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Browsing by Subject "Dental implants"

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    Actin cytoskeletal organization in human osteoblasts grown on different dental titanium implant surfaces
    (Murcia: F. Hernández, 2007) Salido, M.; Vilches, J.I.; Gutiérrez, J.L.; Vilches, J.
    The understanding of the cellular basis of osteoblastic cell-biomaterial interaction is crucial to the analysis of the mechanism of osseointegration. Cell adhesion is a complex process that is dependent on the cell types and on the surface microtopography and chemistry of the substrate. We have studied the role of microtopography in modulating cell adhesion, in vitro, using a human osteoblastic cell line for the assessment of actin cytoskeletal organization. Through application of CLSM combining reflection and fluorescence, 2D or 3D images of cytoskeleton were obtained. On smooth surfaces, Ti CP machined, predominantly planar bone cells with an axial ratio of 1.1 were randomly oriented, with stress fibers running in all directions, and thin filopodia. On TiCP Osseotite® surfaces the osteoblastic cells conformed to the irregular terrain of the sustrate with focal adhesion sites only established on the relative topographical peaks separated for a longer distance than in the machined surface, and defined wide lamellopodia and long filopodia, with enhanced expression of stress fibers, forming large clear focal contacts with the rough surface. The cytoskeletal organization of cells cultured on rough titanium supports an active role for the biomaterial surface in the events that govern osteoblastic cell adhesion. The results enforce the role of the rough sustrate surface in affecting osteoblastic cell adhesion and provide valuable information for the design of material surfaces that are required for the development of an appropriate osteogenic surface for osteoblastic anchorage, compared to machined surface, in dental implants.
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    Aesthetic outcomes of different materials for delayed, single-tooth restorations for immediately placed implants. A randomized controlled clinical trial
    (Elsevier, 2024-07) Pardo Zamora, Guillermo; Molina-González, Juan Manuel; Martínez Marco, José Francisco; Ortiz Ruiz, Antonio José; Mardas, Nikos; García-Sánchez, Rubén; Dermatología, Estomatología, Radiología y Medicina Física; Clínica Odontológica Integrada Infantil
    Objectives The aim of this study is to compare the aesthetic outcomes of metal porcelain (C), lithium disilicate (T1) and porcelain-layered zirconium (T2) immediate implant-supported single crowns in the anterior maxilla. Materials and methods Forty-five immediate dental implants were provided for 45 patients that required the extraction of a single tooth in the anterior maxilla. A temporary prosthesis was provided at 8 weeks after placement followed by the final prosthesis at 24 weeks post-implantation. The patients were randomly allocated into 3 groups: 15 patients in the control group (C) received a metal-porcelain restoration, 15 patients (T1) received a lithium disilicate (LD) restoration and 15 patients (T2) received a porcelain-layered, zirconium (Z) restoration. Pink (PES) and White (WES) esthetic scores, radiographic bone levels, periodontal parameters and patient's esthetic satisfaction using a visual analogue scale (VAS) were evaluated at the time of final restoration placement (t0) and at 12-months post-loading (t12). Results No implants were lost during the duration of this study. Statistically significant higher WES and VAS scores (p < 0.05) were recorded in T1 vs C and T1 vs T2 groups respectively. Similar radiographic bone levels and periodontal parameters were recorded in all groups. Conclusion Within the limitations of this study, it was concluded that T1 restorations provided better WES outcomes when compared to C restorations and better VAS scores when compared to T2 restorations at 12 months post-loading. Besides, different material interphases did not have an impact in PES, bone levels or periodontal parameters. Clinical relevance There is limited data comparing aesthetic outcomes of implant supported single crowns made of different ceramic materials based on accepted and comparable indexes and the evaluation of the patient's perspective regarding these aesthetic outcomes.
