough surface groups and chemical treatment group. CONCLUSION Within the limitations of this study, the following clinical protocol is recommended for finishing, polishing, and disinfecting implant provisional restorations: coarse, medium, fine pumice → high polishing (if desired) → steam. It is recommended to avoid applying varnish in the perimucosal area near the epithelium. This study could establish the most appropriate way to handle provisional restorations in the peri-implant sulcus for improved soft tissue health, esthetics, and long-term stability.
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Erhan Çömlekoğlu M., Nizam N, Çömlekoğlu MD. Immediate definitive individualized abutments reduce peri-implant bone loss: a randomized controlled split-mouth study on 16 patients. Clin Oral Investig 2017; 22:475-486. [DOI: 10.1007/s00784-017-2136-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 05/22/2017] [Indexed: 01/05/2023]
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16
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Sanz-Martín I, Sanz-Sánchez I, Noguerol F, Cok S, Ortiz-Vigón A, Sanz M. Randomized controlled clinical trial comparing two dental implants with different neck configurations. Clin Implant Dent Relat Res 2017; 19:512-522. [DOI: 10.1111/cid.12482] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 12/26/2016] [Accepted: 02/04/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Ignacio Sanz-Martín
- Section of Post-graduate Periodontology, Faculty of Odontology; University Complutense of Madrid; Spain
| | - Ignacio Sanz-Sánchez
- Section of Post-graduate Periodontology, Faculty of Odontology; University Complutense of Madrid; Spain
| | - Fernando Noguerol
- Section of Post-graduate Periodontology, Faculty of Odontology; University Complutense of Madrid; Spain
| | - Susy Cok
- Section of Post-graduate Periodontology, Faculty of Odontology; University Complutense of Madrid; Spain
| | - Alberto Ortiz-Vigón
- Section of Post-graduate Periodontology, Faculty of Odontology; University Complutense of Madrid; Spain
| | - Mariano Sanz
- Section of Post-graduate Periodontology, Faculty of Odontology; University Complutense of Madrid; Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
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17
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Telleman G, Raghoebar GM, Vissink A, Meijer HJA. Impact of platform switching on inter-proximal bone levels around 8.5 mm implants in the posterior region; 5-year results from a randomized clinical trial. J Clin Periodontol 2016; 44:326-336. [PMID: 27883203 DOI: 10.1111/jcpe.12654] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2016] [Indexed: 01/28/2023]
Abstract
AIM To assess the medium-term results of 8.5 mm implants supplied with a conventional platform-matched implant-abutment connection or a platform-switched design. MATERIALS AND METHODS Eighty patients with one or more missing teeth in the maxillary or mandibular posterior zone were randomly assigned for treatment with implants with a conventional (control group) or platform-switched (test group) implant-abutment connection. Follow-up visits were conducted 1 month, 1 year and 5 years after functional loading. Inter-proximal bone loss, assessed with standardized peri-apical radiographs, clinical parameters, survival of implants and satisfaction of patients were the outcome parameters studied. RESULTS After 5 years of loading, five of the 80 patients were lost to follow-up. The inter-proximal bone loss in the test group (0.38 ± 0.61 mm) was comparable to the bone loss in the control group (0.41 ± 0.47 mm; p = 0.201). Remarkably, bone loss has not progressed compared to the 1-year results. Implant survival, clinical parameters and satisfaction of the patients were favourable and comparable for the test and control group. CONCLUSION The 5-years results showed that inter-proximal bone resorption was minor and comparable around platform-matched and platform-switched implants, and implant survival, peri-implant health and patients' satisfaction were favourable.
