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Clinical Oral Implants Research 
Vol. 21 No. 1 (January 2010) 
Vol. 21 No. 2 (February 2010) 

Sanz M, Cecchinato D, Ferrus J, Pjetursson EB, Lang NP, Lindhe J. A prospective, randomized-controlled 
clinical trial to evaluate bone preservation using implants with different geometry placed into extraction 
sockets in the maxilla
Clin Oral Implants Res 2010;21(1):13-21. 

Patients requiring implants in the maxillary region 15-25 were enrolled in  the study; after tooth extraction, 
patients received either a cylindrical or tapered implant. The dimensions of the ridge and void between the 
implants and the extraction socket were then measured and repeated after 16 weeks. Substantial alterations in the dimension of the buccal ridge and in the horizontal and vertical gap between the implant and the bone walls following tooth extraction and immediate implant placement, and horizontal and vertical changes were greater with cylindrical than with tapered implants. Implant placement in immediate extraction sockets therefore reduced the alveolar ridge. 
Ferrus J, Cecchinato D, Pjetursson EB, Lang NP, Sanz M, Lindhe J. Factors influencing ridge alterations 
following immediate implant placement into extraction sockets.
 Clin Oral Implants Res 2010;21(1):22-29.

Implants were immediately placed into extraction  sockets in maxillary region 15-25 in 93 patients and 
measurements performed at placement and after 16 weeks. The results indicated that implant location, 
thickness of the buccal bone crest and size of the horizontal buccal gap had a significant influence on the 
extent of hard tissue alteration. Horizontal gap fill was more pronounced in the premolar segment than in the incisor-canine segment, and there was substantial gap  fill where there was thick buccal wall and a large horizontal gap. 
Popelut A, Rousval B, Fromentin O, Feghali M, Mora F, Bouchard P.  Tooth extraction decision model in 
periodontitis patients.
 Clin Oral Implants Res 2010;21(1):80-89. 

A decision analysis was created based on a fictitious patient with adult chronic periodontitis with a single 
tooth with a periodontal defect that may affect the  decision process. The decision tree evaluated options 
based on probabilities identified by a systematic literature analysis. The options, ranked by expected utilities were: no treatment (EU1), periodontal treatment (EU2), extraction followed by FPD (EU3), or extraction followed by implant-supported crown (EU4). It was not possible to calculate EU1 due to the lack of available probabilities. The probabilities indicate that the FPD option was the worst strategy, and it was not possible to differentiate between periodontal therapy or an implant-supported crown. 
Canullo L, Fedele GR, Iannello G, Jepsen S. Platform switching and marginal bone-level alterations: the 
results of a randomized-controlled trial.
 Clin Oral Implants Res 2010;21(1):115-121. 

A total of 80 implants were placed according to the platform diameter (3.8, 4.3, 4.8 or 5.5 mm) in the 
posterior maxilla in 31 patients. An abutment of 3.8 mm diameter was connected to each after 3 months and final restorations prepared. Bone levels were measured at implant placement and after 9, 15, 21 and 33 
months. A total of 69 implants were available for  analysis after 21 months; although all implants were 
osseointegrated, 11 were excluded due to cover screw exposure. Mean bone loss was significantly higher 
for the Ø 3.8 mm implants (control; 1.49 ± 0.54 mm) versus the test implants (0.99 ± 0.42 mm, 0.82 ± 0.36 
mm and 0.56 ± 0.31 mm for the Ø 4.3 mm implants, Ø 4.8 mm implants and Ø 5.5 mm implants, 
respectively). A total of 60 implants were available for 33 months follow-up, and there was no difference from 
the values at 21 months, except for the 4.8 mm and 5.5 mm diameter implants. Changes in marginal bone 
level may therefore be related to the implant/abutment diameter mis-match. 
Galindo-Moreno P, Moreno-Riestra I, Ávila G, Fernández-Barbero JE, Mesa F, Aguilar M, Wang H-L, O’Valle F.  Histomorphometric comparison of maxillary pristine bone and composite bone graft biopsies obtained after sinus augmentation. Clin Oral Implants Res 2010;21(1):122-128. 

Bilateral sinus augmentation with anorganic bovine bone combined with autologous bone was performed in 
45 patients, and bone cores were taken for analysis 6 months after grafting and compared with pristine 
biopsies taken from the posterior maxilla in 10 control patients. Radiographs were assessed up to 24 months after implant loading. Cores from the grafted areas showed a mean 46.08 ± 16.6% vital bone, 42.27 ± 15.1% non-mineralized connective tissue and 37.02 ± 25.1% remaining bovine bone particles. A significantly higher number of osteoid lines were observed in the graft group, and trabecular bone was in close contact with the graft particles. Sinus grafting therefore provides good information on  de novo bone formation and graft consolidation. 
Faggion CM Jr, Chambrone L, Gondim V, Schmitter M, Tu Y-K. Comparison of the effects of treatment of 
peri-implant infection in animal and human studies: systematic review and meta-analysis.
 Clin Oral Implants Res 2010;21(2):137-147. 

The effects of treatment of peri-implantitis or peri-implant mucositis were investigated via a literature search, 
and a meta-analysis was conducted to assess the difference between effects in human and animal studies. 
The meta-analysis showed that differences for probing depth and attachment level were not significantly 
different between human and animal studies and that probing depth reduction was greater for studies with 
longer follow-up times. However, there was substantial heterogeneity between studies so the results should 
be interpreted with caution. Further investigation is warranted. 
Bürgers R, Gerlach T, Hahnel S, Schwarz F, Handel G, Gosau M.  In vivo and  in vitro biofilm formation on 
two different titanium implant surfaces.
 Clin Oral Implants Res 2010;21(2):156-164.

