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THEMATIC

ABSTRACT REVIEW
Section Editor
Clark Stanford, DDS, PhD
The University of Iowa, Iowa City, Iowa

Emad W. Estafanous, BDS, MSD


The University of Iowa, Iowa City, Iowa

Guy Huynh-Ba, DDS, MS Jan-Eirik Ellingsen, DDS, PhD


University of Texas Health Science Center University of Oslo
San Antonio, Texas Oslo, Norway

Thomas W. Oates, DMD, PhD Martin Osswald, BDS, MDent


University of Texas Health Science Center University of Alberta
San Antonio, Texas Alberta, Canada

Dental Implant Success in Challenging Situations?

O sseointegration of dental implants has reached a


great success rate, yet challenging clinical scenari-
os and/or conditions impact these survival and success
interventions for treating peri-implantitis around den-
tal implants, suggesting that few current methods
exist to control peri-implantitis but concluding that
rates. Several recent studies have investigated these no reliable evidence existed to rule out a definitive
clinical scenarios, updating the management and the treatment.
strategic treatment planning to increase the success Balshi et al had retrospectively analyzed factors that
rate of dental implants. can affect the use of All-on-Four protocol, such as loca-
Linsen et al investigated the effect of head and neck tion, gender, and implant orientation, but concluded
radiation therapy on the long-term survival of implants that these factors are not significant parameters when
and concluded that no significant effects were noted formulating this protocol.
on survival rates, but described higher initial failure Lately, implant placement in fresh extraction sock-
rates during the early healing of oral implants. Claudy ets has been gaining ground. Lang et al analyzed five
et al suggested that a waiting period of 12 months af- factors that can affect the survival rate and concluded
ter radiotherapy may decrease this risk of failure. To de- that only the regimen of antibiotic use affected the sur-
crease the chances of oral implant failure in irradiated vival rate. Groups that had a course of postoperative
patients, hyperbaric oxygen therapy (HBO) was intro- antibiotics fared better. The Cochrane group recently
duced in the 1980s. Recently, the Cochrane Oral Health reported that the use of antibiotics one hour preop-
Group evaluated the effect of HBO therapy on the suc- eratively may reduce the failure of dental implants.
cess of dental implants in randomized controlled trials Clinical scenarios, including the ones described
and concluded that HBO may not offer any appreciable above, need to be further addressed, and more long-
clinical benefits. term in vivo studies and research will be needed to
A recent animal study addressed the issue of hyper- assess the outcomes and the effects of these different
glycemia and its putative effects on osseointegration. clinical situations on the survival rate of dental im-
Ajami et al modified the nanotopography of dental im- plants and the benefit implant treatment offers to the
plants, leading to significantly increased osteoconduc- patients.
tion compared to microsurface topographies.
Esposito et al, in another Cochrane Oral Health
Group review, tried to pinpoint the most effective Emad W. Estafanous BDS, MSD