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Affiliation(s)
- Gerdien Telleman
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.,Department of Fixed and Removable Prosthodontics, Centre for Dentistry and Oral Hygiene, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
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18
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Soft Tissue Response to Titanium Abutments with Different Surface Treatment: Preliminary Histologic Report of a Randomized Controlled Trial. BIOMED RESEARCH INTERNATIONAL 2016; 2016:2952530. [PMID: 27366741 PMCID: PMC4913056 DOI: 10.1155/2016/2952530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/01/2016] [Accepted: 05/11/2016] [Indexed: 01/28/2023]
Abstract
The aim of this preliminary prospective RCT was to histologically evaluate peri-implant soft tissues around titanium abutments treated using different cleaning methods. Sixteen patients were randomized into three groups: laboratory customized abutments underwent Plasma of Argon treatment (Plasma Group), laboratory customized abutments underwent cleaning by steam (Steam Group), and abutments were used as they came from industry (Control Group). Seven days after the second surgery, soft tissues around abutments were harvested. Samples were histologically analyzed. Soft tissues surrounding Plasma Group abutments predominantly showed diffuse chronic infiltrate, almost no acute infiltrate, with presence of few polymorphonuclear neutrophil granulocytes, and a diffuse presence of collagenization bands. Similarly, in Steam Group, the histological analysis showed a high variability of inflammatory expression factors. Tissues harvested from Control Group showed presence of few neutrophil granulocytes, moderate presence of lymphocytes, and diffuse collagenization bands in some sections, while they showed absence of acute infiltrate in 40% of sections. However, no statistical difference was found among the tested groups for each parameter (p > 0.05). Within the limit of the present study, results showed no statistically significant difference concerning inflammation and healing tendency between test and control groups.
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19
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Rocha S, Wagner W, Wiltfang J, Nicolau P, Moergel M, Messias A, Behrens E, Guerra F. Effect of platform switching on crestal bone levels around implants in the posterior mandible: 3 years results from a multicentre randomized clinical trial. J Clin Periodontol 2016; 43:374-82. [PMID: 26847169 PMCID: PMC5071662 DOI: 10.1111/jcpe.12522] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2016] [Indexed: 11/28/2022]
Abstract
Objective Evaluation of differences in the clinical performance and crestal bone levels between implants restored with single crowns with platform‐matched or platform‐switched abutments after 3 years. Material and Methods The study enrolled adult patients missing two or more adjacent teeth in the posterior mandible with natural teeth mesial to the implant site. Randomization followed open‐flap implant insertion and the corresponding matching or switching healing abutments placed at surgery. Conventional loading was made with cemented crowns. Clinical follow‐up took place annually after loading up to 3 years. Bone level changes were measured in standardized radiographs as the variation in crestal bone from one evaluation to the next. Results Sixty‐three patients with a total of 135 implants (66 platform matching, 69 platform switching) were analysed. From surgery to 36 months, mean bone loss was 0.28 ± 0.56 mm for the platform‐switching group and 0.68 ± 0.64 mm for the platform‐matching group. A statistically significant difference was found between groups (p = 0.002) with an estimate of 0.39 mm (0.15–0.64, 95% CI) in favour of platform switching. Conclusions After 3 years, platform‐switching restorations showed a significant effect in the preservation of marginal bone levels compared to platform‐matching restorations.
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Affiliation(s)
- Salomão Rocha
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Wilfried Wagner
- Medical Centre of Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Jörg Wiltfang
- Schleswig-Holstein University Hospital, University of Kiel, Kiel, Germany
| | - Pedro Nicolau
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Maximilian Moergel
- Medical Centre of Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Ana Messias
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Eleonore Behrens
- Schleswig-Holstein University Hospital, University of Kiel, Kiel, Germany
| | - Fernando Guerra
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Macedo JP, Pereira J, Vahey BR, Henriques B, Benfatti CAM, Magini RS, López-López J, Souza JCM. Morse taper dental implants and platform switching: The new paradigm in oral implantology. Eur J Dent 2016; 10:148-154. [PMID: 27011755 PMCID: PMC4784146 DOI: 10.4103/1305-7456.175677] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to conduct a literature review on the potential benefits with the use of Morse taper dental implant connections associated with small diameter platform switching abutments. A Medline bibliographical search (from 1961 to 2014) was carried out. The following search items were explored: “Bone loss and platform switching,” “bone loss and implant-abutment joint,” “bone resorption and platform switching,” “bone resorption and implant-abutment joint,” “Morse taper and platform switching.” “Morse taper and implant-abutment joint,” Morse taper and bone resorption,” “crestal bone remodeling and implant-abutment joint,” “crestal bone remodeling and platform switching.” The selection criteria used for the article were: meta-analysis; randomized controlled trials; prospective cohort studies; as well as reviews written in English, Portuguese, or Spanish languages. Within the 287 studies identified, 81 relevant and recent studies were selected. Results indicated a reduced occurrence of peri-implantitis and bone loss at the abutment/implant level associated with Morse taper implants and a reduced-diameter platform switching abutment. Extrapolation of data from previous studies indicates that Morse taper connections associated with platform switching have shown less inflammation and possible bone loss with the peri-implant soft tissues. However, more long-term studies are needed to confirm these trends.
