Jun 2026· Clinical Implant Dentistry and Related Research· Vol 28 4, pp.
e70170
· 1 citation· 15 references
Medicine
TL;DR
GBR with bioceramic demonstrated stable radiographical bone on the buccal side of the implant 1 year after crown delivery, and implant survival rate was 100% in both groups.
Abstract
Objectives
This multicenter prospective cohort study follows a 1-year period after a previously published randomized controlled trial, comparing the radiographic and clinical outcomes of implants placed with simultaneous guided bone regeneration (GBR) using bioceramic (BC) versus xenograft (BO).
Materials And Methods
Patients from the previous trial were recalled 1 year after crown delivery. The follow-up data focused on the buccal bone stability evaluated by CBCT and implant survival rate, Probing Depth (PD), Bleeding on Probing (BOP), Plaque Index (PI), and patient satisfaction through Oral Health Impact Profile-5 (OHIP-5).
Results
Out of 150 enrolled patients in a previous trial, a total of 97 patients completed the 1-year follow-up: 44 in the BC group and 53 in the BO group. The implant survival rate was 100% in both groups. Change in horizontal buccal bone thickness (△HBBT) at 1 year post-crown delivery versus immediately post-surgery was -0.28 ± 0.10 mm for the BC group and -0.91 ± 0.09 mm (mean ± standard error) for the BO group, with the BC group exhibiting less bone resorption along the implant than the BO group (p = 0.0000). No significant differences were observed in PI, BOP, or PD. Patient satisfaction remained high in both groups.
Conclusions
GBR with bioceramic demonstrated stable radiographical bone on the buccal side of the implant 1 year after crown delivery.
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
Marginal bone preservation around osseointegrated dental implants continues to represent a critical challenge in modern implant dentistry. To address this issue, subcrestal implant placement along the apico-coronal axis has been proposed as a reliable clinical strategy aimed at reducing the risk of implant thread exposure within the oral environment. In the present study, 38 healthy patients were treated with either bone-level implants (BLG-Control) or implants positioned 2 mm subcrestally (SCG-Test). All implants featured an internal conical connection and a platform-switching design. In addition, implants in the test group were restored using an immediate tissue-level abutment following the one-time abutment (OTA) protocol. Marginal bone modifications (MBMs) were evaluated through standardized radiographic examinations performed at surgery (T0), implant loading (T1), and after 6 (T2), 12 (T3), 24 (T4), and 36 (T5) months of functional loading. MBMs, meaning the overall changes in the radiographic bone structure over time, were categorized as bone loss (BL) when occurring apical to the implant neck, and as bone remodeling (BR) when detected coronally to the implant neck. Clinical parameters, including probing pocket depth (PPD), bleeding on probing (BoP), and plaque index (PI), were also recorded and analyzed throughout the follow-up period. At the 36-month evaluation, mean MBM values were 0.61 mm for the test group and 0.58 mm for the control group. After three years of follow-up, the test group demonstrated a mean PPD of 2.03 mm, compared with 2.78 mm in the control group. Bleeding on probing was recorded at 13% in the test group and 11% in the control group, while plaque index values were 11% and 5%, respectively. Within the limitations of the present investigation, implants placed 2 mm subcrestally and characterized by an internal conical connection combined with platform switching demonstrated favorable clinical and radiographic outcomes over a short- to medium-term observation period of three years. When compared with equicrestally positioned implants, the subcrestal approach seemed to favor the peri-implant hard tissue conditions while reducing the possibility of marginal bone loss below the implant neck. However, one should bear in mind that this clinical behavior applies specifically to the investigated implant design and should be interpreted within the limitations of the present study.
M. Mensi, E. Scotti, S. Calza et al.· Applied Sciences· 0 citations
Peri-implantitis therapy aims at overcoming peri-implant inflammation and preventing further marginal bone loss; however, the achievement of stable reconstructive outcomes remains challenging in non-contained defects. This retrospective study evaluated the 5-year effectiveness of reconstructive surgical protocol using a mixed graft composed of deproteinized bovine bone mineral and biphasic calcium sulfate in non-contained peri-implant defects around standard-length implants. Patients treated for peri-implantitis at a university clinic between January 2018 and June 2019 were retrospectively screened: 28 (32 implants) met the inclusion criteria (probing depth ≥5 mm with bleeding and/or suppuration on probing and radiographic bone loss ≥3 mm). Surgical treatment consisted in full-thickness flap elevation, implant surface decontamination using a standardized protocol, defect grafting, and non-submerged tension-free closure. Clinical and radiographic parameters were assessed at surgery, 3- and 5-year follow-up. Mean follow-up was 61.4 ± 8.5 months. Implant survival at 5 years was 100%. Implant-based treatment success was 75%, disease recurrence occurred in 25% of implants. Probing depth and clinical attachment level showed significant improvements from baseline to both follow-up time points (p < 0.001); radiographic analyses demonstrated significant defect fill and improvement in bone-related parameters (p ≤ 0.002). The proposed reconstructive approach provided stable results in the long-term for non-contained peri-implant defects.