The International Journal of Oral & Maxillofacial Implants 1455

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Thematic Abstract Review

Linsen SS, Martini M, Stark H. Long-term results meta-analysis was performed. Overall, 3,749 observa-
of endosteal implants following radical oral cancer tional studies were identified. After the screening of titles
surgery with and without adjuvant radiation thera- and abstracts, 236 publications were selected, and 10
py. Clin Implant Dent Relat Res 2012;14:250–258. were included in the final analysis. The pooled relative risk
The aim of this study was to analyze the long-term sur- (RR) of failure was RRpooled = 1.34 (95% confidence inter-
vival of implants and implant-retained prostheses in pa- val [CI]: 1.01-1.79), higher in individuals who had dental
tients after ablative surgery of oral cancer with or without implants placed between 6 and 12 months after receiv-
adjunctive radiation therapy. Between 1997 and 2008, 66 ing radiotherapy. I2 indicated nearly 21% heterogeneity
patients who had undergone ablative tumor surgery in the (P = .25). Egger’s test indicated no evidence of publica-
oral cavity were treated with dental implants (n = 262). tion bias (P = .62); however, the removal of one study sig-
Thirty-four patients received radiation therapy in daily frac- nificantly affected the overall RR (RRpooled = 1.08, 95% CI:
tions of 2 Gy administered for 18 to 30 days. Implants 0.77–1.52). It was concluded that placing implants in bone
were inserted in the maxilla (49; 18.7%) or mandible (213; within a period shorter than 12 months after radiotherapy
81.3%), in nonirradiated residual (65; 24.8%) or grafted may result in a higher risk of failure; however, additional
bone (44; 16.8%) and in irradiated residual (15.6%) or evidence from clinical trials is needed to verify this risk.
grafted bone (39; 14.9%). Seventeen fixed prostheses Correspondence to: mpclaudy@gmail.com
and 53 removable dentures (34 bar attachments, 9 tele-
scopic, and 10 ball-retained dentures) were inserted. The Esposito M, Worthington HV. Interventions for re-
mean follow-up after implant insertion was 47.99 (±34.31) placing missing teeth: Hyperbaric oxygen therapy
months (range 12 to 140 months). The overall 1-, 5-, and for irradiated patients who require dental implants.
10-year survival rates of all implants were 96.6%, 96.6%, Cochrane Database Syst Rev 2013;9:CD003603.
and 86.9%, respectively. Fourteen implants were lost in doi: 10.1002/14651858.CD003603.pub3.
nine patients (5.3% of all implants); eight implants were Dental implants offer one way to replace missing teeth.
primary losses, and five secondary losses because of Patients who have undergone radiotherapy and those who
an operation of tumor recurrence. There was no signifi- have also undergone surgery for cancer in the head and
cantly lower implant survival for implants inserted into ir- neck region may particularly benefit from reconstruction
radiated bone (P = .302), bone and/or soft-tissue grafts with implants. Hyperbaric oxygen therapy (HBO) has been
(P = .436), and maxilla or mandible (P = .563). All prosthet- advocated to improve the success of implant treatment
ic restorations in patients without tumor recurrence could in patients who have undergone radiotherapy, but this re-
be maintained during the observation period. It was con- mains a controversial issue. The objective of this study
cluded that implant survival is not significantly influenced is to compare the success, morbidity, patient satisfaction,
by radiation therapy, grafts (bone and/or soft tissue), or and cost-effectiveness of dental implant treatment carried
location (maxilla or mandible). However, implants placed out with and without HBO in irradiated patients. The fol-
in irradiated bone exhibit a higher failure rate during the lowing electronic databases were searched: the Cochrane
healing period than those placed in nonirradiated bone. No Oral Health Group’s Trials Register (to June 17, 2013), the
superstructure was particularly favorable. Osseointegrated Cochrane Central Register of Controlled Trials (CENTRAL)
implants can be used successfully in patients with prior (The Cochrane Library 2013, Issue 5), MEDLINE via OVID
history of ablative surgery with and without additional ra- (1946 to June 17, 2013), and EMBASE via OVID (1980 to
diation therapy. June 17, 2013). No restrictions were placed on the lan-
Correspondence to: sabinelinsen@web.de guage or date of publication when searching the electron-
ic databases. We checked the bibliographies of relevant
Claudy MP, Miguens SA Jr, Celeste RK, Camara clinical trials and review articles for studies outside the
Parente R, Hernandez PA, da Silva AN Jr. Time in- searched journals. We wrote to authors of the identified
terval after radiotherapy and dental implant failure: randomized controlled trials (RCTs) and to more than 55
Systematic review of observational studies and meta- oral implant manufacturers; we used personal contacts
analysis. Clin Implant Dent Relat Res 2013 June 7. and we made a request on an internet discussion group
doi: 10.1111/cid.12096 [epub ahead of print]. in an attempt to identify unpublished or ongoing RCTs. The
Typically, dental implants are placed in irradiated bone after selection criteria were randomized controlled trials (RCTs)
a delay that exceeds 6 months, but it is not known whether of HBO therapy for irradiated patients requiring dental im-
longer delays are beneficial. The purpose of the study is to plants: Screening of eligible studies, assessment of the
review the literature comparing the failure rate of dental im- methodological quality of the trials, and data extraction
plants placed in irradiated bone between 6 and 12 months were conducted in duplicate and independently by two re-
and after 12 months from the cessation of radiotherapy. view authors. Results were analyzed using random-effects
Four electronic databases were searched for articles pub- models to determine mean differences for continuous out-
lished until February 2013 without language restriction: comes and risk ratios for dichotomous outcomes, with 95%
Lilacs, Medline, Scopus, and the Cochrane Central Register confidence intervals. Only one RCT, providing very low qual-
of Controlled Trials. Two reviewers independently assessed ity evidence, was identified and included. Thirteen patients
the eligibility criteria and extracted data. Fixed effect received HBO therapy while another 13 did not. Two to six