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Affiliation(s)
- José Paulo Macedo
- School of Dentistry, Universidade Fernando Pessoa (UFP), Porto, 4249-004, Portugal
| | - Jorge Pereira
- School of Dentistry, Universidade Fernando Pessoa (UFP), Porto, 4249-004, Portugal
| | - Brendan R Vahey
- Herman Ostrow School of Dentistry of USC, 925 W 34 St. Los Angeles, CA 90089, USA.,School of Dentistry (ODT), Federal University of Santa Catarina (UFSC), Florianopolis/SC, 88040-900, Brazil
| | - Bruno Henriques
- School of Dentistry (ODT), Federal University of Santa Catarina (UFSC), Florianopolis/SC, 88040-900, Brazil
| | - Cesar A M Benfatti
- School of Dentistry (ODT), Federal University of Santa Catarina (UFSC), Florianopolis/SC, 88040-900, Brazil
| | - Ricardo S Magini
- School of Dentistry, Universidade Fernando Pessoa (UFP), Porto, 4249-004, Portugal
| | - José López-López
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Group), School of Dentistry, L'Hospitalet de Llobregat, Universitat de Barcelona, 402 4270, Barcelona, Spain
| | - Júlio C M Souza
- School of Dentistry (ODT), Federal University of Santa Catarina (UFSC), Florianopolis/SC, 88040-900, Brazil
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Nader N, Aboulhosn M, Berberi A, Manal C, Younes R. Marginal Bone Remodeling around healing Abutment vs Final Abutment Placement at Second Stage Implant Surgery: A 12-month Randomized Clinical Trial. J Contemp Dent Pract 2016; 17:7-15. [PMID: 27084856 DOI: 10.5005/jp-journals-10024-1795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND The periimplant bone level has been used as one of the criteria to assess the success of dental implants. It has been documented that the bone supporting two-piece implants undergoes resorption first following the second-stage surgery and later on further to abutment connection and delivery of the final prosthesis. OBJECTIVE The aim of this multicentric randomized clinical trial was to evaluate the crestal bone resorption around internal connection dental implants using a new surgical protocol that aims to respect the biological distance, relying on the benefit of a friction fit connection abutment (test group) compared with implants receiving conventional healing abutments at second-stage surgery (control group). MATERIALS AND METHODS A total of partially edentulous patients were consecutively treated at two private clinics, with two adjacent two-stage implants. Three months after the first surgery, one of the implants was randomly allocated to the control group and was uncovered using a healing abutment, while the other implant received a standard final abutment and was seated and tightened to 30 Ncm. At each step of the prosthetic try-in, the abutment in the test group was removed and then retightened to 30 Ncm. Horizontal bone changes were assessed using periapical radiographs immediately after implant placement and at 3 (second-stage surgery), 6, 9 and 12 months follow-up examinations. RESULTS At 12 months follow-up, no implant failure was reported in both groups. In the control group, the mean periimplant bone resorption was 0.249 ± 0.362 at M3, 0.773 ± 0.413 at M6, 0.904 ± 0.36 at M9 and 1.047 ± 0.395 at M12. The test group revealed a statistically significant lower marginal bone loss of 20.88% at M3 (0.197 ± 0.262), 22.25% at M6 (0.601 ± 0.386), 24.23% at M9 (0.685 ± 0.341) and 19.2% at M9 (0.846 ± 0.454). The results revealed that bone loss increased over time, with the greatest change in bone loss occurring between 3 and 6 months. Alveolar bone loss was significantly greater in the control condition than the test condition. CONCLUSION The results of this prospective study demonstrated the benefit of placing a prosthetic component with a stable connection at second-stage surgery, in terms of reduced marginal bone remodeling when compared with conventional procedure. CLINICAL SIGNIFICANCE The use of a stable connection in a healing component during try-in stages prior to final restoration placement leads to less periimplant marginal bone loss.