Machined or sandblasted and acid-etched titanium specimens were mounted buccally and worn by six 
volunteers for 12 hours to evaluate in vivo biofilm formation. Bacterial adhesion in vitro was also evaluated. 
Surface roughness was significantly higher and surface free energy was significantly lower for the 
sandblasted/acid-etched specimens, and bacterial adhesion was significantly higher both in vitro and in vivo, but there was no significant difference in the percentage of dead cells among adhering bacteria between the two surfaces. Ectopic epithelial cells from the oral mucosa found on the sandblasted/acid-etched specimens but not on the machined specimens. Implant parts that are exposed to the oral mucosa should therefore be highly polished to prevent plaque accumulation. 
Frenken JFWH, Bouwman WF, Bravenboer N, Zijderveld SA, Schulten EAJM, ten Bruggenkate CM. The use of Straumann Bone Ceramic in a maxillary sinus floor elevation procedure: a clinical, radiological, histological and histomorphometric evaluation with a 6-month healing period. Clin Oral Implants Res 2010;21(2):201-208. 

Unilateral sinus floor elevation was performed in six patients using Straumann BoneCeramic, with biopsies 
taken for histology and histomorphometry after 6 months. Healing was uneventful and vertical was gained in 
each case. The implants placed achieved primary stability and were well osseointegrated after 3 months. 
Histology showed newly formed mineralized tissue with osteoid islands around the BoneCeramic particles. 
The newly formed bone was trabecular in structure in close bone-to-graft contact, indicating osteoconductive properties. Straumann BoneCeramic was shown to be suitable for vertical augmentation of the atrophied maxilla for sinus floor elevation and the placement of implants. 
Park J-C, Ha S-R, Kim S-M, Kim M-J, Lee J-B, Lee J-H. A randomized clinical 1-year trial comparing two 
types of non-submerged dental implants.
 Clin Oral Implants Res 2010;21(2):228-236. 

A total of 56 patients received control implants (36 Straumann implants, 28 patients) or test implants (39 
Osstem implants, 28 patients) to  restore one or two molars in the mandible. Peak insertion torque and 
implant stability quotient (ISQ) at surgery were significantly different between the two systems but Periotest 
values were not, and there was no significant difference in the pattern of ISQ over 10 weeks. Marginal bone 
loss was not significantly different between groups  up to functional loading, but there was a borderline 
difference after 1 year. No implants were lost in either group up to 1 year. 
Jofré J, Hamada T, Mishimura M, Klattenhoff C. The effect of maximum bite force on marginal bone loss of 
mini-implants supporting a mandibular overdenture: a randomized controlled trial.
 Clin Oral Implants Res 

Two mini-implants were placed in the anterior mandible of each of 45 patients; the implants were either ball-
type (22 patients) or splinted with a prefabricated bar (23 patients). Maximum bite force and marginal bone 
loss were assessed at baseline and after 5, 7,  10 and 15 months. The results showed no relationship 
between maximum bite force and marginal bone loss,  although both parameters were higher for the ball 
mini-implants after 15 months. 
European Journal of Oral Implantology 
Vol. 2 No. 4 (December 2009) 

Esposito M, Grusovin MG, Papamikolaou N, Coulthard P, Worthington HV.  Enamel matrix derivative 
(Emdogain) for periodontal tissue regeneration in intrabony defects. A Cochrane systematic review
Eur J 
Oral Implantol 2009;2(4):247-266. 

A literature search was performed for studies using EMD in comparison to open flap debridement, GTR and 
various grafting procedures to treat intrabony defects of ≥ 3 mm. From 35 trials that were potentially eligible, 13 were selected. Nine trials showed significantly  greater improvements in probing attachment level and probing depth reduction compared to control or placebo, although heterogeneity  among the results was found, and there was no difference in tooth loss or  esthetic appearance. In comparison with GTR, EMD showed significantly fewer post-operative complications and less gingival recession. 
Felice P, Checci V, Pistilli R, Scarano A, Pellegrino G, Esposito M. Bone augmentation versus 5-mm dental implants in posterior atrophic jaws. Four-month post-loading results from a randomized controlled clinical trial. Eur J Oral Implantol 2009;2(4):267-281. 

Patients with bilateral posterior edentulism and residual crest height 5-7 mm (15 patients) or 4-6 mm (15 
patients) received either 5 mm long implants or bone augmentation with Bio-Oss and 10 mm long implants in a split-mouth design. In five of the 15 patients in the augmented group there was insufficient mandibular 
bone height to place 10 mm implants, so 7 and 8-5 mm implants were placed. One implant was found to be 
mobile in each group. Three complications occurred in the short implant group (maxillary sinus perforation) 
and two in the augmented group (one maxillary sinus perforation and one mandibular wound dehiscence) 
and paresthesia occurred in significantly more patients in the augmented group. There was no difference in 
patient preference between the two groups. 
International Journal of Oral and Maxillofacial Implants 
Vol. 24 No. 6 (November/December 2009) 

Cehreli MC, Karasoy D, Akca K, Eckert SE. Meta-analysis of methods used to assess implant stability. Int J Oral Maxillofac Implants 2009;24(6):1015-1032. 

Implant stability methods were evaluated by a systematic literature review and meta-analysis. Of 50 articles 
identified, 47 were included (11 human cadaver, 16 clinical, 15 animal and 5  in vitro). A significant 
association  between cutting torque and RFA, and between Periotest and cutting torque or insertion torque 
were noted, but no significant associations between RFA and reverse torque or between Periotest and RFA 
were found. In the articles where correlation coefficients were available, a direct relationship between cutting 
or insertion torque and RFA was noted. 
Lindgren C, Sennerby L, Mordenfeld A, Hallman M. Clinical histology of microimplants placed in two different biomaterials.Int J Oral Maxillofac Implants 2009;24(6):1093-1100. 

