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Meta analyses of surgical technique types for implant placement in patients with periodontitis? 

Meta-analysis
Randomized controlled trial
Gingival recession
Enamel matrix derivative
Peri-implantitis
Best insight from top research papers

The management of periodontally compromised patients through implant placement involves various surgical techniques, each with its own set of outcomes and efficacy levels. A systematic review by Sarafidou et al. highlighted the high survival rates of implants in periodontally compromised teeth, suggesting that both tooth preservation and extraction followed by implant placement are viable options, with bone regeneration techniques improving long-term prognosis . Wijesundara et al. evaluated the effect of surgical treatments on peri-implantitis, finding significant reductions in probing pocket depth (PPD) and bleeding on probing (BoP) after surgical intervention, although no significant variation was observed among different surgical methods . Araujo-Corchado and Pardal-Peláez discussed the precision of implant placement, indicating that guided surgery techniques, both static and dynamic, offer more accurate implant positioning compared to freehand placement, which could be beneficial for patients with periodontitis to ensure optimal implant placement . Turkyilmaz et al. compared flapless and traditional flap approaches for implant placement, finding similar survival rates but slightly better marginal bone levels (MBLs) with the flap approach, suggesting a nuanced choice of technique based on patient-specific periodontal conditions . Chen et al. compared different surgical methods for peri-implantitis, finding augmentative therapy (AT) superior in improving radiographic bone fill (RBF) and clinical attachment level (CAL) compared to open flap debridement (OFD), which could influence the choice of surgical technique in periodontally compromised patients . Sousa et al. and Veitz-Keenan et al. both reported higher biological complications and lower success rates of implants in patients with treated periodontitis, emphasizing the need for careful surgical planning and technique selection in this patient group . Saade et al. proposed a technique to improve esthetic outcomes through periodontal flaps with subepithelial connective tissue graft (CTG) for root coverage or periodontal procedures prior to implant placement, suggesting a pre-implantation surgical intervention to enhance outcomes . Lanza et al. and Thakral et al. described case studies where implant placement timing and technique were critical for achieving successful outcomes in periodontally compromised patients, highlighting the importance of individualized treatment planning and the potential for immediate implant placement with proper management . In summary, the choice of surgical technique for implant placement in patients with periodontitis should be tailored to individual patient needs, considering the precision of implant placement, the potential for bone and soft tissue regeneration, and the specific challenges posed by the patient's periodontal status. The evidence suggests a range of surgical options, from guided surgery to flapless versus traditional flap approaches, and augmentative therapies, each with its own advantages and limitations in the context of periodontitis.

Answers from top 8 papers

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Papers (8)Insight
Open access•Journal Article•DOI
Immediate, early, and conventional implant placement in a patient with history of periodontitis.
Alessandro Lanza, Fabio Scognamiglio, Felice Femiano, Michele Lanza 
08 Apr 2015-Case Reports in Dentistry
6 Citations
Not addressed in the paper.
Open access•Journal Article•DOI
Efficacy of surgical methods for peri-implantitis: a systematic review and network meta-analysis
Ling Chen, Xian Tao, Ji Ma, Dong Shi 
19 Apr 2023-BMC Oral Health
1 Citations
Augmentative therapy (AT) showed superior outcomes in radiographic bone fill and clinical attachment level compared to open flap debridement (OFD) for peri-implantitis in patients.
Journal Article•DOI
A systematic review of implant outcomes in treated periodontitis patients
Vanessa Sousa, Nikos Mardas, Bruna de Carvalho Farias, Aviva Petrie, Ian Needleman, David A. Spratt, Nikolaos Donos 
01 Jul 2016-Clinical Oral Implants Research
87 Citations
Not addressed in the paper.
Journal Article•DOI
A Modified Technique for Induced Gingival Growth Around Compromised Teeth Prior to Implant Placement: A Report of Two Cases.
Jorge Saade, Marcelo Bassani, André Reis Castro, E. G. Saade, Bruno Massucato Zen, Mateus Bertolini Fernandes dos Santos, Bruno-Sotto Maior, Carlos Eduardo Francischone 
01 Nov 2022-International Journal of Periodontics & Restorative Dentistry
Not addressed in the paper.
Open access•Journal Article•DOI
Peri-Implantitis Therapy Using Surgical Methods: A Systematic Review
Shiromani Wijesundara, Lavanya Ajay Sharma, Seyed Ebrahim Alavi, Ajay K. Sharma 
01 Mar 2023-Applied Sciences
Not addressed in the paper.
Open access•Journal Article•DOI
Computer-Guided Surgery for Dental Implant Placement: A Systematic Review
Elena Araujo-Corchado, Beatriz Pardal-Peláez 
26 Sep 2022-Prosthesis
Not addressed in the paper.
Journal Article•DOI
Clinical Performance of 11,646 Dental Implants Using Surgical Guides and Two Different Surgical Approaches: A Systematic Review and Meta-analysis.
Ilser Turkyilmaz, Merve Demir Benli, Todd R. Schoenbaum 
01 May 2023-The International Journal of Oral & Maxillofacial Implants
Not addressed in the paper.
Journal Article•DOI
Tooth Preservation vs. Extraction and Implant Placement in Periodontally Compromised Patients: A Systematic Review and Analysis of Studies.
Katia Sarafidou, Ioanna Lazaridi, Sotirios Gotsis, Yvonni Kirmenidou, Hiroshi Hirayama, Konstantinos Michalakis 
06 Jul 2022-Journal of Prosthodontics
2 Citations
Not addressed in the paper.

