Results at the 1-Year Follow-Up of a Prospective Cohort Study with Short, Zirconia Implants

The objective of this study was to clinically and radiologically evaluate the performance of a short (8 mm), 1-piece, zirconia implant after an observation period of 1 year in function. A total of 47 patients with 1 missing tooth in the position of a premolar or molar were recruited. Short (8 mm), 1-piece, zirconia implants were placed and loaded after a healing period of 2 to 4 months with monolithic crowns made of 3 different materials. Implants were followed up for one year and clinically and radiologically assessed. A total of 46 implants were placed. One was excluded since no primary stability was achieved at implant placement. At the 1-year follow-up, mean marginal bone loss 1 year after loading was 0.05 ± 0.47 mm. None of the implants showed marginal bone loss greater than 1 mm or clinical signs of peri-implantitis. A total of 2 implants were lost during the healing phase and another after loading, resulting in a survival rate of 93% after 1 year. All lost implants showed a sudden increased mobility with no previous signs of marginal bone loss or peri-implant infection. The short, 8 mm, zirconia implants showed stable marginal bone levels over the short observation period of 1 year. Although they revealed slightly lower survival rates, they can be suggested for the use in sites with reduced vertical bone. Scientific data are very limited, and long-term data are not yet available, and therefore, they are needed

Outcome measures and methods of assessment of soft-tissue augmentation interventions in the context of dental implant therapy: A systematic review of clinical studies published in the last 10 years.

AIM The aim of the study was to identify and report outcome measures and methods of assessment on soft-tissue augmentation interventions in the context of dental implant therapy reported in clinical studies published in the last 10 years. MATERIAL AND METHODS The protocol of this PRISMA 2020-compliant systematic review was registered in PROSPERO (CRD42021252214). A literature search was conducted to identify articles that met the pre-established eligibility criteria. Data of interest, with an emphasis on outcome measures, were extracted. For each outcome, specific methods and timing of assessment were described in detail. Following a critical qualitative analysis of the data, outcome measures were categorized. Primary outcomes were identified and the frequency of reporting in the selected articles was calculated. Additionally, risk of bias assessments were performed for individual articles and primary outcomes. RESULTS Ninety-two articles, of which 39 reported randomized controlled trials (RCTs), 20 reported non-RCTs, and 33 reported case series studies, were selected. Outcome measures were categorized into either investigator-evaluated outcome measures (i.e., clinical, digital imaging, esthetic, histologic, biomarker, and safety) or patient-reported outcome measures (PROMs). Clinical outcomes were the most frequently reported type of outcome. Considering all categories, the most frequently reported primary outcomes were facial mucosa thickness assessed with clinical methods (22.83%), facial keratinized mucosa width assessed with clinical methods (19.57%), facial mucosal margin position/recession assessed with clinical methods (18.48%), facial mucosa thickness assessed with digital imaging methods (11.96%), facial soft-tissue volume assessed with digital imaging methods (9.78%), and supracrestal tissue height assessed with clinical methods (9.78%). No distinguishable patterns of association between specific types or quality (level of bias) of clinical studies and the choice of primary outcomes were observed. CONCLUSION Clinical research on peri-implant soft-tissue augmentation has progressively increased in the last 10 years. Although clinical outcome measures were the most frequently reported outcomes in the selected literature, trends in the field are indicative of a shift from traditional clinical assessment methods to the use of digital technologies. PROMs were generally underreported but should be considered an integral methodological component in future clinical studies

Outcome measures and methods of assessment of soft tissue augmentation interventions in the context of dental implant therapy: A systematic review of clinical studies published in the last 10 years.

