Clinical Oral Implants Research Vol. 20 No. 7 (July 2009)

Jung RE, Windisch SI, Eggenschwiler AM, Thoma DS, Weber FE, Hämmerle CHF. A randomized-controlled
clinical trial evaluating clinical and radiographic outcomes after 3 and 5 years of dental implants placed in
bone regenerated by means of GBR techniques with or without the addition of BMP-2. Clin Oral Implants
Res 2009;20(7):660-666.

Lateral bone defect sites in 11 patients received a total of 34 implants and were treated with xenogenic bone
substitute graft and a collagen membrane, with or without rhBMP-2. After both 2 and 5 years, the implant
survival rate was 100%, and peri-implant soft tissues were stable and healthy in both groups. There were
four instances of prosthetic screw loosening in the first 3 years, and seven ceramic chippings after 3 and 5
years. The mean distance from implant-abutment junction to first BIC was 1.37 mm and 1.22 mm for test and
control implants, respectively, after 3 years,  and 1.38 mm and 1.23 mm for test and control implants,
respectively, after 5 years; the differences were not significant. There were also no significant differences for
mean marginal bone level change between test and control at 3 and 5 years.
 
Pjetursson BE, Rast C, Brägger U, Schmidlin K, Zwahlen M, Lang NP. Maxillary sinus floor elevation using
the (transalveolar) osteotome technique with or without grafting material. Part I: implant survival and patients’
perception. Clin Oral Implants Res 2009;20(7):667-676.

A total of 252 implants were placed using a modified osteotome technique in 181 patients between 2000 and
2005. The implant survival rate was 97.4% for a mean follow-up time of 3.2 years; survival rates were 91.3%
at sites with ≤ 4 mm residual bone height, 90% for sites with 4-5 mm residual bone height and 100% at sites
with ≥ 5 mm residual bone height. The survival rate was only 47.6% for 6 mm long implants, compared to
100%, 98.7% and 98.7% for implants 12, 10 and 8 mm long, respectively. Over 90% of patients expressed
satisfaction with the therapy, as measured by visual analog scale, and the cost of therapy was considered to
be justified.
 
Pjetursson BE, Ignjatovic D, Matuliene G, Brägger U, Schmidlin K, Lang NP. Transalveolar maxillary sinus
floor elevation using osteotomes with or without grafting material. Part II: radiographic tissue remodeling.
Clin Oral Implants Res 2009;20(7):677-683.

A total of 252 implants were placed using a modified osteotome technique in 181 patients between 2000 and
2005. Deproteinized bovine bone was used as grafting material for 35% of the implants, while no grafting
material was used for the remaining implants. Mean residual bone height was 7.5 ± 2.2 mm (range 2 to
12.7 mm); the mean residual height at sites with and without grafting material was 6.4 mm and 8.1 mm,
respectively; the difference was significant. Mean bone gain with grafting material was significantly greater
(4.1 ± 2.4 mm compared to 1.7 ± 2.0 mm without grafting material). Substantial new bone gain was therefore
observed with grafting material.
 
Nedir R, Bischof M, Vazquez L, Nurdin N, Szmukler-Moncler S, Bernard J-P. Osteotome sinus floor elevation
technique without grafting material: 3-year results of a prospective pilot study.  Clin Oral Implants Res
2009;20(7):701-707.

In 17 patients, 25 implants were placed (16 molars and nine premolars) using osteotome sinus floor
elevation; 21 of the implants were 10 mm long, while the others were 6 mm and 8 mm long. The implants
were placed in newly formed bone tissue. All implants met the survival criteria after 3 years. Mean endo-
sinus bone gain was 3.1 ± 1.5 mm and mean crestal bone loss was 0.9 ± 0.8 mm. Residual protrusion length
decreased from 4.9 ± 2.1 mm to 1.8 ± 2.1 mm. Osteotome sinus floor elevation was therefore sufficient to
gain bone without graft material.
 
Friedman A, Dard M, Kleber B-M, Bernimoulin J-P, Bosshardt DD. Ridge augmentation and maxillary sinus
grafting with a biphasic calcium phosphate:  histologic and histomorphometric observations.  Clin Oral
Implants Res 2009;20(7):708-714.

