Influence of laser-lok surface on immediate functional loading of implants in single-tooth replacement: a 2-year prospective clinical study.

he purpose of this study was to evaluate the influence of a Laser-Lok microtexturing surface on clinical attachment level and crestal bone remodeling around immediately functionally loaded implants in single-tooth replacement. Seventy-seven patients were included in a prospective, randomized study and divided into two groups. Group 1 (control) consisted of non-Laser-Lok type implants (n = 39), while in group 2 (test), Laser-Lok type implants were used (n = 39). Crestal bone loss (CBL) and clinical parameters including clinical attachment level (CAL), Plaque Index (PI), and bleeding on probing were recorded at baseline examinations and at 6, 12, and 24 months after loading with the final restoration. One implant was lost in the control group and one in the test group, giving a total survival rate of 96.1% after 2 years. PI and BOP outcomes were similar for both implant types without statistical differences. A mean CAL loss of 1.10 ± 0.51 mm was observed during the first 2 years in group 1, while the mean CAL loss observed in group 2 was 0.56 ± 0.33 mm. Radiographically, group 1 implants showed a mean crestal bone loss of 1.07 ± 0.30 mm compared with 0.49 ± 0.34 mm for group 2. The type of implant did not influence the survival rate, whereas Laser-Lok implants resulted in greater CAL and in shallower radiographic peri-implant CBL than non-Laser-Lok implants

Enamel matrix derivative and bone grafts for periodontal regeneration of intrabony defects. A systematic review and meta-analysis

OBJECTIVE The aim of the present systematic review and meta-analysis was to assess the clinical efficacy of regenerative periodontal surgery of intrabony defects using a combination of enamel matrix derivative (EMD) and bone graft compared with that of EMD alone. MATERIALS AND METHODS The Cochrane Oral Health Group specialist trials, MEDLINE, and EMBASE databases were searched for entries up to February 2014. The primary outcome was gain of clinical attachment (CAL). Weighted means and forest plots were calculated for CAL gain, probing depth (PD), and gingival recession (REC). RESULTS Twelve studies reporting on 434 patients and 548 intrabony defects were selected for the analysis. Mean CAL gain amounted to 3.76 ± 1.07 mm (median 3.63 95 % CI 3.51-3.75) following treatment with a combination of EMD and bone graft and to 3.32 ± 1.04 mm (median 3.40; 95 % CI 3.28-3.52) following treatment with EMD alone. Mean PD reduction measured 4.22 ± 1.20 mm (median 4.10; 95 % CI 3.96-4.24) at sites treated with EMD and bone graft and yielded 4.12 ± 1.07 mm (median 4.00; 95 % CI 3.88-4.12) at sites treated with EMD alone. Mean REC increase amounted to 0.76 ± 0.42 mm (median 0.63; 95 % CI 0.58-0.68) at sites treated with EMD and bone graft and to 0.91 ± 0.26 mm (median 0.90; 95 % CI 0.87-0.93) at sites treated with EMD alone. CONCLUSIONS Within their limits, the present results indicate that the combination of EMD and bone grafts may result in additional clinical improvements in terms of CAL gain and PD reduction compared with those obtained with EMD alone. The potential influence of the chosen graft material or of the surgical procedure (i.e., flap design) on the clinical outcomes is unclear. CLINICAL RELEVANCE The present findings support the use of EMD and bone grafts for the treatment of intrabony periodontal defects