Soft tissue integration of different abutment surfaces: an experimental study with histological analysis

May 2021 Abstract Objective To evaluate whether abutment surface and surface bio-activation has an effect on soft tissue morphogenesis. Materials and Methods 36 patients (36 implants) were included. Abutments were randomly divided into 4 groups (n=9): Smooth Surface – MAChined (MAC), Ultrathin Threaded Microsurface (UTM), MAC Plasma of Argon activated (Plasma MAC), UTM Plasma of Argon activated (Plasma UTM). After 2 months of healing, soft tissue samples were collected and prepared for histological analysis. The margin of the peri-implant mucosa (PM), the apical extension of the barrier epithelium (aJE), the apical location of the abutment (AM) were identified. Significances of differences among groups were tested by means of the Kruskal-Wallis test, and between pairs of results by means of the Mann-Whitney test. Results The mean (SD) vertical dimension of the mucosa was 2.5mm (1.0), including a connective tissue portion (CTP) of 0.8mm (0.8) in the MAC group; 3.6mm (0.2) with a CTP of 1.6mm (0.4) in the Plasma-MAC group; 3.2mm (1.0), with a CPT of 0.5mm (0.6) in the UTM; 3.3mm (0.8), with a CPT of 0.9mm (0.7) in the Plasma-UTM group. Statistically significant differences were observed in the aJE-AM height and PM-aJE profile among the four experimental groups (P=0.042 and P=0.039, respectively). The Mann-Whitney test indicated differences between the Plasma-abutments and the untreated abutments both for PM-AM (p=0.025) and AjE-AM (p=0.021). The differences appeared more evident when the preoperative soft tissue thickness was ≤2mm. Conclusions Within its limits, the study demonstrated a favorable effect of the plasma treatment on the connective tissue portion tissues. Plasma MAC group highlighted the best performance. This behavior appeared strictly correlated to the soft tissue thickness. Luigi Canullo, David Penarrocha, Paolo Pesce, Cristina Zarauz, Rossano Lattanzio, Miguel Penarrocha, Giovanna Iezzi. View

Prevalence of maxillary sinus alterations after zygomatic surgery. A comparative study between intra-sinus and ZAGA approaches.

May 2021 Zygomatic implant (ZI) is an option of the edentulism. Complications associated with ZI are maxillary sinusitis and soft tissue recession. The Zygoma Anatomy-Guided Approach (ZAGA), reduce the complications of the Original zygomatic intra-sinus Surgical technique (OI-ST). P.Clarós 1, N. Końska 2, P. Clarós-Pujol 3, D. Clarós-Pujol 3, J. Sentís 4, A. Clarós 1, M. Peñarrocha-Diago 5, C. Aparicio 6 1 Clarós Otorhinolaryngology Clinic, Barcelona, Spain. ORCID No: (Pedro Clarós 0000-0002-7567-0370, Andrés Clarós 0000-0001-6084-3470). 2 Department of Otorhinolaryngology, Stefan Zeromski Specialist Hospital, Cracow, Poland; Scholarship in Clarós Clinic, Barcelona, Spain. 3 Clarós Dental Clinics, Barcelona, Spain. 4 Department of Public Health (Statistics), School of Medicine, University of Barcelona, Barcelona, Spain. 5 Professor of Oral Surgery, Faculty of Medicine and Dentistry, University of Valencia, Spain. 6 Hepler Bone Clinic, ZAGA Center Barcelona, Spain.