Bilateral sinus augmentation was performed in 11 patients (nine completely edentulous and two partially 
edentulous); biphasic calcium phosphate (BCP) was used in one side and deproteinized bovine bone (DBB) 
was used in the contralateral side. One microimplant was placed in each side, which were retrieved after 8 
months together with the surrounding bone core. BIC was 64.6 ± 9% for BCP and 55 ± 16% for DBB, and the amount of newly formed bone was not  significantly different between the groups. Significantly more DBB particles were in contact with newly formed bone than BCP particles, but the clinical relevance of this has yet to be established.   
Romanos GE, Nentwig G-H.  Immediate functional loading in the maxilla using implants with platform 
switching: five-year results.
 Int J Oral Maxillofac Implants 2009;24(6):1106-1112.

A total of 90 implants were placed in the maxillary arches of 15 patients (six implants per arch) and 
immediately loaded with a provisional prosthesis, with splinting for 6-8 weeks of healing. Patients with 
augmented sites required 3 months of provisionalization, and a soft/liquid diet was recommended. After a 
mean loading time of 42.4 ± 19.15 months, implant survival was 96.66% (three implants lost) and there were no complications reported. Immediate loading in the maxilla can therefore be successful under controlled conditions. 
Balshe AA, Assad DA, Eckert SE, Koka S, Weaver AL. A retrospective study of the survival of smooth- and rough-surface dental implants. Int J Oral Maxillofac Implants 2009;24(6):1113-1118. 

A retrospective review was performed for smooth- and rough-surface implants from 1991-1996 and 2001-
2005, respectively, with implants from the first and second periods followed through mid-1998 and mid-2007, respectively, to facilitate the comparison. A total of 2,182 smooth-surface implants were placed in 593 patients and 2,425 rough-surface implants were placed in 905 patients. Five-year survival rates were 94.0% for smooth implants and 94.5% for  rough implants. Implant length  ≤ 10 mm and anatomic location were significantly associated with implant failure for smooth implants but were not risk factors for rough implants. 
Corinaldesi G, Pieri F, Sapigni L, Marchetti C. Evaluation of survival and success rates of dental implants 
placed at the time of or after alveolar ridge augmentation with an autogenous mandibular bone graft and 
titanium mesh: a 3- to 8-year retrospective study.
 Int J Oral Maxillofac Implants 2009;24(6):1119-1128. 

Alveolar ridge augmentation was performed in 24 patients using autogenous bone and titanium micromesh. 
Twenty implants were placed at the time of reconstruction in 13 patients, and 36 implants were placed after 
8-9 months in 11 patients; follow-up data were collected after 3-8 years. Premature micromesh exposure 
was observed in 14.8% of cases, necessitating removal. No implants were lost and mean vertical bone 
augmentation was 5.4 ± 1.81 mm and 4.5 ± 1.16 mm  for simultaneous and delayed implant placement, 
respectively. Radiographic bone levels were stable, with mean bone resorption of 1.58 ± 0.48 mm, and the 
cumulative success rate was 96.4% (two implants showed increased bone loss). 
Minoretti R, Triaca A, Saulacic N. The use of extraoral implants for distal-extension removable dentures: a 
clinical evaluation of up to 8 years.
 Int J Oral Maxillofac Implants 2009;24(6):1129-1137. 

A total of 47 extraoral implants were placed in 29 patients with partially or completely edentulous ridges with ≤ 6 mm bone height in the posterior region. Abutments were connected after 4-6 months, and implants were restored with magnets (23), ball anchors (18) or conical cylinders (4). Peri-implant soft and hard tissues were recorded at baseline and at recall appointments. After 8 years, the cumulative success rate was 91.8% (two implants failed) and the mean distance from extraoral implant to most distal tooth/implant was 28.1 mm. The results indicated that extraoral implants can be used successfully for distal-extension removable dentures in severely resorbed posterior alveolar ridges. 
International Journal of Periodontics and Restorative Dentistry 
Vol. 29 No. 6 (November/December 2009) 
Vol. 30 No. 1 (January/February 2010) 

Trammel K, Guers NC, O’Neal J, Liu P-R, Haigh SJ, McNeal S, Kenealy JN, Reddy MS.  A prospective, 
randomized, controlled comparison of platform-switched and matched-abutment implants in short-span 
partial denture situations. Int J Periodontics Restorative Dent 2009;29(6):599-605. 
Radiographic bone loss around platform-switched implants or implants with matching abutment diameters 
(25 implants in total) was measured in 10 patients for 2 years. The results indicated that there was 
significantly less crestal bone loss around platform-switched implants. 
Degidi M, Piattelli A, Shibli JA, Perrotti V, Iezzi G. Bone formation around one-stage implants with a modified sandblasted and acid-etched surface: human histologic results at 4 weeks. Int J Periodontics Restorative Dent 2009;29(6):607-613. 

One-stage modified surface implants were placed in the posterior mandibles of three partially edentulous 
patients and retrieved after 4 weeks for histological examination. Mature compact pre-existing bone and 
newly formed bone were found in all cases, with BIC percentages ranging from 42% to 61%. The results 
indicated that the BIC may be related to the microporosity and hydrophilicity of the surfaces. 
Wagenberg B, Froum SJ. Prospective study of 94 platform-switched implants observed from 1992 to 2006. 
Int J Periodontics Restorative Dent 2009;30(1):9-17. 

This study planned to evaluate implant survival and crestal bone levels around 94 platform-switched implants for a minimum of 11 years; for this investigation, radiographs were obtained between 11 and 14 years of follow-up. There was no bone loss on the medial and distal aspects for 75.5%  and 71.3% of implants, respectively, and bone loss at the mesial and distal surfaces was less than 0.8 mm for 84% and 88% of the surfaces, respectively. The concept of long-term crestal bone preservation with platform-switched implants was therefore demonstrated. 
Valentine P, Abensur D, Albertini JF, Rocchesani M.  Immediate provisionalization of single extraction-site 
implants in the esthetic zone: a clinical evaluation. Int J Periodontics Restorative Dent 2009;30(1):41-51. 
A total of 43 implants were placed in fresh extraction sockets in the anterior maxilla of 40 patients and 
provisionally restored after 1 week. After 1 year, implant survival was 95.3% and there was no significant 
marginal bone loss. Complete papilla preservation was observed in 78% of patients. Extraction sockets with buccal or circumferential defects can therefore  be predictable treated by single implants and immediate provisionalization. 
International Journal of Prosthodontics 
Vol. 23 No. 1 (January/February 2010) 

Liddelow G, Henry P. The immediately loaded single implant-retained mandibular overdenture: a 36-month 
prospective study.
 Int J Prosthodont 2010;23(1):13-21. 

