Dentin Thickness at Danger Zone and Canal Morphology of Maxillary Molars

ObjectivesDentin thickness in concave areas of the root creates risk for complications such as strip perforation during endodontic treatment. The study aims to examine dentin thickness of the danger (DZ) and safety zone (SZ), canal configuration, and the presence of isthmus in the mesiobuccal root of maxillary molars.Material and MethodsCone-beam Computed Tomography (CBCT) images of 1251 teeth belonging to 642 patients were retrospectively reviewed. The dentin thicknesses at DZ and SZ in maxillary molars with one (MB) or two mesiobuccal canals (MB1, MB2) were measured at the 3 mm apical to the furcation level. Vertucci''s canal configurations and the isthmus rate were recorded. The Chi-square test andThe Student’s t-test were performed.ResultsMB2 rate was higher in maxillary first molars (61.68%) than second molars (39.36%). Isthmus rates were 27.3% and 44.11% in first and second molars. DZ thickness was thinner than the dentin thickness in the SZ in both first and second molars with one or two mesial canals (p< 0.05). In teeth with single canal, the mean DZ thickness was 0.88mm. In teeth with two canals, the mean DZ thicknesses were 0.83mm and 0.80mm for MB1 and MB2 canals, respectively.ConclusionMB2 rate was higher in the first molar (61.68%), and the isthmus rate was higher in the second molar (44.11%). DZ and SZ were thinner in MB2 than in MB1 at the maxillary molars with two mesial canals. The results indicated that more conservative preparation must be applied to the MB2 canal in the maxillary molars.     

Evaluation of the Effect of Long-term Use of Three Intracanal Medicaments on the Radicular Dentin Microhardness and Fracture Resistance: An in vitro study

ObjectivesThe aim of this research was to evaluate the effect of long-term use of three intracanal medicaments on the radicular dentin microhardness and fracture resistance.Material and methodsA chemomechanical preparation was done using the Protaper rotary instruments up to F3. The teeth were stored in an incubator at 37°C at 100% humidity and were categorized in three groups by random allocation, namely: Triple Antibiotic Paste (TAP), Calcium hydroxide paste (Apexcal) and Ledermix. Following medicament application, the access openings of all teeth were sealed with 4 mm thickness of cavit. The samples were stored for periods of 1 week, 1 month and 3months. Two dentin cylinders measuring 5mm and 3mm were obtained from each sample. The cervical third was used for fracture resistance and the middle third was used for micro hardness evaluation. The microhardness testing was done using a Knoop microhardness tester, and the fracture resistance testing was done using the universal testing machine.ResultsCalcium hydroxide showed maximally negative effect on the physical properties of radicular dentin compared to TAP (p= 0.0100 at one month and Ledermix (p=0.0001 at one month). With an increase in the application time, there was an increased deterioration in the physical properties of radicular dentin.ConclusionLong-term placement of calcium hydroxide, Triple Antibiotic Paste, and Ledermix (p= 0.0001at 3 months) significantly affects the microhardness and fracture resistance of radicular dentin.     

微焦点CT技术评价镍钛再治疗器械去根管内充填材料的效果

目的：利用微焦点CT技术定量比较两种镍钛再治疗器械与手用不锈钢器械去根管内充填材料的效果。方法：30颗离体前牙经逐步后退法预备根管后行冷侧方加压充填,随机分为3组,分别使用K锉、ProTaper D和Mtwo R去根管内充填物。再治疗前后分别对实验牙进行微焦点CT扫描,CT图像处理软件处理图像,计算根管内中1/3段和尖1/3段充填材料体积并比较其残留充填材料体积百分数。结果：在根管中1/3段,Mtwo R组根管残留充填材料体积百分数均数最小,与其他两组根管中1/3段间存在显著性差异（P〈0.05）。结论：在本实验条件下,K锉、Mtwo R和ProTaper D这3种器械在去根管内充填材料时,Mtwo R组清理效果最好。     

Comparison of the Efficacy of NeoNiTi,ProTaper, and Reciproc Files in the Retreatment of Curved Root Canals: a CBCT Assessment