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Affiliation(s)
- Nabih Nader
- School of Dentistry, Lebanese University, Beirut, Lebanon
| | | | - Antoine Berberi
- Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Lebanese University, Beirut, Lebanon, Phone: +9613731173 e-mail:
| | - Cordahi Manal
- Medical School, Lebanese University, Beirut, Lebanon
| | - Ronald Younes
- Faculty of Dental Medicine, Saint Joseph University Beirut Lebanon
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22
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DUQUE AD, ARISTIZABAL AG, LONDOÑO S, CASTRO L, ALVAREZ LG. Prevalence of peri-implant disease on platform switching implants: a cross-sectional pilot study. Braz Oral Res 2016; 30:S1806-83242016000100204. [DOI: 10.1590/1807-3107bor-2016.vol30.0005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 07/28/2015] [Indexed: 11/22/2022] Open
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23
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Gutmacher Z, Levi G, Blumenfeld I, Machtei EE. Soft and Hard Tissue Changes around Tissue-Oriented Tulip-Design Implant Abutments: A 1-Year Randomized Prospective Clinical Trial. Clin Implant Dent Relat Res 2015; 17:891-7. [PMID: 26434929 DOI: 10.1111/cid.12209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The advantages of platform switching using narrower abutments remain controversial. Many researchers suggest that platform switching can yield enhanced clinical results, while others remain skeptical. We hypothesize that the effectiveness of platform switching might be associated with the degree of reduction in size of the abutment. PURPOSE To radiographically and clinically examine a new abutment design created to move the implant-abutment interface farther medially. MATERIALS AND METHODS This was a prospective, randomized controlled clinical trial that included 27 patients (41 MIS Lance Plus® implants; MIS Implant Technologies, Karmiel, Israel). The patients' age ranged from 39 to 75 years. At the second stage of the surgery, the implants were randomly assigned to either the new platform switch Tulip abutment (TA) design or to the standard platform abutment (SA). Implant probing depth (IPD) and bleeding on probing (BOP) were recorded at baseline and after 12 months. Standardized periapical radiographs were taken (at baseline and at 12 months) and the marginal bone height measured. RESULTS All implants were successfully integrated. The mean IPD at 1 year post-op was 2.91 mm for the SA group and 2.69 mm for the TA group (p > .05). Similarly, the BOP at 1 year was almost identical in both groups. The mean values of bone resorption at baseline were 0.98 ± 0.37 mm and 0.69 ± 0.20 for the TA and SA groups, respectively (p > .05). Bone loss (baseline to 12 months) was significantly greater in the SA group compared with the TA group. CONCLUSIONS Use of the new TA, with its significantly downsized diameter, resulted in reduced bone loss at 1 year. Further research will be required to assess the long-term effect of this abutment on peri-implant health.