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    Assessment of the tissue response to modification of the surface of dental implants with carboxyethylphosphonic acid and basic fibroblastic growth factor immobilization (Fgf-2): an experimental study on minipigs
    (MDPI, 2021-04-23) Aragoneses, Javier; Suárez, Ana; López Valverde, Nansi; Martínez Martínez, Francisco; Aragoneses, Juan Manuel; Cirugía, Pediatría y Obstetricia y Ginecología
    Simple Summary This study aimed to evaluate the efficacy of treating the surface of dental implants with carboxyethylphosphonic acid for the immobilization of FGF-2, the influence of FGF-2 on cortical bone in close contact with dental implants, new bone formation around dental implants in the presence of FGF-2 and the influence of FGF-2 on the interthread bone area of dental implants during the healing period after insertion. Abstract The aim of this study was to evaluate the effect of implant surface treatment with carboxyethylphosphonic acid and fibroblast growth factor 2 on the bone–implant interface during the osseointegration period in vivo using an animal model. The present research was carried out in six minipigs, in whose left tibia implants were inserted as follows: eight implants with a standard surface treatment, for the control group, and eight implants with a surface treatment of carboxyethylphosphonic acid and immobilization of FGF-2, for the test group. At 4 weeks after the insertion of the implants, the animals were sacrificed for the histomorphometric analysis of the samples. The means of the results for the implant–bone contact variable (BIC) were 46.39 ± 17.49% for the test group and 34.00 ± 9.92% for the control group; the difference was not statistically significant. For the corrected implant–bone contact variable (BICc), the mean value of the test group was 60.48 ± 18.11%, and that for the control group, 43.08 ± 10.77%; the difference was statistically significant (p-value = 0.035). The new bone formation (BV/TV) showed average results of 27.28 ± 3.88% for the test group and 26.63 ± 7.90% for the control group, meaning that the differences were not statistically significant (p-value = 0.839). Regarding the bone density at the interthread level (BAI/TA), the mean value of the test group was 32.27 ± 6.70%, and that of the control group was 32.91 ± 7.76%, with a p-value of 0.863, while for the peri-implant density (BAP/TA), the mean value of the test group was 44.96 ± 7.55%, and that for the control group was 44.80 ± 8.68%, without a significant difference between the groups. The current research only found a significant difference for the bone–implant contact at the cortical level; therefore, it could be considered that FGF-2 acts on the mineralization of bone tissue. The application of carboxyethylphosphonic acid on the surface of implants can be considered a promising alternative as a biomimetic coating for the immobilization of FGF-2. Despite no differences in the new bone formation around the implants or in the interthread or peri-implant bone density being detected, the biofunctionalization of the implant surface with FGF-2 accelerates the mineralization of the bone–implant interface at the cortical level, thereby reducing the osseointegration period.
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    Atraumatic maxillary sinus elevation using threaded bone dilators for immediate implants. A three-year clinical study
    (Medicina Oral S.L, 2010-03) Calvo Guirado, José Luis; Gómez Moreno, Gerardo; López Marí, Laura; Ortiz Ruiz, Antonio José; Guardia Muñoz, Javier; Dermatología, Estomatología, Radiología y Medicina Física
    Objective: The aim of this study was to evaluate the efficacy of sinus floor elevation using sequential bone dilators. Materials and Methods: Thirty patients took part in the study (18 women and 12 men) with ages ranging between thirty-six and sixty-three years, selected according to inclusion and exclusion criteria, who showed a bone deficit in the upper posterior alveolar margin of 5-8 mm in height. Sixty expanded platform internal connection implants were placed with diameters of 4/5/4 mm and lengths varying between 10 (n=10) and 11.5 mm (n= 50). Results: Data obtained were analyzed using SPSS 15.0 software. The average intra-sinus bone gain with MP3 biomaterial of porcine origin was 4.13 +/- 0.97 SD mm at the moment of implant placement, 3.90 +/- 1.15 SD mm after twelve months, 3.74 +/- 1.05 SD mm after 24 months and 3.62 +/- 1.75 SD mm after 36 months. Two implants were lost at the moment of prosthesis placement. Conclusions: Alveolar lifting technique in the upper maxilla using bone dilators achieved a 96.6 % implant success rate after a three-year follow-up. Intra-sinus bone biomaterial remodeling was 0.51 +/- 0.08 mm from day zero to the thirty-six-month follow-up. This is a procedure that reduces the amount of surgery necessary and is of both aesthetic and functional benefit to the patient.
