The Journal of Oral Implantology is the official publication of the American Academy of Implant Dentistry and of the American Academy of Implant Prosthodontics. It is dedicated to providing valuable information to general dentists, oral surgeons, prosthodontists, periodontists, scientists, clinicians, laboratory owners and technicians, manufacturers, and educators. The JOI distinguishes itself as the first and oldest journal in the world devoted exclusively to implant dentistry.

Journal of Oral Implantology

	In dentistry, bone grafts are performed after tooth extraction to preserve the integrity of the jawbone. It is a common issue that, when performing a bone graft, the graft material will lose its shape during the suturing of the soft tissue. This complication can be prevented with the use of “tenting” screws or tacks to help keep the graft in place; however, removal of the screws or tacks requires a second retrievable surgery.

	To avoid additional surgeries and increased treatment costs, researchers have introduced a new surgical technique for closing the grafted area.

	Researchers from the University of Minnesota, Minneapolis, along with the Implant Cosmetic Dental Center in Silver Spring, MD, have 

 that aims to maintain the integrity of the graft during closure. Termed the Continuous Periosteal Strapping Suture (CPSS) technique, this method uses resorbable sutures and membrane, materials that can be resorbed and assimilated into the body. If implemented correctly, CPSS requires a less complex surgical procedure than currently available techniques.  This simpler procedure leads to lower overall treatment costs.

More from the Journal of Oral Implantology: Study finds microthreaded dental implants may preserve crestal bone

	The technique used by the researchers relies on resorbable sutures and membrane and does not include any surgical screws or tacks to help keep the graft in place. Instead, a series of intricate knots made with resorbable sutures surrounding the membrane are used. The knots help to maintain the strength of the sutures, creating a firmer hold on the wound closure area.

	With the use of resorbable materials, the need for a separate surgery to remove “tenting” screws or tacks can be eliminated.  The researchers also found that using sutures with a higher tension rate, or tensile strength, increased the duration of the suture time from 56-70 days to 91-119 days. This increased tensile strength for a longer period is expected to be a critical part of membrane and graft stabilization, because having longer-lasting sutures will help ensure the sustainability of the procedure.

	Researcher Dr. Gregori M. Kurtzman has noted, “One of the biggest challenges when osseous grafting the ridge to widen the site with particulate material is containing the graft and avoiding lateral displacement during healing. The CPSS technique predictably helps contain the graft without the need for an increase in material costs or complicated techniques.”

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	The researchers conclude that although their technique is limited by the tensile strength and resorption rate of the specific suture used, they still found it to have fewer complications and predictable outcomes. The authors also suggest that future studies should be conducted comparing the CPSS technique with other membrane fixation techniques (i.e. “tenting” screw or tack techniques).

	Full text of the article, “Continuous Periosteal Strapping Sutures for Stabilization of Osseous Grafts with Resorbable Membranes for Buccal Ridge Augmentation: A Technique Report,” Journal of Oral Implantology, Vol. 43, No. 4, 2017, is available at: 

http://joionline.org/doi/full/10.1563/aaid-joi-D-17-00060

Articles

The new technique could help maintain graft integrity during closure.

Researchers introduce technique to simplify dental bone graft procedures

	Peri-implantitis is an irreversible inflammatory disease that is commonly caused by plaque and biofilm that accumulates on the exterior of a dental implant. It affects both the soft and hard tissues surrounding the implant, and without treatment, may result in excessive bone loss proximal to the implant and its eventual failure. Surgical therapies are most suitable for accessing and removing the biofilm, and thereby impeding the progression of the disease.

	Researchers from Wonkwang University (Daejeon, Korea), Yonsei University (Seoul, Korea) and the Global Academy of Osseointegration (Seoul, Korea) published a study in the current issue of the 

 that examines a novel surgical procedure to combat peri-implantitis. In the article, the authors conducted two case studies using a newly developed cleaning and regenerative surgical process.

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	In both cases, a round titanium brush was used to remove the debris, while maintaining the rough surface of the diseased implant. A regenerative approach incorporating bone graft materials was used to rebuild the bone surrounding the implant. The key to successful regeneration of the bone proximal to the implant is to successfully remove the plaque biofilm while maintaining the rough implant surface. The titanium brush used in this technique was extremely effective at removing the plaque biofilm that was causing the disease, while also preserving the rough surface of the implant threads. This made the regenerative process more successful and predictable.

	The researchers note that, “The results obtained in the present two cases emphasize the importance of mechanical decontamination by eliminating the contaminated surface and creating a new rough surface for a regenerative approach in the treatment of severe peri-implantitis. This technique has the advantages of effective cleaning of the contaminated implant surface and producing positive clinical and radiological results during the two-year follow-up period. However, further studies are necessary to verify the reliability and validity of this technique.”

