ITI Literature Update

for Members

ITI International Team for

Implantology
ITI Center
Peter Merian-Weg 10
Compiled by: Colin A McKinnon CH-4052 Basel
Tel. +41 (0)61 270 83 83
e-mail: literature@iticenter.ch Fax +41 (0)61 270 83 84
ITI International Team for
iticenter@iticenter.ch
Implantology
www.iti.org
ITI Center
Peter Merian-Weg 10
CH-4052 Basel
Tel. +41 (0)61 270 83 83
Fax +41 (0)61 270 83 84
iticenter@iticenter.ch
www.iti.org
 Table of Contents

Literature Update ............................................................................................................... 4

Clinical Oral Implants Research ....................................................................................... 4
Vol. 21 No. 7 (July 2010) .............................................................................................. 4
Vol. 21 No. 8 (August 2010) ......................................................................................... 4
European Journal of Oral implantology ............................................................................ 6
Vol. 3 No. 2 (June 2010)............................................................................................... 6
European Journal of Oral Sciences.................................................................................. 7
Vol. 118 No. 4 (August 2010) ....................................................................................... 7
Implant Dentistry .............................................................................................................. 8
Vol. 19 No. 3 (June 2010)............................................................................................. 8
International Journal of Oral and Maxillofacial Implants ................................................... 8
Vol. 25 No. 3 (May/June 2010) ..................................................................................... 8
International Journal of Periodontics and Restorative Dentistry..................................... 10
Vol.30 No. 3 (May/June 2010) .................................................................................... 10
International Journal of Prosthodontics .......................................................................... 11
Vol. 23 No. 3 (May/June 2010) ................................................................................... 11
Journal of Clinical Periodontology .................................................................................. 12
Vol. 37 No. 7 (July 2010) ............................................................................................ 12
Vol. 37 No. 8 (August 2010) ....................................................................................... 12
Journal of Dentistry ........................................................................................................ 13
Vol. 38 Suppl. 1 (June 2010) ...................................................................................... 13
Vol. 38 No. 7 (July 2010) ............................................................................................ 13
Vol. 38 No. 8 (August 2010) ....................................................................................... 13
Journal of Oral and Maxillofacial Surgery....................................................................... 14
Vol. 68 No. 7 (July 2010) ............................................................................................ 14
Vol. 68 No. 8 (August 2010) ....................................................................................... 14
Journal of Oral Implantology .......................................................................................... 14
Vol. 36 No. 3 (June 2010)........................................................................................... 14
Journal of Oral Rehabilitation......................................................................................... 15
Vol. 37 No. 7 (July 2010) ............................................................................................ 15
Vol. 37 No. 8 (August 2010) ....................................................................................... 15
Journal of Periodontology .............................................................................................. 15
Vol. 81 No. 6 (June 2010)........................................................................................... 15
Vol. 81 No. 7 (July 2010) ............................................................................................ 15
Journal of Prosthetic Dentistry ....................................................................................... 17
Vol. 103 No. 6 (June 2010)......................................................................................... 17
Vol. 104 No. 1 (July 2010) .......................................................................................... 17
Quintessence International ............................................................................................ 18
Vol. 41 No. 5 (May 2010)............................................................................................ 18
2
 Vol. 41 No. 6 (June 2010)........................................................................................... 18
Vol. 41 No. 7 (July/August 2010) ................................................................................ 18
Tissue Engineering Part B: Reviews .............................................................................. 19
Vol. 16 No. 3 (June 2010)........................................................................................... 19
Vol. 16 No. 4 (August 2010) ....................................................................................... 19

3
Literature Update

Clinical Oral Implants Research

Vol. 21 No. 7 (July 2010)
Vol. 21 No. 8 (August 2010)
Degidi M, Nardi D, Piattelli A. A comparison between immediate loading and immediate restoration in cases
of partial posterior mandibular edentulism: a 3.year randomized clinical trial. Clin Oral Implants Res
2010;21(7):682-687.
Either immediate loading or immediate restoration was performed in 50 patients with partial posterior
mandibular edentulism (25 patients per group). A total of 100 implants were placed in healed sites. The
prostheses in the restoration group were placed out of occlusal contact, and both groups received definitive
restorations in occlusion after 6 months. Marginal bone loss was evaluated after 6, 12, 24 and 36 months.
Mobility was detected in two implants, one in each group. Mean marginal bone loss after 3 years was 0.987
± 0.375 mm and 0.947 ± 0.323 mm in the immediate restoration and immediate loading groups, respectively;
there was no significant difference between the groups. Immediate rehabilitation was therefore predictable
with both procedures.

Mardas N, Chadha V, Donos N. Alveolar ridge preservation with guided bone regeneration and a synthetic
bone substitute or a bovine-derived xenograft: a randomized, controlled, clinical trial. Clin Oral Implants
Res 2010;21(7):688-698.
Following single tooth extraction in 27 patients, sockets were grafted with either Straumann BoneCeramic
(SBC; test) or Bio-Oss (control), both covered with a collagen barrier membrane; complete soft tissue
coverage was not achieved. The residual ridge was evaluated and biopsies were taken after 8 months.
Reduction of the bucco-lingual alveolar ridge dimensions was significantly less in the test group (1.1 ± 1 mm
versus 2.1 ± 1 mm), while mesio-distal bone height was equally preserved in both groups. No differences in
buccal and palatal bone width were observed between the groups. Histology showed new bone formation in
the apical part of the biopsies, while dense fibrous connective tissue was observed in the coronal part.

Chang M, Wennström JL. Bone alterations at implant-supported FDPs in relation to inter-unit distances: a 5-
year radiographic study. Clin Oral Implants Res 2010;21(7):735-740.
A total of 43 patients with 48 fixed prostheses supported by 130 implants were enrolled in a supportive care
program, with radiography performed at prosthesis placement and after 1 and 5 years. Mean bone loss after
5 years was 0.1 mm, 0.4 mm and 0.2 mm at the tooth, implant and mid-proximal bone crest, respectively,
and mean mid-longitudinal bone loss at implant/implant units was 0.5 mm at the implants and 0.3 mm mid-
proximally. Change in BIC was found to be a significant predictor for 5-year mid-proximal bone level change
at implant/implant units, but no significant associations were observed at tooth/implant units.

Passeri G, Cacchioli A, Ravanetti F, Galli C, Elezi E, Macaluso GM. Adhesion pattern and growth of primary
human osteoblastic cells on five commercially available titanium implant surfaces. Clin Oral Implants Res
2010;21(7):756-765.
Human primary osteoblastic cells were cultured on five titanium surfaces: polished; machined;
sandblasted/acid-etched; sandblasted/acid-etched and modified with H2O2 rinse; and, titanium plasma-
sprayed. Cell growth was measured after 3, 7 and 9 days and the production of osteocalcin and
osteoprotegerin was evaluated. Cell shape and anchorage was affected by surface topography, with large
lamellipodia observed on the polished and machined surfaces and thin filopodia on both sandblasted/acid-
etched surfaces. Cell proliferation was greater on the rough surfaces and focal adhesions were stronger on
both sandblasted/acid-etched surfaces. Osteoprotegerin increased on all surfaces over time, but osteocalcin
production was highest on the sandblastzed/acid-etched/H2O2 rinse surface.

Simonis P, Dufour T, Tenebaum H. Long-term implant survival and success: a 10-16-year follow-up of non-
submerged dental implants. Clin Oral Implants Res 2010;21(7):772-777.n
A total of 55 patients (from an original 76) who received 131 implants between 1990 and 1997 were available
for a 10-16-year clinical and radiographic examination and a questionnaire on satisfaction. Cumulative
implant survival up to 16 years was 82.94%, and the biological and technical complication rates were 16.94%
and 31.09%, respectively. Most implant losses and biological complications were concentrated in a relatively
small number of patients. Patients with a history of periodontitis were noted to have lower implant survival
and were more prone to biological complications.
Leung KCM, McGrath CPJ. Willingness to pay for implant therapy: a study of patient preference. Clin Oral
Implants Res 2010;21(8):789-793.
Subjects attending a dental hospital were presented with two hypothetical clinical scenarios, i.e. missing one
anterior or posterior tooth. Clinical procedures, outcomes and potential complications of various treatment
options were then explained, as well as the consequences of no treatment. The subjects were then asked to
bid how much they would be prepared to pay for tooth replacement, with a starting bid of HK $20,000,
decreasing in HK $1000 increments until the subject chose the opposite option or the bid reached HK $0.
Implant treatment for the replacement of anterior or posterior teeth was chosen by 94% and 84% of subjects.
And the mean willingness-to-pay amounts were HK $11,000 and HK $10,000, respectively. Female subjects,
those with no missing teeth or restorative need, and those with higher levels of education were willing to pay
greater amounts, and these were considered independent predictors.

