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      Influence of Biologically Oriented Preparation Technique on Peri-Implant Tissues; Prospective Randomized Clinical Trial with Three-Year Follow-Up. Part II: Soft Tissues

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          Abstract

          Purpose : The objective of this prospective randomized clinical trial (RCT) was to analyze and compare the clinical behavior of three types of prosthesis supported by single implants in the posterior region after three years of functional loading. Materials and methods : Seventy-five implants were divided into three groups according to the type of prosthetic restoration: screw-retained crown (group GS); cemented crown without finishing line (biologically oriented preparation technique) (group GBOPT); and conventional cemented crown with finishing line (group GCC). After three years in function, clinical parameters (presence of keratinized mucosa, probing depths, bleeding on probing, and radiographic bone loss) were compared between the three experimental groups. The possible correlation between soft tissue clinical parameters and bone loss was also analyzed. Results : Statistical analysis found significant differences in clinical parameters between the different types of crown, with the cemented restoration without finishing line (BOPT) presenting fewer complications and better peri-implant health outcomes including: significantly different KMW data (mm), with significant differences between groups GBOPT and GCC ( p < 0.001, Kruskal–Wallis test), with GBOPT obtaining larger quantities of keratinized mucosa (KM); statistically significant differences in probing depth (PD) values between groups GBOPT and GCC ( p = 0.010, Kruskal–Wallis test); significant differences in bleeding on probing (BOP) between groups GBOPT and GCC ( p = 0.018, Chi 2 test) in favor of GBOPT. Conclusions : Soft tissue behavior around implants is related to the type of prosthetic restoration used, with cemented prostheses with BOPT presenting better peri-implant soft tissue behavior.

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          Most cited references33

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          Implant placement post extraction in esthetic single tooth sites: when immediate, when early, when late?

          Implant placement in post-extraction sites of single teeth in the esthetic zone has been a topic of great interest in the field of implant dentistry since 1990. Triggered by the development of guided bone regeneration, the concept of immediate implant placement became quite popular in the 1990s. In the past 12 years, however, the dental community has begun to focus increasingly on the esthetic outcomes of post-extraction implant placement and several studies indicated a significant risk for the development of mucosal recessions with immediate implants. Parallel with this, significant progress has been made in the understanding of tissue biology in terms of hard and soft tissue alterations post extraction, based on preclinical, clinical and radiological studies. This knowledge has helped better to understand the etiology of these esthetic complications with immediate implant placement. The present review first analyzes the various phases of the development of therapeutic strategies over the years for post-extraction implant placement in single tooth sites in the esthetic zone. It presents the current knowledge concerning the terminology with immediate, early and late implant placement, the risk factors for the development of esthetic complications, and the selection criteria for the various treatment options. In the second part, clinical recommendations are given, since a clinician active in this field of implant therapy can use all treatment options depending on the preoperative analysis including a 3D cone beam computed tomography. The selection criteria for all four treatment options are presented and documented with typical case reports to illustrate the current treatment approaches applied in daily practice.
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            The positive relationship between excess cement and peri-implant disease: a prospective clinical endoscopic study.

            Cement-retained restorations are commonly used on dental implants. Residual excess cement after placement of fixed partial dentures has been associated with clinical and radiographic signs of peri-implant disease. The purpose of this study was to explore the relationship between excess dental cement and peri-implant disease using the dental endoscope. Thirty-nine consecutive patients with implants exhibiting clinical and/or radiographic signs of peri-implant disease were studied. Patients were enrolled in the study during a 5-year period in a private periodontal practice. Twelve of these patients had similar implants without signs of inflammation; these implants served as controls. There were 20 controls and 42 test implants. All were evaluated using a dental endoscope initially, and all but one implant was evaluated at a 30-day follow-up. Results from both groups were assessed by two trained operators and recorded. None of the controls and all 42 of the test implants had clinical signs of peri-implant disease at initial treatment. Excess cement was found in none of the controls and 34 of the test sites. Thirty days after cement removal, 25 of 33 test sites from which the cement was removed had no clinical or endoscopic signs of inflammation. Excess dental cement was associated with signs of peri-implant disease in the majority (81%) of the cases. Clinical and endoscopic signs of peri-implant disease were absent in 74% of the test implants after the removal of excess cement.
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              The effect of material characteristics, of surface topography and of implant components and connections on soft tissue integration: a literature review.

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                Author and article information

                Journal
                J Clin Med
                J Clin Med
                jcm
                Journal of Clinical Medicine
                MDPI
                2077-0383
                16 December 2019
                December 2019
                : 8
                : 12
                : 2223
                Affiliations
                Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; rubenagustinpanadero@ 123456gmail.com (R.A.-P.); carlos.labaig@ 123456uv.es (C.L.-R.); antonio.fons@ 123456uv.es (A.F.-F.); lucia.fernandez-estevan@ 123456uv.es (L.F.-E.); m.fernanda.sola@ 123456uv.es (M.F.S.-R.)
                Author notes
                Author information
                https://orcid.org/0000-0003-2757-6619
                https://orcid.org/0000-0002-6412-0488
                https://orcid.org/0000-0001-7663-6740
                https://orcid.org/0000-0002-7946-6932
                Article
                jcm-08-02223
                10.3390/jcm8122223
                6947358
                31888207
                76c4ff76-a181-460d-9289-9ae0f9cb4b89
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 09 November 2019
                : 13 December 2019
                Categories
                Article

                implant-supported prosthesis,complications,soft tissues,bone loss and clinical parameters,screw-retained,cemented,bopt

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