Objective To evaluate the effect of bone substitute materials on hard and soft tissue healing in reconstructive surgical therapy of experimental peri‐implantitis at implants with different surface characteristics. Material and methods Six female, Labrador dogs were used. 3 months after tooth extraction, four implants with two different surface characteristics (A and B) were installed on each side of the mandible. Experimental peri‐implantitis was induced 3 months later. During surgical treatment of peri‐implantitis, the implants were cleaned with curettes and cotton pellets soaked in saline. The implant sites were allocated to one of four treatment categories; (a) Group C; no augmentation, (b) Group T1; bone defect filled with deproteinized bovine bone mineral (c) Group T2; bone defect filled with a biphasic bone graft material, (d) Group T3; bone defect filled as T1 and covered with a collagen membrane. Clinical and radiological examinations were performed, and biopsies were obtained and prepared for histological analysis 6 months after peri‐implantitis surgery. Results Implant B (smooth surface) sites showed significantly (a) larger radiographic bone level gain, (b) enhanced resolution of peri‐implantitis lesions, and (c) larger frequency of re‐osseointegration than implant A (moderately rough surface) sites. Implant B sites also showed superior preservation of the mucosal margin. Differences between bone substitute materials and control procedures were overall small with limited advantages for T1 and T2 sites. Conclusion Healing following reconstructive surgical treatment of experimental peri‐implantitis was superior around implants with a smooth surface than implants with a moderately rough surface. Benefits of using bone substitute materials during surgical therapy were overall small.

A new classification of peri-implant diseases was presented in a consensus report from the 2017 World Workshop on Classification on Periodontal and Peri-implant diseases and Conditions (Berglundh et al., 2018). Thus, peri-implant mucositis is an inflammatory lesion in the soft tissue surrounding a dental implant in the absence of loss of supporting bone, while peri-implantitis is characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of peri-implant bone (

Avulsion fractures of the tibial eminence, although generally a rare injury pattern, are more common in children and adolescents than in adults. Many open and arthroscopic techniques are available with variable degrees of satisfying results and incidence of complications and adverse effects. Arthroscopic fixation appeared to improve the functional outcomes with fewer complications than the open fixation. New techniques were reported using commercially available suspension sling devices for the acromioclavicular joint that offers an easy and rapid method of fixation. However, this technique has the disadvantages of the presence of hardware (button) over the tibial anterior cruciate ligament attachment inside the joint and the need to drill a relatively large tunnel through the center of the avulsed fragment that may increase the chance of fracture. So small-diameter tunnels need to be drilled that will decrease bone loss and growth plate injury in children and adolescents. We describe here a technique that offers a better 4-point fixation through the anterior cruciate ligament with fewer complications by avoiding drilling through the avulsed fragment, absence of hardware inside the joint, and decreasing bone loss in adolescents by drilling only smaller transosseous tunnels and allowing for correction of the fixation using a special configuration of knots and cortical button.

Aim To evaluate the effect of surgical treatment of experimental peri‐implantitis at implants with different surface characteristics using mechanical and chemical decontamination methods. Materials and Methods Following extraction of mandibular premolars, four implants with two different surface characteristics (A, moderately rough and B, smooth) were placed in each side of the mandible of six dogs. Experimental peri‐implantitis was induced. Surgical treatment of the peri‐implantitis sites was carried out using four implant surface decontamination protocols: (i) deposition of a citric acid gel, (ii) mechanical cleaning using a rotating titanium brush, (iii) a combination of the mechanical and chemical procedures, and (iv) saline (control). Clinical and radiographic examinations were performed. Block biopsies were obtained 6 months after therapy and prepared for histological analysis. Results Irrespective of the treatment group, treatment resulted in 0.63 ± 0.92 and 0.65 ± 0.67 mm radiographic bone gain around implants A and B, respectively. Histological analyses revealed that persisting soft tissue inflammation as assessed using an infiltrated connective tissue (ICT) score was significantly lower at implant type B than at implant type A for all treatment groups. The test decontamination procedures did not demonstrate better results regarding resolution of peri‐implantitis lesions, as indicated by the ICT scores, than the control procedure. The control treatment resulted in significantly superior outcomes of resolution of peri‐implantitis lesions than the citric acid regimen. Conclusions It is concluded that decontamination procedures including citric acid gel or rotating titanium brush did not improve outcomes following surgical treatment of experimental peri‐implantitis. Results were, however, influenced by the implant surface characteristics.

Aims The purpose of this study was to evaluate the accuracy of bone‐level assessments using either cone‐beam computed tomography (CBCT), intra‐oral peri‐apical (PA) radiographs or histology following reconstructive treatment of experimental peri‐implantitis. Materials and Methods Six Labrador dogs were used. Experimental peri‐implantitis was induced 3 months after implant placement. Surgical treatment of peri‐implantitis was performed and peri‐implant defects were allocated to one of four treatment categories; no augmentation, bone graft materials with or without a barrier membrane. Six months later, intra‐oral PA radiographs and block biopsies from all implants sites were obtained. Marginal bone levels (MBLs) were measured using PA radiographs, CBCT and histology. Results Significant correlations of MBL assessments were observed between the three methods. The measurements in PA radiographs consistently resulted in an overestimation of the bone level of about 0.3–0.4 mm. The agreement between the methods was not influenced by the use of bone substitute materials in the management of the osseous defects. Conclusions Although MBL assessments obtained from PA radiographs showed an overestimation compared to MBL assessments on corresponding CBCT images and histological sections, PA radiographs can be considered a reliable technique for peri‐implant bone‐level evaluations following reconstructive surgical therapy of experimental peri‐implantitis.