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Affiliation(s)
- Zvi Gutmacher
- Department of Maxillofacial Rehabilitation, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Guy Levi
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Israel Blumenfeld
- Department of Maxillofacial Rehabilitation, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Eli E Machtei
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.,Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel
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Guerra F, Wagner W, Wiltfang J, Rocha S, Moergel M, Behrens E, Nicolau P. Platform switch versus platform match in the posterior mandible – 1-year results of a multicentre randomized clinical trial. J Clin Periodontol 2015; 41:521-9. [PMID: 24829969 PMCID: PMC4282357 DOI: 10.1111/jcpe.12244] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective The purpose of this ongoing randomized study was to assess differences in bone level changes and success rates using implants supporting single crowns in the posterior mandible either with platform matched or platform switched abutments. Material and Methods Patients aged 18 and above, missing at least two teeth in the posterior mandible and with a natural tooth mesial to the most proximal implant site were enrolled. Randomization followed implant placement. Definitive restorations were placed after a minimum transgingival healing period of 8 weeks. Changes in crestal bone level from surgery and loading (baseline) to 12-month post-loading were radiographically measured. Implant survival and success were determined. Results Sixty-eight patients received 74 implants in the platform switching group and 72 in the other one. The difference of mean marginal bone level change from surgery to 12 months was significant between groups (p < 0.004). Radiographical mean bone gain or no bone loss from loading was noted for 67.1% of the platform switching and 49.2% of the platform matching implants. Implant success rates were 97.3% and 100%, respectively. Conclusions Within the same implant system the platform switching concept showed a positive effect on marginal bone levels when compared with restorations with platform matching.
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Affiliation(s)
- Fernando Guerra
- Faculty of Medicine, University of CoimbraCoimbra, Portugal
- Address: Fernando Guerra, Área de Medicina Dentária da Faculdade de Medicina da Universidade de Coimbra, Avenida Bissaia Barreto, Blocos de Celas – HUC, 3030 075 Coimbra, Portugal, E-mail:
| | - Wilfried Wagner
- Medical Center of Johannes Gutenberg University of MainzMainz, Germany
| | - Jörg Wiltfang
- Schleswig-Holstein University Hospital, University of KielKiel, Germany
| | - Salomão Rocha
- Faculty of Medicine, University of CoimbraCoimbra, Portugal
| | | | - Eleonore Behrens
- Schleswig-Holstein University Hospital, University of KielKiel, Germany
| | - Pedro Nicolau
- Faculty of Medicine, University of CoimbraCoimbra, Portugal
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Glibert M, Vervaeke S, De Bruyn H, Östman PO. Clinical and Radiographic Comparison between Platform-Shifted and Nonplatform-Shifted Implant: A One-Year Prospective Study. Clin Implant Dent Relat Res 2014; 18:129-37. [DOI: 10.1111/cid.12269] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Maarten Glibert
- Department of Periodontology and Oral Implantology; Dental School; Faculty of Medicine and Health Sciences; University of Ghent; Ghent Belgium
| | - Stijn Vervaeke
- Department of Periodontology and Oral Implantology; Dental School; Faculty of Medicine and Health Sciences; University of Ghent; Ghent Belgium
| | - Hugo De Bruyn
- Department of Periodontology and Oral Implantology; Dental School; Faculty of Medicine and Health Sciences; University of Ghent; Ghent Belgium
- Department of Prosthodontics; School of Dentistry; Malmö University; Malmö Sweden
| | - Pär-Olov Östman
- Department of Periodontology and Oral Implantology; Dental School; Faculty of Medicine and Health Sciences; University of Ghent; Ghent Belgium
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Herekar M, Sethi M, Mulani S, Fernandes A, Kulkarni H. Influence of platform switching on periimplant bone loss: a systematic review and meta-analysis. IMPLANT DENT 2014; 23:439-50. [PMID: 24819807 DOI: 10.1097/id.0000000000000080] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This meta-analysis aims to systematically review and draw a comparison between conventional implant designs and "platform-switched" implants in terms of crestal bone loss. MATERIALS AND METHODS Electronic (PubMed) and hand searches were conducted. Literature, clinical studies, and case reports pertaining to reduction of crestal bone loss and obtaining better esthetic outcome by platform switching were reviewed till October 2011. Controlled trials comparing marginal bone-level changes around platform-switched and platform-matched implants were selected. For the assessment of accuracy, meta-analysis was performed. RESULTS The marginal bone loss around platform-switched implants was significantly lesser than platform-matched implants (mean difference [MD]: -0.34; 95% confidence interval [CI]: -0.37 to -0.30; P < 0.00001). CONCLUSIONS According to this review and meta-analysis, platform switching seems to preserve periimplant bone and soft tissue levels. However, long-term clinical studies on the proper diameter of abutment without deformation and the effective degree of platform switching in terms of the bone resorption are still awaited.