Biopsies were harvested after 6-10 months from sites augmented using biphasic calcium phosphate
(Straumann BoneCeramic) in five patients; augmentations were one-stage lateral, two-stage lateral and two-
stage sinus grafting, and a degradable collagen membrane was used in all cases. The 11 biopsies showed
graft particles bridged by new bone, in close contact with the particles; mean newly formed bone was 38.8%,
while mean soft tissue and graft material were 41.75% and 19.63%, respectively. Bone-to-graft contact
ranged from 27.83% to 80.17%, and mean bone coverage was 55.39%. The results indicated
osteoconductivity scores similar to those for xenogenic and alloplastic graft materials.
 
 
International Journal of Oral and Maxillofacial Implants Vol. 24 No. 3 (May/June 2009)

Romano MM, Soares MS, Pastore CA, de Oliveira Guare R. Adde CA.  Electrocardiographic alterations
during endosseous implant placement performed with local anaesthetic agents.  Int J Oral Maxillofac
Implants 2009;24(3):412-418.

In 18 healthy patients, electrocardiograms were obtained during the placement of 20 implants. Significant
differences were found for heart rate and duration of RR and QT intervals, all of which increased during
incision and drilling; heart rate also increased during anaesthesia. Individual assessment showed alterations
for P wave duration, QRS complex and QT and QTc intervals, and sinusal tachycardia and bradycardia,
sinusal arrhythmia, supraventricular asystole, ventricular extrasystole and T-wave inversion were noted.
Implant placement may therefore induce electrocardiographic alterations.
 
Karbach J, Callaway A, Kwon Y-D, d’Hoedt B, Al-Nawas B. Comparison of five parameters as risk factors for
peri-mucositis. Int J Oral Maxillofac Implants 2009;24(3):491-496.

Plaque index, bleeding on probing and pocket probing depth were recorded in 100 patients, and a sample
from the deepest pocket analyzed for periodontal pathogens. Clinical signs of peri-implant mucositis were
observed in 31 patients, and 25 sites showed periodontal pathogens. Smoking was significantly correlated
with signs of peri-implant mucositis in both univariate and multivariate analyses, and the type of dentition was
significant for periodontal pathogens. Radiation therapy was also a significant variable in a multivariate
analysis. Agreement for finding signs of peri-implant mucositis and periodontal pathogens, or no signs and
no signs, was found in 72% of patients.
 
Urban IA, Jovanovic SA, Lozada JL. Vertical ridge augmentation using guided bone regeneration (GBR) in
three clinical scenarios prior to implant placement: a retrospective study of 35 patients 12 to 72 months after
loading. Int J Oral Maxillofac Implants 2009;24(3):502-510.

A total of 35 patients with vertical bone defects (single missing teeth (group A), multiple missing teeth (group
B) or vertical defects in the posterior maxilla only (group C)) received 82 implants. Group C patients received
sinus and vertical augmentation, and all patients received vertical  augmentation with ePTFE membrane
(later replaced by a collagen membrane) and particulated autografts. Mean vertical augmentation was 5.5 ±
2.29 mm at the time of ePTFE membrane removal, and mean crestal remodeling was 1.01 ± 0.57 mm at
12 months, remaining stable up to 6 years; there were no significant differences between the groups. Implant
survival and success rates were 100% and 94.7%, respectively, which is similar to those of implants placed
in native bone. Vertical augmentation with particulate graft and ePTFE ,membrane is therefore a safe and
predictable technique.
 
Toljanic JA, Baer RA, Ekstrand K, Thor A. Implant rehabilitation of the atrophic edentulous maxilla including
immediate fixed provisional restoration without the use of bone grafting: a review of 1-year outcome data
from a long-term prospective clinical trial. Int J Oral Maxillofac Implants 2009;24(3):518-526.

A total of 51 patients with atrophic edentulous maxillae each received six implants and provisional restoration
within 24 h; no grafting was performed. After 3  months, 294/306 implants were integrated, giving a
cumulative survival rate of 96%, with no additional  implant losses up to 1 year. Marginal bone loss was 0.5
mm after 1 year. Predictable outcomes can therefore be obtained with immediate loading in the atrophic
edentulous maxilla.
 
 
International Journal of Periodontics and Restorative Dentistry Vol. 29 No. 3
(May/June 2009)

Cortellini P, Pini-Prato G, Nieri M, Tonetti MS. Minimally invasive surgical technique and enamel matrix
derivative in intrabony defects: 2. factors associated with healing outcomes. Int J Periodontics Restorative
Dent 2009;29(3):257-265.

