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Materials and methods : Clinical and radiographics results at 3 years of RCT with split-mouth design of submerged vs. nonsubmerged single laser-microgrooved implants in posterior areas [2]

Materials and methods : Clinical and radiographics results at 3 years of RCT with split-mouth design of submerged vs. nonsubmerged single laser-microgrooved implants in posterior areas [2]

author: Renzo Guarnieri, Dario Di Nardo, Gianni Di Giorgio, Gabriele Miccoli, Luca Testarelli | publisher: drg. Andreas Tjandra, Sp. Perio, FISID

The cases were randomly divided into two groups as two-stage/submerged and one-stage/nonsubmerged. Thus, in each patient, the two implants (submerged and nonsubmerged) were placed randomly in the left and right posterior area of the mandible, or in the left and right posterior area of the maxilla (Tables 1 and 2).

For a complete pre-surgical evaluation, an intra-oral rx and a CBCT scan examination were performed for each implant site.

The surgical procedures were all performed by two operators (RG, LT). Before the implant placement, in each site, the vertical keratinized tissue thickness (KTT) was measured after performing anesthesia, by means of n. 30 K-file inserted until touching the bone crest in the center of future implant placement.

The vertical KTT was dichotomized into two groups (≤ 2 mm and > 2 mm) in accordance with the results of an animal study performed by Berglundh and Lindhe [13]. Implants were placed, with the rough/microgrooved border flush with the bone crest, with the laser-microgrooved surface at the supra crestal level, and at a minimum distance of ≥ 1.5 mm from the adjacent natural teeth.

Patients scheduled for surgery were prescribed systemic amoxicillin/clavulanic acid (Augmentin, GlaxoSmithkline, Italy), 1 g, twice a day for 7 days, and a chlorhexidine digluconate solution 0.12% (Dentosan 0,12%, Johnson & Johnson, USA) rinse (twice daily for 1 min). After local anesthesia by infiltration using articaine/epinephrine (Ecocain 20 mg/ml, Molteni Dental, Italy), surgical access with a midcrestal incision in the center of the edentulous ridge was performed. A minimally extended incision, paramarginal at the adjacent teeth, was released. A full-thickness flap was carried out to expose the crest and the vestibular limit of the bone. Utmost care was taken to preserve the periodontal integrity of adjacent teeth. Following implant placement, the flap was sutured without tension using 4.0 or 5.0 monofilament sutures which were left in place for 10 days. Patients were instructed to have a liquid or semiliquid diet for the first three days and gradually return to a normal diet. An analgesic, ibuprofen 600 mg (Abbott srl, Italy) was prescribed to take immediately after surgery and after 8 h.

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