Tran BLT, Chen ST, Caiafa A, Davies HMS, Darby IB. Transmucosal healing around peri-implant defects:
crestal and subcrestal placement in dogs. Clin Oral Implants Res 2010;21(8):794-803.
In the mandibular premolar regions of three dogs, 23 implants were placed 3 months after tooth removal.
Five were control implants, placed at crestal bone level, and 18 were test implants placed with surgically
created peri-implant defects at either the crestal bone level (nine implants) or 2 mm below the crestal bone
level (nine implants). After 3 months of healing, greater BIC was observed in the coronal region for all
implants, but the healing response was incomplete for the test implants after 1 month, compared to the
control implants. Histometric measurements for the test implants were more coronal or closer to the implant
margin compared to the control implants, and the degree of osseointegration was similar for both test implant
groups.

Payer M, Heschl A, Wimmer G, Wegscheider W, Kirmeier R, Lorenzoni M. Immediate provisional restoration

of screw-type implants in the posterior mandible: results after 5 years of clinical function. Clin Oral Implants
Res 2010;21(8):815-821.
A total of 40 implants were placed in 24 patients to replace mandibular molars and premolars, and were
immediately provisionalized after placement. Bone levels and implant survival/success were assessed after
12, 24, 36, 48 and 60 months. Significant bone loss was observed in the first year after final restoration, but
no further significant increase occurred between 12 and 60 months. Two implants were lost, giving an
implant survival rate of 95%; the corresponding implant success rate was 92.5% (two failures plus one
implant with excessive bone loss). Careful patient selection appeared to be a key criterion for success.

Koizumi H, Sur J, Seki K, Nakajima K, Sano T, Okano T. Effects of dose reduction on multi-detector
computed tomographic images in evaluating the maxilla and mandible for pre-implant surgical planning: a
cadaveric study. Clin Oral Implants Res 2010;21(8):830-834.
Micro-detector CT with variable tube currents of 80, 40, 20 and 10 mA was used to evaluate the maxillae and
mandibles in six cadaver specimens. Multi-planar images were created and assessed by five oral
radiologists for visibility of various anatomical landmarks, and the quality of the images was compared to the
80 mA images. The results indicated that anatomical landmarks could be visualized on 40 mA images to
almost the same quality as 80 mA images, and 20 mA images were acceptable for diagnostic purposes, but
with substantial deterioration of image quality. Significant dose reduction is therefore possible for pre-surgical
implant planning with CT.

Widmann G, Zangeri A, Keiler M, Stoffner R, Bale R, Puelacher W. Flapless implant surgery in the
edentulous jaw based on three fixed intraoral reference points and image-guided surgical templates:
accuracy in human cadavers. Clin Oral Implants Res 2010;21(8):835-841.
Implant planning was performed on the basis of CT scans of edentulous cadaver specimens. Surgical
templates were fabricated, and the registration mouthpiece and surgical template were supported via three
fixed reference points. Implants were inserted through the guide sleeves and the accuracy was evaluated via
post-surgical CT. A total of 51 implants were placed in five maxillary and three mandibular edentulous
specimens. Mean (± SE) total and lateral error was 1.1 ± 0.6 mm and 0.7 ± 0.5 mm, respectively, at the
implant base, and 1.2 ± 0.7 mm and 0.9 ± 0.7 mm at the implant tip and the mean angular error was 2.8° ±
2.2°. Similar accuracy to tooth-supported surgical templates or surgical navigation was therefore found.

5
von See C, Gellrich N-C, Jachmann U, Laschke MW, Bormann K-H, Rücker M. Bone augmentation after
soft-tissue expansion using hydrogel expanders: effects on microcirculation and osseointegration. Clin Oral
Implants Res 2010;21(8):842-847.
Bone grafts from eight isogenic rats and were implanted in eight rats without tissue expansion and eight rats
after tissue expansion. Hydrogel expanders were inserted subperiostally in the tissue expansion group at the
augmentation sites. Microcirculation was monitored for 19 days and histological samples were evaluated.
Microvessel density was significantly higher in the region above the augmentation material in the tissue
expansion group over the whole study, but physiological microcirculation was observed in both groups.
Osseointegration of the graft was observed in the tissue expansion group, while connective and granulation
tissue was observed in the group without tissue expansion. Hydrogel expanders may therefore increase the
probability of success in bone augmentation.

Northdurft F, Pospiech P. Prefabricated zirconium dioxide implant abutments for single-tooth replacement in
the posterior region: evaluation of peri-implant tissues and superstructures 12 months after function. Clin
Oral Implants Res 2010;21(8):857-865.
A total of 24 patients received 40 implants, which were subsequently restored with all-ceramic Y-TZP
abutments and all-ceramic crowns. Clinical parameters and mesial and distal bone levels were evaluated
after 12 months, and implant stability was measured. Sulcus fluid flow rate and modified sulcus bleeding
index indicated stable and healthy soft tissues, and probing pocket depth was generally low. Proximal bone
defects were reduced from -1.1 mm to -1 mm. No implant or crown losses were recorded, but chipping of the
veneering ceramic was observed in four cases. No mechanical failure of the all-ceramic abutments therefore
occurred.

Klinger A, Asad R, Shapira L, Zubery Y. In vivo degradation of collagen membranes exposed to the oral
cavity. Clin Oral Implants Res 2010;21(8):873-876.
Collagen membranes of three different types (ribose cross-linked, glutaraldehyde cross-linked or non-cross-
linked) were placed over the buccal mucosa in the premolar and molar region in 20 subjects. A periodontal
dressing was placed over the membrane, which was removed after 10 days to assess membrane integrity.
Discomfort, pain or dislodging of the pack led eight subjects to withdraw from the study. Marked differences
in membrane integrity between the three types were observed. The results indicated that the ribose cross-
linked membrane appeared to be more resistant to degradation.

European Journal of Oral implantology

Vol. 3 No. 2 (June 2010)
Esposito M, Grusovin MG, Loli V, Coulthard P, Worthington HV. Does antibiotic prophylaxis at implant
placement decrease early implant failures? A Cochrane systematic review. Eur J Oral Implantol
2010,3(2):101-110.
The authors performed a literature search for randomized controlled trials comparing the outcomes of
prophylactic regimens versus no antibiotics in implant placement. Four trials were identified; three compared
2 g amoxicillin preoperatively versus placebo (927 patients) and one compared 1 g amoxicillin preoperatively
plus 500 mg four times daily versus no antibiotics (80 patients). Significantly more patients experienced
implant failures in the groups not receiving antibiotics, but other outcomes were not statistically significantly
different. Some evidence therefore suggests that prophylactic amoxicillin may reduce implant failures in
ordinary conditions.

Cannizarro G, Torchio C, Felice P, Leone M, Esposito M. Immediate occlusal versus non-occlusal loading of
single zirconia implants. A muticentre pragmatic randomised clinical trial. Eur J Oral Implantol
2010,3(2):111-120.
A total of 40 edentulous patients each received a single zirconia implant loaded immediately either occlusally
or non-occlusally. There were five early implant failures (three occlusally loaded and two non-occlusally
loaded) and three complications were noted. Peri-implant bone was gradually lost in both groups up to 1
year (0.9 mm and 0.7 mm in the occlusal and non-occlusal loading groups, respectively). An association was
also noted between immediate post-extraction implants and implant failures.

6
Alissa R, Esposito M, Horner K, Oliver R. The influence of platelet-rich plasma on the healing of extraction
sockets. An explorative randomised clinical trial. Eur J Oral Implantol 2010,3(2):121-134.
A total of 15 extraction sockets were treated with PRP in 12 patients and 14 control sockets were left
untreated in 11 patients. Pain was significantly greater in the control group for the first 3 days, and analgesic
consumption was significantly higher for the first and second days. There were significant differences in favor
of PRP treatment for presence of bad taste/bad smell in the mouth and food stagnation in the operation area.
Two dry sockets and one inflamed alveolus occurred in the control group, and soft tissue was significantly
better in the PRP group. Significant differences favoring PRP were also detected radiographically for sockets
with dense homogeneous trabecular pattern and trabecular pattern for bone volume, but there were no
differences for trabecular separation, length, width of number. PRP may therefore have some benefits, but
data are currently insufficient.