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Affiliation(s)
- Manisha Herekar
- *Professor and Head of the Department, Department of Prosthodontics, Maratha Mandals NGH Institute of Dental Sciences and Research Centre, Belgaum, India. †Postgraduate Student, Department of Prosthodontics, Maratha Mandals NGH Institute of Dental Sciences and Research Centre, Belgaum, India. ‡Ex Professor, Department of Prosthodontics, Goa Dental College and Hospital, Panaji, India; and Private Practice, Prosthodontics, Implantology, Goa, India. §Principal, Professor, and Head of Department, Department of Oral and Maxillofacial Surgery, Tatyasaheb Kore Dental College and Research Centre, Warnanagar, India
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27
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Linkevicius T, Puisys A, Steigmann M, Vindasiute E, Linkeviciene L. Influence of Vertical Soft Tissue Thickness on Crestal Bone Changes Around Implants with Platform Switching: A Comparative Clinical Study. Clin Implant Dent Relat Res 2014; 17:1228-36. [DOI: 10.1111/cid.12222] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Tomas Linkevicius
- Institute of Odontology; Faculty of Medicine; Vilnius University; Vilnius Lithuania
- Vilnius Research Group
- Vilnius Implantology Center; Vilnius Lithuania
| | - Algirdas Puisys
- Vilnius Research Group
- Vilnius Implantology Center; Vilnius Lithuania
| | - Marius Steigmann
- Department of Periodontics and Oral Medicine; School of Dentistry; University of Michigan; Ann Arbor MI USA
| | - Egle Vindasiute
- Vilnius Research Group
- Vilnius Implantology Center; Vilnius Lithuania
| | - Laura Linkeviciene
- Institute of Odontology; Faculty of Medicine; Vilnius University; Vilnius Lithuania
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28
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Finelle G, Papadimitriou DEV, Souza AB, Katebi N, Gallucci GO, Araújo MG. Peri-implant soft tissue and marginal bone adaptation on implant with non-matching healing abutments: micro-CT analysis. Clin Oral Implants Res 2014; 26:e42-e46. [DOI: 10.1111/clr.12328] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Gary Finelle
- Division of Regenerative and Implant Sciences; Department of Restorative Dentistry and Biomaterials Sciences; Harvard School of Dental Medicine; Boston MA USA
| | - Dimitrios E. V. Papadimitriou
- Division of Regenerative and Implant Sciences; Department of Restorative Dentistry and Biomaterials Sciences; Harvard School of Dental Medicine; Boston MA USA
| | - André B. Souza
- Department of Dentistry; State University of Maringa; Parana Brazil
| | - Negin Katebi
- Department of Developmental Biology; Harvard School of Dental Medicine; Boston MA USA
| | - German O. Gallucci
- Division of Regenerative and Implant Sciences; Department of Restorative Dentistry and Biomaterials Sciences; Harvard School of Dental Medicine; Boston MA USA
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Impact of immediate loading on early soft tissue healing at two-piece implants placed in fresh extraction sockets: an experimental study in the beagle dog. Clin Oral Implants Res 2013; 25:919-25. [DOI: 10.1111/clr.12187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2013] [Indexed: 12/01/2022]
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Sivolella S, Guazzo R, Bressan E, Berengo M, Stellini E. Platform switching on wide-diameter external hex implants: a finite element analysis. J Clin Exp Dent 2013; 5:e77-82. [PMID: 24455061 PMCID: PMC3892223 DOI: 10.4317/jced.50991] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 01/01/2013] [Indexed: 11/06/2022] Open
Abstract
Objectives: The objective of this work was to use finite element analysis to compare the effect of forces coming to bear on abutments 4.1 or 5.0 mm in diameter connected to a 5.0 mm implant (i.e. with or without platform switching).
