Anthony M. Iacopino

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Purpose: To evaluate the effect of functional cyclic loading on two retrieved abutment screws used with single implant supporting cement-retained porcelain-fused-to-metal crowns by characterizing the structure, properties, and biotribologic behavior after long-term use in vivo. Materials and Methods: Two abutment screws were retrieved from the same patient and same implant at two different times. An external hex implant was used to replace a missing central incisor. A traumatic incident occurred 9 months after insertion and displaced the implant palatally by bending the screw. A second, similar incident occurred 31 months after insertion. In both cases, the abutment screws were retrieved and subjected to thorough nondestructive and destructive testing. Results: Light and scanning electron microscopic examinations revealed very minimal surface deterioration of the thread profile for the first screw (in service for 9 months) and demonstrated advanced metal adhesive wear in the form of galling for the second screw (in service for 31. months). The galling led to moderate thinning of the thread profile. Both screws were composed of Au-based alloy, where the microstructure of the matrix consisted of homogeneous equiaxed fine grains with two different second phase particles. Conclusion: It appears that the occurrence of adhesive wear on abutment screws in the form of galling is highly related to the length of in-service time in the mouth. This biotribologic behavior was inevitable and considered to be a normal consequence of long-term use in vivo. Metallurgic analysis indicated that both screws were identical in terms of composition and microstructure. INT J ORAL MAXILLOFAC IMPLANTS 2012;27:1474-1480

Disease related to peri-implant mucosal inflammation (PIMI) has been reported as one of the major factors leading to failure of dental implants. Many authors have suggested options for treatment of these lesions, ranging from simple mechanical debridement and regenerative surgical techniques to removal of the implant. Prognostic classification systems have become an integral part of dental practice because they provide direct guidance in planning treatment. However, there is limited evidence to support the appropriate classification of PIMI and the corresponding treatments, and a more specific prognostic system is required. Because the number of patients with implants is increasing, clinicians must be aware of PIMI as an entity with specific management requirements. This report describes a simple prognostic system to help clinicians to foresee the outcomes of PIMI treatment.

For decades there has been an ongoing search for clinically acceptable methods for the accurate, non‐invasive diagnosis and prognosis of periodontitis. There are several well‐known inherent drawbacks with current clinical procedures. The purpose of this review is to summarize some of the newly emerging diagnostic approaches, namely, infrared spectroscopy, optical coherence tomography (OCT), and ultrasound. The history and attractive features of these new approaches are briefly illustrated, and the interesting and significant inventions related to dental applications are discussed. The particularly attractive aspects for the dental community are that some of these methods are totally non‐invasive, do not impose any discomforts to the patients during the procedure, and require no tissue to be extracted. For instance, multiple inflammatory indices withdrawn from near infrared spectra have the potential to identify early signs of inflammation leading to tissue breakdown. Morphologically, some other non‐invasive imaging modalities, such as OCT and ultrasound, could be employed to accurately measure probing depths and assess the status of periodontal attachment, the front‐line of disease progression. Given that these methods reflect a completely different assessment of periodontal inflammation, if clinically validated, these methods could either replace traditional clinical examinations for the diagnosis of periodontitis or at least serve as attractive complementary diagnostic tools. However, the potential of these techniques should be interpreted more cautiously given the multifactorial character of periodontal disease. In addition to these novel tools in the field of periodontal inflammatory diseases, other alternative modalities like microbiologic and genetic approaches are only briefly mentioned in this review because they have been thoroughly discussed in other comprehensive reviews.