AIM
To evaluate outcome measures in clinical studies on alveolar ridge augmentation (ARA) and map them to the Implant Dentistry Core Outcome Set and Measurement (ID-COSM) framework and the Food and Drug Administration (FDA) terminology.
METHODS
A systematic search was carried out across four databases through June 2025. Randomised and non-randomised clinical trials, prospective clinical studies, cohort studies and pilot clinical studies evaluating ARA performed before or simultaneously with implant placement were included. Extracted outcomes were mapped to ID-COSM domains, subdomains and specific outcomes, and all were classified into FDA-style outcome types. Risk of bias (RoB) was assessed using Domain 4 of RoB 2.0/ROBINS-I, and associations between RoB and completeness of outcome reporting were analysed with Spearman's rank correlation and Kruskal-Wallis tests (α = 0.05).
RESULTS
Four hundred and twenty-nine studies were included, predominantly randomised controlled trials (56.4%). Less than half of the studies fulfilled the mandatory ID-COSM domains (47.6%), and none reported all nine subdomains. For mandatory outcomes, surgical complications (52.7%) and implant placement feasibility (48.3%) were more frequently reported than bone dimensional changes (33.8%), and peri-implant bone stability was reported in only 11.0% of studies. For FDA categorisation, clinician-reported outcomes (86.3%) and biomarkers (87.7%) predominated, while patient-reported outcomes were reported in 31.9% of studies. Observer-reported or performance outcomes were completely absent. Lower risk of bias was associated with more complete reporting of outcomes across domains, subdomains and specific outcomes (p = 0.032, 0.017 and 0.009, respectively).
CONCLUSION
Outcome reporting for ARA trials is highly heterogeneous and poorly aligned with the standardised minimum outcomes recommended by ID-COSM and FDA categorisation.
K. Kalani, Hamoun Sabri, M. Lodhi et al.· Journal of Clinical Periodon...· 0 citations
BACKGROUND
Peri-implantitis poses a significant challenge to implant longevity, leading to progressive bone loss and potential implant failure. While reconstructive surgery has been proven effective in regenerating peri-implant tissues, the long-term stability of the regenerated tissues and the impact of supportive peri-implant care (SPIC) on bone levels remains underexplored. This case study presents a 10-year follow-up of a patient treated with reconstructive surgery for peri-implantitis and enrolled in a structured maintenance program.
METHODS
A 68-year-old male with a failing implant in the mandibular right first molar was treated using a reconstructive approach involving surface decontamination, particulate bone grafts, and an acellular dermal matrix as a barrier. Three re-entry procedures were performed over a 10-year period: at 9 months for the second stage of the two-step GBR procedure and at 8 and 10 years for implant placement to replace fractured teeth. These interventions allowed for direct clinical and radiographic assessment of bone-level changes.
RESULTS
At 9 months, bone regeneration was observed with minor residual dehiscences. After 8 years, bone remodeling and crestal bone gain on the lingual aspect were noted in the absence of further surgical interventions. At 10 years, radiographic evaluations confirmed minimal changes in marginal bone levels.
CONCLUSIONS
The presented two-stage regenerative approach successfully restored peri-implant health and function over time while minimizing the patient's financial burden. The three re-entry procedures provided direct clinical evidence of bone regeneration and demonstrated the positive impact of effective maintenance therapy on marginal bone levels and their long-term stability.
KEY POINTS
The described regenerative treatment for peri-implantitis may ensure long-term satisfactory outcomes. Supportive peri-implant care (SPIC) is effective in preventing disease recurrence and may improve crestal bone levels over time.
PLAIN LANGUAGE SUMMARY
This study presents the case of a 68-year-old patient with a failing dental implant due to peri-implantitis. The implant was treated by thoroughly cleaning its surface, placing bone grafts, and using a protective membrane to regenerate bone around the fixture and obtain disease resolution. The patient returned for three follow-up surgeries over 10 years, providing a unique opportunity to directly examine bone stability around the implant. Direct observations revealed that the bone graft healed well within the first 9 months, and the regenerated peri-implant bone remained stable with minimal changes for a decade. Regular check-ups and cleanings also helped prevent disease recurrence and further bone loss. By saving the existing implant, the patient avoided the extra expenses of removing and replacing it. Overall, these results suggest that a regenerative surgical approach, combined with structured maintenance care, can help obtain disease resolution and maintain stable long-term outcomes. This can improve comfort and function while reducing costs for patients.
S. Parma-Benfenati, M. Roncati, Lucrezia Parma-Benfenati et al.· Clinical Advances in Periodo...· 0 citations