Patients with problematic conventional dentures were selected to receive either oxidized or machined 
surface implants to support mandibular overdentures; each patient received a single implant in the midline of the mandible with a ball attachment and a retentive cap in the existing denture. Assessments were made 
after 3, 12 and 36 months after treatment. Of the eight machined surface implants placed three failed, giving 
an unacceptable success rate of 62.5%. Implant survival was 100% after 3 years for the 25 immediately 
loaded oxidized surface implants. Patient satisfaction significantly increased and was very high. Immediate 
loading of single implant-retained overdentures therefore appeared to be a feasible and beneficial treatment 
Gómez-Polo, M, Bartens F, Sala L, Tamini F, Celemín A, del Rio J. The correlation between crown-implant-
ratios and marginal bone resorption: a preliminary clinical study.
 Int J Prosthodont 2010;23(1):33-37. 

Data from fixed implant prostheses were retrieved  to assess crown-implant ratios and any correlation with 
bone resorption clinically and radiographically. Results indicated no such correlation between crown-implant ratio (ranging from 0.43 to 1.5 mm) and marginal bone loss (mean 2.11 ± 1.30 mm). It has been suggested that increased crown-implant ratios may increase non-axial forces transmitted to the implant or tooth, making them more vulnerable to bone loss; however, additional factors appear to be involved that influence long-term bone maintenance. 
Journal of Clinical Periodontology 
Vol. 37 No. 1 (January 2010) 
Vol. 37 No. 2 (February 2010) 

Correa FOB, Gonçalves D, Figueredo CMS, Bastos AS, Gustafsson A, Orrico SRP. Effect of periodontal 
treatment on metabolic control, systemic inflammation and cytokines in patients with type 2 diabetes
J Clin Periodontol 2010;37(1):53-58. 

Periodontal clinical parameters were evaluated in 23 patients with types 2 diabetes and chronic periodontitis, and plasma levels of high-sensitivity capsule reactive protein (hs-CRP), fibrinogen, TNF-α and IL-4, -6, -8 and -10 were analyzed, in addition to HbA1c and fasting plasma glucose. Evaluations were performed before and after 3 months of non-surgical periodontal therapy. A significant improvement in all parameters was observed after 3 months, with a tendency towards decreased levels of biomarkers, and a non-significant reduction of hs-CRP and HbA1c. 
Tu Y-K, Woolston A, Faggion CM Jr. Do bone grafts or barrier membranes provide additional treatment 
effects for intrabony lesions treated with enamel matrix derivatives? A network meta-analysis of randomized-controlled trials.
 J Clin Periodontol 2010;37(1):59-79. 

A literature search was conducted for treatment outcomes with EMD in combination with other regenerative 
materials. Mean values for reduction in probing depth and  gain in clinical attachment level were slightly 
greater with EMD in combination with bone graft materials or membranes, but the differences were not 
significant, and greater treatment effects were observed with EMD in combination with bovine bone graft. 
Yilmaz S, Cakar G, Ipci SD, Kuru B, Yildirim B. Regenerative treatment with platelet-rich plasma combined 
with a bovine-derived xenograft in smokers and non-smokers: 12-month clinical and radiographic results.
Clin Periodontol 2010;37(1):80-87. 

A total of 113 intrabony defects in 24 patients with advanced chronic periodontitis (12 smokers and 12 non-
smokers) were treated with PRP combined with bovine-derived graft. Clinical parameters were recorded at 
baseline and after 12 months. Clinical and radiographic bone gains, reduction in probing depth and gain in 
clinical attachment level were all significantly greater in the non-smoking group; less recession was also 
noted for non-smokers, but the difference was not significant. Treatment outcomes with PRP and bovine-
derived graft were therefore impaired by smoking. 
Aroca S, Keglevich T, Nikolidakis D, Gera I, Nagy K, Azzi R, Etienne D.  Treatment of class III multiple 
gingival recessions: a randomized clinical trial.
 J Clin Periodontol 2010;37(1):88-97. 

In 20 patients, a modified tunnel/connective tissue graft technique was used to treat class III gingival 
recessions in one side of the mouth (control), while EMD was used in addition to the technique in the other 
side (test). Clinical parameters were evaluated at 28 days and 3, 6 and 12 months. Mean root coverage at 12 months was 82% and 83% for the test and control groups, respectively, with complete root coverage 
obtained in 38% of cases. The modified tunnel/connective tissue technique is therefore suitable in the 
treatment of recession defects, and is not enhanced by the addition of EMD. 
Slot W, Raghoebar GM, Vissink A, Slater JJH, Meijer HJA.  A systematic review of implant-supported 
maxillary overdentures after a mean observation period of at least 1 year
J Clin Periodontol 2010;37(1):98-110. 

A literature search was performed for studies assessing  implant and prosthesis survival for studies with 
implant-supported maxillary overdentures with a mean follow-up of at least 1 year. A total of 147 articles 
were initially selected, of which 31 fulfilled the inclusion criteria. Implant survival rates were calculated to be 
98.2%, 96.3% and 95.2% for six implants + bar, four implants and bar and four implants and ball, 
respectively. High survival rates were therefore apparent with all treatment options, with six implants and bar anchorage proving to be the most successful. 
Stavropoulos A, Karring T. Guided tissue regeneration combined with deproteinized bovine bone mineral 
(Bio-Oss) in the treatment of intrabony periodontal defects: 6-year results from a randomized-controlled 
clinical trial.
 J Clin Periodontol 2010;37(2):200-210. 