Esposito M, Cannizarro G, Bozzoli P, Checchi L, Ferri V, Landriani S, Leone M, Todisco M, Torchio C,

Testori T, Galli F, Felice P. Effectiveness of prophylactic antibiotics at placement of dental implants: a
pragmatic multicentre placebo-controlled randomised clinical trial. Eur J Oral Implantol 2010,3(2):135-143.
Patients scheduled for implant surgery were randomized to received 2 g amoxicillin (252 patients) or
identical placebo (254 patients) 1 h prior to implant placement and were evaluated 1 and 2 weeks and 4
months later. There were four prosthesis and seven implant failures in the antibiotic group compared to 10
prosthesis and 13 implant failures in the placebo group. The number of complications was similar (11 in the
antibiotic group, 13 in the placebo group). Differences were not significant but the risk of implant failure was
increased without antibiotic prophylaxis.

Cairo F, Nieri M, Gori AM, Tonelli P, Branchi R, Castellani S, Abbate R, Pini-Prato GP. Markers of systemic
inflammation in periodontal patients: chronic versus aggressive periodontitis. An explorative cross-sectional
study. Eur J Oral Implantol 2010,3(2):147-153.
Blood samples from 45 systemically healthy patients with either chronic (21 patients) or aggressive (24
patients) periodontitis were evaluated for high-sensitivity CRP, cytokine and chemokine levels. No significant
differences were found between the groups for periodontal parameters or inflammatory markers, indicating a
similar inflammatory profile for chronic and aggressive periodontitis.

Puig CP. A retrospective study of edentulous patients rehabilitated according to the ‘all-on-four’ od the ‘all-
on-six’ immediate function concept using flapless computer-guided implant surgery. Eur J Oral Implantol
2010,3(2):155-163.
A total of 195 implants were placed and immediately loaded in 30 patients to support 25 maxillary (128
implants) and 17 mandibular (67 implants) full-arch prostheses via the ‘all-on-four’ or ‘all-on-six’ protocols;
provisional prostheses were placed immediately with definitive prostheses after 6-12 months. Implant
positioning and guided flapless implant placement was by means of Procera software. There were four
implant failures in three patients (two each in the maxilla and mandible), three of which were successfully
replaced. No definitive prostheses failed and no patients dropped out of the study, but three patients were
surgically and antibiotically treated for apically infected implants. Both surgical protocols appeared to be
viable and predictable, but may be sensitive to the clinician’s experience.

European Journal of Oral Sciences

Vol. 118 No. 4 (August 2010)
Taylor B, Tofler G, Morel-Kopp M-C, Carey H, Carter T, Elliott M, Dailey C, Villata L, Ward C, Woodward M,
Schenck K. The effect of initial treatment of periodontitis on systemic markers of inflammation and
cardiovascular risk: a randomized controlled trial. Eur J Oral Sci 2010;118(4):350-356.
A total of 136 patients with chronic periodontitis were randomized to receive initial periodontal treatment
(test) or no treatment (control) in a 3-month study. Cardiovascular risk factors and hematological,
inflammatory and metabolic markers were measured at the start and end of the study. Data were available
for 51 test and 64 control patients, and the results showed a non-significant trend towards lower fibrinogen
levels in the test group and a significant increase in hemoglobin and hematocrit after intervention. Systemic
effects of periodontal treatment were therefore observed.

7
Meijndert L, van der Reijden WA, Raghoebar GM, Meijer HJA, Vissink A. Microbiota around teeth and dental
implants in periodontally healthy, partially edentulous patients: is pre-implant microbiological testing
relevant?
Eur J Oral Sci 2010;118(4):357-363.
Subgingival microbial samples from 93 patients requiring single tooth replacement were obtained before
implant treatment and after 1 year. Threshold levels for periodontal breakdown were applied, and periodontal
treatment was given to patients with levels of pathogens above these thresholds. One or more marker
pathogens were found in 49.5% of subjects at baseline, and periodontal treatment reduced the levels to
below the thresholds in 78.3% of these patients. Marker pathogens were above the threshold level in 74.1%
of patients after 1 year. The long-term effectiveness of reducing pathogen levels prior to implant treatment
was therefore limited; pre-implant reduction did not predict post-implant levels. Pre-implant microbiological
testing may therefore not be relevant.

Implant Dentistry
Vol. 19 No. 3 (June 2010)
Sánchez-Ayala A, Lagravère MO, Gonçalves TMSV, Lucena SC, Barbosa CMR. Nutritional effects of implant
therapy in edentulous patients – a systematic review. Implant Dent 2010;19(3):196-207.
Studies relating to the nutrient intake improvement of edentulous subjects rehabilitated with various
treatments were reviewed. Despite an extensive literature search, only five articles met the selection criteria.
Inadequate nutrient intake after treatment was found in two of these, while a randomized controlled trial
showed an improvement in nutrient intake after treatment and another found adequate nutritional intake both
before and after treatment. No difference between conventional and implant treatment was found in these
four studies, but the fifth study indicated a higher risk of malnutrition for those wearing conventional complete
dentures.

Chow YC, Wang H-L. Factors and techniques influencing peri-implant papillae. Implant Dent
2010;19(3):208-219.
A literature search was performed for articles relating to esthetics in terms of inter-implant papillae. Factors
that can influence the appearance of inter-implant papillae include crestal bone height, interproximal
distance, gingival width and the width of keratinized tissue. Promotion of inter-implant papillae formation has
also been successfully achieved using a number of techniques.

Acocella A, Bertolai R, Sacco R. Modified insertion technique for immediate implant placement into fresh
extraction socket in the first maxillary molar sites: a 3-year prospective study. Implant Dent 2010;19(3):220-
228.
Each of 68 patients scheduled for extraction of a first maxillary molar immediately received an implant in the
fresh extraction socket. Regenerative therapy was simultaneously performed, if necessary. Single crowns
were placed after 3 months. After 3 years, there were three implant failures, giving a cumulative survival rate
of 97.96%. Immediate implant placement in the maxillary first molar position, with appropriate regenerative
material, is therefore a valid treatment option.

Bilhan H, Mumcu E, Erol S, Kutay Ö. Influence of platform-switching on marginal bone levels for implants
with mandibular overdentures: a retrospective clinical study. Implant Dent 2010;19(3):250-258.
A total of 51 patients with 126 implants supporting mandibular overdentures appeared for routine recall visits
after 6, 12, 24 and 36 months and were included in the study group. Mean marginal bone level change was
assessed from successive radiographs. Significantly lower bone loss was observed for platform-switched
implants after 36 months, although rates of mesial and distal bone loss differed at 6, 12 and 24 months.

International Journal of Oral and Maxillofacial Implants

Vol. 25 No. 3 (May/June 2010)
Baixe S, Fauxpoint G, Arntz Y, Etienne O. Microgap between zirconia abutments and titanium implants. Int J
Oral Maxillofac Implants 2010;25(3):455-460.
For each of four different systems (Procera zirconia, Cercon Balance Anterior, ZirDesign and Straumann
Cares ceramic) assemblies (five per system) were embedded in epoxy, cut along the long axes, polished
and examined by scanning electron microscopy for microgaps. Mean marginal microgap was 0.89 ± 1.67
μm, and significant differences were observed between the systems (Cercon 0.38 ± 0.28 μm, ZirDesign 0.55
± 0.23 μm, Procera 1.83 ± 3.21 μm, Straumann Cares 0.90 ± 0.59 μm). The microgap quickly decreased
from the outer region to the inner in all systems. The mean microgap for flat connection systems was greater
than that for internal conical connection systems.

8
Hudieb M, Wakabayashi N, Suzuki T, Kasugai S. Morphologic classification and stress analysis of the
mandibular bone in the premolar region for implant placement. Int J Oral Maxillofac Implants
2010;25(3):482-490.
Scans of the premolar region were performed for 102 patients with missing mandibular premolars and were
classified into nine groups according to bone morphology and alveolar crest. Finite element models were
then constructed, with implants and superstructures, and 200 N loads applied 30° buccal from the vertical
axis. Maximum compressive stresses were observed in the lingual cervical regions, but no influence of bone
morphology on stress distribution was observed, but maximum stress and strain was affected by the alveolar
contour; microstrain over 4,000 was only seen when the alveolar crest was lingual in relation to the body of
the mandible. The alveolar crest contour therefore plays a role in maintaining peri-implant bone levels.