AIM To identify and report outcome measures and methods of assessment on soft tissue augmentation interventions in the context of dental implant therapy reported in clinical studies published in the last 10 years. MATERIALS AND METHODS The protocol of this Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) 2020-compliant systematic review was registered in PROSPERO (CRD42021252214). A literature search was conducted to identify articles that met the pre-established eligibility criteria. Data of interest, with an emphasis on outcome measures, were extracted. For each outcome, specific methods and timing of assessment were described in detail. Following a critical qualitative analysis of the data, outcome measures were categorized. Primary outcomes were identified, and the frequency of reporting in the selected articles was calculated. Additionally, risk-of-bias assessments were performed for individual articles and primary outcomes. RESULTS Ninety-two articles, of which 39 reported randomized controlled trials (RCTs), 20 non-RCTs, and 33 case series studies, were selected. Outcome measures were categorized into either investigator-evaluated outcome measures (i.e., clinical, digital imaging, aesthetic, histological, biomarker, and safety) or patient-reported outcome measures (PROMs). Clinical outcomes were the most frequently reported type of outcome. Considering all categories, the most frequently reported primary outcomes were facial mucosa thickness assessed with clinical methods (22.83%), facial keratinized mucosa width assessed with clinical methods (19.57%), facial mucosal margin position/recession assessed with clinical methods (18.48%), facial mucosa thickness assessed with digital imaging methods (11.96%), facial soft tissue volume assessed with digital imaging methods (9.78%), and supracrestal tissue height assessed with clinical methods (9.78%). No distinguishable patterns of association between specific types or quality (level of bias) of clinical studies and the choice of primary outcomes were observed. CONCLUSIONS Clinical research on peri-implant soft tissue augmentation has progressively increased in the last 10 years. Although clinical outcome measures were the most frequently reported outcomes in the selected literature, trends in the field are indicative of a shift from traditional clinical assessment methods to the use of digital technologies. PROMs were generally under-reported but should be considered an integral methodological component in future clinical studies

Randomized controlled clinical study comparing two types of two-piece dental implants supporting fixed restorations-Results at 8 years of loading

Objectives To assess clinical, technical, biological, and radiographic outcomes of implants supporting fixed restorations using two types of dental implants with non-matching implant–abutment junctions at 8 years. Materials and methods Sixty-four patients were randomly assigned to receive one of two implant systems (S1 or S2) and eventually fixed restorations. Patients were examined at loading (TL), one (T1), three (T3), five (T5), and eight years (T8). Outcome measures included implant and restoration survival, technical and biological complications, and radiographic bone levels. All data were analyzed on the implant and patient level. Results Ninety-eight implants were inserted in 64 patients and loaded with fixed restorations. At 8 years, 49 patients with 42 (S1) and 36 (S2) implants (25 in group S1 and 24 in group S2 on the patient level) were re-examined. The survival rates on the patient level were 97.6% (S1) and 97.2% (S2). The marginal bone levels (the primary endpoint) amounted to a gain of 0.21 mm (Q1: −0.11 mm; Q3: 0.5 mm) (S1) (p = .007) and to a loss of 0.24 mm (Q1: −0.79 mm; Q3: 0.05 mm) (S2) (p = .001) between baseline (TL) and T8 (intergroup p < .001). The technical complication rates were 28% (S1) and 12.5% (S2) (intergroup p = .289). Peri-implant mucositis was observed in 24% (S1) and 50% (S2) of the implants on the patient level (intergroup p = .792). The respective figures for peri-implantitis were 0% (S1) and 12.5% (S2) (intergroup p = .11). Conclusions Dental implants with non-matching implant–abutment junctions supporting fixed restorations resulted in high survival rates independent of the system used. Differences, mainly observed in terms of technical complications (in favor of S2), biological complications (in favor of S1), and marginal bone-level changes (in favor of group S1), appear to be clinically negligible

An analysis of the state of major industrial accidents prevention in the coating industry