Dec 2020
Es un estudio retrospectivo que analiza nuestra casuística de cirugía periapical de los últimos 20 años, centrándonos en los casos para los que tenemos controles de larga evolución porque son pacientes que han seguido viniendo a la consulta. Eso nos ha permitido estudiar factores pronósticos del resultado de la cirugía. En global, tras una media de casi 8 años, el 82% de los dientes tratados seguían perfectamente sanos. El principal factor pronóstico fue la posición del diente: los dientes anteriores tenían una tasa de éxito superior al 90% mientras que los molares están en torno al 70%. La conclusión fundamental es que la cirugía periapical es una técnica predecible para salvar dientes con infección endodóntica que permite alargar muchos años la vida de los dientes naturales.
Jun 2020
Purpose To study the influence of the access window dimensions on the healing at the antrostomy and within the augmented maxillary sinus.Material and methodsA maxillary sinus augmentation was performed in twenty-four albino New Zealand rabbits. Antrostomies of 3 × 6 mm (small) or 5 × 6 mm (large) in dimensions were randomly prepared in each animal….
May 2020
Background: A literature review was made to determine when third molar (3M) extraction is recommended in symptomatic patients and when it is not recommended.
Apr 2020
Objective: An in vitro study was made to compare mean thermal variation according to the material, design and wear of the surgical drills used during dental implant site preparation. Material and methods: Three study groups (stainless steel drills with straight blades; diamond-like carbon-coated drills with straight blades; and diamond-like carb…
Mar 2020
Purpose: To present a case series of zygomatic implants combined with bone regeneration and soft tissue enhancement techniques to reduce the risk of biological delayed complications such as maxillary sinusitis and soft tissue recession. Materials and methods: Zygomatic implants placed simultaneously with different bone regeneration techniques (b…
Mar 2020
Aim: To study the influence on the healing of the placement of particulate autogenous bone in the antrostomy and in the subjacent region after maxillary sinus elevation. Material and methods: Sixteen New Zealand rabbits were undergone to bilateral maxillary sinus floor augmentation with 4 × 4 mm antrostomy dimension. The sinus mucosa was elevate…
Feb 2020
Background: To review the literature on the effect of different surgical flaps upon patient morbidity (pain perception, trismus, swelling and osteitis) after impacted third molar extraction. Material and methods: An electronic and complementary search of main databases and grey literature was performed up to January 2019 to retrieve randomized cli…
Feb 2020
Purpose: To describe implant survival at least 1 year after the surgical treatment of early apical peri-implantitis (EAP) and explore potential risk factors of failure of such treatment. Materials and methods: An ambispective cohort study was conducted, involving all patients in whom EAP was detected and surgically treated between 1996 and 2016….
Jan 2020
Cirugía periapical con regeneración del defecto óseo Caso clínico con seis años de seguimiento INTRODUCCIÓN La cirugía periapical es un procedimiento quirúrgico que se realiza para tratar la periodontitis apical cróni-ca persistente en casos en los que no ha habido cura-ción tras el retratamiento de conductos o, en algunos casos, el tratamiento de…
Jan 2020Placement of postextraction dental implants has become a common practice. Here, we reviewed current literature, along with clinical procedures, outcomes, and incidence of complications, associated with immediate implants in infected postextraction sites. The YSGG (yttrium, scandium, gallium, and garnet) laser can significantly reduce the bacterial…
Jan 2020
Purpose: A systematic review was performed of the dimensional changes in facial cortical bone following implant placement into healed ridges, with the aim of establishing a minimum bone thickness that limits such changes. The influence of such bone remodeling upon the soft tissues and implant survival was also evaluated. Materials and methods: A…
Jan 2020
Purpose: To explore risk indicators potentially associated with early apical peri-implantitis (EAP). Materials and methods: A retrospective survey was performed in 2017 with recorded information from patients receiving dental implants between 1996 and 2016. Reporting follows the STROBE (strengthening the reporting of observational studies in epi…