Minimally invasive surgical technique, performed using microsurgical instruments and an operating
microscope, was used to access 40 deep intrabony defects and apply EMD to the root surfaces. CAL gain
after 1 year was 4.9 ± 1.7 mm, with > 4 mm gain in 70% of the defects, and was significantly associated with
the depth of the three-wall component, intraoperative bleeding tendency and its interaction with the initial
amount of bone loss.
  
 
Bakaeen L, Quinlan P, Schoolfield J, Lang NP, Cochran DL. The biologic width around titanium implants:
histometric analysis of the implantogingival junction around immediately and early loaded implants.  Int J
Periodontics Restorative Dent 2009;29(3):297-305.

In four dogs, 48 implants were placed 3 months, 21 days, 10 days or 2 days prior to restoration. The results
after 3 months of abutment connection showed no significant difference between the groups for sulcus
depth, connective tissue contact area, recession from  the interface to the gingival margin, or other
histometric parameters. The peri-implant soft tissue dimensions around early and immediately loaded
implants are therefore similar to those around conventionally loaded implants.
 
 
International Journal of Prosthodontics Vol. 22 No. 3 (May/June 2009)

Kaufmann R, Friedli M, Hug S, Mericske-Stern R.  Removable dentures with implant support in strategic
positions followed for up to 8 years. Int J Prosthodont 2009;22(3):233-241.

A total of 60 patients with removable partial prostheses and tooth-implant support treated between 1998 and
2006 were evaluated. The patients  consisted of a planned group (42 patients, reduced residual dentition
requiring partial dentures or overdentures) and a repair group (18 patients, wearing removable partial
dentures with the loss of one abutment tooth, replaced by implants). The observation time was 12 years and
8 months. Biological problems, including caries and infection, were significantly higher in the repair group but
technical complications, mostly related to anchorage, were frequent in both groups. Maintenance and
complications were more frequent in the first year  than in the subsequent 3 years. Implant placement can
therefore allow maintenance of compromised dentition, and combination tooth-implant support can facilitate
treatment planning and enhance the design of the denture.
 
Walton TR. Changes in the outcome of metal-ceramic tooth-supported single crowns and FPDs following the
introduction of osseointegrated implant dentistry into a prosthodontic practice.  Int J Prosthodont
2009;22(3):260-267.

The cumulative survival of metal-ceramic tooth-supported single crowns and FPDs was evaluated at two
time periods: 1989-1993 (404 single crowns and 189 FPDs); and 1997-2001 (539 single crowns and 142
FPDs). There was a 500% increase in implant restorations between the two time periods. Results indicated
significantly better survival for single crowns in the latter period, and non-vital single crowns had significantly
decreased survival compared to other single crowns in  the first time period but not the second. Cumulative
10-year survival for single crowns in the second period was 94.3%. There was significantly better survival for
non-vital abutments with FDPs in the second period,  and survival was significantly reduced for non-vital
abutments versus vital abutments in the first period but not the second. Cumulative 10-year survival for FDPs
in the second period was 90%. The advent of implant dentistry therefore significantly improved the survival of
single crowns and FDP abutments.
 
Canullo L, Goglia G, Iurlaro G, Iannello G.  Short-term bone level observations associated with platform
switching in immediately placed and restored single maxillary implants: a preliminary report.  Int J
Prosthodont 2009;22(3):277-282.

A total of 22 patients each received an implant with a platform diameter of 5.5 mm; half were connected with
5.5 mm diameter abutments (control) and half with  3.8 mm diameter abutments (test) and received non-
functional immediate crowns, with final crowns after 2 months. The mean follow-up time was 25 months. All
implants were successfully osseointegrated. Bone level reduction was significantly less in the test group
(0.30 ± 0.16 mm versus 1.19 ± 0.35 mm), and there were no differences between the groups for probing
depth, bleeding on probing or modified plaque index. Immediate restoration with platform switching in the
maxilla may therefore help preserve peri-implant bone levels.
 
 
Journal of Clinical Periodontology Vol. 36 No. 7 (July 2009)

Grabe HJ, Schwahn C, Völzke H, Spitzer C, Freyberger HJ, John U, Mundt T, Biffar R, Kocher T. Tooth loss
and cognitive impairment. J Clin Periodontol 2009;36(7):550-557.

Subjects in the Study of Health in Pomerania were evaluated for cognitive impairment, as assessed by Mini-
Mental Status Examination (MMSE), and tooth loss/periodontitis. Analysis of the 1,336 subjects showed that
reduced number of teeth was associated with lower MMSE scores in women but not in men; the association
was not accounted for by potential cofounders. One cause may be periodontitis, as this was the reason for
many of the tooth extractions.
 
