Dario Di Nardo

Background: The peri-implant soft-tissue seal is believed to help with bone loss and peri-implant infection. Aim: The present narrative literature review aims to determine whether a laser-microtextured/micro-grooved surface (LMTS) on the dental implant collar and prosthetic abutment influences soft tissue organization of the implant–abutment interface. Methods: Two independent reviewers conducted electronic and manual literature searches for articles written in English up to June 2026. An assessment of the research’s level of evidence was conducted according to the Oxford Centre for Evidence-Based Medicine (OCEBM) guidelines. The search was conducted electronically via MEDLINE (through PubMed) to identify articles for inclusion, using the following terms: (implant[Title/Abstract] OR abutment) AND (attachment[Title/Abstract] OR adherence) AND (laser microgrooved[Title/Abstract] OR laser microtextured[Title/Abstract] OR laser etched[Title/Abstract] OR laser-ablated[Title/ Abstract] OR laser-lok[Title/Abstract]). References of relevant articles were reviewed manually to include them in the review to show, directly, the performance of LMTS implant collars/abutments. Cumulative marginal bone loss (MBL), periodontal probing depth (PPD), and cumulative success rate (CSR) were calculated to review, indirectly, the performance of LMTS. Results: Seven in vitro studies, ten experimental studies in animals, nine experimental studies in humans, and fourteen comparative clinical studies (LMTS vs. non-LMTS) were included. Conclusions: Histologically, LMTS appears to induce the formation of a physical connective tissue attachment on the implant collar and abutment with collagen fibers oriented perpendicularly. Outcomes of clinical studies showed favorable clinical effects on periodontal probing depth (PPD), marginal bone loss (MBL), and a potential improvement in aesthetic and peri-implant health.

Objectives: The long-term prognostic value of the biomarker-guided implant risk (BGIR) score was compared with two other risk models, the IDRA (implant disease risk assessment) and the PiRA (peri-implantitis risk assessment), in predicting the onset of implant diseases in patients attending a private practice and enrolled in a supportive care program (SCP). Methods: From a pool of private implant patients subjected to at least 10 years of SCP, 80 partially edentulous subjects were recruited and retrospectively evaluated. The BGIR, the IDRA and the PiRA scores were calculated during SCP and compared to each other. Prognostic scores of BGIR, IDRA and PiRA were estimated based on the area under the curve for receiver operating characteristic (ROC), including 95% confidence intervals. High-risk BGIR, IDRA and PiRA subgroups versus low/moderate BGIR, IDRA and PiRA subgroups were compared at the patient level using Cox regression analyses. Results: The mean implant follow-up was 10.5 years. Peri-implantitis incidence was 17.5%. The BGIR, IDRA and PiRA high-risk percentages were 27.5%,21.2% and 25%, respectively. The areas under the ROC curve for BGIR, IDRA and PiRA were 0.836, 0.758, and 0.769, respectively, for peri-implantitis events. BGIR, IDRA and PiRA high-risk scores were found to be significantly associated with the onset of peri-implantitis, with hazard ratios (HR) of 4.7, 3.6 and 3.8, respectively. Compared to IDRA and PiRA, BGIR showed higher specificity and sensitivity. However, comparisons between the area under the, curves (AUC) of the three independent ROC curves showed no statistical significance. Conclusions: Compared to IDRA and PiRA, calculation of the BGIR score during follow-up seems to have a greater ability to predict the onset of peri-implant diseases in daily clinical practice.

The presence of severe atrophy in proximity to the maxillary sinus or the inferior alveolar nerve is a primary indication for the use of short dental implants. The placement of standard-length implants in such cases often requires complex regenerative procedures, leading to prolonged healing time and an increased invasiveness of the surgical procedure. The aim of the study was to evaluate crestal bone remodeling, implant success, complications, and implantand patient-related risk factors associated with the use of short, platform-switched dental implants with a laser-microgrooved collar for prosthetic rehabilitation of atrophic posterior jaws. This multicenter retrospective study involved a chart review of medical records from 5 private dental clinics. Variables such as age, sex, smoking, periodontal disease, systemic diseases, medications, anatomical location, implant diameter and length, crown-to-implant ratio, and type of placement were collected. A total of 132 short implants placed in 84 patients were analyzed, with a follow-up of 3-5 years (mean (M): 4.2 ±0.8 years). Eight short implants failed, including 62.5% of those affected by peri-implantitis. The implantlevel and patient-level success rates were 93.9% and 95.0%, respectively. The mean crestal bone loss (CBL) was 0.385 ±0.7 mm. Univariate regression analysis revealed that female sex, smoking status and periodontal disease were significantly associated with implant success at both the implant and patient levels. Platform-switched short implants with a laser-microgrooved coronal design demonstrated high success rates in atrophic posterior jaws after 3-5 years of function, with stable crestal bone levels.