Oct 2019
Background Clinical evidence of the autologous platelet concentrates effects on the patient-reported outcome measures (PROMs) after endodontic surgery is still limited. Objectives To investigate the effect of the advanced platelet-rich fibrin (A-PRF+) membrane application upon patient postoperative pain, and quality of life in endodontic surgery….
Oct 2019
The immediate implant-supported provisional restoration in the partially or totally edentulous patients is a predictable and well-accepted procedure in dentistry. The Glossary of Prosthodontic Terms defines a provisional prosthesis as a prosthesis designed to improve or evaluate esthetics, speech, and occlusal function in a period of time between i…
Oct 2019
Despite the increasing patients’ desire for immediate prosthetic loading of implants, several factors must be taken into account before pursuing the immediate loading (IL) protocol. In general, the number, size, characterization, and distribution of implants should be based on the implant-prosthodontic plan, arch form, and available bone quality an…
Oct 2019
Current literature does not contribute to a high level of evidence regarding possible indications for immediate loading. A great variety of exclusion criteria for immediate loading of dental implants are used in different studies. However, the reported criteria are similar to those chosen for conventional loading of dental implants. Despite its sev…
Oct 2019
Severe bone atrophy of the upper maxilla (Cawood and Howell class V and VI) is associated with certain problems such as reduced perioral tissue support, the impossibility of wearing complete dentures, chewing and speech alterations, and difficulties in placing dental implants due to the limited amount of available bone.
Oct 2019
Dental implants can be integrated at both hard and soft tissue levels. Osseointegration is a dynamic process during its establishment and maintenance, characterized by resorption and apposition events, and the extent and degree of osseointegration is in part affected by implant surface configuration. It is marked by three distinct healing stages du…
Oct 2019
The zygomatic fixture is an extended length (35–55 mm) titanium implant, placed into the zygomatic and maxillary alveolar bone. It was designed for situations where atrophy of the posterior maxilla complicates or prevents the placing of conventional implants. The use of zygomatic implants avoids the need for bone grafting, shortens treatment times,…
Oct 2019
Brånemark traditional recommendation was to perform implant rehabilitation in two stages: the first entry was only for implant placement; after 3–6 months of undisturbed submerged healing for mandible and maxilla, respectively, a second surgical entry would have allowed loading of the implants. The rationale behind this approach was that implant mi…
Oct 2019
Immediate loading is basically a prosthetic concept. However, the surgical implantological planning is very important to ensure a primary stability in the total edentulous patient. This characteristic is crucial to allow immediate loading in this type of patients. For the first time, the incisional design has allowed the clinician to overview about…
Aug 2019
Objective: The study aims to evaluate the feasibility of erbium-chromium: yttrium-scandium-gallium-garnet (ErCr:YSGG 2780 nm) laser irradiation on infected and/or inflamed post-extraction sites for the immediate placement, and when possible, immediate loading, of endosseous implants. Background: Post-extraction site infection is a serious complica…
Aug 2019
María Peñarrocha-Diago,1 José Carlos Balaguer-Martí,1 David Peñarrocha-Oltra,1 José Bagán,1 Miguel Peñarrocha-Diago,1 Dennis Flanagan2,31Department of Stomatology, University of Valencia, Valencia, Spain; 2Department of Dental Medicine, Lugano University of Switzerland, Lugano, Switzerland; 3Private Practice, Willimantic, CT, USAAbstract: Complicat…
Jul 2019
Background: The aim of the study was compare the sensitivity and measurements obtained from teeth with apical lesions scheduled for periapical surgery using three different diagnostic methods: periapical radiography (Gendex Expert DC), panoramic radiography (Planmeca® Promax 3D Classic) and cone beam computed tomography (CBCT) (Planmeca® Promax 3D…
Jul 2019
BACKGROUND: To evaluate the effect of two different implant macro-designs on the sequential osseointegration at bicortically installed implants in the rabbit tibia. A further aim is to compare the osseointegration at different topographic zones. MATERIAL AND METHODS: 27 New Zealand rabbits were implemented. Two implants, one for each macro-design
Jul 2019
Background: To determine whether saliva is a good means of evaluating concentrations of oxidative stress biomarkers, analyzing the correlation between concentrations in saliva and in follicular tissue, and to compare biomarker concentrations in patients with one asymptomatic mandibular impacted third molar (MITM) (before extraction) with a healthy…
Jun 2019
Peri-implantitis is an inflammatory disease affecting tissues surrounding dental implants. Although it represents a common complication of dental implant treatments, the underlying mechanisms have not yet been fully described. The aim of this study is to identify the role of titanium nanoparticles released form the implants on the chronic inflammat…
Jun 2019
BACKGROUND: To evaluate the effect of two different implant macro-designs on the sequential osseointegration at bicortically installed implants in the rabbit tibia. A further aim is to compare the osseointegration at different topographic zones. MATERIAL AND METHODS: 27 New Zealand rabbits were implemented. Two implants, one for each macro-design…
Jun 2019
Introduction Bleeding control is an important aspect in endodontic surgery. Two hemostatic techniques were compared with regard to their efficacy to bleeding control in endodontic surgery. Methods A randomized, 2-arm, parallel pilot study involving 30 patients with periradicular lesions was performed including the following hemostatic agents: po…
May 2019
Background The purpose of this cross-sectional study was to evaluate radiologically, the relation between the distance from the cementoenamel junction (CEJ) to the facial bone crest (FBC), and the facial alveolar bone (FAB) width at maxillary anterior teeth. A further aim was to assess if the CEJ-FBC distance had an impact in the prevalence to find…
May 2019
Statement of problem: The treatment of patients with recessive dystrophic epidermolysis bullosa has been compromised in the past by the lack of oral therapeutic information and the use of conventional complete dentures. Purpose: The purpose of this clinical case series study was to describe a digital rehabilitation protocol involving computer-ai…
Apr 2019
How to cite this article: Cervera Ballester J, Menén-dez Nieto I, Peñarrocha Oltra D, Peñarrocha Diago M. Periapical surgery with a new retrograde root canal filling material: tricalcium silicate cement. J Oral Science Rehabilitation. 2019 Mar;5(1):34-41. Abstract Background The prognosis of periapical surgery has been improved in recent years with…
Feb 2019
Objective: To compare implant survival, marginal bone loss, peri-implant clinical parameters, and complications in dental implants placed in the posterior maxilla in native bone or after grafting using the open sinus lift technique. Materials and methods: A search was made of two electronic databases (MEDLINE via PubMed and the Cochrane Oral Hea…
Feb 2019
Background: PLGA is widely used for the development of delivery systems for drugs and therapeutic biomolecules in tissue engineering applications. Particles of biphasic calcium phosphate can be covered by PLGA to change their manipulating characteritics. Purpose: Aim of this study was to investigate the radiological and histomorphometric results o…
Feb 2019
Introduction The aim of this study was to evaluate the efficacy of 2 hemostatic agents in periapical surgery and its relationship with patient- and tooth-dependent variables. Methods A prospective study was designed with 2 randomized parallel groups established according to the hemostatic agent used: aluminum chloride or electrocauterization. The…
Purpose: To evaluate whether there is a difference in aesthetic outcomes positioning immediate post-extractive implants in the natural position (where the tooth should have been in relation to adjacent teeth/implants) or approximately 3 mm more palatally. Materials and methods: Just after tooth extraction, 20 patients requiring one single immedi…
Jan 2019
This atlas, in which a wealth of illustrations are supported by clear explanatory text, offers an up-to-date and comprehensive overview of the immediate restoration of teeth and immediate functional loading when using different implant systems and surfaces in patients with single tooth loss or partial or complete edentulism. It provides guidance on…


