Objective The aim of this review was to investigate the evidence correlating the emergence profile (EP) and emergence angle (EA), peri‐implant tissue height, implant neck design, abutment and/or prosthesis material, retention and connection types with risk of peri‐implant mucositis and peri‐implantitis. Methods Seven focus questions were identified, and seven electronic search queries were conducted in PubMed. Human studies reporting on bleeding on probing, probing depth or case definitions of peri‐implant mucositis and peri‐implantitis were included. Results Emerging evidence with bone‐level implants suggests a link between EA combined with convex EP and peri‐implantitis. Depth of the peri‐implant sulcus of ≥3 mm is shown to be reducing the effectiveness of treatment of established peri‐implant mucositis. Modification of the prosthesis contour is shown to be an effective supplement of the anti‐infective treatment of peri‐implant mucositis. Limited evidence points to no difference with regard to the risk for peri‐implant mucositis between tissue‐ and bone‐level implants, as well as the material of the abutment or the prosthesis. Limited evidence suggests the use or not of prosthetic abutments in external connections and does not change the risk for peri‐implantitis. Literature with regard to prosthesis retention type and risk for peri‐implantitis is inconclusive. Conclusions Limited evidence indicates the involvement of EA, EP, sulcus depth and restricted accessibility to oral hygiene in the manifestation and/or management of peri‐implant mucositis/peri‐implantitis. Conclusions are limited by the lack of consensus definitions and validated outcomes measures, as well as diverse methodological approaches. Purpose‐designed studies are required to clarify current observations.

Background To analyse via life cycle analysis (LCA) the global resource use and environmental output of the endodontic procedure. Methodology An LCA was conducted to measure the life cycle of a standard/routine two-visit RCT. The LCA was conducted according to the International Organization of Standardization guidelines; ISO 14040:2006. All clinical elements of an endodontic treatment (RCT) were input into OpenLCA software using process and flows from the ecoinvent database. Travel to and from the dental clinic was not included. Environmental outputs included abiotic depletion, acidification, freshwater ecotoxicity/eutrophication, human toxicity, cancer/non cancer effects, ionizing radiation, global warming, marine eutrophication, ozone depletion, photochemical ozone formation and terrestrial eutrophication. Results An RCT procedure contributes 4.9 kg of carbon dioxide equivalent (CO2 eq) emissions. This is the equivalent of a 30 km drive in a small car. The main 5 contributors were dental clothing followed by surface disinfection (isopropanol), disposable bib (paper and plastic), single-use stainless steel instruments and electricity use. Although this LCA has illustrated the effect endodontic treatment has on the environment, there are a number of limitations that may influence the validity of the results. Conclusions The endodontic team need to consider how they can reduce the environmental burden of endodontic care. One immediate area of focus might be to consider alternatives to isopropyl alcohol, and look at paper, single use instrument and electricity use. Longer term, research into environmentally-friendly medicaments should continue to investigate the replacement of current cytotoxic gold standards with possible natural alternatives. Minimally invasive regenerative endodontics techniques designed to stimulate repair or regeneration of damaged pulp tissue may also be one way of improving the environmental impact of an RCT.

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