Področje večjih industrijskih nesreč v EU regulira t. i. SEVESO direktiva. SEVESO direktiva je bila v Sloveniji vsebinsko vgrajena v Uredbo o preprečevanju večjih nesreč in zmanjševanju njihovih posledic. Uredba določa obvezne varnostne ukrepe, ki jih mora izpolnjevati povzročitelj tveganja za preprečevanje večjih nesreč z nevarnimi kemikalijami in za zmanjšanje posledic teh nesreč za ljudi in okolje. Po Uredbi o preprečevanju večjih nesreč in zmanjševanju njihovih posledic se mora upravljavec v skladu z merili, kjer se upošteva vrsto in količino nevarnih snovi, ustrezno razvrstiti. Za obrat večjega tveganja ključni vsebinski del predstavlja varnostno poročilo. Z varnostnim poročilom, ki je del vloge za pridobitev okoljevarstvenega dovoljenja, upravljavec upravnemu organu dokaže, da zagotavlja varno obratovanje v skladu z njegovo vsebino in da je storil vse potrebno, da se pri načrtovanju, gradnji, obratovanju, vzdrževalnih delih, večjih spremembah, zaustavitvi in prenehanju obratovanja preprečijo večje nesreče in zmanjšajo njihove posledice. V delu se obravnava obrat večjega tveganja iz premazne industrije, ki je s strani Ministrstva za okolje in prostor, Agencije Republike Slovenije za okolje pridobil okoljevarstveno dovoljenje, kar pomeni, da je z varnostnim poročilom formalno dokazal, da zagotavlja varno obratovanje. Ali je temu res tako, kje so morebitne pomanjkljivosti oz. vrzeli in priložnosti za izboljšave, je vsebina tega dela, ki je bila dosežena s sistematičnim pregledom delovanja upravljavca. Pri tem se je upoštevalo tri enakovredne naslovnike za ukrepanje: tehniko, organizacijo dela in ravnanje delavca. V delu so opravljeni analiza stanja, pregled učinkovitosti obstoječih ukrepov ter predlogi za izboljšave tako na sistemski ravni, kot tudi možnost organizacijskih in tehničnih izboljšav. Sistematičen strukturiran pregled in rezultati analize so uporabni tudi za ostale upravljavce, saj je opravljen celovit pregled vodenja tveganja z možnostjo izboljšav ne glede na panogo.The field of major industrial accidents in the EU is regulated by the Seveso Directive. In Slovenia, the content of the Seveso Directive was incorporated into the Decree on the Prevention of Major Accidents and Mitigation of their Consequences. The decree lays down mandatory precautionary measures to be taken by operators causing risk to prevent major accidents involving dangerous chemicals and to mitigate the consequences of such accidents for people and the environment. According to the Decree on the Prevention of Major Accidents and Mitigation of their Consequences, operators must be properly classified in accordance with the criteria for which the type and quantity of hazardous substances are considered. For a high risk facility, a key content element is the safety report. With the safety report, which is part of the application for an environmental permit, the operator proves to the administrative body that it ensures safe operation in accordance with its content and that it has taken all necessary steps to plan, build, operate, maintain, make major changes, stop, and prevent major accidents and mitigate their consequences. This thesis deals with a high risk facility in the coating industry, that has obtained an environmental permit from the Ministry of the Environment, the Environmental Agency of the Republic of Slovenia, which means that it has formally proven that it ensures safe operation. Whether this really is the case, and where the possible shortcomings, gaps, and opportunities for improvement are is examined through a systematic review of the operator’s performance. In doing so, three areas of equal importance for action were considered: technique, work organization and worker behavior. The thesis provides an analysis of the situation, a review of the effectiveness of existing measures and proposals for improvements at the system level as well as an opportunity for organizational and technical improvements. A systematic structural review and the results of the analysis are also useful to these other operators, because a comprehensive review of risk management has been performed with the opportunity for improvements regardless of the industry

Contour Changes Following Implant Placement and Concomitant Soft Tissue Augmentation Applying a Volume-Stable Collagen Matrix