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    Dental implants in patients with oral lichen planus: a cross-sectional study
    (Wiley, 2014-02-17) López Jornet, María Pía; Camacho Alonso, Fabio; Sánchez Siles, Mariano; Dermatología, Estomatología, Radiología y Medicina Física
    Purpose: The main aim of this study was to evaluate the patients with oral lichen planus (OLP) and dental implants. Material and Methods: Three groups of 16 patients took part in the study. Group I patients had received dental implants and been diagnosed with OLP; Group II had not received implants but were diagnosed with OLP; Group III had implants but not OLP. Clinical observations and OLP symptoms were registered in each case. Periodontal pocket depth, implant mobility, bleeding upon probing, erythema, pain, and radiolucency around implants were measured. Patient quality of life was evaluated using OHIP 14. Results: Peri-implant mucositis and peri-implantitis were detected in 17.86% and 25% of the OLP-implant group, while the control group with implants showed 18% and 16%. The implant survival rate in patients treated for OLP did not appear to differ from the survival rate among the general population. Quality of life was better among patients with implants and without OLP (p = .001). Conclusions: The results of the present study suggest that implants do not influence manifestations of OLP. OLP is not a risk factor for peri-implantitis.
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    Effect of photofunctionalization with 6 W or 85 W UVC on the degree of wettability of RBM titanium in relation to the irradiation time
    (MDPI, 2021-06-11) Sánchez Pérez, Arturo Joaquín; Cano-Millá, Nuria; Moya Villaescusa, María José; Montoya Carralero, José María; Navarro Cuellar, Carlos; Dermatología, Estomatología, Radiología y Medicina Física
    Photoactivation with ultraviolet C light can reverse the effects derived from biological ageing by restoring a hydrophilic surface. Ten titanium discs were randomly divided into three groups: a control group, a 6 W group, and an 85 W group. A drop of double-distilled, deionized, and sterile 10 µL water was applied to each of the discs. Each disc was immediately photographed in a standardized and perpendicular manner. Measurements were taken based on the irradiation time (15, 30, 60, and 120 min). UVC irradiation improved the control values in both groups. There was no difference in its effect between the 6 W group and the other groups during the first 30 min. However, after 60 min and up to 120 min, 85 W had a significantly stronger effect. The contact angles with the 85 W ultraviolet light source at 60 and 120 min were 19.43° and 31.41°, respectively, whereas the contact angles for the 6 W UVC source were 73.8° and 61.45°. Power proved to be the most important factor, and the best hydrophilicity result was obtained with a power of 85 W for 60 min at a wavelength of 254 nm.
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    Effects of the preoperative administration of Dexketoprofen Trometamol on pain and swelling after implant surgery: a randomized, double-blind controlled trial
    (American Academy of Implant Dentistry, 2018-04-01) Sánchez-Pérez, Arturo; Muñoz-Peñalver, Jesús; Moya Villaescusa, María José; Sánchez-Matás, Carmen; Dermatología, Estomatología, Radiología y Medicina Física
    The fear of postoperative pain is often mentioned by patients as one of the factors that is most frequently associated with dental implants. To reduce this factor, a single oral dose of 25 mg dexketoprofen trometamol (DKT) or placebo was administered 15 minutes before implant surgery. One hundred patients who required single-implant treatments were randomly assigned to 1 of 2 blinded groups. The patients in the test group were given 25 mg DKT (DKT group), and those in the control group were given 500 mg vitamin C as a placebo (PLACEBO group). A subjective visual analogue scale of 100 mm in length was used to evaluate pain. Inflammation and complications were assessed using a 5-point Likert scale. An analysis of variance, t-tests, and a Mann-Whitney U test were performed. Among the 100 patients, 83 completed the study (there were 8 dropouts in the PLACEBO group and 9 in the DKT group). The patients who received DKT reported a lower pain intensity during the immediate postoperative period. The inflammatory response was weaker in the DKT group than the control group at 48 hours, but bleeding was greater. There were no other complications in either of the groups. In conclusion, the preemptive use of 25 mg soluble DKT administered orally 15 minutes before implant surgery can reduce the severity of immediate postoperative pain.