Study design: A 3D CAD model of a 5 x 11.5 mm external hex implant was developed, complete with a connection screw and either of two abutments, one 4.1 and the other 5 mm in diameter, to assess the influence of two loading conditions, i.e. 200 N loaded either axially or off center on the top of the abutment.
Results and conclusions: In the symmetrically loaded models, greater stresses were transmitted to the bone in the area below the neck of the implant in the case of the wider-diameter abutment. When the narrower abutment was considered, the stress lines remained confined to the metal and were transferred to the bone in a more distal position. When the stresses in the bone where compared under non-symmetrical loading of the larger- and smaller-diameter abutments, the stresses reached lower values in the latter case. These findings indicate that platform switching (i.e. coupling a 4.1 mm abutment with a 5 mm implant) achieves a better, more even distribution of the peri-implant stresses deriving from simulated occlusal loads on the bone margins.
Key words:Platform switching, finite element analysis, implant.
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Affiliation(s)
- Stefano Sivolella
- DDS, Clinical Assistant, Department of Oral Surgery, Padova University, Institute of Clinical Dentistry, Padova, Italy
| | - Riccardo Guazzo
- DDS, Resident, Department of Oral Surgery, Padova University, Institute of Clinical Dentistry, Padova, Italy
| | - Eriberto Bressan
- DDS, Associate Professor, Department of Periodontology, Padova University, Institute of Clinical Dentistry, Padova, Italy
| | - Mario Berengo
- MD, DDS, Professor and Chairman, Department of Oral Surgery, Padova University, Institute of Clinical Dentistry, Padova, Italy
| | - Edoardo Stellini
- DDS, Associate Professor, Department of Periodontology, Padova University, Institute of Clinical Dentistry, Padova, Italy
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Blanco J, Mareque S, Liñares A, Pérez J, Muñoz F, Ramos I. Impact of immediate loading on early bone healing at two-piece implants placed in fresh extraction sockets: an experimental study in the beagle dog. J Clin Periodontol 2013; 40:421-9. [DOI: 10.1111/jcpe.12070] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Juan Blanco
- Department of Stomatology; University of Santiago de Compostela; Santiago de Compostela Spain
| | - Santiaqo Mareque
- Department of Stomatology; University of Santiago de Compostela; Santiago de Compostela Spain
| | - Antonio Liñares
- Department of Stomatology; University of Santiago de Compostela; Santiago de Compostela Spain
| | - Javier Pérez
- Department of Stomatology; University of Santiago de Compostela; Santiago de Compostela Spain
| | - Fernando Muñoz
- School of Veterinary; University of Santiago de Compostela; Santiago de Compostela Spain
| | - Isabel Ramos
- Department of Stomatology; University of Santiago de Compostela; Santiago de Compostela Spain
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Mazor Z, Ioannou A, Venkataraman N, Kotsakis G. A Minimally Invasive Sinus Augmentation Technique using a Novel Bone Graft Delivery System. ACTA ACUST UNITED AC 2013. [DOI: 10.5005/jp-journals-10012-1097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Telleman G, Raghoebar GM, Vissink A, Meijer HJ. Impact of Platform Switching on Peri-Implant Bone Remodeling around Short Implants in the Posterior Region, 1-Year Results from a Split-Mouth Clinical Trial. Clin Implant Dent Relat Res 2012; 16:70-80. [DOI: 10.1111/j.1708-8208.2012.00461.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Telleman G, Raghoebar GM, Vissink A, Meijer HJA. Impact of platform switching on inter-proximal bone levels around short implants in the posterior region; 1-year results from a randomized clinical trial. J Clin Periodontol 2012; 39:688-97. [PMID: 22540412 DOI: 10.1111/j.1600-051x.2012.01887.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2012] [Indexed: 01/07/2023]
Abstract