Defects in 45 patients were treated with either GTR alone or in combination with deproteinized bovine bone 
mineral hydrated in either saline or gentamicin sulphate. Clinical parameters were evaluated for 6 years, at 
which time 36 patients were available for analysis. Significant clinical improvements were observed after 1 
year in all cases, which remained stable over 6 years. Gain in clinical attachment level and probing depth, or the extent of change for these parameters, did not appear to be influenced by the individual treatment. The improvements obtained using GTR with or without deproteinized bovine bone mineral can therefore be 
maintained over a long period. 
Journal of Oral and Maxillofacial Surgery 
Vol. 68 No. 2 (February 2010) 

Olate S, Lyrio MCN, de Moraes M, Mazzonetto R, Moreira RWF. Influence of diameter and length of implant in early implant failure. J Oral Maxillofac Surg 2010;68(2):414-419. 
Three different implant systems and two surgical techniques were evaluated in a retrospective study of 1,649 implants in 650 patients. Implant lengths were classified as short (6-9 mm), medium (10-12 mm) or long (13-18 mm) and diameters were classified as wide, regular or narrow. Early overall survival rate was 96.2%; 50 implants were lost. In terms of implant diameter, narrow implants failed most (5.1%) followed by regular (3.8%) and wide (2.7%). A significantly higher failure rate was also observed in short implants (9.9%) versus medium (3.0%) or ling (3.4%) implants, and in implants placed in the anterior (4.3%) versus the posterior (2.8%).  
Journal of Oral Implantology 
Vol. 35 No. 6 (December 2009) 

Irinakis T, Wiebe C.  Initial torque stability of a new bone condensing dental implant. A cohort study of 140 
consecutively placed implants.
 J Oral Implantol 2009;35(6):277-282. 

Final insertion torque was measured for 140 implants consecutively placed in 84 patients over a 13-month 
period; implant were placed both immediately  and delayed and were placed in native bone and fresh 
extraction sockets. Mean insertion torque was 49.7 Ncm and 52.6 Ncm for delayed and immediate implants respectively, with an overall mean of 50.8 Ncm. The torque was higher than is typical for straight walled and tapered implants, suggesting that they may be suitable for early provisionalization and loading. 
Irinakis T, Wiebe C. Clinical evaluation of the NobelActive implant system: a case series of 107 consecutively placed implants and a review of the implant features. J Oral Implantol 2009;35(6):283-288. 

A total of 67 patients received 107 implants over an  8-month period; indications included sinus graft, 
insufficient ridge thickness and facial bone loss. Final insertion torque ranged from 15-70 Ncm. Redirection 
of the implant was possible in all types of bone but was limited in higher density bone. The results of the 
investigations confirmed the claims made for the implant, but some recommendations for clinical use and 
placement were suggested. 
Journal of Oral Rehabilitation 
Vol. 37 No. 2 (February 2010) 

Veltri M, Ferrari M, Balleri P.  Stability values of titanium dioxide-blasted dental implants in edentulous 
maxillas: a 3-year pilot study.
 J Oral Rehabil 2010;37(1):63-68. 

The study evaluated 50 implants  in eight edentulous patients. Resonance frequency and clinical and 
radiographic parameters were measured at abutment connection (6 months after implant placement) and 
after 1 and 3 years. Mean ISQ values were 65 ± 4.8 at abutment connection, 66 ± 3.4 after 1 year and 64 ± 
3.8 after 3 years and the cumulative implant survival was 100%. Mean reduction in bone level over 3 years 
was 0.6 mm. Since no late implant failures occurred, it was not possible to establish an predictive ISQ value for implant failure. 
Journal of Periodontology 
Vol. 80 No. 12 (December 2009) 
Vol. 81 No. 1 (January 2010) 

Markou N, Pepelassi E, Vavouraki H, Stamatakis HC, Nikolopoulos G, Vrotsos I, Tsiklakis K. Treatment of 
periodontal osseous defects with platelet-rich plasma alone or in combination with demineralized freeze-
dried bone allograft: a comparative clinical trial.
 J Periodontol 2009;80(12):1911-1919. 

PRP alone or in combination with DFDBA was used in proximal endosseous defects in 24 patients with 
severe chronic periodontitis. Gains in clinical attachment level from baseline to 6 months were significant and similar in both groups, as were reductions in probing depth, defect depth and area  surface. Results with DFDBA and PRP showed a non-significant trend to greater defect fill and reductions in defect depth and area surface compared to PRP alone; however, both treatments resulted in significant improvements and there was no significant benefit from the addition of DFDBA. 
Ferreira CEA, Novaes AB Jr, Haraszthy VI, Bittencourt M, Martinelli CB, Luczyszyn SM. A clinical study of 
406 sinus augmentations with 100% anorganic bovine bone
J Periodontol 2009;80(12):1920-1927. 

Sinus grafting with anorganic bovine bone was performed  in 222 patients requiring unilateral sinus grafting 
and 92 patients requiring bilateral sinus grafting; a total of 1,025 implants were placed (118 simultaneous 
with grafting and 907 at second stage surgery after 6-12 months). After 3 years, the implant survival rate was 98.1% (19 implants were lost), with no significant differences in survival between implants with rough or 
machined surfaces, or between implants placed in  various heights of native bone. Histomorphometry 
showed 39.0 ± 12% new bone formation and 52.9% ± 9.3% marrow space.   
Song D-W, Lee D-W, Kim C-K, Park K-H, Moon I-S. Comparative analysis of peri-implant marginal bone loss based on microthread location: a 1-year prospective study after loading. J Periodontol 2009;80(12):1937-1944. 