Waasdorp J, Reynolds MA. Allogeneic bone onlay grafts for alveolar ridge augmentation: a systematic
review. Int J Oral Maxillofac Implants 2010;25(3):525-531.
A literature search was performed for clinical studies using allogeneic bone grafts for alveolar bone
augmentation. From an initial 35 publications identified, nine were included in the review (six case series,
one prospective multicenter case series and two case reports). High graft incorporation and implant survival
were found in observational studies, but most articles involved selected defects in the anterior region with < 3
years follow-up. Clinical evidence therefore differed in terms of defects, treatment and therapeutic endpoints.
The potential for allogeneic block grafts was shown, but there is insufficient evidence to establish treatment
efficacy.

Valderrama P, Jones AA, Wilson TG Jr, Higginbottom F, Schoolfield JD, Jung RE, Noujeim M, Cochran DL.
Bone changes around early loaded chemically modified sandblasted and acid-etched surface implants with
and without a machined collar: a radiographic and resonance frequency analysis in the canine mandible. Int
J Oral Maxillofac Implants 2010;25(3):548-557.
A total of 72 implants, 36 with a 2.8 mm machined collar and 36 without a machined collar, were placed in six
dogs. Implant stability (by resonance frequency analysis) was measured weekly for 3 weeks, and the
implants were loaded after 21 days. Periapical radiographs were taken at 3 weeks and 3, 6, 9 and 12
months. Implant stability increased by 5 ISQs for implants with a machined collar and by 7 ISQs for implants
without a machined collar from implant placement to week 3. After 12 months, a mean bone loss of 1.0 mm
was observed for the machined collar implants, compared to mean bone gain of 0.11 mm for implants
without a machined collar. Coronal bone apposition was attributed to the properties of the chemically
modified implant surface.

Degidi M, Daprile G, Piattelli A. Determination of primary stability: a comparison of the surgeon’s perception
and objective measurements. Int J Oral Maxillofac Implants 2010;25(3):558-561.
A total of 514 implants were placed in 152 patients. The surgeon was asked to indicate the probable ISQ
value after placement for all implants and the probable insertion torque for 483 implants. The actual values
were measured and classified into low, medium and high groups. Mean perceived and actual RFA values
were 72.2 ± 9.8 and 73.5 ± 10.2, respectively, and the perceived and actual insertion torque values were
39.1 ± 20.1 Ncm and 39.9 ± 20.7 Ncm, respectively. Good primary stability was obtained but was generally
underestimated, especially in the presence of low of medium ISQ and torque values. However, the accuracy
of prediction is not enough to prevent mistakes, so more systematic use of objective measurements is
encouraged.

van Kesteren CJ, Schoolfield J, West J, Oates T. A prospective randomized clinical study of changes in soft
tissue position following immediate and delayed implant placement. Int J Oral Maxillofac Implants
2010;25(3):562-570.
In 24 patients, implants were either placed immediately or ridge preservation was performed with implant
placement 3 months later. Soft tissue, vertical and ridge width measurements were performed after 6
months. Minimal recession of mid-buccal tissue margins was found after 6 months, with no differences
between the groups. There was a significant decrease in interproximal soft tissue height, with no significant
differences between the groups, but ridge width reduction was greater at the immediate implant sites. No
significant relationship could be seen between tissue biotype and tissue changes. No differences in soft
tissue changes were therefore noted between immediate and delayed implants.

9
Fickl S, Zuhr O, Stein JM, Hürzeler MB. Peri-implant bone level around implants with platform-switched
abutments. Int J Oral Maxillofac Implants 2010;25(3):577-581.
A total of 89 implants were placed in 36 patients in two different groups: 75 wide diameter implants placed
subcrestally with regular diameter cover screws (platform-switched) or 14 regular diameter implants placed
at crestal level with regular diameter cover screws. Radiographs were taken at prosthesis placement and
after 1 year. Significantly less bone loss was observed at the platform-switched implants at both prosthesis
placement and after 1 year, therefore suggesting that this configuration can limit crestal bone remodeling.

Weinländer M, Piehslinger E, Krennmair G. Removable implant-prosthodontic anchorage of the edentulous

mandible: five-year results of different prosthetic anchorage concepts. Int J Oral Maxillofac Implants
2010;25(3):589-597.
Different bar retention designs were evaluated in 76 patients: 39 patients received an overdenture with an
ovoid bar supported on two implants (design 1) or multiple ovoid bars on four implants (design 2), and 27
patients received a rigid implant-supported prosthesis with a milled bar. Implant survival, peri-implant
parameters and prosthodontic maintenance were assessed over 5 years. Implant survival was 100% and
there was no difference in peri-implant parameters between the groups. Prosthodontic maintenance was not
significantly different between the overdenture groups, but was significantly lower for the group with rigid
prostheses and milled bars. High patient satisfaction was noted for all designs.

Lambert F, Lecloux G, Rompen E. One-step approach for implant placement and subantral bone
regeneration using bovine hydroxyapatite: a 2- to 6-year follow-up study. Int J Oral Maxillofac Implants
2010;25(3):598-606.
Patients previously treated with sinus floor elevation and simultaneous implant placement were
retrospectively selected for follow-up evaluation. Sinus elevation was performed using a lateral window
technique with bovine HA, with immediate placement of non-submerged implants. A total of 50 subantral
bone augmentations were performed in 40 patients, and 102 implants were placed. Two implants were lost
before loading, but none were lost after definitive restoration; implant and prosthodontic survival were
therefore 98% and 100%, respectively, after 2 to 6 years. Subantral bone regeneration with bovine HA is
therefore safe and effective.

Prosper L, Crespi R, Valenti E, Capparé P, Gherlone E. Five-year follow-up of wide-diameter implants placed
in fresh molar extraction sockets in the mandible: immediate versus delayed loading. Int J Oral Maxillofac
Implants 2010;25(3):607-612.
Wide-diameter implants were placed immediately after tooth extraction and loaded either immediately (60
implants) or after 3 months (60 implants) in 71 patients. Radiographs were taken at baseline and after 1, 2,
3, 4 and 5 years. Four implants were lost (two in each group), giving an implant survival rate of 96.67% after
5 years. No significant radiographic or clinical differences were found between the groups.

Garcia-Bellosta S, Bravo M, Subirá C, Echeverría JJ. Retrospective study of the long-term survival of 980
implants placed in a periodontal practice. Int J Oral Maxillofac Implants 2010;25(3):613-619.
Clinical records of 323 patients with 980 implants were retrospectively reviewed; 71.1% of implants were
placed in patients undergoing periodontal maintenance care and 38.8% were placed in smokers. The
cumulative implant survival rate was 96.2%, and most implant failures occurred before implant loading. The
risk of failure was not increased with periodontitis or smoking, but the risk of failure was increased in
individuals with many implants and with implants placed in sinus elevation. Implant placement is therefore
reliable long-term, even in smokers or patients with periodontitis.

International Journal of Periodontics and Restorative Dentistry

Vol.30 No. 3 (May/June 2010)
Kan JYK, Morimoto T, Rungcharassaeng K, Roe P, Smith DH. Gingival biotype assessment in the esthetic
zone: visual versus direct measurement. Int J Periodontics Restorative Dent 2010;30(3):237-243.
The gingival biotype of an anterior maxillary failing tooth in 48 patients was assessed by three different
methods: visual, periodontal probing or direct measurement; for direct measurements, ≤ 1.0 mm was
considered thin and > 1.0 mm was considered thick. Mean gingival thickness was 1.06 ± 0.27 mm, and thick
and thin biotypes were evenly distributed. There was a significant difference between visual assessment and
assessment with a periodontal probe or direct measurement, but there was no significant difference between
periodontal probing and direct measurement. Periodontal probing for assessment of gingival biotype is
therefore adequately reliable, but visual assessment alone is not.

10
Rasperini G, Canullo L, Dellavia C, Pellegrini G, Simion M. Socket grafting in the posterior maxilla reduces
the need for sinus augmentation. Int J Periodontics Restorative Dent 2010;30(3):265-273.
In 14 patients, 16 extraction sockets were either grafted (six patients) or left untreated (eight patients). Ridge
alterations were evaluated at baseline and after 3 and 6 months, and histological analysis was performed at
3, 6 and 9 months, and implant placement, with or without sinus augmentation, was decided at 6 months.
Sinus augmentation for implant placement was performed in three of eight control patients but only one of six
patients in the test group. Alveolar ridge augmentation therefore increases the likelihood of placing implants
without sinus augmentation.