G. Lombardo, Miriana Gualtieri, Guido Lobbia et al.· Journal of cranio-maxillo-fa...· 0 citations
Introduction: This study aimed to compare implant stability and crestal bone loss between titanium platelet-rich fibrin (T-PRF)-treated implants and conventional implants. Methods: A prospective, randomized, split-mouth clinical trial was conducted in 10 healthy patients, with 20 implants per mouth (test and control). Each patient received one T-PRF-treated implant and one conventional implant. Implant stability was assessed using implant stability quotient (ISQ) at placement and at 3 months. Crestal bone loss was evaluated radiographically at 3 and 6 months. Soft tissue parameters were assessed at follow-up visits. Results: The T-PRF group showed higher ISQ values and reduced bone loss, with trends favoring the intervention at the three-month follow-up compared with the control group. Bone loss at three and six months was lower around anterior implants in the T-PRF group than in the control group. At this time, T-PRF may help improve soft tissue measurements; however, the measured values did not differ significantly from those of the control groups. Due to limitations such as a small sample size, a relatively short follow-up period, and varying baseline crestal bone levels, these findings should be interpreted with caution. Conclusion: Due to the restrictions of this split-mouth study, T-PRF-treated sites showed a trend towards increased early implant stability and decreased crestal bone loss compared to control sites. However, because of the small sample size and short follow-up period, conclusive evidence cannot be drawn about the clinical superiority of T-PRF. Further appropriately powered randomized controlled trials with prolonged follow-up periods are necessary to determine the long-term clinical efficacy of T-PRF in implant therapy. Clinical Trial Registration number: CTRI/2022/11/047159.
Anuraga Tejaswi Thotimpuri, M. Pasupuleti, G. Penmetsa et al.· Journal of Advanced Periodon...· 0 citations
OBJECTIVE
Evidence on zirconia dental implants remains limited. This retrospective study evaluated clinical and radiographic outcomes of contemporary ceramic implant systems placed in private practice with variable follow-up of up to 11 years.
MATERIALS AND METHODS
This retrospective cohort evaluation included 174 patients receiving 275 zirconia implants (one-piece systems and a two-piece tissue-level screw-retained system) placed between 2013 and 2025 with a minimum one-year follow-up. Implant survival and success rates were assessed. Standardized periapical radiographs were analyzed using ImageJ to measure marginal bone levels at placement and annually thereafter. Peri-implant soft tissue health was evaluated using the modified Plaque Index and modified Gingival Index.
RESULTS
Kaplan-Meier cumulative implant survival was 97.6%, and overall success was 95.3%. Mean first-year marginal bone loss ranged from 0.25 to 0.74 mm, with a pooled mean of 0.49 mm. Mean annual bone loss after year 1 was low at 0.12 mm/year. Soft tissue indices remained low, and no suppuration was observed. Two implant fractures occurred (0.73%); remaining failures were associated with lack of osseointegration or aseptic loosening.
CONCLUSIONS
Within the limitations of this retrospective study, contemporary ceramic implant systems demonstrated high survival and success with stable peri-implant bone levels and favorable soft tissue conditions.
CLINICAL SIGNIFICANCE
This study provides real-world clinical and radiographic data on contemporary ceramic implant systems, including one-piece ceramic implants and ATZ two-piece ceramic implants with carbon fiber screws. These findings may help clinicians contextualize the observed performance of ceramic implants in daily practice. Ceramic implants may represent a viable metal-free treatment option for appropriately selected patients, particularly in esthetically demanding situations, when careful case selection, system-specific training, and adherence to surgical and restorative protocols are applied.
M. Monzavi, Medis Masnavi, Ayman Zraiqat et al.· Journal of Esthetic and Rest...· 0 citations
The clinically meaningful esthetic advantages of IIP support its preferential use in the anterior zone when anatomical conditions permit and when combined with guided protocols and customized healing abutments, IIP and EIP yield comparable 12-month marginal bone outcomes.
Sara N. El Touliani, Ahmed M. Abdel-Hamid, Nada M. H. Fahmy et al.· Frontiers in Dental Medicine· 0 citations