AIM To assess the outcome of short implants (8.5 mm) supplied with a conventional platform-matched implant-abutment connection or a platform-switched design. MATERIALS AND METHODS Eighty patients with one or more missing teeth in the posterior zone were randomly assigned to be treated with implants with either a conventional (control) or a platform-switched (mismatch 0.35-0.40 mm) implant-abutment connection (test). Follow-up visits were conducted 1 month and 1 year after placing the implant crown. Outcome measures were inter-proximal bone loss, using standardized peri-apical radiographs, implant survival, clinical parameters and patients' satisfaction. RESULTS One year after loading, inter-proximal bone loss around test implants (0.51 ± 0.51 mm) was significantly less than around control implants (0.73 ± 0.48 mm) (p = 0.011). Moreover, bone loss was less around 1 versus 2 adjacent implants (p = 0.001), in both the test (0.29 ± 0.36 versus 0.71 ± 0.55 mm) and control (0.46 ± 0.42 versus 0.88 ± 0.45 mm) group. With regard to implant survival, clinical parameters and patients' satisfaction no differences were observed between the test and control group. CONCLUSION This study suggested that crestal bone resorption may be reduced by platform switching. One year after loading, inter-proximal bone levels were better maintained at implants restored according to the platform switching concept.
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Affiliation(s)
- Gerdien Telleman
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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Cairo F, Sanz I, Matesanz P, Nieri M, Pagliaro U. Quality of reporting of randomized clinical trials in implant dentistry. A systematic review on critical aspects in design, outcome assessment and clinical relevance. J Clin Periodontol 2012; 39 Suppl 12:81-107. [DOI: 10.1111/j.1600-051x.2011.01839.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Francesco Cairo
- Department of Periodontology; University of Florence; Florence; Italy
| | - Ignacio Sanz
- Department of Periodontology; Universidad Complutense ; de; Madrid; Madrid; Spain
| | - Paula Matesanz
- Department of Periodontology; Universidad Complutense ; de; Madrid; Madrid; Spain
| | - Michele Nieri
- Department of Periodontology; University of Florence; Florence; Italy
| | - Umberto Pagliaro
- Department of Periodontology; University of Florence; Florence; Italy
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Canullo L, Iannello G, Penarocha M, Garcia B. Impact of implant diameter on bone level changes around platform switched implants: preliminary results of 18 months follow-up a prospective randomized match-paired controlled trial. Clin Oral Implants Res 2011; 23:1142-6. [DOI: 10.1111/j.1600-0501.2011.02297.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2011] [Indexed: 12/01/2022]
Affiliation(s)
| | | | - Miguel Penarocha
- Master of Oral Surgery and Implantology; Valencia University Medical and Dental School; Valencia; Spain
| | - Berta Garcia
- Master of Oral Surgery and Implantology; Valencia University Medical and Dental School; Valencia; Spain
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Dellavia C, Canullo L, Allievi C, Lang NP, Pellegrini G. Soft tissue surrounding switched platform implants: an immunohistochemical evaluation. Clin Oral Implants Res 2011; 24:63-70. [DOI: 10.1111/j.1600-0501.2011.02301.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2011] [Indexed: 11/26/2022]
Affiliation(s)
- Claudia Dellavia
- Department of Human Morphology and Biomedical Sciences “Città Studi”; Università degli Studi di Milano; Milan; Italy
| | | | - Cristina Allievi
- Department of Human Morphology and Biomedical Sciences “Città Studi”; Università degli Studi di Milano; Milan; Italy
| | - Niklaus P. Lang
- Faculty of Dentistry; The University of Hong Kong; Hong Kong; China
| | - Gaia Pellegrini
- Department of Human Morphology and Biomedical Sciences “Città Studi”; Università degli Studi di Milano; Milan; Italy
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