02.01.2023_JCP Rafael

Question 1

Is there a superior technique for the surgical debridement of the peri-implantitis implant surface?

Answer 1

Almohandes JCP
Dog study: 4 implants (of 2 different surface characteristics) placed on both sides of the mandible. (48 implants total)

Implant surfaces examined:
* A = moderately rough (TiO-blasted and acid-etched surface)
* B = smooth (turned and dual acid-etched surface)

Surgical Tx = implant surface decontamination protocols:
* Pair T1: deposition of a citric acid gel
* Pair T2: mechanical cleaning using a rotating titanium brush
* Pair T3: combination of the mechanical and chemical
* Pair C: saline (control)

Results: NSSD

Question 2

How effective is sub-G air-polishing therapy compared to conventional SRP?

Answer 2

Divnic-Resnik JCP
Compare erythritol powder + SRP compared to SRP only in generalized Stages II and III grade B periodontitis.

Critique: Stage III: 85% / Stage II: 25% = adds to more than 100%

Results: NSSD

Question 3

How effective are tooth root blocks for ridge augmentation?

Answer 3

Schwarz JCP
Purpose: To compare autogenous tooth root block vs. autogenous bone block for combined vertical and horizontal alveolar ridge augmentation and 2-stage implant placement.
* Wisdom tooth removed w/o root resections. Roots isolated by a horizontal separation of the crown at CEJ
Cementum carefully removed (diamond bur) until dentin entirely exposed (to improve ankylosis between the graft)
* Monocortical retromolar block harvested from the ext. oblique line

Results: “both TR and AB grafts appeared to be associated with comparable efficacy and safety for combined vertical and horizontal alveolar ridge augmentation.”

Question 4

What was the 5-year followup results for the 6mm splinted short implants in the posterior mandible?

Answer 4

Sui JCP
Aim: Evaluate the MBL and clinical changes over 5 years after the short implant placement with splinted crowns.
6mmx4mm OsseoSpeed TX implants were
placed
2. Amoxicillin prescribed for 1 week
3. <15ncm => submerged
4. >15ncm => healing abutment 6wks
5. At 6wks, implants were provisionalized
6. At 6mos, final splinted restorations delivered

Findings: MBL was 0.12 mm and it remained stable over 5 years.
Peri-implant mucositis varied from 30 - 55% after loading
3.5% (3/86) of implants had peri-implantitis at T60.

**Success rate: 88.4% **at the patient-level

Question 5

What is the RCT comparing peri-implantitis regeneration using soft-type blocks vs. particulate bone?

Answer 5

Benic JCP
Aim: Compare the dimension of augmented hard tissue resulting from GBR of peri-implantitis defects using either: a soft-type block bone substitute versus a particulate bone substitute.
* Soft-type block - made of particulate synthetic BCP embedded into a native porcine-derived type I collagen matrix (Osteon 3)
* Particulate BCP - particulate synthetic BCP made of 60% hydroxyapatite and 40% beta tricalcium phosphate (HA/TCP) (Osteon 3)
* Resorbable collagen matrix (Collagen Graft, Genoss) **used to cover the bone graft **and overlap the margins of the bone defect by at least 2 mm + 2 pins buccally apically + resorbable horizontal mattress and single interrupted sutures.

Findings: At 6 months, the mean Horizontal defect measured 1.31 mm in the soft- block group and 1.05 mm in the particulate group (p = 0.6). The mean vertical fill 3.9 mm for the block and 3.8 mm for the particulate (remaining dehiscence: 1 vs 1.4 mm, respectively)

At re-entry surgery, 2 out of 14 (7.1%) contained defects and 13 out of 21 (61.9%) non-contained defects showed a clinically measured incomplete vertical defect fill. = this means that non-contained defects will likely have incomplete fill

Conclusion: Soft-type block of BCP + collagen used for GBR of peri-implant defects did not differ from particulate BCP regarding the dimension of the augmented hard tissue after 6 months of healing.

Question 6

What is Bone ceramic?

Answer 6

60% Hydroxyapatite
40% beta-TCP
It’s also called “resorbable HA”, but HA will never resorb. Beta-TCP will only last 2 weeks, and then will disappear.

Bio-Oss is bovine HA, so this is why Bio-Oss does not resorb. This can cause problems when doing sinus lift and infection happens. So, you need to have a 0.5 mm allograft cushion around the implant in a sinus lift (Testori & Wang).
Also, BioOss likes to merge with the soft tissues; so, a collagen membrane should be used if augmenting with the BioOss.

New versions of xenograft are mixing Bovine HA with allograft.