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	After a two-year follow-up period, the researchers found that the bone level was preserved following the use of this technique. In addition, another advantage was shown to be a reduction in chair time benefiting both the implant surgeon with a higher success rate and the patient with less muscle fatigue and joint pain that is associated with the prolonged opening of the mouth. Overall, the researchers are confident in the outcome of this new technique and recommend future research to track the long-term success of the procedure.

Surgical Treatment of Severe Peri-Implantitis Using a Round Titanium Brush for Implant Surface Decontamination: A Case Report With Clinical Reentry

," was published in the Journal of Oral Implantology.

Researchers discover new surgical procedure to treat peri-implantitis

	Tooth loss is not simply an aesthetic problem for adults. It can have severe consequences for overall dental health, including complications with speech, eating and overcompensation of the mouth due to the deficiency. To combat these issues, people often turn to dental implants to replace lost teeth. As the number of tooth replacements increases, it is imperative to design an implant that will uphold the integrity of an individual’s mouth structure.

	Researchers from the University of Dammam in Dammam, Saudi Arabia, and the University of Kentucky in Lexington, Kentucky, 

 in the Journal of Oral Implantology that investigated how the design of the implant affects the mouth. Specifically, if using a microthreaded-neck design would preserve more of the crestal bone, the part of the bone at the top (or “neck”) of the implant that supports the replacement teeth. The researchers conducted a systematic review of 23 articles to test their hypothesis.

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	These articles were derived from three electronic scientific databases and published between January 1995 and June 2016. The review analyzed the effectiveness of using an implant with a microthreaded-neck design versus the more traditional machine- or rough-surface implants. The researchers concluded that the addition of deeper threads on the implant allowed for more stabilization between the implant and the bone, especially with weaker bones. They also noted that the threads created more bone-to-implant contact and allowed for more of the bone to be preserved.

	The researchers stated: “This research was one of the early projects that provide high evidence from literature on the design of the most current generation of dental implants. That includes a continuous micro-rough or nano-rough surface extending up to the implant neck, along with microthreads in the cervical region. So, the aim of this systematic review was to evaluate and analyze the effect of a microthreaded-neck implant on [crestal bone loss], as determined by various clinical trials.”

	This study shows that thread geometry does affect the amount of stress and strain that is put on the implant, and that crestal bone loss can be minimized. This finding helps practitioners to make a more informed decision when choosing a type of implant for their patients. The researchers believe that additional randomized controlled trials are necessary to evaluate how the microthread implant will affect different types of bone loss under different implantation techniques.

	The study, titled “Microthreaded Implants and Crestal Bone Loss: A Systematic Review,” appeared in the 

Researchers investigated how the design of an implant affects the mouth. 


Study finds microthreaded dental implants may preserve crestal bone

	Both obstructive sleep apnea and sleep bruxism are linked to several health issues; however, no previous studies linked obstructive sleep apnea (OSA) to prosthetic complications. Now, new data demonstrate a strong correlation between OSA and complications with previously implanted oral prosthetics.

	Researchers from OSI Araba University Hospital in Victoria, Spain 

. The frequency with which a complication occurred and the type of complication were studied in 67 patients. Contradictory to their initial hypothesis, the researchers found a high instance of complications related to OSA.

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	Of the 67 patients included in the study, the researchers found that 16 experienced complications; 13 of which had OSA. Among these 16 patients with complications, there were 22 prostheses with a total of 30 issues. The researchers found these complications consisted of porcelain fracture, fracture of the screw/implant, loosening of the screw and decementation. The average time for a complication to occur was 73 months post-implantation.

	During the study, the researchers also noted a strong relation between individuals who suffer from OSA and those who suffer from bruxism. Past studies revealed that those afflicted with 

 had a higher instance (6/10) of complications with implant prostheses than those without bruxism (13/75). This shows that people suffering from OSA and/or bruxism have a more difficult time with successful prosthetic implantation.

	The researchers note that, “Among dental practitioners, there has been increasing awareness of the reciprocal relationship between obstructive sleep apnea (OSA) and dental diseases. One new aspect of interest would be the occurrence of technical complication in fixed prosthodontics."

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	This study shows that 81% of patients with OSA experienced complications with their prostheses. Given that the success rate of implants is reported to be between 92 percent and 97 percent, there is a strong correlation between OSA and prosthetic complications. The researchers believe that additional exploration on the correlation between OSA and implant complications is necessary to further understand the risk factors and frequencies of these occurrences.

	Full text of the article, “Frequency of Prosthetic Complications Related to Implant-Borne Prosthesis in a Sleep Disorder Unit,” 

, Vol. 43, No. 1, February 2017, is available at: 

http://joionline.org/doi/full/10.1563/aaid-joi-D-16-00100

The study examined the relationship between OSA and damage to implant-borne prostheses.