Bersani E, Coppede AR, de Paula Pinto Prata HH. Immediate loading of implants placed in fresh extraction
sockets in the molar area with flapless and graft procedures: a case series. Int J Periodontics Restorative
Dent 2010;30(3):291-299.
A total of 23 implants were placed to replace single teeth in the molar regions of 20 patients, with no flap
reflection or grafting. There were nom implant losses or signs of significant bone resorption or soft tissue
complications. This treatment method may therefore be a suitable alternative for the replacement of failing
molars.

Tymstra N, Meijer HJA, Stellingsma K, Raghoebar GM, Vissink A. Treatment outcome and patient
satisfaction with two adjacent implant-supported restorations in the esthetic zone. Int J Periodontics
Restorative Dent 2010;30(3):307-316.
Ten patients with two adjacent implants in the anterior maxilla, and who previously received augmentation
with autogenous bone, were included in this study. Clinical and esthetic parameters were evaluated. No
implants were lost. Bone crest level between the implants was significantly more apical than that between an
implant and the adjacent tooth, and complete filling of the interproximal space was observed was observed in
only one patient, but the papilla between implant and neighboring tooth was seen in seven patients. The
esthetic outcome of the implant-supported was rated as ‘acceptable’ in all cases by the patients, but
clinicians rated six as ‘acceptable’ and four as ‘unacceptable’. Esthetic results were therefore difficult to
achieve.

International Journal of Prosthodontics

Vol. 23 No. 3 (May/June 2010)
Andreiotelli M, Att W, Strub J-R. Prosthodontic complications with implant overdentures: a systematic
literature review. Int J Prosthodont 2010;23(3):195-203.
A literature search was performed for clinical studies with data regarding prosthetic complications with follow-
up periods of at least 5 years. Only a limited number of randomized controlled trials were identified, and very
few prospectively compared prosthetic complications for over 5 years. Predictable results were observed
with implant-supported overdentures in terms of stability, retention and patient satisfaction, but lower implant
survival and a higher prosthetic complication rate is observed for maxillary overdentures. Considerable
information on complications can be found, but analysis is difficult due to variations in study design. Well
designed longitudinal studies are therefore required.

Eliasson A, Narby B, Ekstrand K, Hirsch J, Johansson A, Wennerberg A. A 5-year prospective clinical study
of submerged and nonsubmerged Paragon system implants in the edentulous mandible. Int J Prosthodont
2010;23(3):231-238.
This investigation included 29 patients who received 168 titanium plasma-sprayed implants supporting fixed
mandibular prostheses; 24 patients were evaluated at the 5-year follow-up. The prostheses remained in
function for all patients, and the implant survival rate was 99.4%; however, three implants fractured in one
patient. Mean bone loss after 5 years was 0.42 ± 0.48 mm for non-submerged implants and 0.51 ± 0.33 m
for submerged implants, but 19 implants (including the three fractured implants) exhibited annual bone loss >
0.2 mm after the first year, giving a success rate of 86.2%.

11
Journal of Clinical Periodontology
Vol. 37 No. 7 (July 2010)
Vol. 37 No. 8 (August 2010)
Benguigui C, Bongard V, Ruidavets J-B, Chamontin B, Sixou M, Ferrières J, Amar J. Metabolic syndrome,
insulin resistance, and periodontitis: a cross-sectional study in a middle-aged French population. J Clin
Periodontol 2010;37(7):601-608.
A cross-sectional survey on cardiovascular risk factors included 276 subjects, 21 of whom were excluded
due to edentulism or infectious risk. Periodontal parameters were recorded and periodontitis was classified
as moderate or severe. Moderate or severe periodontitis was identified in 41% and 39% of subjects,
respectively, and periodontitis was found to be associated with metabolic syndrome, most of its components,
and the homeostasis model assessment of insulin resistance (HOMA) index. The association between
HOMA index and severe periodontitis remained after adjusting for confounders, and HOMA was also
associated with the number of periodontal sites with clinical attachment level ≥ 4 or 5 mm, or probing depth ≥
4 mm, but there was no such relationship in patients who had never smoked.

Han D-H, Lim S-Y, Sun B-C, Paek D, Kim H-D. The association of metabolic syndrome with periodontal
disease is confounded by age and smoking in a Korean population: the Shiwha-Banwol Environmental
Health Study. J Clin Periodontol 2010;37(7):609-616.
A cross-sectional survey was performed for 1,046 subjects in the Shiwha-Banwol Environmental Health
Study. Medical and dental examinations were performed, periodontitis was assessed and confounders (age,
gender, smoking, drinking, monthly income, brushing frequency and physical activity) were evaluated. A
strong association between metabolic syndrome and periodontitis was found, and the association was
greater with more metabolic syndrome components and for subjects aged ≥ 65 years, males and smokers.
The association was also found to be higher if the metabolic syndrome included high glucose and
hypertension compared to other types of metabolic syndrome.

Ylöstalo P, Anttila S, Rajala U, Päivänsalo M, Keinänen-Kiukaanniemi S, Sakki T, Knuuttila M. Periodontal

infection and subclinical atherosclerosis: the role of high-density lipoprotein as a modifying factor. J Clin
Periodontol 2010;37(7):617-624.
Data from 60 dentate subjects in a diabetic study were analyzed and measurements of atherosclerosis were
performed. There was no consistent association between the presence of periodontal pockets and
subclinical atherosclerosis, but there was a strong association in subjects with low HDL and an opposing but
less consistent association in subjects with high HDL. Product terms indicating potential HDL modification
were significant for all total plaques, carotid artery plaques with cut-off values 1.2-1.4 and for intima-media
thickness with cut-off values 1.1-1.2, but not for aortic plaques.

Pini-Prato GP, Cairo F, Nieri M, Franceschi D, Rotundo R, Cortellini P. Coronally advanced flap versus
connective tissue graft in the treatment of multiple gingival recessions: a split-mouth study with a 5-year
follow-up. J Clin Periodontol 2010;37(7):644-650.
In 13 patients, a total of 93 Miller class I, II and III gingival recessions were treated with coronally advanced
flap (CAF) alone or combined with connective tissue graft (CTG) and assessed after 6 months and 1 and 5
years. After 6 months, there was no difference in the number of sites with complete root coverage between
the groups, but the prevalence of complete root coverage was significantly greater in the CAF+CTG group
after 5 years. Between 6 months and 5 years, the gingival margins showed an apical relapse in the CAF
group but a coronal improvement in the CAF+CTG group.

Ronaldo B, Mattos CML, Dibart S. A clinical comparison of two flap designs for coronal advancement of the
gingival margin: semilunar versus coronally advanced flap. J Clin Periodontol 2010;37(7):651-658.
In this investigation the semilunar coronally re-positioned flap (SLCRF) technique, one of the variants of the
semilunar incision was evaluated versus coronally advanced flap (CAF) in 22 patients with 22 contralateral
Miller class I gingival recessions. Clinical parameters were recorded at baseline and after 6 months. Coronal
displacement of the gingival margin was effective with both techniques, but significantly greater root
coverage, frequency of complete root coverage and gain in clinical attachment level was found with CAF.
Root coverage obtained immediately following SLCRF surgery was not maintained.

12
Thoma DS, Jung RE, Schneider D, Cochran DL, Ender A, Jones AA, Görlach C, Uebersax L, Graf-Hausner
U, Hämmerle CHF. Soft tissue volume augmentation by the use of collagen-based matrices: a volumetric
analysis. J Clin Periodontol 2010;37(7):659-666.
Soft tissue volume augmentation in dogs was performed with collagen matrix (CM) or subepithelial
connective tissue graft (SCTG); controls were sham-operated. Impression casts were taken at baseline and
after 28 and 84 days, and were scanned and analyzed. In the CM group, significant gains in volume were
obtained in the CM and CSTG groups after 28 and 84 days compared to control, and there was no significant
difference between CM and SCTG, indicating that CM may be a suitable replacement for autogenous
connective tissue.

Chambrone L, Chambrone D, Lima LA, Chambrone LA. Predictors of tooth loss during long-term periodontal
maintenance: a systematic review of observational studies. J Clin Periodontol 2010;37(7):675-684.
A literature search was performed for articles on patients with periodontitis who underwent periodontal
therapy and at least 5 years of maintenance care. From a total of 527 potential articles, 13 retrospective case
series were included, eight and five of which were shown to of medium and low methodological quality,
respectively. A total of 41,404 teeth were present after periodontal therapy and 3,919 were lost during
periodontal maintenance. Tooth loss due to periodontal reasons varied from 1.5% to 9.8% and no tooth loss
varied from 36.0% to 88.5%. Age and smoking (patient-related factors), tooth type and location and initial
tooth prognosis (tooth-related factors) were associated with tooth loss during periodontal maintenance.
However, definitive conclusions could not be drawn due to the heterogeneity of the studies.