Dec 2018
This study evaluates the bone-healing patterns on the surface of titanium implants at the cortical and marrow compartments of bicortically-installed implants in the diaphysis and metaphysis of rabbit tibiae. In 27 New Zealand rabbits, two implants, one for each macro-design and with equal resorbable blasted media (RBM) implant surfaces, were random…
Dec 2018
Purpose: An adequate hemostasis is of utmost importance for the success of apical surgery, because it not only improves operative visibility, but also provides a dry environment within the bony crypt, ideal for an adequate retrograde obturation. This article describes a new approach for the successful management of hemostasis during apical surgery…
Background The measurement of peri-implant marginal bone loss is currently carried out using digital methods of radiographic analysis assisted by various types of software. The purpose of this study was to compare the characteristics of three different softwares: specific radiology software for the development and visualization of radiological imag…
Background: To compare the radiological parameters and success of posterior maxillary direct sinus lift with simultaneous or delayed implant placement, or implant placement in native bone, after a minimum follow-up period of 5 years. Material and methods: A retrospective cohort study was carried out in a university clinic, selecting patients sub…
Purpose: Preserving peri-implant bone and reducing exposure of the rough implant surface might influence long-term outcomes of implant therapy. The aim of this study was to compare peri-implant clinical and radiologic parameters after crestal and subcrestal dental implant placement at 36 months’ follow-up. Materials and methods: We carried out a…
Oct 2018
Objective The objective of this study was to evaluate the influence of smoking and oral hygiene on the success and periimplant marginal bone loss of implants placed in one-stage and two-stage direct sinus lift procedures. Materials and methods A retrospective clinical study of patients who underwent direct sinus lift and imp…
B a c k g r o u n d Periapical implant lesions may be a cause of early failure of implants. The purpose of this article is to describe the surgical treatment of the periapical implant lesion and its intraoperative approach. C a s e p r e s e n t a t i o n s Three patients with periapical implant lesions (2 in the maxilla and 1 in the mandible) afte…
Background GBRs are essential procedures in implant dentistry and periodontology where barrier membranes play an important role by isolating soft tissue and allowing bone to grow. Not all membranes function the same way, as they differ from their origin and structure, it is important to understand how membranes behave and differ one from others in…
May 2018
Our purpose was to analyse the influence of O2 pressure on the adhesion, proliferation, and osteogenic differentiation of human dental pulp stem cells (DPSC) on 3-tricalcium phosphate (3-TCP) scaffold. DPSC isolated from extracted third molars were seeded on 3-TCP and cultured under 3% or 21% O2 pressure. Cell adhesion, proliferation, and different…
Mar 2018
An update is made of the aspects to be taken into account during flap detachment and retraction in periapical surgery as one of the key elements for treatment success. Raising of the flap and traction must be carried out firmly but gently in order to minimize trauma. This requires an adequate mucoperiosteal incision. Retraction separates the flap i…
Purpose: To evaluate the effect of incision design in implant surgery on interproximal bone loss of posterior teeth adjacent to interdental single implants, comparing intrasulcular and paramarginal incision. A further aim was to assess the influence of the incision technique on peri-implant bone remodeling. Materials and methods: A controlled ra…
Jan 2018
Purpose: To evaluate the peri-implant soft and hard tissues of dental implants placed in vertically regenerated posterior mandibles with intraoral onlay block bone grafts and patient satisfaction at 3-year follow-up. Materials and methods: A retrospective study of patients with dental implants placed in posterior mandibular sites vertically augm…
Purpose: To evaluate whether there is a difference in aesthetic outcomes positioning immediate post-extractive implants in the natural position (where the tooth should have been in relation to adjacent teeth/implants) or about 3 mm more palatally. Materials and methods: Just after tooth extraction, 30 patients requiring one single immediate maxi…