Implants with microthreads either at  the top of the implant or 0.5 mm below the top (20 of each type) were 
placed in 20 patients, with bone loss and gingival parameters evaluated after 1 year. Mean bone loss was 
significantly different between the groups (0.16 ± 0.19 mm in the implants with microthreads at the top and 
0.30 ± 0.22 mm in the implants with microthreads below  the top) but there were no differences in gingival 
parameters. Peri-implant bone loss was therefore reduced in implants with microthreads at the top of the 
Northdurft FP, Pospeich PR. Zirconium dioxide implant abutments for posterior single-tooth replacement: first results. J Periodontol 2009;80(12):2065-2072. 

All-ceramic zirconium dioxide Y-TZP abutments were used on 40 implants placed in the posterior region of 
24 patients and zirconia-based crowns used as superstructures. Clinical parameters and implant stability 
were evaluated for up to 6 months. All implants were stable and well osseointegrated after 6 months, and 
sulcus fluid flow rate and modified sulcus bleeding index indicated stable and healthy soft tissue. Chipping of the veneering ceramic was noted in three cases. No mechanical failures were noted for the all-ceramic 
abutments over 6 months. 
Toscano NJ, Holtzclaw D, Rosen PS.  The effect of piezoelectric use on open sinus lift perforation: a 
retrospective evaluation of 56 consecutively treated cases from private practices.
  J Periodontol 

Data on perforation of the Schneiderian membrane, Underwood septa and laceration of the blood supply to 
the maxillary sinus were retrospectively evaluated in 50 patients who received 56 lateral window sinus lifts. 
No instances of membrane perforation occurred with piezoelectric surgery, but there were two perforations 
during subsequent membrane elevations with hand instruments, both associated with sinus septa; the 
overall perforation rate was 3.6%. There were no instances of arterial laceration. 
Quintessence International 
Vol. 41 No. 1 (January 2010) 
Vol. 41 No. 2 (February 2010) 

Danza M, Riccardo G, Carinci F.  Bone platform switching: a retrospective study on the slope of reverse 
conical neck.
 Quintessence Int 2010;41(1):35-40. 

A total of 191 implants with three different reverse conical neck slopes were placed and retrospectively 
evaluated. By the end of the follow-up period, five of the implants had been  lost, giving an survival rate of 
97.4%. Crestal bone remodeling was evaluated by radiography. No significant differences were found 
between the three implant types, although there  appeared to be some correlation between crestal bone 
remodeling and the reverse conical neck slope; implants with a more angulated neck appeared to show an 
improved outcome. 
Kosyfaki P, Pinilla Martín MdelP, Strub JR. Relationship between crowns and  the periodontium: a literature 
 Quintessence Int 2010;41(2):109-122. 

Electronic and manual literature searches were performed for information on crown margin, marginal fit, 
crown material and crown contour and their relationship to the periodontium. A total of 64 studies were 
identified. Results showed that the supragingival location is  the most advantageous, but that an 
intracrevicular location in the anterior zone may be preferable for esthetics. Marginal fit is acceptable with 
both all-ceramic and metal-ceramic crowns, but plaque  retention is lower with ceramic materials, and 
periodontal health and esthetics can be shown with  normal crown contours. Current approaches were 
therefore confirmed. 
Chambrone D, Pasin IM, Chambrone L, Pannuti CM, Conde MC, Lima LA. Treatment of infrabony defects 
with or without enamel matrix proteins: a 24-month follow-up randomized pilot study
.  Quintessence Int 

Open-flap debridement (OFD) was used alone (control) or in combination with enamel matrix proteins (test) 
to treat 38 intrabony defects in 10 patients. Clinical parameters were measured at baseline and after 2 years. 

Significant probing depth reductions from baseline were observed in both groups, but the reduction was 
significantly greater for the test group compared to the control group. Significant reductions in relative 
attachment level were also found for both groups. The change in recession was greater for the test group, 
and there was a significant reduction in keratinized tissue in the control group, but not in the test group. 

Clinical Implant Dentistry and Related Research

Vol. 13 No. 1 (March 2011)

Scarano A, Piattelli A, Perrotti V, Manzon L, Iezzi G. Maxillary sinus augmentation in humans using cortical porcine bone: a histological and histomorphometric evaluation after 4 and 6 monthsClin Implant Dent Relat Res 2011;13(1):13-18.

A total of 77 specimens were obtained from augmented sinuses after 4 and 6 months and evaluated histologically and histomorphometrically. The proportions of newly formed bone, marrow spaces and residual graft material were 28%, 36% and 37%, respectively. The same proportions after 6 months were 31%, 34% and 37%, respectively. The results indicated that porcine bone can be used in maxillary sinus augmentation without interfering with normal bone processes.  

De Coster P, Browaeys H, De Bruyn H. Healing of extraction sockets filled with BoneCeramic prior to implant placement: preliminary histological findingsClin Implant Dent Relat Res 2011;13(1):34-45.

In 10 patients, 15 sockets were filled with Straumann BoneCeramic and 10 sockets were left to heal naturally prior to implant placement, with biopsies collected after 6-74 weeks. Softer bone was observed at the substituted sites at implant placement, and loose connective tissue and less woven bone was observed.

Sahrmann P, Attlin T, Schmidlin PR. Regenerative treatment of peri-implantitis using bone substitutes and membrane: a systematic reviewClin Implant Dent Relat Res 2011;13(1):46-57.

A literature search was conducted for studies using GBR to treat bone defects caused by peri-implantitis. From an initial list of 399 titles, 17 were included in the review. In terms of qualitative measurements, 10.4% of implants showed complete bone fill, compared to incomplete defect closure at 85.5% and no bone fill at 4.0%. Information on probing depth before and after  treatment was found for only 53.2%, and only three studies reported the inflammatory status of the soft tissues. Complete bone fill with GBR was therefore not predictable, and mucosal health is not well considered.  

Clinical Oral Implants Research

Vol. 22 No. 1 (January 2011)

Vol. 22 No. 2 (February 2011)

Tan WC, Lang NP, Schmidlin K, Zwahlen M, Pjetursson BE.  The effect of different implant neck configurations on soft and hard tissue healing: a randomized-controlled clinical trialClin Oral Implants Res 2011;22(1):14-19.

