Papillae alterations around single-implant restorations in the anterior maxillae:thick versus thin mucosa

To evaluate the papilla alterations around single-implant restorations in the anterior maxillae after crown attachment and to study the influence of soft tissue thickness on the papilla fill alteration.According to the inclusion criteria,32 patients subjected to implant-supported single-tooth restorations in anterior maxillae were included.The patients were assigned to two groups according to the mucosal thickness:(i) group 1,1.5mm≤fmucosal thicknessf≤3mm;and (ii) group 2,3 mm≤mucosal thickness≤4.5 mm.Assessments of interproximal papillae at the time of crown placement (baseline) and at 6-month postloading (follow-up) were made by two prosthodontists using papilla fill index (PFI).The mean mucosal thickness was (2.49±0.31) mm (group 1) and (3.81±0.31) mm (group 2) for the two groups respectively.A significant difference in PFI between the groups was detected at the baseline (P<0.001).PFI improvements over time occurred after 6-month follow-up irrespective of the groups.When compared to group 1,the likelihood to obtain papilla fill was significantly higher for group 2 with an odds ratio of 6.05 (P<0.001).The interproximal papilla level around single-implant restorations could improve significantly over time after 6-month restoration according to PFI assessment.The thicker mucosa before implant placement implied a more favorable esthetic outcome in papilla alteration.     

Clinical viability of single implant-retained mandibular overdentures: a systematic review and meta-analysis

The aim of this meta-analysis was to verify the clinical viability of single implant-retained mandibular overdentures (SIMO). An electronic search of the PubMed and Cochrane databases was performed (end date July 2017); this was supplemented by a manual search of the literature. Only prospective clinical trials and randomized controlled trials (RCTs) that evaluated SIMO with a minimum follow-up of 12 months were included. The meta-analysis was based on the Mantel–Haenszel method. Dental implant and prosthetic failure were the dichotomous outcome measures; these were evaluated through the risk ratio (RR) and odds ratio (OR), with corresponding 95% confidence intervals (CI). Of 499 articles identified, nine fulfilled the inclusion criteria. A total of 205 implants were placed in patients with a mean age of 64.1 years; the cumulative survival rate was 96.6% over a mean follow-up period of 37.3 months. The procedure used (SIMO vs. two implant-retained mandibular overdenture) did not affect dental implant failure (P = 0.45) or prosthetic failure (P = 0.65): RR 1.06 (95% CI 0.91–1.23) and RR 0.88 (95% CI 0.51–1.51), respectively; OR 2.56 (95% CI 0.27–24.39; P = 0.41) and OR 0.44 (95% CI 0.15–1.26; P = 0.13), respectively. Within the limitations of this systematic review and meta-analysis, SIMO with a complete denture as the opposing arch may be considered an alternative treatment for completely edentulous patients. However, this study also confirmed the need for more RCTs on this topic.