1456 Volume 28, Number 6, 2013

© 2 0 1 3 BY Q UIN TESSEN CE PUBLISHIN G C O , IN C. PRIN TIN G O F T HIS D O CUMEN T IS RESTRIC TED T O PERSO N AL USE O NLY.
N O PART MAY BE REPRO DUCED OR TRA NSMIT TED IN A NY F ORM WIT H O UT WRIT TEN PERMISSIO N FRO M T HE PUBLISHER.
Thematic Abstract Review

implants were placed in people with fully edentulous man- surfaces in euglycemic animals. In conclusion, the compro-
dibles to be rehabilitated with bar-retained overdentures. mised implant integration in hyperglycemia is abrogated by
One year after implant loading, four patients had died from the addition of nanotopographic features to an underlying
each group. One patient, treated with HBO, developed an microtopographically complex implant surface.
osteoradionecrosis and lost all implants, so the prosthe- Correspondence to: jed.davies@utoronto.ca
sis could not be provided. Five patients in the HBO group
had at least one implant failure versus two in the control Esposito M, Grusovin MG, Worthington HV. Treat-
group. There were no statistically significant differences ment of peri-implantitis: What interventions are
for prosthesis and implant failures, postoperative compli- effective? A Cochrane systematic review. Eur J Oral
cations, and patient satisfaction between the two groups. Implantol 2012;5(suppl):S21–41.
The authors concluded that, despite the limited amount of The purpose of this study was to identify the most effective
clinical research available, it appears that HBO therapy in interventions for treating peri-implantitis around osseoin-
irradiated patients requiring dental implants may not offer tegrated oral implants. The Cochrane Oral Health Group’s
any appreciable clinical benefits. There is a definite need Trials Register, CENTRAL, MEDLINE, and EMBASE were
for more RCTs to ascertain the effectiveness of HBO in searched up to June 9, 2011 for randomized controlled
irradiated patients requiring dental implants. These trials trials (RCTs) comparing agents or interventions for treat-
ought to be of a high quality and reported as recommended ing peri-implantitis around oral implants. Primary outcome
by the CONSORT statement (www.consort-statement.org/). measures were implant failure, radiographic marginal bone
Each clinical center may have limited numbers of patients, level change, complications and side effects, and recur-
and it is likely that trials will need to be multicentered. rence of peri-implantitis. Screening of eligible studies, as-
Correspondence to: espositomarco@hotmail.com. sessment of the methodological quality of the trials, and
data extraction were conducted in duplicate and indepen-
Ajami E, Mahno E, Mendes VC, Bell S, Moineddin R, dently by two review authors. The statistical unit was the
Davies JE. Bone healing and the effect of implant patient and not the implant unless the clustering of the
surface topography on osteoconduction in hypergly- implants within the patients had been taken into account.
cemia. Acta Biomater 2013 Sept 26. doi: 10.1016/ Results were expressed as random-effects models using
j.actbio.2013.09.020 [epub ahead of print]. mean differences for continuous outcomes and risk ratios
Dental implant failures that occur clinically for unknown for dichotomous outcomes with 95% confidence intervals
reasons could be related to undiagnosed hyperglycemia. (CI). Fifteen eligible trials were identified, but six were ex-