Implants with a 1.8 mm turned neck (test) or a 2.8 mm  turned neck (control) were placed in the posterior jaws of 18 patients with multiple missing teeth; each patient received one of each implant. All implants were placed transmucosally to a sink depth of 1.8 mm. After 6 months and 1 year, no significant differences were observed in soft tissue parameters or mean crestal bone levels between the two implant types, but significantly less crestal bone loss was seen at the test implants after 1 year. The percentage of implants with crestal bone levels 1-2 mm below the implant shoulder was also greater at  the test implants (50% versus 5.6%) after 1 year. A reduced height of turned neck may therefore reduce crestal bone resorption and maintain higher crestal bone levels.


Truninger TC, Philipp AOH, Siegenthaler DW, Roos M, Hämmerle CHF, Jung RE. A prospective, controlled, clinical trial evaluating the clinical and radiological outcome after 3 years of immediately placed implants in sockets exhibiting periapical pathologyClin Oral Implants Res 2011;22(1):20-27.

Each of 29 patients received an implant immediately following tooth extraction, 13 of the sockets exhibited periapical pathology (test) and 16 did not (control). Clinical and radiological parameters were assessed for 3 years. The implant survival rate was 100%, and no significant differences in clinical or radiological parameters were observed between the test and control groups. The mean distance from the implant shoulder to the first bone-to-implant contact was 1.54 ± 0.88 mm and 1.69 ± 0.92 mm mesially and distally, respectively, in the test group. No retrograde peri-implantitis was observed at the sites with periapical pathology after 3 years. Immediate placement of implants in sites with periapical pathology, with careful debridement of the socket, can therefore be performed.


Schneider D, Grunder U, Ender A, Hämmerle CHF, Jung RE. Volume gain and stability of peri-implant tissue following bone and soft tissue augmentation: 1-year  results from a prospective cohort study.  Clin Oral Implants Res 2011;22(1):28-37.

Implant-supported crowns were used to replace missing central or lateral maxillary incisors in 16 patients. Impressions were taken before and after implant placement and hard tissue augmentation, after soft tissue augmentation, after crown placement, and after 1 year to assess alterations in peri-implant tissue contours. A mean gain of 1.27 ± 0.67 mm in the labial direction was observed after the surgical procedures, with a mean loss of 0.04 ± 0.31 mm in the labial direction after 1 year. Crown length and papilla height increased by 0.22 ± 0.57 mm and 0.07 ± 0.61 mm, respectively, in the same time. However, changes were highly variable between individuals.


Aglietta M, Siciliano VI, Rasperini G, Cafiero C, Lang NP, Salvi GE.  A 10-year retrospective analysis of marginal bone-level changes around implants in periodontally healthy and periodontally compromised tobacco smokersClin Oral Implants Res 2011;22(1):47-53.

A total of 40 tobacco smokers were divided into two groups of periodontally healthy patients and periodontally compromised patients; the latter had  been treated for periodontal conditions before implant placement. Each group received two different types of implants, making four patient groups in all. Bone loss was evaluated over 10 years. Implant survival rates ranged from 70-100% but were not significantly different between the groups. Significantly higher marginal bone loss was observed in the periodontally compromised patients, regardless of the implant system.

Pramstraller M, Farina R, Franceschetti G, Pramstraller C, Trombelli L. Ridge dimensions of the edentulous posterior maxilla: a retrospective analysis of a cohort of 127 patients using computerized tomography data. Clin Oral Implants Res 2011;22(1):54-61.

CT scans from 127 patients with at least one missing  tooth in the posterior maxilla were analyzed for bone height, bone width (1, 3 and 7 mm from most coronal point of alveolar crest; BW1mm, BW3mm and BW7mm) and relative vertical ridge position at the edentulous sites. The maxillary sinus was  evident at 50% of first premolar sites and 90-100% of second premolar and molar sites. BW1mm was higher at second molar compared to premolar sites, and BW3mm and BW7mm were higher at molar compared to premolar sites. Bone height ≥ 8 mm and BW1mm ≥ 6 mm was observed at 86.7% of first premolar, 59.2% of second premolar, 19.8% of first molar and 34.8% of second molar sites. Bone augmentation of the alveolar crest may therefore be required at second premolar sites as well as molar sites for implant placement.


Gallucci GA, Grütter L, Nedir R, Bischof M, Belser UC. Esthetic outcomes with porcelain-fused-to-ceramic and all-ceramic single-implant crowns: a randomized clinical trialClin Oral Implants Res 2011;22(1):62-69.

A total of 20 patients received either all-ceramic (test; 10 patients) or porcelain-fused-to-ceramic (control; 10 patients) screw-retained single implant crowns and were  followed up for 2 years. No significant differences were found for objective measurements between the test and control groups. Mean PES/WES scores were 13.1 and 13.9 for the test and control groups, respectively; however, major discrepancies were observed for implant crown volume, outline, translucency and characterization with the contralateral teeth. Patient perceptions of the esthetic outcomes were not significantly different between the groups, and similar clinicians’ accuracy scores were achieved. Outcomes were similar between the two groups; implant crown material alone, therefore, does not ensure optimal esthetic outcomes.


Brägger U, Hirt-Steiner S, Schnell N, Schmidlin K, Salvi GE, Pjetursson B, Matuliene G, Zwahlen M, Lang NP. Complication and failure rates of fixed dental prostheses in patients treated for periodontal diseasesClin Oral Implants Res 2011;22(1):70-77.