Background/Objectives: The aim of the study was to investigate the risk factors related to early implant failures in patients treated in a private implant clinic. Methods: The study was retrospectively conducted on 392 patients (mean age = 51.2 ± 15.4 years, 48.9% female and 51.1% male) who received 930 dental implants within the period from 2000 to 2020. Included patients had received at least one implant. Patients were excluded in case of incomplete dental records that did not contain the necessary information, including personal information (patient’s name, age, gender, history and current condition of systemic diseases) and treatment protocol record. No patients were excluded on the basis of systemic disease if it did not contraindicate dental implant surgery. Patient-related variables (age, gender, smoking, history of periodontitis, accompanying disease), surgical-related variables (surgical technique, bone augmentation, lateral sinus lift, internal sinus lift, immediate implant placement after tooth extraction, immediate mucosal grafting, insertion torque,) and implant-related variables (implant design, implant level, implant surface, site of implant placement, implants diameter, length and implants brand name) were recorded. Results: GEE analysis results showed that the implant-based failure rate before or at the abutment connection stage was 5.8%. Seven factors were identified associated with early implant failures: male gender, smoking, history of radiotherapy and chemotherapy, maxilla implant placement, non-submerged healing method, implant design and implant brand. Conclusions: In light of the results obtained, both patient-related variables (gender, smoking, history of radiotherapy and chemotherapy) and variables related to the type of implant, its position and the surgical technique used (maxilla implant placement, non-submerged healing method, implant design and implant brands) were found to be statistically correlated with early failures in this study.

To evaluate the gingival crevicular fluid (GCF) and the peri- implant crevicular fluid (PICF) concentration of oxidative stress markers, such as malondialdehyde (MDA) and superoxide dismutase (SOD) in healthy sites and in those affected by periodontitis (PER) and peri-implantitis (PIM). Sites in periodontal (PH) and peri-implant (PIH) healthy conditions and sites with PER and PIM were investigated in 120 subjects. Clinical parameters including plaque index (PI), gingival index (GI), probing pocket depth (PPD), and bleeding on probing (BOP) were recorded. Levels of MDA and SOD in GCF and PICF were determined using commercially available enzyme-linked immunosorbent assay (ELISA) kits and statistically correlated with PI, GI PPD and BOP. No statistically significant differences (p>0.05) in level of MDA and SOD were found in PH vs. PIH sites with. Compared to PH sites, PER sites presented a higher level of MDA and SOD, but the difference was not statistically significant (p>0.05). Statistically significant higher concentrations of MDA (p=0.009) and SOD (p= 0.004) were found in PIM sites compared to PIH. Moreover, PIM sites showed also statistically higher levels of MDA (p=0.012) and SOD (p=0.013) than PER sites. MDA and SOD concentrations were found positively correlated with PD and BOP. The measured oxidative stress markers were statistically higher in diseased peri-implant sites than in diseased periodontal sites.

The search for a superior bone graft substitute compared to the gold standard of harvesting autogenous bone grafts has plagued dentists for decades. With the advent of tissue engineering, the search has been aimed at bone graft substitutes with osteogenic potential and osteoinductive and osteoconductive properties. Bone Marrow Aspirates (BMAs) have evolved as a potential adjunct to conventional bone grafts that can substantially enhance the bone regeneration potential of these materials. This systematic review aims to explore and assess the literature on the efficacy of bone marrow aspirates in new bone formation. An electronic search of PubMed, Web of Science, and Scopus databases was conducted to identify articles that evaluated the efficacy of bone marrow aspirates for new bone formation, published until September 2022, and a supplementary manual search of references from these articles was also conducted. Case reports, case series, commentaries, letters to the editor, narrative or systematic reviews, and articles in languages other than English were excluded from consideration. The articles were assessed against the ROB-II tool for Randomised Controlled Trials (RCTs) for risk of bias assessment. GRADE assessment based on the Cochrane Handbook for quality assessment and a summary of findings table were used to present the results. In a comprehensive electronic search of 150 articles from the three databases, seven studies assessed new bone formation in healthy partially edentulous patients who underwent bone regeneration with bone marrow aspirates compared to conventional bone grafts - autogenous harvested bone, allogenic, and alloplastic substitutes. This review concludes that adding bone marrow aspirates results in comparable results to bone graft alone. The results must be interpreted cautiously owing to their 'low quality' GRADE assessment. Future research with a greater sample size, homogenous populations, and comparable digital imaging and software may provide results that can be aptly applied to broader populations.