Pires ILO, Cota LOM, Oliveira OCB, Costa JE, Costa FO. Association between periodontal condition and use
of tongue piercing: a case-control study. J Clin Periodontol 2010;37(8):712-718.
Oral health records of 60 patients with tongue piercings and 120 without tongue piercings were evaluated,
including periodontal parameters and tooth fracture, and risk variables for gingival recession were identified.
The presence and severity of gingival recession was much higher for those with tongue piercings than for
those without, and the risk of gingival recession in the anterior lingual region was 11 times greater. Use of
piercings, age, male gender and bleeding on probing were associated with gingival recession in the anterior
lingual region.

Zucchelli G, Mele M, Stefanini M, Mazzotti C, Marzadori M, Montebugnoli L, de Sanctis M. Patient morbidity

and root coverage outcome after subepithelial connective tissue and de-epithelialized grafts: a comparative
randomized-controlled clinical trial. J Clin Periodontol 2010;37(8):728-738.
Recessions in 50 patients were treated with coronally advanced flap (CAF) combined with connective tissue
graft (CTG) or de-epithelialized gingival graft (DGG). No significant differences in painkiller consumption,
post-operative discomfort or bleeding were observed between the groups, but consumption of painkillers
increased with the height of the graft and with primary flap dehiscence/necrosis. A negative correlation was
found between pain and residual thickness of soft tissue over the palatal bone, and the DGG group showed
significantly greater buccal soft tissue thickness.

de Sanctis M, Vignoletti F, Discepoli N, Muñoz F, Sanz M. Immediate implants at fresh extraction sockets: an
experimental study in the beagle dog comparing four different implant systems. Soft tissue findings. J Clin
Periodontol 2010;37(8):769-776.
Immediately following tooth extraction, implants were placed in the distal sockets of the third and fourth
premolars in eight dogs; four implant sites were used in each dog. After 6 weeks, the biological width
consisted of junctional epithelium of 2 to 2.7 mm and connective tissue from 1 to 1.8 mm; the length of the
junctional epithelium was longer than that observed in healed-ridge models. No significant differences
between any of the implant systems were found.

Journal of Dentistry
Vol. 38 Suppl. 1 (June 2010)
Vol. 38 No. 7 (July 2010)
Vol. 38 No. 8 (August 2010)
Javed F, Romanos GE. The role of primary stability for successful immediate loading of dental implants. A
literature review. J Dent 2010;38(8):612-620.
A literature search was performed for articles relating to primary stability in immediate loading of implants.
The evidence suggested that good primary stability is a key criterion for immediate loading and is dependent
on a number of factors, including bone density, bone quality, implant design and surface characteristics, and
surgical technique. In certain situations, e.g. poor bone quality/quantity, multiple implants or augmentation
procedures, further research on the influence of primary stability is required.
13
Journal of Oral and Maxillofacial Surgery
Vol. 68 No. 7 (July 2010)
Vol. 68 No. 8 (August 2010)
Uckan S, Deniz K, Dayangac E, Araz K, Özdemir BH. Early implant survival in posterior maxilla with or
without β-tricalcium phosphate sinus floor graft. J Oral Maxillofac Surg 2010;68(7):1642-1645.
A total of 121 implants were placed in 70 maxillary sinuses in 62 patients with simultaneous sinus
augmentation using β-tricalcium phosphate (test), and 136 implants were placed in the posterior maxillae of
65 patients without sinus augmentation (control). For mean follow-up times of 29.8 and 32.3 months for test
and control, respectively, there was one implant failure in each group, giving implant survival rates of 99.17%
and 99.26%, respectively. Implant survival was therefore similar for augmented and non-augmented sites.

Jang H-Y, Kim H-C, Lee S-C, Lee J-Y. Choice of graft material in relation to maxillary sinus width in internal
sinus floor augmentation. J Oral Maxillofac Surg 2010;68(8):1859-1868.
Three different sinus floor elevation methods were used in 57 patients for the placement of 100 implants, and
the distance of the grafts from the lateral and medial walls at the apex of the implant were evaluated using
cone-beam CT. The mean buccolingual distance of the grafts was 12.1 ± 2.0 mm. Contact was made with
the medial wall in 29.9% of cases where the distance was > 12.1 mm and complete contact was made in
95.7% of cases where the distance was < 12.1 mm. The buccolingual width at the apical end of the implant
should therefore be measured, and autogenous bone with osteogenic potential should be used for grafting
larger sinuses, or the median wall should be reflected in a lateral window technique.

Scarano A, Piattelli A, Assenza B, Quaranta A, Perrotti V, Piattelli M, Iezzi G. Porcine bone used in sinus
augmentation procedures: a 5-year retrospective evaluation. J Oral Maxillofac Surg 2010;68(8):1869-1873.
Sinus augmentation with porcine bone was performed in 121 patients, and implants were placed 4-6 months
after surgery. No major complications were noted during healing, with the exception of lack of regeneration at
time of implant placement in two cases. Minor peri-implant bone resorption was noted. A total of 21 implants
were lost, giving an implant survival rate of 92% after 5 years. Porcine bone can therefore be successful in
sinus augmentation procedures.

Journal of Oral Implantology

Vol. 36 No. 3 (June 2010)
Develioglu H, Saraydin S, Kartal Ü, Taner L. Evaluation of the long-term results of rat cranial bone repair
using a particular xenograft. J Oral Implantol 2010;36(3):167-173.
Parietal bone defects 6 mm in diameter were created in rats and filled with a porous particle xenograft
material, while defects in the contralateral side were used as control. Tissue samples and histological
sections were assessed after 3, 6 and 12 months. Dense collagenous tissue was found in the control sites
after 3 months, compared to a fibrous tissue layer surrounding graft particles at the test sites. No significant
bone repair was found at subsequent time points. Evidence of resorption or enhanced bone formation were
not apparent with the graft material, but biocompatibility and osteoconductivity were observed.

Potijanyakul P, Sattayasansakul W, Pongpanich S, Leepong N, Kintarak S. Effects of enamel matrix

derivative on bioactive glass in rat calvarium defects. J Oral Implantol 2010;36(3):195-204.
Two critical-sized calvarial defects 5 mm in diameter were created in each of 20 rats. In three groups, one
defect was filled with bioactive glass alone and the contralateral defect was filled with bioactive glass and
EMD and evaluated after 2, 4 and 8 weeks, while in a fourth group one defect was filled with EMD alone and
the contralateral defect was left empty and evaluated after 8 weeks. Radiomorphometry showed no
difference between bioactive glass alone or with EMD, but histology showed a greater percentage of new
bone with the combination but the difference was not significant. The greatest new bone formation was with
the combination at 8 weeks.

14
Journal of Oral Rehabilitation
Vol. 37 No. 7 (July 2010)
Vol. 37 No. 8 (August 2010)
Patel PM, Lynch CD, Sloan AJ, Gilmour ASM. Treatment planning for replacing missing teeth in UK general
dental practice: current trends. J Oral Rehabil 2010;37(7):509-517.
A total of 500 questionnaires were sent to general dental practitioners in Wales to assess treatment for the
replacement of missing teeth. The response rate was 43.4% (217 questionnaires), most of whom were
confident in providing removable partial dentures (acrylic (100%) or metal-based (99.5%)), cantilever resin-
bonded bridges (94.4%) and conventional bridgework (98.6%). However, most were not confident in
providing implants (81.4%) and many were not confident in providing fixed resin-bonded bridges (21.1%).
Some financial barriers were identified, particularly due to treatment limitations by the NHS, and privately
funded patients were more likely to be offered implant replacement for upper first molars or fixed bridges.

Ogawa T, Dhaliwal S, Naert I, Mine A, Kronstrom M, Sasaki K, Duyck J. Impact of implant number,
distribution and prosthesis material on loading of implants supporting fixed dentures. J Oral Rehabil
2010;37(7):525-531.
Seven implants were placed in an edentulous composite mandible and prostheses (all-acrylic, fiber-
reinforced acrylic or milled titanium framework) were placed with a 50N vertical load on the extension 10 mm
distal from the most posterior implant. Axial forces and bending moments were measured with different
numbers of supporting implants, different implant distribution conditions and different prosthesis materials.
The maximum bending moments were observed on three implants and were significantly influenced by
implant distribution (the largest bending moments resulted from the smallest distribution). Bending moments
were also lower with the titanium prosthesis.