ObjectiveEffective tools and methods are applied during root canal retreatment to eliminate root canal obturation materials and preserve the initial root canal anatomy. The present study compared the efficacy of Reciproc, Neoniti, ProTaper, and Hedstrom files in the retreatment of curved root canals.Material and methodsIn the present in vitro study, 100 root canals with 25‒45º curvatures were used. After the samples were initially prepared and examined by CBCT, the root canals were obturated with gutta-percha and randomly assigned to four groups (n=25). A retreatment was carried out in each group with NeoNiTi, ProTaper, Reciproc, and Hedstrom files. CBCT examinations were carried out again under the same conditions. The samples were evaluated at 3-, 6-, and 9-mm distances from the apex on the first and the second CBCT image for root canal transportation and remaining gutta-percha in the root canals. The time required for retreating each canal in each sample was recorded. One-way ANOVA and corresponding non-parametric tests were applied for data analysis.ResultsThe root canal transportation in the NeoNiTi group was lower than that in the other groups and significantly different from the ProTaper group (P<0.05). There was a remaining gutta-percha after retreatments in all the four groups, which was not statistically significant (P>0.05).ConclusionDespite the fact that the NeoNiTi file produced less transportation than other file systems evaluated in the retreatment of curved root canals, all the files were very effective at the clinically acceptable levels.     

Efficacy of Reciprocating Instruments in Retreatment of Bioactive and Resin-Based Root Canal Sealers

ObjectiveTo compare the effectiveness of reciprocating instruments in removing gutta-percha and bioactive-based (BioRoot RCS and MTA Fillapex) and epoxy resin-based (AH Plus) sealers from root canals based on filling residues and the time required for root canal revision.Material and methodsRoot canals of 90 teeth were instrumented with Reciproc R40. All root canals were obturated using the single-cone technique with Reciproc R40 gutta-percha and with one of the selected sealers. Samples with oval, straight canals were used and randomly divided into three groups: (i) filled with AH Plus sealer and gutta-percha (n=30); (ii) filled with MTA Fillapex and gutta-percha (n=30); (iii) filled with BioRoot RCS and gutta-percha (n=30). Each group was divided into two subgroups (n=15) according to the retreatment instrument used (Reciproc M-Wire R25/R40 or Reciproc blue RB25/RB40). Root canals were longitudinally split and analyzed with a stereomicroscope at 15 × magnifications in the coronal, middle, and apical third. Computational analyses were performed with the Image J software. Data were compared using the Kruskal-Wallis test and Mann-Whitney U test.ResultsWhile no statistically significant differences in the residual material surface were found for Reciproc Blue, Reciproc M-Wire showed significantly higher residual material surface for AH Plus and MTA Fillapex compared to BioRoot RCS. For AH plus. Residual material surface was significantly lower for Reciproc Blue than for Reciproc M-Wire. In contrast, BioRoot RCS showed a significantly higher residual material surface for Reciproc Blue.ConclusionsCalcium silicate-containing sealers were more retrievable compared to AH Plus, with fewer sealer remnants and shorter retreatment time. Retreatment with Reciproc M-Wire instruments was superior to Reciproc blue instruments in retreatment of BioRoot RCS. However, none of the sealers were removed completely.     

两种预备方法对根管再治疗清洁效率的临床评价

目的：评价临床NiTi机动根管预备系统和手用K锉进行根管再治疗的清洁效率。方法：选择临床上进行过牙胶充填,需重新进行根管治疗的病例20例,随机分为两组。10例使用NiTi机动根管预备系统;10例使用手用K锉预备根管。根管预备前后拍X线片,观察牙胶清除的情况,分别打分,统计学处理。结果：NiTi机动根管预备系统和K锉预备根管后均不能完全清除充填的牙胶,二者秩和检验没有统计学意义。结论：NiTi机动根管预备系统和手用K锉均不能彻底清除再治疗根管内的牙胶。     

Color Stability of Dental Composites after Immersion in Beverages and Performed Whitening Procedures

