Enrica Giammarinaro

Clinical Outcomes of Implants Placed in Extraction Sockets and Immediately Restored: A 7‐Year Single‐Cohort Prospective Study

BACKGROUND The placement of implants immediately after tooth extraction has proven to be a predictable treatment strategy with a very high success rate. PURPOSE The aim of the present 7-year prospective single cohort study was to evaluate the success rate, marginal bone level (MBL), soft tissue stability of implants placed in fresh extraction sockets and immediately restored. MATERIAL AND METHODS This prospective cohort study included 37 implants in 32 patients (19 females and 13 males) with an average age of 40.1 ± 13.3 (range: 21-63 years) who received immediate implants and immediate single unit restorations. Outcome evaluations were: implant failures, complications, MBL, width of keratinized gingiva, facial soft tissue (FST) levels, modified Plaque Index and modified Bleeding Index. RESULTS AND CONCLUSIONS The cumulative survival rate was of 94.6% at 7-year visit. The mean MBL was -0.6 ± 0.49 mm at baseline and 1 ± 0.2 mm after 7 years. The FST Level was 0.4 ± 0.69 mm at baseline and 0.02 ± 0.70 mm at the 7-year follow-up. The Width of Keratinazed Gingiva was 3.8 ± 0.47 mm at baseline and 3.1 ± 0.42 mm at 7-year follow-up. Implants placed immediately after tooth extraction and immediately restored showed predictable clinical outcomes in this prospective study.

Longitudinal analysis on the effect of insertion torque on delayed single implants: A 3-year randomized clinical study

BACKGROUND Implant stability is commonly related to insertion torque. Recently, it has been suggested that higher insertion torque may lead to greater bone resorption. PURPOSE The aim of the present randomized clinical study was to evaluate the role of different insertion torque values in terms of implant success, marginal bone loss, and facial soft tissues recession. MATERIALS AND METHODS Patients requiring a single dental implant were recruited and randomized to receive one of two implants with the same macro-geometry but different cutting designs. First group consists of a 90 degrees cutting groove know as self-tapping implant, and the second group known as Blossom™ cutting groove. (Intra-Lock, Boca Raton, Florida). The insertion torque (IT) was assessed and two groups followed: high-IT (≥50 Ncm) group and regular-IT (<50 Ncm) group. After 3 months, all the implants were restored. At baseline, buccal bone thickness (BBT) was recorded. During the 3-year survey, the following outcomes had been registered: implant failures and success, radiographic marginal bone level around dental implant (MBL) and facial soft tissue level (FSTL). RESULTS A hundred and sixteen implants were placed in healed sites. The overall survival rate after 3 years was 96.5%. The Cumulative Success Rate was 91.3% for the High IT group and 98.2% for the Regular IT group. The mean marginal bone loss and facial soft tissue recession, at a 3-year evaluation, were significantly greater for the High-IT group and in the mandible than that reached in the Regular-IT group and in the maxilla. CONCLUSION Present findings showed that implants placed with higher insertion torque in mandible led to greater bone resorption and mucosal recession than that registered for implants placed with a regular IT. Moreover, sites with a thick buccal bone wall (≥1 mm) showed smaller recession at the facial soft tissue level after 3 years.

In Vitro Comparison of Three Desensitizing Prophylaxis Pastes: AMorphological Analysis

Background and Objective: Dentine hypersensitivity (DH) characterizes for short sharp pain arising from exposed dentine. Nowadays, there is a vast choice of products to overcome it. The aim of the present observational study was to compare the efficacy of three prophylaxis pastes in occluding dentinal tubules from in an in vitro setting. Methods: Longitudinal mesio-distal sections were obtained from a sample of ten extracted teeth. Morphological analysis with scanning electron microscopy (SEM) assessed the penetration of three different prophylaxis pastes in dentinal tubules: Nupro by GSK, Stomyprox by Biorepair, Colgate Pro-Sollievo. The use of the Energy Dispersive X-ray Analysis (EDX probe) allowed assessing the exact composition of each product. Results: The SEM analysis revealed that only Stomyprox by Biorepair could penetrate the dentinal tubule due to its low crystallinity. Its small sized particles (˜1.60 μ) fit better the tubules lumen if compared to the other two pastes with higher sized granules. The small sample size and the lacking of a quantitative evaluation of tubules filling limit this result. Conclusion: The occlusion of dentinal tubules is one of the possible ways to reduce dentine hypersensitivity in a professional setting. Small sized particles fit better the lumen of tubules. In conclusion, there is a biological rationale in preferring prophylaxis pastes characterized by a low crystallinity. It is worthy to investigate furthermore, and in a clinical setting, the efficacy of the prophylaxis paste made by small sized particles of Hydroxyapatite.

