| 1. |
- De Angelis, Nicola, et al.
(författare)
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Guided bone regeneration with and without a bone substitute at single post-extractive implants: 1-year post-loading results from a pragmatic multicentre randomised controlled trial.
- 2011
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Ingår i: European journal of oral implantology. - 1756-2406. ; 4:4, s. 313-25
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate whether the adjunctive use of a bone substitute at immediate single implants placed in fresh extraction sockets with a residual buccal bone-to-implant gap of at least 1 mm could improve the aesthetic outcome of guided bone regeneration (GBR).Eighty patients requiring bone augmentation at a single immediate postextractive implant to improve the aesthetic outcome were randomly allocated to an augmentation procedure using a resorbable barrier alone (GBR group; 40 patients) or a bone substitute plus a resorbable barrier (GBR + BS group; 40 patients) according to a parallel group design at four different centres. Three to 4 months after implant placement/augmentation, implants were loaded with provisional or definitive single crowns. Outcome measures were implant failures, complications, aesthetics assessed using the pink esthetic score (PES), patient satisfaction and peri-implant marginal bone levels, recorded by blinded assessors. All patients were followed up to 1 year after loading.One patient dropped out from the GBR group. Seven (9%) implants failed: 2 (5%) in the GBR + BS group and 5 (12.5%) in the GBR group. Six minor complications occurred in the GBR + BS group versus 2 in the GBR group. These differences were not statistically significant. Just after implant placement/augmentation, mean bone levels were -0.21 mm at GBR + BS implants and -1.92 mm at GBR implants whereas at 1 year after loading they were -1.04 and -1.76, respectively. When comparing the two groups, GBR + BS implants had 0.70 mm more peri-implant marginal bone than GBR implants. Aesthetics was scored by a blinded assessor as statistically significantly better for the GBR + BS group. Patients were equally satisfied. There were no differences between centres regarding the clinical outcomes.The use of additional an organic bovine bone substitute (Endobon) with resorbable collagen barriers (OsseoGuard) in defects around post-extractive implant improves the aesthetic outcome, though single post-extractive implants might be at a higher risk for implant failures.
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| 2. |
- Esposito, Marco, 1965, et al.
(författare)
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The adjunctive use of light-activated disinfection (LAD) with FotoSan is ineffective in the treatment of peri-implantitis: 1-year results from a multicentre pragmatic randomised controlled trial.
- 2013
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Ingår i: European journal of oral implantology. - 1756-2406. ; 6:2, s. 109-19
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate possible benefits of the adjunctive use of light-activated disinfection (LAD) in the treatment of peri-implantitis.A total of 80 patients with at least one implant affected by peri-implantitis defined as at least 3 mm of bone loss on baseline radiographs in the presence of signs of infection (pus exudation and/or soft tissue swelling and/or soft tissue redness) were non-surgically or surgically treated for peri-implantitis and 50% of them were randomly allocated to receive an additional LAD treatment (FotoSan) according to a parallel group design at four different centres. Only one implant per patient was considered. Outcome measures were implant failures, recurrence of peri-implantitis, complications, peri-implant marginal bone level (RAD) changes, probing pocket depth (PPD) changes and number of re-treatment sessions recorded by blinded assessors. Patients were followed up for 1 year after treatment.Five treated patients did not fit the original inclusion criteria: 4 because they were not affected by the present definition of peri-implantitis and 1 due to being treated with antibiotics. However, they were included according to an intention-to-treat-analysis concept. Nine patients of the LAD group were treated surgically versus 10 control patients. After 1 year, 3 patients dropped out, all from the LAD group. One implant treated with the LAD therapy failed versus none of the control group. Four complications occurred: 3 in 3 patients of the LAD group and 1 in the control group. Recurrence of peri-implantitis defined as 2 mm of peri-implant bone loss or more recorded on standardised periapical radiographs was observed in 6 patients, 3 from each group. In total, 29 implants were re-treated 1 to 4 times in the LAD group versus 33 implants 1 to 4 times in the control group; the difference was not statistically significant. Peri-implant marginal bone levels remained stable up to 1 year with no statistically significant differences between groups (0.13 mm favouring LAD therapy; 95% CI of difference -0.47 to 0.72; P = 0.68). PPD significantly reduced in both groups, and at 1 year there were no significant differences between groups (difference 0.19 mm favouring LAD therapy; 95% CI of difference -0.70 to 1.07; P = 0.68). There were significant differences between centres for the number of re-treatment sessions delivered, PPD changes, plaque and marginal bleeding 1 year after treatment, but not for implant failures, complications, RAD changes and recurrence of peri-implantitis. The results did not change when removing the 5 patients who did not match the original inclusion criteria.Adjunctive use of LAD therapy (FotoSan) with mechanical cleaning of implants affected by peri-implantitis did not improve any clinical outcomes when compared to mechanical cleaning alone up to 1 year after treatment.
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| 3. |
- Ferrantino, Luca, et al.
(författare)
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Aesthetic Outcomes of Non-functional Immediately Restored Single Post-extraction Implants with and without Connective Tissue Graft: A Multicenter Randomized Controlled Trial.
- 2021
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Ingår i: Clinical oral implants research. - : Wiley. - 1600-0501 .- 0905-7161. ; 32:6, s. 684-694
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Tidskriftsartikel (refereegranskat)abstract
- To compare the one-year aesthetic results of flapless single implants, placed in fresh extraction sockets with bone replacement and immediate provisional restoration with or without a connective tissue graft (CGT).The present study proposes a partially blinded multicenter parallel randomized controlled trial, where computer-generated tables were used for central randomization to allocate treatments. 59 out of the 60 patients screened by eight private practices in Northern Italy fulfilled the inclusion criteria. Immediate implants was placed in a fresh extraction socket with a non-functional immediate provisional restoration with (Test group) or without (Control group) a CGT. The primary outcome variable was the implant Crown Aesthetic Index (ICAI) at the 1-year follow-up.ICAI for the 59 randomized patients (Test group = 31, Control group = 28) at the 1-year follow-up was 4.69 (95% CI = 3.16 - 6.22) for the Test group and 3.45 (95%CI = 1.83-5.08) for the Control group, without statistically significant difference between the two groups (p=0.086). One implant failure was recorded in each group, resulting in an implant survival rate of 96.8% [95%CI = 83.3 - 99.9] for the Test group and 96.4% [95%CI = 81.7 -99.9] for the Control group. Other secondary outcome variables and complication rates were comparable across the two groups.Within the limitations of the present clinical trial, the results suggested that the adjunct use of CTG is not mandatory to achieve successful aesthetic outcomes for a well-planned immediate implant placement with immediate non-functional provisional restoration in a fresh extraction socket.
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