ObjectivesThe study aimed to compare the color stability of two different light-cured composites after immersion in three liquids and the effectiveness of 16% carbamide peroxide (CP) in removing the discoloration.Material and methodsColor stability of a microhybrid (Z250, 3M ESPE) and nanocomposite (Z550, 3M ESPE) was evaluated after immersion in instant coffee, tea, Coca-Cola, and deionized water as a control group (n=5). Samples were kept in liquids for four hours daily at 37°C for 30 days. Furthermore, 16% CP was applied for the following 14 days, simulating night whitening. A digital spectrophotometer was used for color measurement based on the CIEL*a*b* color coordinates. The color changes (∆E) were measured at baseline, after immersion in the beverages, and also after the teeth whitening procedure. Mixed and factorial ANOVA followed by Bonferroni’s post-hoc test were used for statistical evaluation (p≤0.05).ResultsTested resin composites showed a color change over the acceptability threshold (ΔE*> 3.48) after immersion in coffee and tea. Nanocomposite reported a significant increase in discoloration in coffee after 30 days (p <0.05). The color of both materials significantly changed (p<0.05) along all three L*a*b* axes in coffee and tea to darker, yellow, and red. Whitening with 16% CP was effective in removing external discoloration in both examined composite materials.ConclusionCoffee and tea induced clinically detectable color changes in dental composites tested, with cumulative effects. Whitening represents an efficient method for the removal of surface discoloration in composite restorations.     

两种根充材料治疗乳牙感染根管的临床疗效评价

目的:观察新型注射式根管糊剂作为乳牙根管充填材料的疗效.方法:设碘仿氧化锌丁香油糊剂作为对照组,共对224个乳牙行根管治疗观察3个月、1年后的疗效.结果:注射式新型根管糊剂与碘仿氧化锌丁香油糊剂远期疗效有显著差异(t=0.025,P＜0.05),尤其在乳磨牙治疗效果更为显著(t=0.02,P＜0.05);实验组超充和适充疗效无显著性差异(X2=0.28,P＞0.05),与欠充之间有显著性差异(X2=6.04,P＜0.05).结论:新型注射式根管糊剂更适合临床作为常规乳牙根管充填材料.     

Anatomical Variations of the Bifid Mandibular Canal on Panoramic Radiographs in Citizens from Zagreb,Croatia

BackgroundThe bifid mandibular canal (BMC) is an anatomical variation with reported prevalence ranging from 0.08 to 65%. Identifying anatomical variations of mandibular canal is very important in order to prevent possible complications during oral surgical and other dental procedures.ObjectivesThe aim of this study was to determine the prevalence and to classify the morphology of BMCs using digital panoramic radiographs.Material and methodsA retrospective study was conducted that included 1008 digital panoramic radiographs (412 female and 596 male) used to identify the type of BMC. Panoramic radiographs were analyzed by three oral surgeons and one dentist, and BMCs were classified into six different types, 4 types according to Langlais et al. (types 1-4), and two new types (types 5 and 6) described by authors.ResultsThe prevalence of BMC was 4.66% (n=47), with no significant differences in gender between BMC types (P=0.947; χ²=0.74). The prevalence of type 1 BMC was 0.79% (n=8), type 2 2.08% (n=21), type 3 0.30% (n=3), type 4 0% (n=0), type 5 0.89% (n=9) and type 6 0.60% (n=6).ConclusionThis study revealed a relatively high prevalence of BMCs among Zagreb citizens. Furthermore, two new types of BMCs were described. These results stress the importance of a careful and thorough radiographic analysis prior to each invasive procedure in the mandible.     

Evaluation of Passive Ultrasonic Irrigation and GentleWave System as Adjuvants in Endodontic Retreatment

IntroductionNonsurgical endodontic retreatment continues to be a challenge in endodontics, particularly when dealing with a complex tooth anatomy. This study evaluated the efficacy of passive ultrasonic irrigation (PUI) and the GentleWave system as supplementary techniques to remove remaining filling materials from oval-shaped root canals.MethodsTwenty distal roots of human mandibular molars with single and oval-shaped canals were shaped with R40 (40.06) instrument and filled with gutta-percha and AH Plus sealer using warm vertical obturation. Initial filling material removal was performed with R50 (50.05) instrument, followed by the use of PUI (n = 10) or GentleWave system (n = 10). Micro-computed tomographic images were obtained after obturation, initial material removal, and after the use of PUI and GentleWave. The volume of remaining filling material was calculated for the entire canal as well as for the coronal, middle, and apical thirds. Statistical analyses were performed by using analysis of variance, Kruskal-Wallis and Mann-Whitney tests. P ≤ .05 was considered significant.ResultsThe use of PUI and GentleWave as supplementary techniques significantly reduced the volume of remaining filling material after initial instrumentation (P < .05). However, none of these techniques was able to render canals free from filling materials. PUI showed better performance by removing 18% of the remaining filling material, whereas the GentleWave system was able to remove approximately 10% (P = .02).ConclusionsThe use of supplementary techniques optimized filling material removal after initial instrumentation. PUI enhanced the overall cleaning of the root canal system during endodontic retreatment in oval-shaped canals.     

