To evaluate handling and healing patterns of customized allogenic bone blocks for vertical and horizontal alveolar defect augmentation. In 2 patients, 3 combined horizontal and vertical post-foraminal mandibular defects were grafted using computer-aided design (CAD) trimmed individual block grafts, 3D-designed on preoperative computed tomography scans. After a healing period of 6 months, graft resorption was measured and bone trephines were taken in progress of implant bed preparation. Four months later, implants were restored with single crowns. Moreover, clinical and radiological implant parameters were assessed 6 and 12 months after restorative rehabilitation. Uneventful healing was observed in 2 of the 3 cases. A partial exposure of 1 block after 8 weeks could be successfully treated by block reduction and application of a soft tissue graft. Histological evaluation revealed predictable bone formation within all augmented areas, and both patient satisfaction and long-term stability parameters were considered excellent. It was concluded that the application of individual CAD allografts supports bone formation at deficient sites with reduced patient morbidity, decreased surgery time, and high patient acceptance.
Objectives: The present randomized clinical trial assesses the six-month outcomes following surgical regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and electrolytic method (PEC). Materials and Methods: 24 patients with 24 implants suffering from peri-implantitis with any type of bone defect were randomly treated by EC or PEC. Bone defects were augmented with a mixture of natural bone mineral and autogenous bone and left for submerged healing. The distance from implant shoulder to bone was assessed at six defined points at baseline (T0) and after six months at uncovering surgery (T1) by periodontal probe and standardized x-rays. Results: One implant had to be removed at T1 because of reinfection and other obstacles. None of the other implants showed signs of inflammation. Bone gain was 2.71 ± 1.70 mm for EC and 2.81 ± 2.15 mm for PEC. No statistically significant difference between EC and PEC was detected. Significant clinical bone fill was observed for all 24 implants. Complete regeneration of bone was achieved in 12 implants. Defect morphology impacted the amount of regeneration. Conclusion: EC needs no further mechanical cleaning by powder spray. Complete re-osseointegration in peri-implantitis cases is possible.
2 November 2018 in International Journal of Implant Dentistry
The performance of dental implants in controlled clinical studies is often investigated in homogenous populations. Observational studies are necessary to evaluate the outcome of implant restorations placed in real-life situations, according to standard practice, and to assess the needs of the patients. The aim of this non-interventional study was to reveal the survival, success, and general performance of CAMLOG SCREW-LINE implants and their restorations in daily dental practice. Seventeen private practices across five countries participated in this prospective multicenter study. Patients received implants in the maxilla and mandible which were restored either with platform-matching or platform-switching abutments. Patients were followed-up for up to 5 years post-loading. Radiographs and clinical parameters were evaluated and patient satisfaction was evaluated. From a total of 196 patients planned, 185 patients with 271 implants were restored with abutments and fulfilled the follow-up inclusion criteria. Three implant failures were recorded, resulting in a cumulative survival rate of 98.6% after 5 years post-loading. One persistent complication of peri-implantitis occurred. The soft tissue health remained stable, and the papilla height improved after loading. At 5-year follow-up, the mean crestal bone loss was − 0.28 ± 0.60 mm; over 99% of patients reported satisfaction with the restoration as excellent or good. Implants placed and restored with both platform-matching and platform-switching abutments in daily dental private practice achieved excellent clinical outcomes with highly satisfied patients after 5 years of function, confirming the results obtained in well-controlled clinical trials.
3 September 2017 in Journal of Investigative and Clinical Dentistry
Purpose: Bacterial biofilms are a major problem in the treatment of infected dental and orthopedic implants. The purpose of this study is to investigate the cleaning effect of an electrolytic approach (EC) compared to a powder-spray system (PSS) on titanium surfaces. Materials and Methods: The tested implants (different surfaces and alloys) were collated into six groups and treated ether with EC or PSS. After a mature biofilm was established, the implants were treated, immersed in a nutritional solution, and streaked on Columbia agar. Colony-forming units (CFUs) were counted after breeding and testing (EC), and control (PSS) groups were compared using a paired sample t-test. Results: No bacterial growth was observed in the EC groups. After thinning to 1:1,000,000, 258.1 ± 19.9 (group 2), 264.4 ± 36.5 (group 4), and 245.3 ± 40.7 (group 6) CFUs could be counted in the PSS groups. The difference between the electrolytic approach (test groups 1, 3, and 5) and PSS (control groups 2, 4, and 6) was statistically extremely significant (p-value < 2.2 × 10−16). Conclusion: Only EC inactivated the bacterial biofilm, and PSS left reproducible bacteria behind. Within the limits of this in vitro test, clinical relevance could be demonstrated.
Aim of the study: This RCT assesses patients’ 18-month clinical outcomes after the regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and an electrolytic method (PEC). Materials and Methods: Twenty-four patients (24 implants) suffering from periimplantitis were randomly treated by EC or PEC followed by augmentation and submerged healing. Probing pocket depth (PPD), Bleeding on Probing (BoP), suppuration, and standardized radiographs were assessed before surgery (T0), 6 months after augmentation (T1), and 6 (T2) and 12 (T3) months after the replacement of the restoration. Results: The mean PPD changed from 5.8 ± 1.6 mm (T0) to 3.1 ± 1.4 mm (T3). While BoP and suppuration at T0 were 100%, BoP decreased at T2 to 36.8% and at T3 to 35.3%. Suppuration was found to be at a level of 10.6% at T2 and 11.8% at T3. The radiologic bone level measured from the implant shoulder to the first visible bone to the implant contact was 4.9 ± 1.9 mm at mesial sites and 4.4 ± 2.2 mm at distal sites at T0 and 1.7 ± 1.7 mm and 1.5 ± 17 mm at T3. Conclusions: Significant radiographic bone fill and the improvement of clinical parameters were demonstrated 18 months after therapy.