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    Effects of ultraviolet photoactivation on osseointegration of commercial pure titanium dental implant after 8 weeks in a rabbit model
    (American Academy of Implant Dentistry, 2020-06-01) Sánchez Pérez, Arturo Joaquín; Cachazo-Jiménez, Carlos; Sánchez-Matás, Carmen; Martín-de-llano, José Javier; Davis, Scott; Carda-Batalla, Carmen; Dermatología, Estomatología, Radiología y Medicina Física; Facultad de Medicina
    This study investigated whether a 6-Watt ultraviolet C-lamp was capable of producing photofunctionalization on commercial implants during a medium observation term of 8 weeks. A total of 20 implants were inserted in 5 New Zealand rabbits, with each animal receiving 2 implants per tibia (one photofunctionalized and one untreated), according to a previously established randomization sequence. All implants were inserted by a single surgeon following the manufacturer's instructions. Histological analysis was performed by an evaluator who was blinded to the treatment condition. After 8 weeks of healing, the 2 groups showed no statistically significant differences in terms of bone-to-implant contact. Compared to control implants, the photofunctionalized implants showed improved wettability and more homogenous results. Within the limits of the present study, the use of this 6-W ultraviolet C-lamp, for an irradiation time of 15 minutes at a distance of 15 cm, did not improve the percentages of bone-to-implant contact in rabbits at an osseointegration time of 8 weeks.
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    Electrical potentiometry with intraoral applications
    (MDPI, 2022-07-22) Jornet García, Alfonso Felipe; Sánchez Pérez, Arturo Joaquín; Montoya Carralero, José María; Moya Villaescusa, María José; Dermatología, Estomatología, Radiología y Medicina Física
    Dental implants currently in use are mainly made of titanium or titanium alloys. As these metallic elements are immersed in an electrolytic medium, galvanic currents are produced between them or with other metals present in the mouth. These bimetallic currents have three potentially harmful effects on the patient: micro-discharges, corrosion, and finally, the dispersion of metal ions or their oxides, all of which have been extensively demonstrated in vitro. In this original work, a system for measuring the potentials generated in vivo is developed. Specifically, it is an electrogalvanic measurements system coupled with a periodontal probe that allows measurement of the potentials in the peri-implant sulcus. This device was tested and verified in vitro to guarantee its applicability in vivo. As a conclusion, this system is able to detect galvanic currents in vitro and it can be considered capable of being employed in vivo, so to assess the effects they may cause on dental implants.
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    Etiology, risk factors and management of implant fractures
    (Medicina Oral, S.L., 2010-05) Sánchez Pérez, Arturo; Moya Villaescusa, María José; Jornet García, Alfonso; Gomez, Santiago; Dermatología, Estomatología, Radiología y Medicina Física
    Implant fracture is an infrequent and late biomechanical complication with a serious clinical outcome. In effect, such fractures pose important problems for both the patient and the dental surgeon. According to most literature sources, the prevalence of dental implant fractures is very low (approximately 2 fractures per 1000 implants in the mouth). Considering that implant placement is becoming increasingly popular, an increase in the number of failures due to late fractures is to be expected. Clearly, careful treatment can contribute to reduce the incidence of fracture. An early diagnosis of the signs alerting to implant fatigue, such as loosening, torsion or fracture of the post screws and prosthetic ceramic fracture, can help prevent an undesirable outcome. The present literature review describes the management options and discusses the possible causal mechanisms underlying such failures, as well as the factors believed to contribute to implant fracture.