Lee SY, Piao CM, Koak JY, Kim SK, Kim YS, Ku Y, Rhyu IC, Han CH, Heo SJ. A 3-year prospective
radiographic evaluation of marginal bone level around different implant systems. J Oral Rehabil
2010;37(7):538-544.
Three different types of implants (rough surface, hybrid smooth and rough surface, and rough surface with
microthreads) were placed in 54 patients, with clinical and radiographic examinations performed at implant
placement and after 1 and 3 years. A total of 135 implants were placed, of which 120 completed the study.
After 3 years, mean bone loss was lower with the rough surface/microthread implants (0.59 ± 0.30 mm)
compared to rough (0.95 ±0.27 mm) and hybrid surface (1.05 ± 0.34 mm) implants. The rough
surface/microthread implants may therefore have a positive effect on maintenance of marginal bone level.

Al-Amleh B, Lyons K, Swain M. Clinical trials in zirconia: a systematic review. J Oral Rehabil
2010;37(8):641-652.
The manufacture of zirconia restorations is done by either soft or hard milling processes, each of which has
advantages and disadvantages. This review found 17 clinical trials on zirconia-based restorations (13 on
fixed partial dentures, two on single crowns and two on zirconia abutments). Six of the trials used hard-milled
zirconia and 11 used soft-milled. Chipping of the veneering porcelain was common, while framework fracture
only occurred with soft-milled zirconia. Zirconia appeared to be suitable for fixed partial dentures and single
crowns, but further trials are required to determine the best manufacturing process.

Journal of Periodontology
Vol. 81 No. 6 (June 2010)
Vol. 81 No. 7 (July 2010)
Waasdorp JA, Evian CI, Mandracchia M. Immediate placement of implants into infected sites: a systematic
review of the literature. J Periodontol 2010;81(6):801-808.
Infected sites have been considered a contraindication for implant placement, but data have shown similar
success rates to implants placed in healthy sites. A literature review was therefore performed for studies
where implants were immediately placed in infected sites. A total of 417 articles were identified, of which 12
met the inclusion criteria. Most studies were of sites with chronic periapical infection, but classification was
vague and uncategorized in relation to outcome. High implant survival was observed in animal studies,
although BIC may be impaired. High implant survival was also seen in clinical studies, but evidence was
limited to small numbers of studies and patients. Thorough debridement of the site is required and guided
bone regeneration is usually performed.

15
Bornstein MM, Wittneben J-G, Brägger U, Buser D. Early loading at 21 days of non-submerged titanium
implants with a chemically modified sandblasted and acid-etched surface: 3-year results of a prospective
study in the posterior mandible. J Periodontol 2010;81(6):809-818.
In 39 partially edentulous patients, 56 implants with a chemically modified SLA surface were placed and
loaded with provisional crowns after 21 days. Definitive restorations were placed after 6 months, and
radiography and soft tissue analysis were performed for up to 36 months. There were no implant failures, but
two implants were not osseointegrated after 21 days, so were subjected to a longer healing period. All
implants showed favorable clinical and radiographic findings after 36 months, and the survival and success
rate was 100%. Significantly lower probing depths and clinical attachment levels were observed compared to
a historic control group. Implants with a chemically modified SLA surface can therefore achieve and maintain
successful tissue integration over 3 years.

Anitua E, Orive G. Short implants in maxillae and mandibles: a retrospective study with 8 years of follow-up.
J Periodontol 2010;81(6):819-826.
A total of 1,287 short implants (< 8.5 mm) were placed in 661 patients over an 8-year period, and implant
survival and the influence of demographic and clinical factors, surgery-dependent factors and prosthetic
variables were analyzed. Overall implant- and subject-based survival rates were 99.3% and 98.8%,
respectively (nine implants were lost), after a mean follow-up of 47.9 ± 24.46 months. Because of the low
failure rate, none of the variables analyzed were associated with implant failure. Placement of short implants
can therefore be safe and predictable.

Nickles K, Ratke-Krüger P, Neukranz E, Raetzke P, Eickholz P. Ten-year results after connective tissue
grafts and guided tissue regeneration for root coverage. J Periodontol 2010;81(6):827-836.
A total of 38 Miller class I and II recessions in 15 patients were treated using either connective tissue graft
(CTG) or guided tissue regeneration (GTR), with clinical parameters measured at baseline and after 120 ±
12 months. After 120 months, nine patients were available for analysis. Significant root coverage from
baseline was obtained with CTG after 6 and 120 months, while significantly greater root coverage from
baseline was achieved only at 6 months with GTR. A significant loss in coverage occurred in both groups
between 6 and 120 months, but the stability of root coverage was significantly better with CTG. More post-
surgical discomfort was observed with CTG, but treatment outcomes were significantly better.

Holmlund A, Holm G, Lind L. Number of teeth as a predictor of cardiovascular mortality in a cohort of 7,674
subjects followed for 12 years. J Periodontol 2010;81(6):870-876.
Between 1976 and 2002, 7,674 subjects received a dental examination by periodontal specialists, evaluating
number of remaining teeth, severity of periodontal disease, number of deepened periodontal pockets and
bleeding on probing in relation to cause of death. A total of 629 subjects died over a median follow-up period
of 12 years; 299 died from cardiovascular disease (CVD; 167 from coronary heart disease, 83 from stroke,
49 from aortic aneurysm or congestive heart failure (CHD)). All-cause mortality and mortality in CVD and
CHD was significantly predicted by number of remaining teeth, age, gender and smoking, but mortality from
stroke was not. The risk of mortality from CHD was increased 7-fold for subjects with < 10 teeth compared to
those with > 25 teeth. Severity of periodontal disease, number of deepened periodontal pockets and
bleeding on probing were not found to be related to mortality. There appears to be a relationship, therefore,
between oral health and CVD.

Renvert S, Ohlsson O, Pettersson T, Persson RG. Periodontitis: a future risk of acute coronary syndrome? A
follow-up study over 3 years. J Periodontol 2010;81(7):992-1000.
Periodontal conditions were evaluated in 165 patients with acute coronary syndrome (ACS) and 159 healthy
control patients. Recurrence of ACS was observed in 40% of the ACS patients, while 4.4% of healthy
patients experienced a first ACS event. The patients with future ACS had significantly higher HDL-
lipoprotein, creatinine, and white blood cell counts, and periodontitis was significantly associated with a first
ACS event and recurrence of ACS. Recurrent ACS events were significantly predicted by white blood cell
counts, creatinine and periodontitis.

16
Saito A, Hosaka Y, Kikuchi M, Akamatsu M, Fukaya C, Matsumoto S, Ueshima F, Hayakawa H, Fujinami K,
Nakagawa T. Effect of initial periodontal therapy on oral health-related quality of life in patients with
periodontitis in Japan. J Periodontol 2010;81(7):1001-1009.
A total of 58 patients with periodontitis completed initial periodontal therapy and were assessed for
perceptions of oral health-related quality of life. An impact of oral health status on quality of life was
perceived by 97% of patients at baseline, with pain, eating and chewing and psychologic function influenced.
Oral health was initially rated as poor in over half the patients. Oral health-related quality of life was
significantly improved by periodontal therapy, and significantly more patients reported never or rarely having
problems with pain and eating/chewing.

Zucchelli G, Mele M, Stefanini M, Mazzotti C, Mounssif I, Marzadori M, Montebugnoli L. Predetermination of

root coverage. J Periodontol 2010;81(7):1019-1026.
Distance from apical reference point of a stent was measured and maximum root coverage was
predetermined by a periodontist for 50 patients with multiple and single recession defects; 135 defects were
then treated using coronally advanced flap (CAF) or subepithelial connective tissue graft (CTG). Distance
from apical reference point to a stent and gingival margin were re-evaluated 15, 30 and 90 days after
surgery. The distances before and after surgery coincided exactly in 97% of recessions, with no significant
differences between maxilla and mandible or CAF and CTG. Then distance measured before surgery was
greater in 17.7% of recession defects and lower in 10.3% of gingival recessions than that measured after
surgery. Soft tissue margin could therefore be reliably predetermined.