Renvert S, Samuelsson E, Lindahl C, Persson GR. Mechanical non-surgical treatment of peri-implantitis: a
double-blind randomized longitudinal clinical study. I: clinical results.  J Clin Periodontol 2009;36(7):604-
609.

Peri-implantitis at implants in  37 patients was treated using titanium hand instruments or an ultrasonic
device, and the sites were evaluated for up to 6 months. The mean bone loss was 1.5 ± 1.2 mm in both
groups, and there were no differences for plaque and gingival indices. There were also no differences
between the groups for probing depth at baseline and 6 months or for bleeding scores. Plaque scores at
treated implants were reduced from 73% to 53%. Significantly higher bacterial counts were apparent at
ultrasonic-treated implants immediately after treatment and at 1 week.
 
Journal of Dental Research Vol. 88 No. 6 (June 2009)

Bullon P, Morillo JM, Ramirez-Tortosa MC, Quiles JL, Newman HN, Battino M. Metabolic syndrome and
periodontitis: is oxidative stress a common link? J Dent Res 2009;88(6):503-518.

The factors associated with metabolic syndrome (obesity, hypertension, impaired glucose tolerance or
diabetes, hyperinsulinemia, dyslipidemia) have all been evaluated regarding a relationship with periodontitis,
and available data suggest an association with periodontitis with some of them, e.g. BMI, HDL-cholesterol).
Oxidative stress may be a common component in both systems, as both show increased levels of derivatives
of oxidative damage. This review  suggests that adipocytokines may  modulate the oxidant/anti-oxidant
balance.
 
Goodson JM, Groppo D, Halem S, Carpino E.  Is obesity an oral bacterial disease?  J Dent Res
2009;88(6):519-523.

The possibility of an oral bacterial role in obesity  was investigated by measuring the salivary bacterial
populations of 313 women with a BMI between 27 and 32 and comparing the results with those from 232
healthy individuals. Forty bacterial species were measured, and the mean difference of seven of these was
greater than 2% in the saliva of the women with BMI 27-32; 98.4% of these women could be identified by the
presence of a single bacterial species (S noxia) at levels > 1.05% of total salivary bacteria. Salivary bacteria
may change in obesity, and may therefore act as a biological indicator of a developing condition.
 
 
Journal of Oral Implantology Vol. 35 No. 3 (June 2009)

Avvanzo P, Ciavarella D, Avvanzo  A, Giannone N, Carella M, Lo Muzio L.  Immediate placement and
temporization of implants: three- to five-year retrospective results. J Oral Implantol 2009;35(3):136-142.

Recent goals in implantology have included reducing  the period between implant placement in a fresh
extraction socket and placement of the definitive prosthesis. In this  study, 282 implants placed in fresh
extraction sockets and restored with a provisional prosthesis out of occlusion were evaluated in a 3- to 5-
year retrospective study. Outcomes and complications are discussed.
 
 
Journal of Oral Rehabilitation Vol. 36 No. 7 (July 2009)

Kaya Y, Yalim M, Bahçecitapar M, Baloş K. Comparison of applying particulate demineralized bone matrix
(DBM), putty DBM and open flap debridement in  periodontal horizontal bone defects. A 12-month
longitudinal, multicenter, triple-blind, split-mouth, randomized, controlled, clinical study. Part 1 – clinical and
radiographic evaluation. J Oral Rehabil 2009;36(7):524-534.

In 25 patients, 125 periodontal defects were treated with putty DBM, particulate DBM or open flap
debridement (control). Periodontal parameters were measured and radiography were taken at baseline and
after 12 months. Relative attachment level significantly improved in all groups, and no significant differences
in soft tissue parameters were observed between the groups. However, significant bone gain was found in
the graft groups, while significant bone resorption was apparent in the control group. Similar outcomes were
noted with putty and particulate DBM.
 
Kaya Y, Yalim M, Bahçecitapar M, Baloş K. Comparison of applying particulate demineralized bone matrix
(DBM), putty DBM and open flap debridement in  periodontal horizontal bone defects. A 12-month
longitudinal, multicenter, triple-blind, split-mouth, randomized, controlled clinical study. Part 2 – evaluation of
the interdental soft tissue. J Oral Rehabil 2009;36(7):535-542.

