Publications from 2011 to 2015 were selected to evaluate effect of implant surface roughness on long-term bone loss as surrogate for peri-implantitis risk. 87 out of 2,566 papers reported the mean bone loss after at least 5 years of function. Estimation of the proportion of implants with bone loss above 1, 2, and 3 mm as well as analysis the effect of implant surface roughness, smoking, and history of periodontitis was performed. By means of the provided statistical information of bone loss (mean and standard deviation) the prevalence of implants with bone loss ranging from 1 to 3 mm was estimated. The bone loss was used as a surrogate parameter for "peri-implantitis" given the fact that "peri-implantitis" prevalence was not reported in most studies or when reported, the diagnostic criteria were unclear or of dubious quality. The outcome of this review suggests that peri-implant bone loss around minimally rough implant systems was statistically significant less in comparison to the moderately rough and rough implant systems. No statistically significant difference was observed between moderately rough and rough implant systems. The studies that compared implants with comparable design and different surface roughness, showed less average peri-implant bone loss around the less rough surfaces in the meta-analysis. However, due to the heterogeneity of the papers and the multifactorial cause for bone loss, the impact of surface roughness alone seems rather limited and of minimal clinical importance. Irrespective of surface topography or implant brand, the average weighted implant survival rate was 97.3% after 5 years or more of loading. If considering 3 mm bone loss after at least 5 years to represent the presence of "peri-implantitis," less than 5% of the implants were affected. The meta-analysis indicated that periodontal history and smoking habits yielded more bone loss.

Dental implant placement is a common treatment procedure in current dental practice. High implant survival rates as well as limited peri-implant bone loss has been achieved over the past decades due to continuous modifications of implant design and surface topography. Since the turn of the millennium, implant surface modifications have focused on stronger and faster bone healing. This has not only yielded higher implant survival rates but also allowed modifications in surgical as well as prosthetic treatment protocols such as immediate implant placement and immediate loading. Stable crestal bone levels have been considered a key factor in implant success because it is paramount for long-term survival, aesthetics as well as peri-implant health. Especially during the past decade, clinicians and researchers have paid much attention to peri-implant health and more specifically to the incidence of bone loss. This could furthermore increase the risk for peri-implantitis, the latter often diagnosed as ongoing bone loss and pocket formation beyond the normal biological range in the presence of purulence or bleeding on probing. Information on the effect of surface topography on bone loss or peri-implantitis, a disease process that is to be evaluated in the long-term, is also scarce. Therefore, the current narrative review discusses whether long-term peri-implant bone loss beyond physiological bone adaptation is affected by the surface roughness of dental implants. Based on comparative studies, evaluating implants with comparable design but different surface roughness, it can be concluded that average peri-implant bone loss around the moderately rough and minimally rough surfaces is less than around rough surfaces. However, due to the multifactorial cause for bone loss the clinical impact of surface roughness alone on bone loss and peri-implantitis risk seems rather limited and of minimal clinical importance. Furthermore, there is growing evidence that certain patient factors, such as a history of periodontal disease and smoking, lead to more peri-implant bone loss.

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ObjectivesInvestigate the use of call-out (CO) and closed-loop communication (CLC) during a simulated emergency situation, and its relation to profession, age, gender, ethnicity, years in profession, educational experience, work experience and leadership style.DesignExploratory study.SettingIn situ simulator-based interdisciplinary team training using trauma cases at an emergency department.ParticipantsThe result was based on 16 trauma teams with a total of 96 participants. Each team consisted of two physicians, two registered nurses and two enrolled nurses, identical to a standard trauma team.ResultsThe results in this study showed that the use of CO and CLC in trauma teams was limited, with an average of 20 CO and 2.8 CLC/team. Previous participation in trauma team training did not increase the frequency of use of CLC while ≥2 structured trauma courses correlated with increased use of CLC (risk ratio (RR) 3.17, CI 1.22 to 8.24). All professions in the trauma team were observed to initiate and terminate CLC (except for the enrolled nurse from the operation theatre). The frequency of team members’ use of CLC increased significantly with an egalitarian leadership style (RR 1.14, CI 1.04 to 1.26).ConclusionsThis study showed that despite focus on the importance of communication in terms of CO and CLC, the difficulty in achieving safe and reliable verbal communication within the interdisciplinary team remained. This finding indicates the need for validated training models combined with further implementation studies.

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