Five Years Follow-up of Short Implants Placed in Atrophic Maxilla with Simultaneous Sinus Floor Transcrestal Elevation

ObjectiveMany authors have tried to face the anatomical limitations resulting from maxillary bone atrophy. Up to five millimeters bone height, the lateral sinus floor elevation is the most commonly used and validated strategy to achieve the prosthetic rehabilitation. However, the disadvantages of this technique are its invasiveness and delayed rehabilitation. The aim of this paper was to assess 5 years clinical outcome of implants placed with a technique that allows the percrestal sinus floor elevation and the immediate implant placement.Materials and Methods30 transcrestal sinus floor elevations with immediate implant placement were performed in severely atrophic maxillae. Implant survival, marginal bone level variation, harvested bone height variation and periodontal indices were assessed.ResultsAfter a five year follow up none of the thirty implants were lost. The mean value of vertical harvested bone loss was 5%. The mean crestal bone loss was -0.33 mm (Standard Deviation (SD) 0.11 mm). The mean value of periodontal indices was respectively: PD 1.22 mm (SD 0.72 mm), PI 17.47% (SD 15.01 mm), BOP 9, 87%.,(SD 19.17 mm).ConclusionThe results obtained are comparable with success criteria in implant rehabilitation. The reported technique proved to be successful in the population observed, with minimal trauma and reduced invasiveness.     

Post-Discharge Complications of Dental Treatment in General Anesthesia Performed in a Day-Care Service

ObjectiveTo review the frequency and management of post-discharge complications in patients who underwent dental treatment in general anesthesia (GA) in a day-care surgery setting and identify the factors that increase the risk for these complications.Material and methodsAnonymous questionnaire was sent to parents/caregivers of patients who underwent full mouth restoration in GA at our institution between 1^st January 2017 and 31^st July 2019. Demographic and clinical data of patients as well as the data about the occurrence and management of complications were collected.ResultsSixty-six parents/caregivers (30.5%) responded to the questionnaire. Most frequent complications were drowsiness and pain in 40(60.6%) patients. Complications were managed by parents or caregivers with conservative measures at home in 57(91.9%) cases. Phone consultation with dentist was required in 5(8.1%) cases. One patient (1.6%) was readmitted. Younger age and diagnosis were associated with increased risk for drowsiness.ConclusionPost discharge complications of dental treatment in GA in a day-care service are common and they can be managed by parent/caregiver with conservative measures at home. The rate of readmission is low. Dental treatment in GA in a day-care service is a safe procedure that can be performed with acceptable risk in carefully selected patients.     

Systematic review of the role of corticosteroids in cervicofacial infections

The role of corticosteroids in the management of cervicofacial infections continues to cause controversy. Systemic anti-inflammatory and immunomodulatory effects that reduce swelling and improve symptoms in the head and neck may make these agents an effective addition to the antibiotics used and to surgical management, although this same effect may dull the physiological response to infection, and allow infections to progress. We have systematically reviewed the evidence for the use of corticosteroids in common cervicofacial infections following the PRISMA guidelines. MeSH terms included “head”, “neck”, “infection”, and “glucocorticoid”. In total, 31 papers were identified. Eight reported the use of corticosteroids for peritonsillar abscess (PTA), 10 for pharyngitis, four for deep neck space infection (DNSI), four for periorbital cellulitis, and five for supraglottitis. Whilst there is an established evidence base for their use in the treatment of PTA and pharyngitis, other indications need further study, and we highlight the potential pitfalls. The evidence suggests that the use of adjunctive, short-term, high-dose corticosteroids in cervicofacial infections may be safe and effective.     

Comparison of Two Types of Pit and Fissure Sealants in Reducing the Incidence of Dental Caries Using a Split-Mouth Design