In 25 patients, 125 periodontal defects were treated with putty DBM, particulate DBM or open flap
debridement (control), and sites were assessed by plaque index, gingival index, presence of soft tissue clefts
and loss of interdental papilla height (papilla presence index) after 3, 6, 9 and 12 months. The prevalence of
soft tissue cleft and crater formation significantly increased in all groups, with increases in the papilla and
gingival index scores at the interdental soft tissue defect areas after 3 months. Papilla presence index also
increased in all groups. No significant differences between the groups were observed – all groups showed
similar interproximal soft tissue changes.
 
 
Journal of Periodontal Research Vol. 44 No. 4 (August 2009)

Haffajee AD, Teles RP, Patel MR, Song X, Veiga N, Socransky SS. Factors affecting human supragingival
biofilm composition. I. Plaque mass. J Periodontal Res 2009;44(4):511-519.

A total of 4745 supragingival plaque samples were taken from 187 systemically healthy subjects and
analyzed for 40 bacterial species using checkerboard DNA-DNA hybridization. A wide distribution in mean
total DNA probe counts was noted, and the proportions of species and microbial complexes changed with
increasing plaque levels. High proportions of yellow, orange and purple and other complexes appeared in
small plaques, high proportions of  Actinomycetes and purple complex species appeared in moderate
plaques, and high proportions of green and orange complex species appeared in large plaques. Measures of
gingival inflammation were also associated with total DNA probe counts, and increased plaque numbers
were related to pocket depth.
 
Haffajee AD, Teles RP, Patel MR, Song X, Yaskell T, Socransky SS. Factors affecting human supragingival
biofilm composition. II. Tooth position. J Periodontal Res 2009;44(4):520-528.

A total of 4745 supragingival plaque samples were taken from 187 systemically healthy subjects and
analyzed for 40 bacterial species using checkerboard DNA-DNA hybridization and determined among tooth
surfaces and types. Species differed significantly  among tooth types and categories, with higher plaque
observed on molars and lower incisors. High levels of C gingivalis, A naeslundii genospecies 2, C rectus and
C showae were found at teeth with high plaque mass, but some differed significantly at different tooth
locations. A significant association with tooth location was found for 20 of the test species.
 
 
Journal of Periodontology Vol. 80 No. 6 (June 2009)

Heimonen A, Janket S-K, Kaaja R, Ackerson LK, Muthukrishnan P, Meurman JH. Oral inflammatory burden
and preterm birth. J Periodontol 2009;80(6):884-891.

A post-partum cross-sectional study of 328 women was performed; 251 had normal births and 77 had
preterm births. Various periodontal, oral and inflammatory parameters were recorded and analyzed. After
adjusting for confounding factors (age,  smoking, diabetes, primiparity, antimicrobial treatment, infertility
treatment and weight gain during pregnancy), oral inflammatory burden index was found to be significantly
associated with preterm birth. Oral inflammation score was also significantly associated with preterm birth,
but only if weight gain was not adjusted for.
 
Degidi M, Nardi D, Piattelli A.  Immediate restoration of small diameter  implants in cases of partial posterior
edentulism: a 4-year case series. J Periodontol 2009;80(6):1006-1012.

A total of 93 3.0 mm diameter implants were placed in posterior region healed sites 40 patients (48 in the
maxilla and 45 in the mandible). Final restoration was performed after 6 months, and the implants were
evaluated at 6, 12, 24, 36 and 48 months. All implants were stable at the 6-month follow-up and the mean
marginal bone loss after 48 months was 1.16 ± 0.90 mm. Small diameter implants can therefore be used to
support fixed partial restorations in partial posterior edentulism.
 
 Journal of the American Dental Association Vol. 140 No. 7 (July 2009)

Binkley CJ, Beacham A, Neace W, Gregg RG, Liem EB, Sessler DI. Genetic variations associated with red
hair color and fear of dental pain, anxiety regarding dental care and avoidance of dental care. J Am Dent
Assoc 2009;140(7):896-905.

The authors suggested that people with red hair may have increased anxiety about dental care and dental
pain since they are more resistant to subcutaneous local anesthetics. A total of 144 patients (67 with red hair
and 77 with dark hair) completed a survey and had blood taken to evaluate whether natural red hair color or
a MC1R gene variant could predict dental care anxiety. MC1R gene variants were found in 65 of the 67
participants with red hair and 20 of the 77 with dark hair, and patients with this variant reported significantly
greater dental care-related anxiety and  fear of dental pain, and were twice as likely to avoid dental care as
the other participants.