Agustín-Panadero R, Serra-Pastor B, Peñarrocha-Oltra D, Peñarrocha-Diago M. Maxillary Implant Prosthodontic Treatment Using Digital Laboratory Protocol for a Patient with Epidermolysis Bullosa: A Case History Report. Int J Prosthodont. 2017 Jul/Aug;30(4):390-393. doi: 10.11607/ijp.5065. PubMed Bover-Ramos F, Viña-Almunia J, Cervera-Ballester J, Peñarrocha-Diago M, García-Mira B. Accuracy of Implant Placement with Computer-Guided Surgery: A Systematic Review and Meta-Analysis Comparing Cadaver, Clinical, and In Vitro StudiesInt J Oral Maxillofac Implants. 2017 Jun 20. doi: 10.11607/jomi.5556. PubMed Canullo L, Tallarico M, Chu S, Peñarrocha D, Özcan M, Pesce P. Cleaning, Disinfection, and Sterilization Protocols Employed for Customized Implant Abutments: An International Survey of 100 Universities WorldwideInt J Oral Maxillofac Implants. 2017 May 18. doi: 10.11607/jomi.5402. PubMed Penarrocha-Diago M, Penarrocha-Diago M, Zaragozí-Alonso R, Soto-Penaloza D. Consensus statements and clinical recommendations on treatment indications, surgical procedures, prosthetic protocols and complications following All-On-4 standard treatment. 9th Mozo-Grau Ticare Conference in Quintanilla, SpainJ Clin Exp Dent. 2017 May 1;9(5):e712-e715. doi: 10.4317/jced.53759. eCollection 2017 May. Review. PubMed Rojo J, Viña J, Peñarrocha D, Peñarrocha M. Facial alveolar bone width at the first and second maxillary premolars in healthy patients: A cone beam computed tomography study. J Oral Implantol. 2017 Apr 19. doi: 10.1563/aaid-joi-D-16-00195 PubMed Peñarrocha-Diago M, Balaguer-Martí JC, Peñarrocha-Oltra D, Balaguer-Martínez JF, Agustín-Panadero R. A combined digital and stereophotogrammetric technique for rehabilitation with immediate loading of complete-arch, implant-supported prostheses: A randomized controlled pilot clinical trialJ Prosthet Dent. 2017 Apr 3. pii: S0022-3913(17)30007-0. doi: 10.1016 PubMed

Canullo L, Camacho-Alonso F, Tallarico M, Meloni SM, Xhanari E, Penarrocha-Oltra D. Mucosa Thickness and Peri-implant Crestal Bone Stability: A Clinical and Histologic Prospective Cohort TrialInt J Oral Maxillofac Implants. 2017 Mar 15. doi: 10.11607/jomi.5349.