The exact mechanisms that underlie such failures are not cluded. The following interventions were compared in the
known, but there is general consensus that bone growth nine included studies: different nonsurgical interventions
is compromised in hyperglycemia. Nevertheless, contra- (five trials), adjunctive treatments to nonsurgical interven-
dictory findings exist related to peri-implant bone healing tions (one trial), different surgical interventions (two trials),
in hyperglycemia. We hypothesized that hyperglycemia de- and adjunctive treatments to surgical interventions (one
lays early bone healing by impeding osteoconduction, and trial). Follow-up ranged from 3 months to 4 years. No study
that the compromised implant integration wrought by hy- was judged to be at low risk of bias. Statistically significant
perglycemia could be abrogated by using nanotopographi- differences were observed in two small single trials judged
cally complex implants. Thus, we undertook two parallel to be at unclear or high risk of bias. After 4 months, adjunc-
experiments: an osteotomy model and a bone ingrowth tive local antibiotics to manual debridement in patients who
chamber model. With the osteotomy model, we tracked lost at least 50% of the bone around implants showed im-
temporal bone healing in femora of euglycemic and hyper- proved mean probing attachment levels (PAL) of 0.61 mm
glycemic rats using MicroCT analysis and histology. With (95% CI 0.40 to 0.82) and reduced probing pockets depths
the bone ingrowth chamber model, we used implant sur- (PPD) of 0.59 mm (95% CI 0.39 to 0.79). After 4 years,
faces of either micro- or nanotopographical complexity and patients with peri-implant infrabony defects >3 mm treated
measured bone-implant contact (BIC) using backscattered with Bio-Oss and resorbable barriers showed an improve-
electron imaging in both metabolic groups. Quantitative Mi- ment of 1.4 mm for PAL (95% CI 0.24 to 2.56) and PPD
croCT analyses on bone volume, trabecular number, and (95% CI 0.81 to 1.99) compared to patients treated with a
trabecular connectivity density provided clear evidence nanocrystalline hydroxyapatite. It was concluded that there
that bone healing, both reparative trabecular bone forma- is no reliable evidence suggesting which could be the most
tion and remodeling, was delayed in hyperglycemia, and effective interventions for treating peri-implantitis. This is
the reparative bone volume changed with time between not to say that currently used interventions are not effec-
metabolic groups. Furthermore, fluorochrome labeling tive. A single small trial at unclear risk of bias showed that
proved evidently less mineralized bone in hyperglycemic the use of local antibiotics in addition to manual subgingi-
than in euglycemic animals. An increased probability of val debridement was associated with a 0.6 mm additional
osteoconduction was seen on nano- compared to micro- improvement in PAL and PPD over a 4-month period in pa-
topographically complex surfaces independent of meta- tients affected by severe forms of peri-implantitis. Another
bolic groups. The nanotopographically complex surfaces in small single trial at high risk of bias showed that after 4
hyperglycemia outperformed microtopographically complex years, improved PAL and PPD of approximately 1.4 mm

