Classification of facial periâ implant soft tissue dehiscence/deficiencies at single implant sites in the esthetic zone

BackgroundThe incidence of a periâ implant soft tissue dehiscence/deficiency (PSTD) is not a rare finding. Despite multiple previous attempts aimed at correcting the PSTDs, a classification of these conditions has not yet been proposed. This lack in the literature may also lead to discrepancies in the reported treatment outcomes and thus misinform the clinician or the readers. The aim of the present article was therefore to present a classification of periâ implant PSTD at a single implant site.MethodsFour classes of PSTDs were discussed based on the position of the gingival margin of the implantâ supported crown in relation to the homologous natural tooth. In addition, the buccoâ lingual position of the implant head was also taken into consideration. Each class was further subdivided based on the height of the anatomical papillae.ResultsSubsequently, for each respective category a surgical approach (including bilaminar techniques, the combined prostheticâ surgical approach or soft tissue augmentation with a submerged healing) was also suggested.ConclusionThis paper provides a new classification system for describing PSTDs at single implant sites, with the appropriate recommended treatment protocol.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151905/1/jper10351_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151905/2/jper10351.pd

Soft tissue management at implants: Summary and consensus statements of group 2. The 6th EAO Consensus Conference 2021

OBJECTIVES The task of working Group 2 at the 6th Consensus Meeting of the European Association for Osseointegration was to comprehensively assess the effects of soft tissue augmentation procedures at dental implant sites on clinical, radiographic and patient-reported outcome measures (PROMs) including an overview on available outcome measures and methods of assessment. MATERIALS AND METHODS Three systematic reviews and one critical review were performed in advance on (i) the effects of soft tissue augmentation procedures on clinical, radiographic and aesthetic outcomes, (ii) reliability and validity of outcome measures and methods of assessment and (iii) PROMs applied in clinical studies for soft tissue augmentation procedures at dental implant sites. Major findings, consensus statements, clinical recommendations and implications for future research were discussed in the group and approved during the plenary sessions. RESULTS The four reviews predominantly revealed: Soft tissue augmentation procedures in conjunction with immediate and delayed implant placement result in superior aesthetic outcomes compared to no soft tissue augmentation in the zone of aesthetic priority. Soft tissue augmentation procedures have a limited effect on marginal bone level changes compared to implant sites without soft tissue augmentation. Clinically relevant parameters (gingival index, mucosal recession) and plaque control improve at implant sites when the width of keratinised mucosa is increased. A variety of aesthetic indices have been described with good reliability. Pink Esthetic Score and Complex Esthetic Index are the most validated aesthetic indices for single implants, though. Superimposed digital surface scans are most accurate to assess profilometric tissue changes. PROMs following soft tissue augmentation procedures have been assessed using various forms of questionnaires. Soft tissue augmentation had a limited effect on PROMs. CONCLUSIONS Soft tissue augmentation procedures are widely applied in conjunction with implant therapy. Depending on the indication of these interventions, clinical, radiographic and aesthetic outcomes may improve, whereas the effect on PROMs is limited

Consensus Report of Working Group 2:Soft Tissue Management

OBJECTIVES: The task of working Group 2 at the 6th Consensus Meeting of the European Association for Osseointegration was to comprehensively assess the effects of soft tissue augmentation procedures at dental implant sites on clinical, radiographic and patient‐reported outcome measures (PROMs) including an overview on available outcome measures and methods of assessment. MATERIALS AND METHODS: Three systematic reviews and one critical review were performed in advance on (i) the effects of soft tissue augmentation procedures on clinical, radiographic and aesthetic outcomes, (ii) reliability and validity of outcome measures and methods of assessment and (iii) PROMs applied in clinical studies for soft tissue augmentation procedures at dental implant sites. Major findings, consensus statements, clinical recommendations and implications for future research were discussed in the group and approved during the plenary sessions. RESULTS: The four reviews predominantly revealed: Soft tissue augmentation procedures in conjunction with immediate and delayed implant placement result in superior aesthetic outcomes compared to no soft tissue augmentation in the zone of aesthetic priority. Soft tissue augmentation procedures have a limited effect on marginal bone level changes compared to implant sites without soft tissue augmentation. Clinically relevant parameters (gingival index, mucosal recession) and plaque control improve at implant sites when the width of keratinised mucosa is increased. A variety of aesthetic indices have been described with good reliability. Pink Esthetic Score and Complex Esthetic Index are the most validated aesthetic indices for single implants, though. Superimposed digital surface scans are most accurate to assess profilometric tissue changes. PROMs following soft tissue augmentation procedures have been assessed using various forms of questionnaires. Soft tissue augmentation had a limited effect on PROMs. CONCLUSIONS: Soft tissue augmentation procedures are widely applied in conjunction with implant therapy. Depending on the indication of these interventions, clinical, radiographic and aesthetic outcomes may improve, whereas the effect on PROMs is limited

The Severity of Human Peri-Implantitis Lesions Correlates with the Level of Submucosal Microbial Dysbiosis

AIM To cross-sectionally analyse the submucosal microbiome of peri-implantitis (PI) lesions at different severity levels. MATERIALS AND METHODS Microbial signatures of 45 submucosal plaque samples from untreated PI lesions obtained from 30 non-smoking, systemically healthy subjects were assessed by 16s sequencing. Linear mixed models were used to identify taxa with differential abundance by probing depth, after correction for age, gender, and multiple samples per subject. Network analyses were performed to identify groups of taxa with mutual occurrence or exclusion. Subsequently, the effects of peri-implant probing depth on submucosal microbial dysbiosis were calculated using the microbial dysbiosis index. RESULTS In total, we identified 337 different taxa in the submucosal microbiome of PI. Total abundance of 12 taxa correlated significantly with increasing probing depth; a significant relationship with lower probing depth was found for 16 taxa. Network analysis identified two mutually exclusive complexes associated with shallow pockets and deeper pockets, respectively. Deeper peri-implant pockets were associated with significantly increased dysbiosis. CONCLUSION Increases in peri-implant pocket depth are associated with substantial changes in the submucosal microbiome and increasing levels of dysbiosis

Assessment of Marginal Bone Loss around Platform-Matched and Platform-Switched Implants - A Prospective Study

Abstract The aim of the present study was to perform a software-assisted radiographic assessment of the effect of platform-switching on marginal bone loss (MBL) around dental implants. Forty patients requiring a dental implant in non-grafted partially edentulous mandibles were enrolled and categorized into implants receiving a platform-matched abutment (control group) or implants with a platform-switched abutment (test group). Standardized digital periapical radiographs were taken at the time of implant placement (T0), at implant loading (T1) and 1-year after functional loading (T2). Software-assisted radiographic assessment of the MBL horizontal, vertical and area changes was performed and compared between time intervals (T1-T0, T2-T1 and T2-T0). Mean radiographic horizontal MBL (hMBL) and vertical MBL (vMBL) from implant placement to 1-year after implant loading (T2-T0) were significantly increased around platform-matched when compared to platform-switched abutments (1.04 mm vs 0.84 mm, p<0.05) and (0.99 mm vs 0.82 mm, p<0.05), respectively. Additionally, bone loss area (BLa) was greater (0.77 mm2 vs 0.63 mm2; p<0.05) for platform-matched compared to platform-switched abutments. Platform-switching has a positive impact upon the amount of bone modeling after loading implants with internal hexagon connection