Santamaria MP, Ambrosano GMB, Casati MZ, Nociti FH Jr, Sallum AW, Sallum EA. The influence of local
anatomy on the outcome of treatment of gingival recession associated with non-carious cervical lesions. J
Periodontol 2010;81(7):1027-1034.
A total of 78 gingival recession defects in maxillary canines or premolars were treated with coronally
advanced flap (CAF) alone or with restoration, or with subepithelial connective tissue graft (CTG) alone or
with restoration. Relative reduction in gingival recession and gain in clinical attachment level were evaluated.
For relative reduction in gingival recession, there was a significant association with cervical lesion height
when CAF and CTG + restoration, and when overall data from both CTG groups, were analyzed, and there
was a significant association with cervical lesion depth with CAF. Bone level was also significantly
associated with relative reduction in gingival recession and with gain in clinical attachment level in the CTG
group, and when considering overall data from the CAF groups.

Avila G, Wang H-L, Galindo-Moreno P, Misch CE, Bagramian RA, Rudek I, Benavides E, Moreno-Riestra I,
Braun T, Neiva R. The influence of the bucco-palatal distance on sinus augmentation outcomes. J
Periodontol 2010;81(7):1041-1050.
Sinus augmentation using a lateral window approach and particulate allograft was performed in 24 sinuses in
21 patients after the fabrication of radiographic and surgical guides, and measurement of the bucco-palatal
distance at 8, 10 and 12 mm from the alveolar crest. Biopsies were harvested at the time of implant
placement, and bone core sections from the three distances from the alveolar crest were evaluated. The
success rate for the grafting procedure was 96%. Histomorphometry showed that the mean proportion of
vital bone was 22.71 ± 19.08% and the mean remaining allograft was 23.39 ± 20.85%, with a mean 53.90 ±
13.23% non-mineralized connective tissue. There was a strong negative association between proportion of
vital bone and bucco-palatal distance.

Journal of Prosthetic Dentistry

Vol. 103 No. 6 (June 2010)
Vol. 104 No. 1 (July 2010)
Pettersson A, Kero T, Gillot L, Cannas B, Fäldt J, Söderberg R, Näsström K. Accuracy of CAD/CAM-guided
surgical template implant surgery on human cadavers: Part I. J Prosthet Dent 2010;103(6):334-342.
Implant placement with 145 implants was planned using software in 10 maxillae and seven mandibles from
cadavers and placed using a CAD/CAM surgical template. Pre- and post-operative CT scans were matched
and the differences between the virtual and actual positions of the implants evaluated. The mean differences
were 1.25 mm at the apex, 1.06 mm at the hex, 0.28 mm for depth deviation, 0.71 mm for translation
deviation and 2.64° for angular deviation. The results indicated significant differences between actual and
planned implant positions.

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Kero T, Pettersson A, Fäldt J, Andersson M, Gillot L, Cannas B, Näsström K, Söderberg R. Virtual variation
simulation of CAD/CAM template-guided surgeries performed on human cadavers: Part II. J Prosthet Dent
2010;104(1):48-55.
Computer-aided planning was used for the placement of 145 implants in 17 cadaver specimens; 10,000
virtual surgeries were performed for each, giving a total of 1,450,000 virtual surgeries. The results were
compared with those from the actual surgeries. The difference between the simulated average mean of the
mean and the surgical average of the median was 0.22 mm at the apex and -0.35 mm at the hex in the
maxilla and -0.19 mm at the apex and -0.69 at the hex in the mandible. There were significant differences in
implant distributions between the simulations and surgeries at both apex and hex. However, definitive
geometrical variations were not static and depend on individual jaw anatomy and ability to place the guided
template in the correct position.

Quintessence International
Vol. 41 No. 5 (May 2010)
Vol. 41 No. 6 (June 2010)
Vol. 41 No. 7 (July/August 2010)
Blus C, Szmukler-Moncler S, Vozza I, Rispoli L, Polastri C. Split-crest and immediate implant placement with
ultrasonic bone surgery (Piezosurgery): 3-year follow-up of 180 treated implant sites. Quintessence Int
2010;41(6):463-469.
A total of 61 split-crest procedures were performed with piezosurgery in 43 patients, and 180 implants were
immediately placed. Mean initial ridge width was 3.3 ± 0.7 mm (range 1.5 to 5.0 mm). The mean split length
was 14.8 ± 10.8/ mm and the mean final ridge width achieved was 6.0 ± 0.4 mm. Five implants failed to
osseointegrate by second-stage surgery; the implant success rate was 97.2% (95.1% and 100% in the
maxilla and mandible, respectively). No further implant failures occurred during the 3-year follow-up.
Piezosurgery is therefore a predictable technique for split-crest procedures and reduced the risk of soft
tissue alteration.

Eccellente T, Piombino M, Piattelli A, Perrotti V, Iezzi G. A new treatment concept for immediate loading of
implants inserted into the edentulous mandible. Quintessence Int 2010;41(6):489-495.
A total of 39 patients were treated with mandibular overdentures based on immediate loading of four
interforaminal implants (total = 156 implants). The dentures were retained by prefabricated conical crowns
inserted into the existing denture base. After a mean observation period of 30.3 months, two implants failed,
giving an implant survival rate of 98.7%, while the prosthesis survival rate was 100%. Healthy peri-implant
tissue was observed at all other implants. The concept allowed for stable denture retention, reduction of the
denture base and improved oral hygiene.

Deppe H, Hohlweg-Majert B, Hölzle F, Schneider KTM, Wagenpfeil S. Pilot study for periodontal treatment
and pregnancy outcome: a clinical prospective study. Quintessence Int 2010;41(6):e101-e110.
A total of 302 pregnant women were invited for periodontal examination, of whom 62 agreed to screening
and 54 met the inclusion criteria. No periodontal treatment was indicated in 28 patients, while 12 patients
consented to therapy (full-mouth disinfection) and 14 declined therapy. Gestational age at end of pregnancy,
birth weight and growth restriction were evaluated. Periodontal measurements were improved in the
periodontally treated group, but there were no significant differences in gestational age, birth weight or
growth restrictions between patients who received periodontal therapy and those who did not, and there
were no significant differences from the group not requiring periodontal therapy. Further studies are therefore
required in this field.

da Silva Araújo AC, Gusmão ES, Batista JEM, Cimões R. Impact of periodontal disease on quality of life.
Quintessence Int 2010;41(6):e100-e118.
A cross-sectional study was performed in 401 patients where periodontal, OHIP-14, socioeconomic and
demographic data were collected. Chronic periodontitis was found in 56.7% of patients, and functional
limitation affected 91.5% of the population. The highest impact scores were observed in patients with
aggressive periodontitis and the highest OHIP-14 scores were in those with aggressive or chronic
periodontitis. Impact on quality of life was significantly associated with age, income and periodontal disease.

18
Oghli AA, Steveling HH. Ridge preservation following tooth extraction: a comparison between atraumatic
extraction and socket seal surgery. Quintessence Int 2010;41(7):605-609.
In 125 patients, a total of 173 extraction sites with atraumatic extraction (group A; 101 sites), atraumatic
extraction with autogenous soft tissue graft (group B; 39 patients) or atraumatic extraction with socket seal
surgery (group C; 33 patients) were compared. The width of alveolar bone at the extraction area was
measured from casts taken before and 3 months after extraction. Mean loss of bone width after 3 months
was 0.3 ± 0.5 mm, 0.8 ± 0.7 mm and 0.1 ± 0.1 mm in groups, A, B and C, respectively; no significant
differences were noted. After 10 days, 30 and 31 grafts in groups B and C, respectively, remained vital. Bone
resorption therefore appears to be affected by extraction technique, but the local application of gentamicin
(group C) appeared to allow more vascular ingrowth, therefore supplying better nourishment in early healing.

Tissue Engineering Part B: Reviews

Vol. 16 No. 3 (June 2010)
Vol. 16 No. 4 (August 2010)
Klijn RJ, Meijer GJ, Bronkhorst EW, Jansen JA. Sinus floor augmentation surgery using autologous bone
grafts from various donor sites: a meta-analysis of the total bone volume. Tiss Eng B Rev 2010;16(3):295-
303.
A literature search was performed for articles on sinus augmentation with autologous bone from various
sites; from an initial total of 147 articles, 25 were included in the review. Most (21) were prospective
controlled studies, two were randomized controlled trials, one was a case series and one was a pilot study.
Total bone volume of 47% from iliac bone was used as the standard, which compared to 11% for chin bone
and 14% for bone from other sites. There was no correlation between total bone volume and time of graft
healing. Iliac bone is therefore still considered the gold standard for autologous bone grafting.

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