Background To evaluate the prevalence of peri-implant disease after immediate implant placement and loading. Material and methods This cross-sectional analysis included a total of 47 patients with 64 implants exhibiting a mean loading time of 2 to 10 years (4.23 ± 1.7 years). The surgical and prosthetic procedures were standardized in all patients. Peri-implant health and disease was assessed based on the established case definitions. Results The prevalence of peri-implant health, peri-implant mucositis, and peri-implantitis amounted to 38.3%, 57.5%, and 4.2% of the patients, respectively. Mucosal recession of 1 mm was present at 4 (6%) implants. No suppuration, pain, or implant failures were reported. Ordinal logistic regression revealed that reduced keratinized mucosa height was significantly associated with the diagnosis of peri-implant mucositis and peri-implantitis (OR = 0.514, P = 0.0125). Conclusion Immediate implant placement and loading was associated with high success rates at 2 to 10 years.

Introduction The rehabilitation of a maxillary single dental implant represents a great challenge at clinical practice. Harmony among the implant‐supported crown and adjacent teeth is required in which concerns pink and white esthetics. The aim of the present case report is to depict a multidisciplinary treatment in which the U‐shape flap technique for papillae preservation at second stage surgery was used. Case Presentation One female patient presenting an un‐rehabilitated dental implant at the left central incisor position sought treatment at the Centre of Education and Research on Dental Implants (CEPID). Alterations of color, shape, and position were observed on the anterior maxillary teeth. For proper treatment planning, radiograph, wax‐up, and mock‐up were performed. Second stage surgery was performed by the U‐shape flap technique. A trunnion abutment was installed at the implant and a provisional subcontoured cemented crown was manufactured. Dental bleaching, feldspathic veneers, and a ceramic crown were performed. Oral hygiene instructions were recommended. Follow‐up appointments were set at 1.5 and 3 years after restoration placement. After 3‐year follow‐up, soft tissue stability and health were preserved and papillae coronal migration around the single dental implant was observed. A complication‐free treatment was reached, and patient demonstrated satisfaction towards esthetic and function. Conclusions The use of U‐shape technique at second stage surgery associated to adequate prosthetic contour improved soft tissue esthetic outcomes, while the multidisciplinary treatment planning provided adequate solutions, refining harmony between dental and implant‐supported components.

Background : Current data suggest that peri-implantitis lesions are commonly associated with a circumferential pattern of bone loss. However, the influence of disease progression on the bone-to-implant contact (BIC) within the residual bone areas is currently unknown.Aim/Hypothesis : To histologically assess residual bone to implant contact (BIC) at severe peri-implantitis sites in humans Material and Methods : Four patients (3 female and 1 male) were diagnosed with peri-implantitis at a total of 5 implants (machined surfaces; mean loading time of 12 ± 6 years), based on an established case definition. All implants were clinically stable but had to be removed due to a progressive and severely advanced bone loss. Bone-implant biopsies were prepared for the histological assessment of BIC (%), peri-implant gaps between the residual bone and implant surface (PG), osteocyte-(OD) and empty lacunae density (ELD) at marginal, medial and apical levels.Results : The residual BIC of the analyzed specimens ranged from 3 to 18%, with a mean of 11.4% (95% CI-5-17). The apical BIC (mean-8%±4) was the highest, followed by the medial (mean-3%±2) and marginal regions (mean-1%±2) which showed the lowest values. PG values ranged from 1 to 110 μm and were highest (24 μm ±20) in the marginal areas. This was followed by 13.2 μm±9 in medial, and 5 μm ±3 in apical regions.Mean OD and ELD was 191.2 ± 68 mm 2 and 164.6 ± 69.2 mm 2 with a ratio between osteocytes and empty lacunae of 1.17. Conclusion and Clinical Implications :The present analysis suggests that the progression of peri-implantitis lesions affects BIC within the residual bone areas. Current clinical and radiographic examination of peri-implantitis affected sites has limitations to exhibit the true peri-implant defect extension; however, histological data allowing micro-scale observations can reveal the real extent and disintegration state of severe affected implants.