Clinical outcomes of implants placed in ridge-preserved versus nonpreserved sites: A 4-year randomized clinical trial

BACKGROUND Consistent bone changes occur after tooth removal, often compromising the success of implants placed within the socket left to natural healing The long-term effect of ridge preservation on implant outcomes is still unclear. PURPOSE The aim of the study was to assess success and survival rates of implants placed in extraction sockets, with spontaneous healing, or grafted with cortical porcine bone, or collagenated corticocancellous porcine bone. MATERIALS AND METHODS Ninety patients in need for a single premolar/molar tooth extraction and an implant treatment were selected for the present study. Patients were randomly distributed among 3 groups: sites that healed naturally (ctrl), or sites that received ridge preservation with either cortical (cort) or collagenated corticocancellous porcine bone (coll). Three months after, all the experimental sites were reentered to insert implants. Marginal bone levels were recorded; soft tissues were analyzed and summarized with the Pink Esthetic Score (PES). Forty-two patients out of 90 (initial cohort study) completed the entire follow-up of 4 years. RESULTS Cumulative survival and success rates for all implants were 100% at a 4-year evaluation. Mean marginal bone loss (MBL) was 1.14 ± 0.23 mm in the cort group, 1.13 ± 0.29 mm in the coll group, and 1.92 ± 0.07 mm in the ctrl group. There were no significant differences between the 2 grafting materials but MBL was significantly greater in the nongrafted sites (P value < .001). The PES resulted significantly better (9.42 ± 0.75) for the cort group than for the coll group (8.53 ± 1.18) and ctrl group (6.07 ± 1.89) at 4-year evaluation. CONCLUSIONS Ridge preservation was more effective than natural healing in preserving marginal bone and in achieving better esthetic outcomes around implants 4 years after placement. The cortical porcine bone showed better clinical outcomes than collagenated corticocancellous porcine bone.

Oxidative stress and periodontal disease in diabetic patients: a 3-month pilot study

Aim: Oxidative stress is involved in both Periodontal Disease (PD) and Diabetes Mellitus (DM). The present study aimed to evaluate the oxidative balance in diabetic patients diagnosed with PD before and after non-surgical periodontal treatment. Materials and methods: Sixty patients were divided into three groups all receiving non-surgical periodontal treatment plus either chlorhexidine, ozone-therapy or antioxidant mouth-rinse. Probing depth (PPD), Percentage Plaque Index (%PI) and Percentage Bleeding on Probing (%BoP) were recorded. Free-radicals (dROMs), plasmatic antioxidants (PAT), salivary antioxidants (SAT) and glycated hemoglobin ( HbA1c) were measured. Results: Mean PPD at baseline was 3.14 mm. Mean PPD three months after was 2.05 mm. The overall %PI at baseline was 55% and %BOP 76%. Three months after treatment %PI was 34% and %BoP was 64%. The longitudinal analysis did not show differences between groups. Mean dROMs at baseline was 353 U. Carr (oxidative stress) and decreased after three months reaching 295 U. Carr (normal). SAT was 2083 U. Carr at baseline (inflammation) and decreased to 1337 U. Carr (ideal). The longitudinal analysis did not show differences between groups. Mean HbA1c at baseline was 6.92% and decreased significantly to 6.63% three months after treatment. Conclusion: Based on the results of the present study, oxidative stress should be further investigated as a potential modulator of the clinical course of both DM and PD. Correspondence to: Simone Marconcini, DDS, PhD, MSc, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Via Roma 55, 56100 Pisa (PI), Italy, Tel: +39 (0584) 6059888; Fax: +39 (0584) 6058716, E-mail: simosurg@gmail.com