Marked dimensional alterations had occurred in the edentulous ridge after 3 months of healing following the extraction of the distal root of mandibular pre-molars. The placement of an implant in the fresh extraction site obviously failed to prevent the re-modelling that occurred in the walls of the socket. The resulting height of the buccal and lingual walls at 3 months was similar at implants and edentulous sites and vertical bone loss was more pronounced at the buccal than at the lingual aspect of the ridge. It is suggested that the resorption of the socket walls that occurs following tooth removal must be considered in conjunction with implant placement in fresh extraction sockets.

Peri-implantitis is an inflammatory disease affecting soft and hard tissues surrounding dental implants. As the global number of individuals that undergo restorative therapy through dental implants increases, peri-implantitis is considered as a major and growing problem in dentistry. A randomly selected sample of 588 patients who all had received implant-supported therapy 9 y earlier was clinically and radiographically examined. Prevalence of peri-implantitis was assessed and risk indicators were identified by multilevel regression analysis. Forty-five percent of all patients presented with peri-implantitis (bleeding on probing/suppuration and bone loss >0.5 mm). Moderate/severe peri-implantitis (bleeding on probing/suppuration and bone loss >2 mm) was diagnosed in 14.5%. Patients with periodontitis and with ≥4 implants, as well as implants of certain brands and prosthetic therapy delivered by general practitioners, exhibited higher odds ratios for moderate/severe peri-implantitis. Similarly, higher odds ratios were identified for implants installed in the mandible and with crown restoration margins positioned ≤1.5 mm from the crestal bone at baseline. It is suggested that peri-implantitis is a common condition and that several patient- and implant-related factors influence the risk for moderate/severe peri-implantitis (ClinicalTrials.gov NCT01825772).

The aim of the present study was to evaluate whether a regenerative surgical procedure, based on guided tissue regeneration, could predictably result in the formation of a new attachment in human teeth. The material included 12 teeth in 10 patients with advanced periodontal disease. Following flap elevation, scaling, root planing and removal of granulation tissue, a teflon membrane was placed over the denuded root surface in such a way that the epithelium and the gingival connective tissue were prevented from reaching contact with the root during healing. The flap was replaced on the outer surface of the membrane and secured with interdental sutures. This design of wound preparation gives preference to the cells originating from the periodontal ligament (PDL-cells) to repopulate the wound area adjacent to the root. Histologic analysis of the result of treatment was made in 5 of the 12 teeth scheduled for extraction. In the remaining 7 teeth, the result was evaluated using clinical measurements. The result of healing disclosed that in all teeth treated, substantial amounts of new attachment had formed. This suggests that predictable restitution of the attachment apparatus can be accomplished by using a method of treatment which is based on the principle of guided tissue regeneration.

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The aim of this study of the present experiment was to study the marginal periimplant tissues at intentionally non-submerged (1-stage implants) and initially submerged and subsequently exposed implants (2-stage implants). 5 beagle dogs, about 1-year-old, were used, 3 months after the extraction of the mandibular premolars, fixtures of the Astra Tech Implants Dental System, the Brånemark System and the Bonefit--ITI system were installed. In each mandibular quadrant, 1 fixture of each implant system was installed in a randomised order. The installation procedure followed the recommendations given in the manuals for each system. Thus, following installation, the bone crest coincided with the fixture margin of the Astra Tech Implants Dental System and the Brånemark System, whereas the border between the plasma sprayed and the machined surface of the Bonefit-ITI implant system was positioned at the level of the bone crest. Following a healing period of 3 months, abutment connection was carried out in the 2-stage systems (the Astra Tech Implants Dental System and the Brånemark system). A 6-month period of plaque control was initiated. The animals were sacrificed and biopsies representing each important region dissected. The tissue samples were prepared for light microscopy and exposed to histometric and morphometric measurements. The mucosal barrier which formed to the titanium surface following 1-stage and 2-stage implant installations comprised an epithelial and a connective tissue component, which for that 3 systems studied, had similar dimensions and composition. The amount of lamellar bone contained in the periimplant region close to the fixture part of the 3-implant systems was almost identical. It is suggested that correctly performed implant installation may ensure proper conditions for both and hard tissue healing, and that the geometry of the titanium implant seems to be of limited importance.