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    Histological and immunohistochemical soft-tissue response to cylindrical and concave abutments: multicenter randomized clinical trial
    (Wiley, 2024-08-26) Camacho Alonso, Fabio; Bernabeu Mira, Juan Carlos; Mercado Díaz, Ana María; Pérez Sayans, Mario; Pérez Jardón, Alba; Somoza Martín, José Manuel; Montero, Javier; Gómez Polo, Cristina; Quispe López, Norberto; Peñarrocha Oltra, David; Buendía Marín, Antonio Julián; Sánchez Campillo, Joaquín; Dermatología, Estomatología, Radiología y Medicina Física
    Background:This study aimed to analyze the influence of concave andcylindrical abutments on peri-implant soft tissue. Dimensions, collagen fiberorientation, and immunohistochemical data were assessed.Methods:A multicenter, split-mouth, double-blind randomized clinical trialwas conducted. Two groups were analyzed: cylindrical abutments and concaveabutments. After a 12-week healing period, peri-implant soft tissue samples werecollected, processed, and evaluated for dimensions, collagen fiber orientation,and immunohistochemical data. Inflammatory infiltration and vascularizationwere assessed, and the abutment surfaces were analyzed using scanning elec-tron microscopy. The statistical analysis was performed using the SPSS version20.0 statistical package.Results:A total of 74 samples in 37 patients were evaluated. Histologicalevaluation of peri-implant soft tissue dimensions revealed significant differ-encesbetweenconcaveandcylindricalabutments.Concaveabutmentsexhibitedgreater total height (concave: 3.57±0.28 – cylindrical: 2.95±0.27) and bar-rier epithelium extension (concave: 2.46±0.17 – cylindrical: 1.89±0.21)(p<0.05),whilethesupracrestalconnectivetissueextension(concave:1.11±0.17– cylindrical: 1.03±0.16) was slightly greater (p>0.05). Collagen fiber ori-entation favored concave abutments (23.76±5.86), with significantly moretransverse/perpendicular fibers than for cylindrical abutments (15.68±4.57).The immunohistochemical analysis evidenced greater inflammatory and vascu-lar intensity in the lower portion for both abutments, though concave abutmentsshowed lower overall intensity (concave: 1.05±0.78 – cylindrical: 1.97±0.68) (p<0.05). The abutment surface analysis demonstrated a higher percentage oftissue remnants on concave abutments (42.47±1.32; 45.12±3.03) (p<0.05).Conclusions:Within the limitations of this study, concave abutments pre-sented significantly greater peri-implant tissue height, linked to an extendedbarrier epithelium, versus cylindrical abutments in thick tissue phenotype.This enhanced soft tissue sealing, favoring a greater percentage of transverselyoriented collagen fibers. The concave design reduced chronic inflammatoryexudation with T and B cells, thus minimizing the risk of chronic inflammation.
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    Short dental implants (≤8.5 mm) versus standard dental implants (≥10 mm): a one-year post-loading prospective observational study
    (MDPI, 2021-05-26) Pardo Zamora, Guillermo; Ortiz Ruiz, Antonio José; Camacho Alonso, Fabio; Martínez Marco, José Francisco; Molina González, Juan Manuel; Piqué Clusella, Nuria; Vicente Hernández, Ascensión; Dermatología, Estomatología, Radiología y Medicina Física
    Background: Recent data have shown that short dental implants can be the preferred treatment in most of cases of posterior atrophic alveolar ridges, offering higher survival and lower complication rates than long implants. The survival rates, stability, and marginal bone level changes were compared between short implants (7 and 8.5 mm) and standard-length implants (≥10 mm). Methods: Prospective observational study in which adult patients requiring ≥1 osseointegrated implants to replace missing teeth were recruited consecutively. A clinical examination was performed on the day the definitive prosthesis was placed and after 6 and 12 months. Implant stability quotient (ISQ), marginal bone level (MBL) changes, and the correlation between these parameters and the characteristics of the implants were evaluated. Results: A total of 99 implants were inserted (47 short, 52 standard) in 74 patients. The 12-month survival rate was 100%. ISQ values showed a similar pattern for both types of implants. No correlation was found between ISQ changes after one year and MBL values, nor between the latter and the characteristics of the implants. Conclusions: With clinical treatment criteria, shorter implants (7 and 8.5 mm in length) can be just as useful as standard-length implants in atrophic alveolar ridges, demonstrating similar rates of survival, stability, and crestal bone loss.
