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Background The aim of this 1‐year prospective clinical trial was to compare clinical parameters and marginal bone levels (MBLs) around tissue level implants with a partially smooth collar between patients with thin (≤2 mm) and thick (>2 mm) vertical mucosal phenotypes. Methods Thirty patients needing a single dental implant were recruited and allocated to thin (n = 14) or thick (n = 16) phenotype groups. Post‐restoration, clinical (probing depth, recession, width of keratinized mucosa, bleeding on probing, suppuration, implant mobility, plaque index, and gingival index) and radiographic bone level measurements were recorded at different timepoints for 1 year. Results Twenty‐six patients (13 per group) completed the 1‐year examination. No implants were lost (100% survival rate). There were no significant differences (P >0.05) between thin and thick vertical mucosal phenotypes for any clinical parameter or for the radiographic MBL. Conclusions Tissue level implants at 1 year of function placed in thin vertical mucosa achieved similar clinical parameters and radiographic MBLs as those in thick tissue. The formation of the peri‐implant supracrestal tissue height plays a key role in MBL than mucosal thickness in tissue level implant.

Background: Full-thickness mucoperiosteal flap (FTF) elevation could potentially affect the periodontium of the involved teeth; it is not clear if the periodontal phenotype of teeth involved in a FTF may influence these changes. The aim of this study was to evaluate the impact of FTF on teeth periodontium, as well as assessing the impact of periodontal phenotype on bone remodeling. Methods: In this single arm prospective clinical trial, 26 subjects and a total of 52 adjacent teeth were included. Patients receiving implant surgery in the posterior area, at the time of implant site preparation, an FTF was extended one tooth mesial and distal to the planned site, and the flap was elevated both facially and lingually. Vertical and horizontal bone linear changes were measured on both adjacent teeth, using superimposed cone-beam computerized tomography (CBCT) images taken prior to implant placement (T0) and at 12 months (T1). Baseline digital scans of models and DICOM files were superimposed to assess the periodontal phenotype. Results: Vertical bone changes from T0 to T1 were statistically significant (P = 0.013), with changes were significantly higher at the mesial (−0.31 ± 0.30 mm) and facial (P < 0.05) sites. Horizontal dimensional changes 5 mm subcrestally were similar among different locations (P = 0.086) and the bone width loss was higher closest to the crest (P = 0.001). No correlation was found between soft tissue thickness and bone changes. However, bone thickness at baseline appears to influence the extent of horizontal bone remodeling. Overall, the magnitude of bone loss either vertically or horizontally was clinically insignificant (≤0.4 mm). A preventive effect against bone loss maybe expected with bone thickness > 2 mm. Conclusion(s):Marginal bone changes in maxillary and mandibular posterior teeth following FTF at 12 months are very minimal, and mainly influenced by bone rather than soft tissue thickness. Overall, FTF does not seem to have deleterious effects on adjacent teeth periodontium.

Background This study assesses the association between peri‐implantitis and cardiovascular diseases (CVD). Methods One hundred and twenty‐eight patients with dental implants were recruited to evaluate the prevalence of peri‐implantitis in patients with or without CVD (CVD group, n = 82, control group, n = 46, respectively). Diagnosis of peri‐implantitis followed the 2017 World Workshop guidelines and the severity was defined as mild, moderate, and severe form when the radiographic bone loss (RBL) was <2, 2 to 4, and >4 mm. Multivariable logistic regression was performed to test the association between two diseases. Results A trend of higher prevalence of peri‐implantitis defined by detectable RBL beyond the physiologic bone remodeling was found in the CVD group (64.6%) when compared with the controls (56.5%). A significant higher prevalence (48.8%) of moderate to severe peri‐implantitis was identified in CVD compared with controls(30.4%) with a significant crude association between moderate to severe peri‐implantitis and CVD (odds ratio = 2.18, 95% CI, 1.02 to 4.67; P = 0.04). The CVD group had a trend of higher prevalence of deep pockets (≥7 mm) and higher numbers of sites with bleeding on probing  (>66%) when compared with controls (P > 0.05). However, after controlling for multiple confounders including age, hypertension, smoking, family history of heart attack, and periodontitis, the significant association was not found. Conclusions CVD group had significantly higher prevalence of moderate to severe peri‐implantitis (RBL ≥2 mm). The association between the two diseases did not exist after controlling multiple confounders for CVD. Future studies with a larger sample size controlling for the patient‐ and implant‐related confounders are needed to better understand the link between peri‐implantitis and CVD.