The International Journal of Oral & Maxillofacial Implants 1457

© 2 0 1 3 BY Q UIN TESSEN CE PUBLISHIN G C O , IN C. PRIN TIN G O F T HIS D O CUMEN T IS RESTRIC TED T O PERSO N AL USE O NLY.
N O PART MAY BE REPRO DUCED OR TRA NSMIT TED IN A NY F ORM WIT H O UT WRIT TEN PERMISSIO N FRO M T HE PUBLISHER.
Thematic Abstract Review

were obtained when using Bio-Oss with resorbable barri- cause it may reduce treatment time, number of surgeries,
ers compared to a nanocrystalline hydroxyapatite in peri- and postextraction bone loss. However, this is potentially
implant infrabony defects. There is no evidence from four challenged by inadequate keratinized mucosa for flap ad-
trials that the more complex and expensive therapies were aptation and difficulties in achieving primary stability. More-
more beneficial than the control therapies, which basically over, it has been proven that postextraction bone loss is
consisted of simple subgingival mechanical debridement. an inevitable biological process, which affects treatment
Follow-up longer than 1 year suggested recurrence of peri- outcomes. The objectives of this study were to estimate
implantitis in up to 100% of the treated cases for some of survival and success rates of implants and the implant-
the tested interventions. As this can be a chronic disease, supported prostheses; the prevalence of biological, tech-
re-treatment may be necessary. Larger well-designed RCTs nical, and esthetic complications; and the magnitude of
with follow-ups longer than 1 year are needed. soft and hard tissue changes following implant placement
Correspondence to: espositomarco@hotmail.com immediately into fresh extraction sockets. An electronic
search in MEDLINE (PubMed) and the Cochrane Library
Balshi TJ, Wolfinger GJ, Slauch RW, Balshi SF. from 1991 to July 2010 was performed to include prospec-
A retrospective analysis of 800 Brånemark Sys- tive studies on immediate implants with a mean follow-up
tem implants following the All-on-Four™ protocol. time of at least 1 year. The survival rates were computed
J Prosthodont 2013 Jul 25. doi: 10.1111/jopr.12089 using the STATA statistical software. Weighted means of
[epub ahead of print]. soft and hard tissue changes were obtained by the inverse
The purpose of this study was to retrospectively evaluate variance method. A total of 46 prospective studies, with
implant survival rates in patients treated with the All-on- a mean follow-up time of 2.08 years, were included. The
Four protocol according to edentulous jaws, gender, and annual failure rate of immediate implants was 0.82% (95%
implant orientation (tilted vs. axial). All Brånemark System CI: 0.48–1.39%), translating into the 2-year survival rate
implants placed in patients following the All-on-Four proto- of 98.4% (97.3–99%). Among the five factors analyzed
col in a single private practice were separated into multiple (reasons for extraction, antibiotic use, position of implant
classifications (maxilla vs. mandible; male vs. female; tilt- [anterior vs posterior, maxilla vs mandible], type of load-
ed vs. axial) by retrospective patient chart review. Inclusion ing), only the regimen of antibiotic use affected the sur-
criteria consisted of any Brånemark System implant placed vival rate significantly. Lower failure rates were found in
with the All-on-Four protocol from the clinical inception (May groups that were provided with a course of postoperative
2005) until December 2011. Life tables were constructed antibiotics. The success of implant therapy was difficult
to determine cumulative implant survival rates (CSR). The to assess due to scarce reporting on biological, technical,
arches, genders, and implant orientations were statistically and esthetic complications. Soft tissue changes occurred
compared with ANOVA. One hundred fifty-two patients, com- mostly in the first 3 months after the provision of restora-
prising 200 arches (800 implants) from May 2005 until tion, and then stabilized toward end of the first year. Mar-
December 2011, were included in the study. Overall im- ginal bone loss predominantly took place in the first year
plant CSR was 97.3% (778 of 800). Two hundred eighty- after implant placement, with a magnitude generally less
nine of 300 maxillary implants and 489 of 500 mandibular than 1 mm. Controversy on hard tissue preservation with
implants survived, for CSRs of 96.3% and 97.8%, respec- platform-switching technique remained unsolved. It was
tively. In male patients, 251 of 256 implants (98.1%) re- concluded that despite the high survival rate observed,
main in function, while 527 of 544 implants (96.9%) in more long-term studies are necessary to determine the
female patients survived. Regarding implant orientation, success of implant treatment provided immediately after
389 of 400 tilted implants and 389 of 400 axial implants tooth extraction. Special attention has to be given to es-
osseointegrated, for identical CSRs of 97.3%. All compari- thetic outcomes.
sons were found to be statistically insignificant. The pros- Correspondence to: iriskylau@hotmail.com
thesis survival rate was 99.0%. The results from this study
suggest that edentulous jaws, gender, and implant orienta- Esposito M, Grusovin MG, Worthington HV. Inter-
tion are not significant parameters when formulating an ventions for replacing missing teeth: Antibiotics at
All-on-Four treatment plan. The high CSRs for each variable dental implant placement to prevent complications.
analyzed demonstrate the All-on-Four treatment as a viable Cochrane Database Syst Rev 2013;7:CD004152.
alternative to more extensive protocols for rehabilitating doi: 10.1002/14651858.CD004152.pub4.
the edentulous maxilla or mandible. Some dental implant failures may be due to bacterial con-
Correspondence to: balshi2@aol.com tamination at implant insertion. Infections around biomate-
rials are difficult to treat, and almost all infected implants
Lang NP, Pun L, Lau KY, Li KY, Wong MC. A sys- have to be removed. In general, antibiotic prophylaxis in
tematic review on survival and success rates of surgery is only indicated for patients at risk of infectious
implants placed immediately into fresh extraction endocarditis; with reduced host response; when surgery
sockets after at least 1 year. Clin Oral Implants Res is performed in infected sites; in cases of extensive and
2012;23(suppl 5):39–66. prolonged surgical interventions; and when large foreign
Immediate implant placement has gained popularity be- materials are implanted. A variety of prophylactic systemic