Guzmán-Letelier M, Crisosto-Jara C, Diaz-Ricouz C, Peñarrocha-Diago M, Peñarrocha-Oltra D. Severe odontogenic infection: An emergency. Case report. J Clin Exp Dent. 2017 Feb 1;9(2):e319-e324. doi: 10.4317/jced.53308. eCollection 2017. PubMed David Soto-Peñaloza, Regino Zaragozí-Alonso, María Peñarrocha-Diago, Miguel Peñarrocha-Diago. The all-on-four treatment concept: Systematic review. The all-on-four treatment concept: Systematic review, doi:10.4317/jced.53613 PubMed Miguel Peñarrocha-Diago, María Peñarrocha-Diago, Juan-Antonio Blaya-Tárraga. State of the art and clinical recommendations in periapical implant lesions. Journal of Clinical and Experimental Dentistry, doi:10.4317/jced.53600 PubMed


Serra-Pastor B, Peñarrocha-Diago M, Peñarrocha-Diago MA, Agustín-Panadero R. Treatment and restoration of adult dentoalveolar trauma: A clinical case report. J Clin Exp Dent. (2016), doi:10.4317/jced.52990 Pubmed Fernández-Ferrer L, Montiel-Company JM, Candel-Martí E, Almerich-Silla JM, Peñarrocha-Diago M, Bellot-Arcís C. Corticotomies as a surgical procedure to accelerate tooth movement during orthodontic treatment: A systematic review. Med Oral Patol Oral Cir Bucal. 2016 Nov 1. Pubmed Menéndez-Nieto I, Cervera-Ballester J, Maestre-Ferrín L, Blaya-Tárraga JA, Peñarrocha-Oltra D, Peñarrocha-Diago M. Hemostatic Agents in Periapical Surgery: A Randomized Study of Gauze Impregnated in Epinephrine versus Aluminum Chloride. J Endod. 2016 Nov. Pubmed





  • Oral teratomas: a report of 5 cases Bonet C, Peñarrocha-Oltra D, Minguez JM, Vera-Sirera B, Peñarrocha-Diago M, Peñarrocha-Diago M. Oral teratomas: a report of 5 cases. J Oral Maxillofac Surg. 2012 Dec;70(12):2809-13.2015
  • Pubmed PDF










  • Bifid mandibular canal Sanchis J.M., Peñarrocha M., F. Soler.: Bifid Mandibular Canal. J Oral Maxillofac Surg 61:422-424, 2003. PDF











  • Oral lichen planus and diabetes mellitus J.V. Bagán, J.S. Donat, M. Peñarrocha D., M.A. Milián M., J.M. Sanchís B.: Oral lichen planus and diabetes mellitus. A clinico-pathological study. Bull Group Int Rech Sci Stomatol et Odontol- Vol 36 nº 1-2, 1993. PDF



  • Etude morphométrique dans 74 cas de lichen plan oral José V. Bagán Sebastián, José M. Aguirre Urizar, A. Milián Masanet, M. Peñarrocha Diago, M.J. García Pola Vallejo. Etude morphométrique dans 74 cas de lichen plan oral. Clínica Odontológica, Facultad de Medicina y Odontología, Gascó Oliag 1, 46010 Valencia, Espagne. Rev. Stomatol. Chir. maxillofac. 1991, 92, nº 4, pp. 265-268. PDF


  • Douleur faciale d’origine cardiaque M. Peñarrocha Diago, F.J. Silvestre Donat, R. Rodríguez Gil. Douleur faciale d’origine cardiaque. Unité d’Enseignement de Pathologie Orale, Faculté de Médecine et Odontologie, Gasco Oliag 1, 46021 Valencia. Rev. Stomatol. Chir. maxillofac. 1990, 91, nº 6, p. 477-479. PDF






  • Miastenia grave Alfaro A, Peñarrocha M. Miastenia grave. Med Clin (Barc). 1984 Mar 17;82(10):462-9. PDF


Ir arriba