ObjectivesTo evaluate the effectiveness of two pit and fissure sealants (PFS) in reducing the incidence of dental caries in schoolchildren.Material and MethodsA randomized split-mouth experimental design was used in a sample of 140 subjects assigned to two groups. The sealants used were Clinpro©3M and BeautiSealant©Shofu placed in first permanent molars (FPMs). Each sealant was compared to molars in the controls to determine effectiveness over a period of 6 months. The study had a 12.9% loss to follow-up. No statistically significant differences (p>0.05) were observed for sex, age, baseline dmft, or type of sealants. Nonparametric tests were used for statistical analysis.ResultsAverage dmft index at baseline was 4.10±3.16. Lower incidence of caries was observed in FPMs with pit and fissure sealants (p<0.01), regardless of the type used. When sealants remained intact there was a lower caries incidence compared to sealants partially or completely missing – but differences were only significant for FPM 16. Caries incidence was higher for BeautiSealant sealed teeth than for Clinpro’s, but only statistically significant in FPMs 16, 36 and 46 (p< 0.05). Caries incidence was higher in those cases with a higher baseline dmft but it only reached statistical significance in FPMs 26 and 36. Relative risks for dental caries were lower in sealed teeth (p<0.01).ConclusionsPit and fissures sealants are an effective preventive treatment to reduce caries during a 6-month follow-up in schoolchildren 6 to 8 years of age, regardless of the type of sealant used. The sealant brand that showed greater effectiveness in terms of prevention and retention was Clinpro©3M.     

Clinical and Molecular Microbiological Evaluation of Regenerative Endodontic Procedures in Immature Permanent Teeth

IntroductionThis study evaluated the bacterial levels after regenerative endodontic procedures and their correlation with the treatment outcome using molecular microbiology methods.MethodsRoot canal samples of 15 necrotic immature teeth were analyzed by quantitative polymerase chain reaction. Bacteria were counted before treatment (S1), after irrigation with 6% sodium hypochlorite (S2), and after intracanal dressing (S3) using either triple antibiotic paste (n = 7) or calcium hydroxide with chlorhexidine (n = 8). The Wilcoxon test for related samples and the Mann-Whitney test were used for statistical analysis (P < .05). After a follow-up period of 12–48 months, clinical and radiographic findings were correlated with microbiological data using a linear regression model (P < .05).ResultsAll S1 and S2 samples were positive for bacteria, but the number of positive S3 samples decreased to 53.3% (P = .001). Overall, there was a significant reduction of bacterial levels after each treatment step (S1–S2, P = .001; S2–S3, P = .02). In the triple antibiotic paste and chlorhexidine groups, 57.1% and 50% of S3 samples were positive with median numbers of 6.97 × 10³ and 3.59 × 10⁴ bacterial cells, respectively. No significant differences were found between the groups. Periapical healing occurred in all cases despite the presence of low levels of residual bacteria. However, the latter had a negative impact on the thickness of dentinal walls (R² = 0.0043).ConclusionsAlthough the bacterial levels were drastically reduced after the regenerative endodontic procedures, the residual bacteria influenced the thickness of the dentinal walls.     

BeeFill~（TM） 2in1热牙胶根管充填系统根管封闭性的体外研究

目的：研究BeeFill TM2in1热牙胶根管充填系统对扁形根管的充填效果。方法：将20颗根管的近远中径与颊舌径之比小于0.5的单根管前磨牙,根管预备后,随机分别采用冷牙胶侧方加压充填术和BeeFill TM2in1热牙胶根管充填系统行根管充填。充填后的样本自根尖向冠方垂直于牙体长轴每间隔1mm制备横切片。体视显微镜下观测各横截面中是否存在空隙并计算空隙面积。结果：BeeFill TM2in1组空隙发生率、空隙面积的百分比均低于冷牙胶侧压组并存在统计学差异性;BeeFill TM2in1组在各层次横截面的空隙面积百分比平均值均低于冷牙胶侧压组并存在统计学差异性。结论：和冷牙胶侧方加压充填术相比,BeeFill TM2in1热牙胶根管充填系统在封闭扁形根管方面具有明显优势。     

超声冲洗在死髓牙根管预备中的应用

目的　观察超声冲洗在死髓牙根管预备中的效果。方法　将 14 4例患者的 14 4颗患牙 ,随机分为 2组 ,在根管预备时分别采用超声冲洗和注射器冲洗 ,观察 1周内的术后反应。结果　超声治疗组术后反应的发生率为 18 0 6 % ,轻度反应占13 89% ,中度反应占 4 17% ,无重度反应发生 ;对照组术后反应的发生率为 4 0 2 8% ,轻度反应占 2 5 0 0 % ,中度反应占12 5 0 % ,重度反应占 2 78%。结论　用超声波进行根管冲洗可以显著地减少和减轻死髓牙根管治疗中的根尖周反应     