From a cohort of 392 patients with chronic periodontitis treated between 1978 and 2002, 199 were re-examined in 2005; of these, 84 had received 175 ceramo-metal FDPs supported by teeth, implants or both. Over the mean observation time of 11.3 years, 21  FDPs were lost and there were 46 technical and 50 biological complications. The probability of remaining free of complications was between 70.3% and 88.9% in FDPs with end abutments but only 49.8% to 25% in FDPs with extensions after 10 years. High survival rates were therefore achieved in patients treated for chronic periodontitis, but the incidence rate of negative events increased dramatically in FDPs with extensions. Extensions should therefore be avoided or used only after a full clinical evaluation of various options.


Chiapasco M, Romeo E, Coggiola A, Brusati R.  Long-term outcome of dental implants placed in revascularized fibula free flaps used for the reconstruction of maxillo-mandibular defects due to extreme atrophyClin Oral Implants Res 2011;22(1):83-91.

Extreme atrophy of the edentulous jaws with fibula free flaps was performed in 12 patients, with placement of a total of 75 implants after 5-12 months and prosthetic rehabilitation after a further 4-6 months. The mean follow-up time was 77 months. Three implants were removed during the follow-up period, giving a survival rate of 95.8%. Relevant peri-implant bone loss of (1-7 mm and 1-4.5 mm for maxillary and mandibular implants, respectively) was observed at a number of implants. The results indicated that fibula free flaps do not guarantee dimensional stability of the peri-implant bone.

Bacci C, Berengo M, Favero L, Zanon E.  Safety of dental implant surgery in patients undergoing anticoagulation therapy: a prospective case-control studyClin Oral Implants Res 2011;22(2):151-156.

The incidence of bleeding complications following surgical implant therapy in 50 patients receiving anticoagulant therapy was evaluated; 109 comparable healthy patients were evaluated as a control group. A standard protocol of local homeostasis was performed in both groups. The incidence of late-bleeding complications was two and three in the anticoagulant  and control groups, respectively; the difference in bleeding risk was therefore not significant. Local  homeostasis may therefore help to prevent bleeding complications in patients taking oral anticoagulants.

Tymstra N, Raghoebar GM, Vissink A, Meijer HJA. Dental implant treatment for two adjacent missing teeth in the maxillary aesthetic zone: a comparative pilot study and test of principle.  Clin Oral Implants Res 2011;22(2):207-213.

Patients with a missing adjacent central and upper lateral incisor were treated with a single implant and crown with cantilever (five patients) or two implants with separate crowns (five patients). Patients in the incisor group received one regular diameter implant, while patients in the adjacent implant group received one regular and one narrow diameter implant. No implants were lost after 1 year, and pocket probing values were similar between the groups. Papilla index scores were relatively low in both groups, and marginal bone loss was minimal. No differences in soft and hard tissue parameters were therefore observed between the two groups.

European Journal of Oral Implantology

Vol. 3 No. 4 (December 2010)

Canullo L, Bignozzi I, Cocchetto R, Cristalli MP, Iannello G.  Immediate positioning of a definitive abutment versus repeated abutment replacements in post-extractive implants: 3-year follow-up of a randomised multicentre clinical trial. Eur J Oral Implantol 2010;3(4):285-296.

A hopeless maxillary premolar was extracted in each of 32 patients and randomized to receive an immediate implant-supported restoration with a  provisional abutment or a definitive abutment. Seven patients were excluded from the study after tooth extraction, but the remaining 25 received wide diameter implants with platform-switched titanium provisional or definitive abutments. Provisional crowns were placed, with definitive restorations after 3 months. Provisional abutments were dis- and reconnected several times, while abutment disconnection was avoided in the definitive group. Implant success was 100% in both groups after 3 years. Peri-implant bone resorption was 0.36 mm, 0.43 mm and 0.55 mm at 3 months, 18 months and 3 years, respectively, in the provisional abutment group, and 0.35 mm, 0.33 mm and 0.34 mm, respectively, at the same time points in the definitive abutment group. Radiographic density was also greater in the definitive abutment group. The ‘one abutment-one time’ concept may therefore help to minimize crestal bone resorption.

Esposito M, Piattelli M, Pistilli R, Pellegrino G, Felice P. Sinus lift with guided bone regeneration or anorganic bovine bone: 1-year post-loading results  of a pilot randomised clinical trial.  Eur J Oral Implantol 2010;3(4):297-305.

Ten patients with 1-5 mm residual bone height and ≤ 5 mm bone width below the maxillary sinus received either a Bio-Oss or a GTR biodegradable membrane without graft material. Two or three implants were placed after 6 months and loaded with provisional restorations after a further 4 months, which were replaced by definitive restorations after another 4 months. Up to 1 year after  loading, one patient dropped out of the study and four complications occurred in three patients in the membrane-only group compared to two complications in the Bio-Oss group. No significant differences in bone loss were observed between the groups. Bone graft, therefore, may not be necessary to augment the atrophic maxillary sinus.

Gianserra R, Cavalcanti R, Oreglia F, Manfredonia MF, Esposito M. Outcome of dental implants in patients with and without a history of periodontitis: a 5-year pragmatic multicentre retrospective cohort study of 1727 patientsEur J Oral Implantol 2010;3(4):307-314.

Periodontal status was assessed in 1727 patients requiring implant treatment in four private practices: 258 had no periodontitis, while 839 had moderate periodontitis and 630 had severe periodontitis. In the periodontitis patients, periodontal treatment was given before implant surgery. A total of 647 implants, 2813 implants and 3260 implants were placed in the no  periodontitis, moderate periodontitis and severe periodontitis groups, respectively. After 5 years, 250 patients were lost to follow-up. Implant failure rates were 3.0%, 3.1% and 4.5% in the no, moderate and severe periodontitis groups, respectively; 90% of the failures occurred before implant loading. No significant differences were observed between the three groups, indicating that a previous history of periodontitis may not have a significant effect on implant failure.


Anitua E, Errazquin JM, de Pedro J, Barrio P, Begona L, Orive G. Clinical evaluation of Tiny 2.5- and 3.0-mm narrow-diameter implants as definitive  implants in different clinical situations: a retrospective cohort studyEur J Ora

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