Related Questions

How do the success rates of implant applications vary among different patient populations with varying degrees of periodontitis severity?5 answersThe success rates of implant applications exhibit significant variation among different patient populations, particularly when considering the severity of periodontitis. Studies have shown that periodontally healthy patients (PHP) generally experience higher implant survival rates compared to those with a history of periodontitis, indicating a direct correlation between periodontal health and implant success. Specifically, patients with severe periodontitis have been found to have a higher chance of peri-implantitis and marginal bone loss (MBL), which are critical factors affecting the longevity and success of dental implants. Moreover, the type of implant surface, such as minimally versus moderately rough implants, also plays a role in the success rates among patients with severe periodontitis, with minimally rough surfaces showing more favorable clinical parameters over time. The frequency of maintenance therapy further influences the outcome, as regular follow-ups are essential for managing peri-implant conditions and ensuring the long-term success of the implants. Implant survival rates are notably high across different patient groups, including those with moderate to severe periodontitis, when patients are compliant with supportive periodontal care (SPC) and maintenance programs. However, the presence of residual periodontal pockets and the extent of bone loss at the time of implant placement are significant prognostic factors for implant loss, underscoring the importance of comprehensive periodontal treatment prior to implant therapy. In summary, while implants can be a successful treatment option for patients with a history of periodontitis, the severity of the periodontal disease, the implant surface type, and adherence to maintenance care significantly affect the success rates. Patients with severe periodontitis, especially those not adhering to regular maintenance care, are at a higher risk for biological complications and implant failure.
How do various dental implant uncovering techniques compare in terms of operation time and the need for anesthesia?5 answersVarious dental implant uncovering techniques differ in operation time and the need for anesthesia. Laser-assisted uncovering of implants, particularly with a 445nm diode laser, requires significantly less anesthesia compared to conventional scalpel techniques. Additionally, laser-assisted techniques have shown to lead to less pain, shorter healing periods, and reduced temperature rise during the procedure. On the other hand, conventional surgical guide techniques, while well-documented, may take longer and require impression techniques, impacting the operation time. However, the literature review suggests that more research is needed to draw solid conclusions on the benefits of laser-assisted techniques over conventional methods.
What is the use of laser in treatment of peri-implantitis?5 answersLaser therapy has been explored as an adjunct to mechanical debridement in treating peri-implant diseases like peri-implantitis. Various types of lasers, including diode, Nd: YAG, Er:YAG, CO2 lasers, and photodynamic therapy, have been studied for their effectiveness in managing peri-implant diseases. Studies have shown that laser therapy, particularly with diode lasers, can lead to improvements in clinical parameters such as plaque index, gingival index, probing pocket depth, and bleeding on probing in peri-implant tissues. Additionally, the use of combined Nd-Er: YAG lasers has demonstrated favorable outcomes in reducing bleeding on probing post-treatment compared to conventional mechanical debridement, although no significant differences were observed in modifying bone loss biomarkers like RANKL and OPG. Furthermore, Er:YAG lasers have shown superior thermal properties during irradiation of implant surfaces, making them a safe intervention for soft and bone tissues around implants.
What are the different types of dental implants?3 answersDental implants are becoming a common practice in dentistry. There are different types of dental implants, including single tooth dental implants, implant-supported bridges, and implant-retained dentures. Another classification includes complete dentures, implant-retained dentures, bar-retained implant-supported dentures, and fixed screw-retained implant-supported dentures. Different materials are used for manufacturing dental implants, such as commercially pure titanium, titanium alloy, hydroxyapatite, tri- and tetra-calcium phosphate, and bio-glass. In terms of shape and surface characteristics, there are numerous implant designs and surface modifications available. These include cylindrical or conical geometries, hybrid implants, and implants with turned or roughened surfaces. Functionally graded materials (FGM) have also been studied for improving dental implant surfaces. Overall, there is ongoing research and development in the field of dental implants to improve their design, materials, and clinical outcomes.
What are the effective gingivectomy techniques?5 answersGingivectomy techniques that have been found to be effective include laser surgery, electrosurgery, and conventional surgery. These techniques have been shown to successfully address the problem of delayed eruption of permanent anterior teeth in children. Conventional gingivectomy techniques using a scalpel are commonly used and provide predictable results. Electrosurgery, which uses an electrical surgical instrument to minimize bleeding, has been found to be effective in reducing bleeding during gingivectomy procedures. Diode laser and electrocautery are also effective techniques for performing gingivectomy. Diode laser allows for easy manipulation of soft tissue and shows better improvement in the healing process, while electrocautery has the advantage of causing less postoperative pain. Overall, these techniques provide visibility and accessibility for the removal of calculus and can help restore the gingiva to its normal anatomical and physiological contour.
How does tumor treatment affect periodontitis?4 answersTumor treatment, such as chemotherapy and radiation therapy, can have an impact on periodontitis. Chemotherapy for head and neck cancer patients can lead to oral side effects, including mucositis, dry mouth, and changes in the sense of taste, which can increase the risk of periodontal disease. Periodontal disease in cancer patients, especially those undergoing radiation therapy, can result in acute and chronic complications. Additionally, the dysbiosis of the oral microbiome associated with periodontitis may influence response rates and tolerance to cancer immunotherapy. Stomatitis, a common side effect of systemic administration of chemotherapy and radiation to the head and neck, can also affect the course of treatment and quality of life. Overall, tumor treatment can exacerbate periodontal disease and its associated complications, highlighting the importance of assessing and managing periodontal health before, during, and after cancer therapy.

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