Knowledge and attitudes of Croatian Dentists Regarding Antibiotic Prescription in Endodontics: A Cross-sectional Questionnaire-based Study

ObjectivesTo assess dentists'' level of knowledge and practice concerning antibiotic usage in endodontics using the European Society of Endodontology position statement as a reference.Materials and MethodsA cross-sectional study was conducted in the form of an electronic questionnaire consisting of 23 questions, including dentists’ demographic and professional characteristics, attitudes as well as experiences regarding antibiotics in endodontics. Data were evaluated by the Mann-Whitney test or the Kruskal Wallis 1-way ANOVA, α = 5%.ResultsThe overall mean self-reported knowledge of antibiotics usage in endodontics was 11.7±2.5 points, out of a maximum possible score of 23. The factors associated with a higher knowledge were: age (P≤0.001), clinical experience (P≤0.001), specialist training (P=0.008), and adherence to the guidance on the use of systemic antibiotics in endodontics (P=0.006). Dentists who specialized in endodontics (16.1±2.2) achieved higher levels of knowledge.ConclusionKnowledge on antibiotic usage in endodontics among dentists in Croatia is insufficient. There is a need for continuing education on the use of antibiotics among general dentists.Key words: Antibiotics, Dentists, Endodontics, Knowledge, Questionnaire     

Evaluation of Elastomeric Impression Materials’ Hydrophilicity: An in vitro Study

IntroductionHydrophilicity of dental impression materials is crucial for obtaining an accurate impression and necessary for the production of a well-fitting cast restoration. The most common technique for evaluation of hydrophilicity is a contact angle measurement. The aim of the present in vitro study was to compare the water contact angles of four groups of elastomeric impression materials, before and during setting.Material and methodsFlattened specimens (n=10) of tested impression materials were prepared by the use of a Teflon mold with specific dimensions. A 5μl droplet of deionized water fell on the specimen, and photos were taken using a Nikon D3200 DSLR camera and a 105 mm macro lens (Nikorr, Nikon) in specific time points.ResultsThe CAD/CAM material showed the highest contact angle measurements. The light body polyvinylsiloxane (PVS) material 1, polyether and vinylsiloxanether material showed comparable contact angle measurements especially at the initial time point. A statistically significant reduction of contact angles was reported during setup time for all PVS, PE and vinylsiloxanether materials, while the most expressed reduction of contact angle measurements, and thus the most significant increase of hydrophilicity were reported for light wash PVS material 2.ConclusionsThe CAD/CAM impression material showed the most hydrophobic behavior. PVS materials showed excellent hydrophilicity. Polyether and polyvinyloxanether impression materials presented lower contact angle measurements, and thus superior hydrophilicity, compared with other tested materials initially and during setting. All tested impression materials presented a stepwise development of hydrophilicity during the setting stage.     

Comparison of Osteoimmunological and Microbiological Parameters of Extra Short and Longer Implants Loaded in the Posterior Mandible: A Split Mouth Randomized Clinical Study

ObjectivesThis study aimed to evaluate the levels of TNF-α, PGE₂, RANKL, RANK, OPG, the markers of periimplant bone loss in peri-implant crevicular fluid obtained around standard and extra short implants. Moreover, the levels of putative oral pathogens were investigated in the submucosal biofilm samples.Material and MethodsThe implants were divided into two groups according to their lengths: standard (≥8 mm) and extra short (4 mm). A total of 60 implants were researched in 30 patients. The probing depth (PD), clinical attachment level (CAL), presence of bleeding on probing (BOP), 3-year survival rate (CSR), and bone loss (BL) were measured.ResultsNo statistically significant difference was found in the values of PD, CAL, BOP, CSR, and BL between the groups (P> 0.05). Total amounts of PGE₂, TNF-α, RANKL, RANK, OPG, and RANKL/OPG were not statistically significantly different between the groups (P> 0.05). The abundance of F. nucleatum, T. forsythia, P. intermedia, P. gingivalis, S. oralis and T. denticola was compared between the groups and the results were not statistically significant (P> 0.05).ConclusionThe results of this study suggested that PGE₂, TNF-α, RANKL, RANK, OPG, and RANKL/OPG in PICF, as well as microbiological parameters in submucosal biofilms, were similar between standard (≥8 mm) and extra short (4 mm) implants. Therefore, the implant length does not seem to influence the bone loss, levels of osteoimmunological and microbiological markers in the peri-implant tissues and survival rates.