The objective of this study was to assess volumetric and linear changes of buccal mucosal thickness at implant sites following soft tissue augmentation with a volume-stable collagen matrix (VCMX). Soft tissue augmentation using a VCMX was performed in 12 patients at the time of implant placement. Hydrocolloid impressions were taken prior to surgery and at 1 and 6 months postsurgery. Stone cast models were scanned, and stereolithography (STL) files from the three time points were uploaded to an image-analysis software. At all time points, linear and volumetric measurements of the contour changes up to 3 mm apical to the mucosal margin were performed and were analyzed statistically. At 1 mm apical to the mucosal margin, the change in soft tissue thickness between presurgery (T1) and 1 month (T2) amounted to 0.21 ± 1.22 mm, and the change between T1 and 6 months (T3) was 0.08 ± 1.47 mm. At 3 mm apical to the mucosal margin, the change in soft tissue thickness was 1.92 ± 1.70 mm between T1 and T2 and 0.31 ± 1.26 mm between T1 and T3. Contour (volumetric) changes revealed an increase of 0.58 ± 0.73 mm between T1 and T2 and an overall gain of 0.55 ± 0.73 mm between T1 and T3. Soft tissue augmentation with VCMX increased the ridge profile. The increase in ridge width was greater at 3 mm below the ridge crest than at 1 mm below the ridge crest. Remodeling processes during healing showed a decrease in the ridge contour between 1 and 6 months

Contour changes of peri-implant tissues are minimal and similar for a one- and a two-piece implant system over 12 years

OBJECTIVES: To assess contour changes of peri-implant tissues comparing a one- and a two-piece dental implant system over 12 years. MATERIALS AND METHODS: Patients seeking implant therapy were enrolled and randomly allocated to receive implants (a one-piece (STM) or a two-piece (BRA) system). Impressions were taken at the time of insertion of the final reconstruction (BL), after 1 year (FU-1), 5 years (FU-5), and at 12 years (FU-12). Thirty patients were included in the analysis (STM, 16; BRA, 14). Digital scans of casts were superimposed and analyzed in an image analysis program. Measurements included changes of the crown height, contour changes on the buccal side of the implants and the contralateral teeth (control). RESULTS: Contour changes at implant sites revealed a loss of - 0.29 mm (STM) and - 0.46 mm (BRA) during an observation period of 12 years. Contour changes at the corresponding tooth sites amounted to - 0.06 mm (STM) and - 0.12 mm (BRA) during the same time period. The implant crown gained 0.25 mm (STM) and 0.08 mm (BRA) in height due to recession of the marginal mucosa. The corresponding gain in crown height at the contralateral tooth sites amounted to 0.36 mm (STM) and 0.10 mm (BRA). Interproximal marginal bone level changes measured - 0.28 mm (STM) and - 1.11 mm (BRA). The mean BOP amounted to 38.8% (STM) and 48.7% (BRA) at the 12-year follow-up (FU-12). CONCLUSION: Minimal changes of the peri-implant soft tissue contour were observed at implant sites over the period of 12 years irrespective of the use of a one- or a two-piece implant system. The differences between the implant sites and corresponding teeth were clinically negligible. CLINICAL RELEVANCE: Peri-implant soft tissue stability is of high clinical relevance when monitoring dental implant sites on the long run. Clinical data on the extent of soft tissue changes around different implant systems are scarce. The present RCTs demonstrate minimal changes of the peri-implant soft tissue contour 12 years after implant insertion independent of the use of a one- or a two-piece implant system

Results at the 1-Year Follow-Up of a Prospective Cohort Study with Short, Zirconia Implants

The objective of this study was to clinically and radiologically evaluate the performance of a short (8 mm), 1-piece, zirconia implant after an observation period of 1 year in function. A total of 47 patients with 1 missing tooth in the position of a premolar or molar were recruited. Short (8 mm), 1-piece, zirconia implants were placed and loaded after a healing period of 2 to 4 months with monolithic crowns made of 3 different materials. Implants were followed up for one year and clinically and radiologically assessed. A total of 46 implants were placed. One was excluded since no primary stability was achieved at implant placement. At the 1-year follow-up, mean marginal bone loss 1 year after loading was 0.05 &plusmn; 0.47 mm. None of the implants showed marginal bone loss greater than 1 mm or clinical signs of peri-implantitis. A total of 2 implants were lost during the healing phase and another after loading, resulting in a survival rate of 93% after 1 year. All lost implants showed a sudden increased mobility with no previous signs of marginal bone loss or peri-implant infection. The short, 8 mm, zirconia implants showed stable marginal bone levels over the short observation period of 1 year. Although they revealed slightly lower survival rates, they can be suggested for the use in sites with reduced vertical bone. Scientific data are very limited, and long-term data are not yet available, and therefore, they are needed