In the field of dentistry, achieving a natural look in dental restorations is crucial. This relies significantly on the ability of composite materials to mimic the optical characteristics of natural teeth, particularly their fluorescence. Fluorescence plays a vital role in giving teeth their lifelike appearance and varies widely among different materials, impacting their long-term performance in clinical settings. This study aims to assess and compare the fluorescence properties of four advanced composite restorative materials against natural dental enamel through both laboratory and clinical evaluations. The research involved an in vitro examination of 50 samples categorized into five groups, with one control group (natural dental enamel) and four experimental groups (G-Aenial, GC Essentia, Brilliant Flo, and Omnichroma). Fluorescence intensity was measured both visually and through photographic techniques immediately after application and again after 30 days. Furthermore, a randomized clinical trial was conducted with 40 participants to evaluate the in vivo fluorescence of these composites used in cervical restorations. Statistical analyses were performed using the Kruskal–Wallis test and Wilcoxon signed rank test. The analysis revealed significant differences in fluorescence levels across all groups (p < 0.05). Among the composites tested, Omnichroma exhibited the closest resemblance to natural enamel fluorescence at both baseline and after 30 days, with p-values of 0.01 for in vitro and 0.02 for in vivo assessments. Notably, all composite materials, except for the control group (natural enamel), showed a decrease in fluorescence over time, with G-Aenial and GC Essentia experiencing more pronounced reductions compared to Omnichroma (p = 0.03). Omnichroma was found to most effectively replicate the fluorescence of natural enamel, leading to better esthetic results. However, it is important to note that all composite materials demonstrated a decline in fluorescence over time, indicating a need for ongoing development to enhance their durability.

Full-arch implant-supported fixed dental prostheses, an implant-supported prosthesis, which the patient must carefully manage in home oral hygiene procedures, is the fixed alternative to a mucosal-supported or implant-anchored prosthesis. Clinically, the execution of this rehabilitation requires four implants for the lower jaw and six implants for the upper jaw. The aim of the present study is to verify the survival-rate of implants for implant-fixed prostheses in the edentulous upper jaw. This retrospective study was carried out on patients who received an upper full-arch fixed prostheses on six implants for rehabilitation. A total of 36 patients were included and evaluated from a clinical and radiographical point of view. The follow-up period in which the data were collected on the upper full-arch is between 60 and 84 months. A total of 232 implants were inserted and monitored in this period. Clinical and radiographic evaluations were carried out on all 232 implants, with constant re-evaluation. The total implant survival rate is 93.1%, a value which is similar to previous studies already published on the topic. There were few prosthetic complications, mainly the fracture of anterior prosthetic teeth. Most of these full-arch, which as antagonist had another previously made full-arch implant-supported fixed dental prostheses or overdenture on four or overdenture on two implants, achieves good results in this study at 84 months.

The purpose of this study was to evaluate peri-implant soft tissue response by assessing IL-6, IL-1b and MMP-8 levels in peri-implant crevicular fluid (PICF) around machined vs. laser-microgrooved implants/healing/prosthetic abutments during 1 year of function. Twenty-four patients each received 2 one-stage implants in a split mouth design on the same jaw. In each patient, one implant, one immediate healing, and one prosthetic abutment with a machined surface (M group), and one implant, one immediate healing abutment and one prosthetic abutment with a laser-microgrooved surface (LMS group) were used. PICF sampling, pocket probing depths (PPD) and bleeding on probing (BOP) were assessed at 1, 3, and 12 months. IL-6, IL-1b and MMP-8 levels were determined by specific enzyme-linked immunosorbent assay systems (ELISA). Repeated measure ANOVA was used to run comparisons with groups and between groups months at 1, 3, and 12 months. At 3 and 12 months, the LMS group showed significantly lower PD, BOP and IL-6, IL-1β and MMP-8 levels than the M group (P<.05). This study suggests the presence of more remodeling and/or inflammatory phenomena around implants/abutments with a machined surface than around implants/abutments with a laser-microgrooved surface.

Background. This study evaluated the gingival crevicular fluid (GCF) and Peri- implant crevicular fluid (PICF) concentrations of interleukin-1 beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and active metalloproteinase-8 (a-MMP-8) in sites with healthy conditions vs. sites affected by periodontitis (PER) and peri-implantitis (PIM). Methods. Periodontally healthy (PH) sites with PER, sites with peri-implant health (PIH), and sites with PIM were investigated intra-individually, according to the inclusion criteria of each group. Probing pocket depth (PPD), plaque index, gingival index, and the presence or absence of bleeding on probing (BoP) were evaluated. In GCF and PICF samples, IL-1β, IL-6, and TNF-α were quantified by ELISA Duoset® kit in combination with Ultramark® micro-ELISA digital reader; a-MMP8 concentration was analyzed by a chairside test (Perio/ImplantSafe®) in combination with a digital reader (ORALyzer®). Results. The concentrations of IL-6 and IL-1β, TNF-α, and a-MMP-8 were significantly higher in the PIM and PER sites compared to healthy sites (P<0.05). Significantly higher concentrations of IL-1β and a-MMP-8 were found in PIM vs. PER sites (P0.05). Conclusion. aMMP-8, IL-6, IL-1β, and TNF-α presented higher GCF/PICF concentrations in diseased periodontal and peri-implant sites. However, only the concentrations of IL-1β and a-MMP-8 were significantly higher in PIM than in PER sites.