International Journal of Oral Implantology, 04/2022

Purpose: To investigate various cleaning protocols employed to enable the reuse of healing abutments in the past decade. Materials and methods: The review followed the guidelines set out in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, with guidance from the Cochrane Collaboration Handbook. Electronic searching and handsearching were performed using the National Library of Medicine (MEDLINE via PubMed) and the Cochrane Central Register of Controlled Trials from January 2010 to July 2022, respectively. Studies published in English were evaluated. Two independent examiners conducted the search and the review process. The risk of bias of the included studies was evaluated. Results: In total, 178 articles were evaluated for review, but only 15 of them were selected for full-text reading. Regarding cleaning efficacy, chemical decontamination using sodium hypochlorite produced better results than laser and mechanical decontamination with airflow. Similar efficacy was found between chemical and electrochemical decontamination. Combined use of chemical and electrochemical decontamination protocols demonstrated the greatest efficacy. Chemical and electrochemical decontamination methods were found to achieve better outcomes in preserving the surface properties of decontaminated healing abutments than laser and mechanical methods. Conclusion: The present review found that combined decontamination protocols (chemical, electrochemical processing and autoclave treatment) are favourable for obtaining healing abutments with optimally cleaned surfaces. Moreover, healing abutments located in an area that is difficult to access can be cleaned without affecting the surface properties. This information could benefit researchers and clinicians when multiple-use healing abutments are considered. Keywords: cleaning effectiveness, decontamination, healing abutment, reuse, surface properties Conflict-of-interest statement: The authors report no conflicts of interest relating to this study.

Purpose: To assess the clinical performance of a two-piece zirconia implant system (PURE Ceramic Implants, Straumann, Basel, Switzerland) in the maxilla after a follow-up period of more than 1 year. Materials and methods: A total of 19 patients in three centres received 24 single-tooth implants in the maxilla. The implants were restored after a mean healing period of 7.1 ± 0.4 months (range 7 to 9 months). Implant survival, implant success, Plaque Index, probing pocket depth, bleeding on probing, mucosal recession/creeping attachment, width of keratinised mucosa, papilla index and pink aesthetic score were evaluated after prosthetic loading (T0), after 6 months (T1) and at the final follow-up (T2, mean 15.0 ± 2.1 months, range 12 to 19 months). Results: All implants survived and were suitable for retaining prostheses. Low values were recorded for Plaque Index (0.38 ± 0.68) and probing pocket depth (2.49 ± 0.49 mm). Bleeding on probing increased significantly from T0 (21.7%) to T1 (50.0%) (P = 0.0342) and then remained stable (50.0% at T2). No recession was detected around any of the implants. A statistically significant increase in attachment level was observed from T0 to T2 (0.79 ± 0.88 mm; P = 0.0196). A papilla index of 2.27 ± 0.81 and pink aesthetic score of 11.67 ± 1.60 at T2 indicated a completely satisfying aesthetic result. Conclusion: Within the limitations of the present study, the two-piece zirconia implant system investigated achieved fully satisfying functional and aesthetic results. Keywords: ceramic implant, maxilla, multicentre study, two-piece ceramic implant, zirconia implant Conflict-of-interest statement: Drs Linder and Dard are employees of Straumann Group (Basel, Switzerland). The other authors report no conflicts of interest relating to this study.

Purpose: The root membrane technique was designed to preserve the buccal portion of the root in situ, preventing postextraction bundle bone loss and overlying soft tissue recession. Nevertheless, maintenance of the aesthetic gingival architecture around two or multiple adjacent implants, particularly in the anterior maxilla, remains a challenge, notably regarding the gingival contour and the interimplant papillae. The present study aimed to evaluate the clinical, aesthetic and radiographic outcomes for immediate adjacent implants placed using the root membrane technique in the anterior maxilla in a sample with a 5- to 9-year follow-up. Materials and methods: A retrospective clinical study was designed using the medical records of two private dental practices. A total of 40 patients who were treated using the root membrane technique for at least two adjacent implants and single-crown restorations between January 2010 and February 2019 were selected (100 implants). The clinical and radiographic data were analysed to assess implant survival/success, marginal bone loss and the pink aesthetic score. Results: The cumulative survival rate after a mean follow-up period of 81.5 ± 30.5 months was 99.0% (implant-based) and 97.5% (patient-based), respectively. Between 1 and 5 years (n = 99), the mean marginal bone loss changed from 0.39 ± 0.07 mm to 0.36 ± 0.07 mm and subsequently to 0.37 ± 0.07 mm at the 7-year follow-up (n = 71) and 0.33 ± 0.07 mm at the 9-year follow-up (n = 14). The improvement from 1 year was significant at all the follow-up time points (P = 0.000). The mean global pink aesthetic score increased from baseline (11.33 ± 1.03) to 3 months after placement of the final restoration (11.73 ± 0.95) and the final observation (12.01 ± 0.87). This was a significant increase (P = 0.000 baseline to 3 months, 3 months to final observation and baseline to final observation). Conclusions: In this non-controlled retrospective study, adjacent implants placed using the root membrane technique achieved a satisfactory survival and success rate. The variation in marginal bone loss showed a significant positive trend from 1 year to 5 and 7 years. The overall pink aesthetic scores improved significantly between sequential observation periods. Conflict-of-interest statement: Dr Leitão-Almeida receives personal fees (for sponsored lectures) and non-financial support from MegaGen (Daegu, South Korea) outside of the submitted work; the other authors declare no conflicts of interests relating to this study. Keywords: immediate placement, marginal bone level, partial extraction, root membrane, single immediate adjacent implants, soft tissue aesthetics Dr Leitão-Almeida receives personal fees (for sponsored lectures) and non-financial support from MegaGen (Daegu, South Korea) outside of the submitted work; the other authors declare no coi.

Purpose: To compare the outcomes of soft tissue augmentation during one-stage implant placement using grafts harvested from the hard palate or the maxillary tuberosity. Materials and methods: In this pilot controlled clinical study, non-smoking adults with a single missing tooth in the anterior or premolar region and adequate ridge dimensions for implant placement were enrolled. Each received a single implant and connective tissue graft harvested either from the hard palate (n = 10) or the maxillary tuberosity (n = 10). Digital impressions were taken prior to treatment (T0) and then 2 and 12 months postoperatively (T1 and T2, respectively). The primary study outcome was changes in horizontal ridge dimension. Secondary outcomes included marginal bone level changes over time, pain levels in the first 2 postoperative weeks (W1 and W2) and pink aesthetic score and patient-reported outcome measures at T2. Data analysis included repeated measures analysis of variance for intergroup comparisons. Results: The horizontal ridge dimension increased significantly in both groups (P ≤ 0.002) at all apico-coronal levels examined, with no significant intergroup differences. There was also no significant intergroup difference in marginal bone level changes (P = 0.376). The hard palate group experienced higher pain levels in the donor site compared to the tuberosity group at W1 (P = 0.023). The pink aesthetic score and patient-reported outcome measures were similar between groups at T2. Conclusions: Soft tissue augmentation during one-stage implant placement results in significant increases in the horizontal ridge dimension. Keywords: autogenous tissue graft, connective tissue, dental implants, palate, transplantation, treatment outcome Conflict-of-interest statement: The authors report no conflicts of interest relating to this study.

The following amendments are made to the published article: Int J Oral Implantol 2022;15(3):265–274; PMID: 36082660; First published 9 September 2022.