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    Tobacco as a risk factor for survival of dental implants
    (Wiley, 2007-02) Sánchez Pérez, Arturo; Moya Villaescusa, María José; Caffesse, R.G.; Dermatología, Estomatología, Radiología y Medicina Física
    Background: It has been shown that smoking habits represent an increased risk for impaired bone healing and implant failure. This study aimed to evaluate the implant survival rates among non-smokers (NS) and different kinds of smokers (S). Methods: A retrospective analysis was made over a 5-year period of the clinical and radiographic findings corresponding to 66 consecutive patients who had received a total of 165 dental implants. Patients were divided into two groups: S, 40 patients (95 implants; 58% of the sample); and NS, 26 patients (70 implants; 42% of the sample). Also, S and NS were classified into four different categories according to daily tobacco use: NS, 26 patients and 70 implants; light smokers (LS), 23 patients and 44 implants; moderate smokers (MS), 11 patients and 25 implants; and heavy smokers (HS), six patients and 26 implants. Results: Sixteen implants (9.7%) failed and had to be removed. Group S showed 15 failures and a success rate of 84.2%. Group NS had only one failure, giving a success rate of 98.6%. The risk of implant failure was ∼31% in those who smoked more than 20 cigarettes per day. HS showed statistical differences from NS or LS. However, they did not show any differences from MS. Conclusions: Within the limits of the present study, the use of tobacco involves a 15.8% risk of implant failure, with a 13.1 odds ratio. LS or MS tobacco use involves a 10.1% relative risk of implant loss, whereas the consumption of >20 cigarettes per day increases this risk to 30.8%.
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    La utilizacion de pilares transmucosos definitivos de colocación inmediata
    (2020) Nicolás Silvente, Ana Isabel; Rivas Perez, A.; Garcia Lopez, R.; Alemán-Marín, J.; Chiva García, Fernando; Sánchez Pérez, Arturo Joaquín; Dermatología, Estomatología, Radiología y Medicina Física
    El uso de pilares de cicatrización transmucosos previos a la colocación del,pilar protésico definitivo es una técnica que se ha desarrollado durante muchos años en la implantología clásica. La desconexión y conexión de forma repetida de estos pilares o aditamentos dan lugar a una respuesta ósea negativa que se manifiesta en forma de pérdida de hueso a nivel de la cresta marginal, acompañada por una migración apical de tejidos blandos. Este artículo pretende realizar una revisión de la literatura del estado actual del uso de los pilares transmucosos definitivos con colocación inmediata el día de la inserción de los implantes y el mantenimiento del sellado biológico, minimizando la pérdida ósea periimplantaria y remodelando de forma adecuada los tejidos blandos adyacentes, frente al protocolo tradicional del uso de aditamentos que se desconectan en multiples ocasiones produciendo pérdida ósea periimplantaria. La evidencia científica sugiere que los mejores resultados biológicos, estéticos y funcionales se consiguen con el uso del pilar definitivo colocado de forma inmediata a la inserción del implante, especialmente en implantes colocados de forma yuxtacrestal y en implantes postextracción.
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    Validation of a novel diagnostic test for assessing the risk of Peri-Implantitis through the Identification of the microorganisms present: a pilot clinical study of Periopoc
    (MDPI, 2023-08-25) Moya Villaescusa, María José; Sánchez Pérez, Arturo Joaquín; Al-Lal, Nour Mehdi; Jornet García, Alfonso Felipe; Montoya Carralero, José María; Dermatología, Estomatología, Radiología y Medicina Física
    The aim of this parallel group study was to determine the clinical applicability of a newly developed bacterial test. We evaluated the ability of the test to detect five bacteria associated with peri-implantitis: Porphyromonas gingivalis, Tannerella forsythia, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, and Treponema denticola. Sensitivity, specificity, and positive and negative predictive values were established. Furthermore, by analyzing the pre-test and post-test probabilities, likelihood ratios were established, and a Fagan nomogram was constructed. As the standard, the clinical criteria of peri-implantitis adopted in the latest classification of peri-implant diseases of 2018 were used. The sample consisted of 13 patients clinically diagnosed with peri-implantitis (various implant brands) with at least 1 year of loading, of whom 11 were included in the study. The healthy group comprised 10 patients who received implants (Ticare inhex hybrid) at the university dental clinic and were monitored and exhibited no signs or symptoms of peri-implantitis during 1 year of loading. The results indicated that this test has high sensitivity and low specificity; therefore, positive results will be of great importance for a confirmatory diagnosis of peri-implantitis. However, the test is not suitable as a screening tool.

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