Melbourne Dental School - Research Publications

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Author: Chen, Stephen × Start date: 2018 × End date: 2018 ×

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    Marginal bone level and survival of short and standard-length implants after 3 years: An Open Multi-Center Randomized Controlled Clinical Trial
    Zadeh, HH ; Gulje, F ; Palmer, PJ ; Abrahamsson, I ; Chen, S ; Mahallati, R ; Stanford, CM (WILEY, 2018-08)
    OBJECTIVES: The present multi-center randomized controlled clinical trial sought to compare the marginal bone level (MBL) changes and survival of 6- and 11-mm implants. MATERIAL AND METHODS: Ninety-five patients receiving a total of 209 dental implants were enrolled. Subjects were randomly allocated to two cohorts: test (4.0 × 6 mm; N = 108) or control (4.0 × 11 mm; N = 101) implant groups. To be randomized, all edentulous sites were anatomically qualified to receive 11 mm implant. Two to three implants were placed in maxillary or mandibular posterior regions and loaded with splinted provisional restoration after 6 weeks and definitive restoration 6 months thereafter. Test and control implants were followed by clinical and radiographic examinations on an annual basis up to 3 years. RESULTS: Radiographic assessment of MBL 3 years after loading revealed the bone to be located at 0.27 mm (±0.40) and 0.44 mm (±0.74) apical to the implant platform in the test and control groups, respectively. During the 3 years of follow-up since loading, 0.04 mm (±0.43) MBL gain and 0.02 mm (±0.76) of MBL loss were observed in the 6-mm (test) and 11-mm (control) groups, respectively. The MBL's for test and control were significantly different (p = 0.000) in favor of short implants. The cumulative survival rates from placement after 3 years were 96% and 99% for the 6- and 11-mm implants, respectively, with no statistical significance. CONCLUSIONS: Reconstruction of partially edentulous posterior maxilla or mandible with 6- or 11-mm implants led to stable marginal bone level and high implant survival rate after 3 years.
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    Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions
    Berglundh, T ; Armitage, G ; Araujo, MG ; Avila-Ortiz, G ; Blanco, J ; Camargo, PM ; Chen, S ; Cochran, D ; Derks, J ; Figuero, E ; Hammerle, CHF ; Heitz-Mayfield, LJA ; Guy, H-B ; Iacono, V ; Koo, K-T ; Lambert, F ; McCauley, L ; Quirynen, M ; Renvert, S ; Salvi, GE ; Schwarz, F ; Tarnow, D ; Tomasi, C ; Wang, H-L ; Zitzmann, N (WILEY, 2018-06)
    A classification for peri-implant diseases and conditions was presented. Focused questions on the characteristics of peri-implant health, peri-implant mucositis, peri-implantitis, and soft- and hard-tissue deficiencies were addressed. Peri-implant health is characterized by the absence of erythema, bleeding on probing, swelling, and suppuration. It is not possible to define a range of probing depths compatible with health; Peri-implant health can exist around implants with reduced bone support. The main clinical characteristic of peri-implant mucositis is bleeding on gentle probing. Erythema, swelling, and/or suppuration may also be present. An increase in probing depth is often observed in the presence of peri-implant mucositis due to swelling or decrease in probing resistance. There is strong evidence from animal and human experimental studies that plaque is the etiological factor for peri-implant mucositis. Peri-implantitis is a plaque-associated pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone. Peri-implantitis sites exhibit clinical signs of inflammation, bleeding on probing, and/or suppuration, increased probing depths and/or recession of the mucosal margin in addition to radiographic bone loss. The evidence is equivocal regarding the effect of keratinized mucosa on the long-term health of the peri-implant tissue. It appears, however, that keratinized mucosa may have advantages regarding patient comfort and ease of plaque removal. Case definitions in day-to-day clinical practice and in epidemiological or disease-surveillance studies for peri-implant health, peri-implant mucositis, and peri-implantitis were introduced. The proposed case definitions should be viewed within the context that there is no generic implant and that there are numerous implant designs with different surface characteristics, surgical and loading protocols. It is recommended that the clinician obtain baseline radiographic and probing measurements following the completion of the implant-supported prosthesis.