1458 Volume 28, Number 6, 2013

© 2 0 1 3 BY Q UIN TESSEN CE PUBLISHIN G C O , IN C. PRIN TIN G O F T HIS D O CUMEN T IS RESTRIC TED T O PERSO N AL USE O NLY.
N O PART MAY BE REPRO DUCED OR TRA NSMIT TED IN A NY F ORM WIT H O UT WRIT TEN PERMISSIO N FRO M T HE PUBLISHER.
Thematic Abstract Review

antibiotic regimens have been suggested to minimize in- infections (RR 0.69; 95% CI 0.36 to 1.35), or adverse
fections after dental implant placement. More recent pro- events (RR 1; 95% CI 0.06 to 15.85) (only two minor ad-
tocols recommended short-term prophylaxis, if antibiotics verse events were recorded, one in the placebo group).
have to be used. Adverse events may occur with the ad- No conclusive information can be derived from the only
ministration of antibiotics, and can range from diarrhea to trial that compared three different durations of antibiotic
life-threatening allergic reactions. Another major concern prophylaxis since no event (implant/prosthesis failures,
associated with the widespread use of antibiotics is the infections, or adverse events) occurred in any of the 25
selection of antibiotic-resistant bacteria. The use of pro- participants included in each study group. There were no
phylactic antibiotics in implant dentistry is controversial. trials that evaluated different antibiotics or different anti-
The objectives of this study were to assess the beneficial biotic dosages. It was concluded that scientific evidence
or harmful effects of systemic prophylactic antibiotics at suggests that, in general, antibiotics are beneficial for re-
dental implant placement versus no antibiotic or placebo ducing failure of dental implants placed in ordinary condi-
administration and, if antibiotics are beneficial, to deter- tions. Specifically, 2 g or 3 g of amoxicillin given orally, as a
mine which type, dosage, and duration is the most effec- single administration, one hour preoperatively significantly
tive. The following electronic databases were searched: reduces failure of dental implants. No significant adverse
the Cochrane Oral Health Group’s Trials Register (to June events were reported. It might be sensible to suggest the
17, 2013), the Cochrane Central Register of Controlled use of a single dose of 2 g prophylactic amoxicillin prior to
Trials (CENTRAL) (The Cochrane Library 2013, Issue 5), dental implant placement. It is still unknown whether post-
MEDLINE via OVID (1946 to June 17, 2013), and EMBASE operative antibiotics are beneficial, and which antibiotic is
via OVID (1980 to June 17, 2013). There were no language the most effective.
or date restrictions placed on the searches of the elec- Correspondence to: espositomarco@hotmail.com.
tronic databases. The selection criteria was randomized
controlled clinical trials (RCTs), with a follow-up of at least
3 months, that compared the administration of various
prophylactic antibiotic regimens versus no antibiotics to
people undergoing dental implant placement. Outcome
measures included prosthesis failures, implant failures,
postoperative infections, and adverse events (gastrointes-
tinal, hypersensitivity, etc). Screening of eligible studies,
assessment of the risk of bias of the trials, and data ex-
traction were conducted in duplicate and independently by
DIRECTOR OF IMPLANT DENTISTRY
two review authors. Results were expressed as risk ratios Department of Periodontology
(RRs) using a random-effects model for dichotomous out- and Implant Dentistry
comes with 95% confidence intervals (CIs). Heterogeneity, NYU COLLEGE OF DENTISTRY
including both clinical and methodological factors, was to
be investigated. Six RCTs with 1,162 participants were in- New York University College of Dentistry is one of the most dynamic
and robust dental education and research institutions in the world. The
cluded: Three trials compared 2 g of preoperative amoxicil- Department of Periodontology and Implant Dentistry is one of the largest
of its kind, educating students from both the United States and abroad.
lin versus placebo (927 participants), one compared 3 g
The Implant Dentistry Program, an integral component of the
of preoperative amoxicillin versus placebo (55 partici- Department of Periodontology and Implant Dentistry is seeking a
pants), one compared 1 g of preoperative amoxicillin plus full-time Director at the faculty rank of Assistant Professor or above.
The Director, along with the Department Chairperson, will be given
500 mg four times a day for 2 days versus no antibiotics significant resources to redefine the mission of the Program in its
(80 participants), and one compared four groups: (1) 2 g of continued quest toward excellence in its educational, patient care and
research programs.
preoperative amoxicillin; (2) 2 g of preoperative amoxicillin
Responsibilities will include leading and administering the Division of
plus 1 g twice a day for 7 days; (3) 1 g of postoperative Implant Dentistry, didactic and clinical teaching in pre and post doctoral
amoxicillin twice a day for 7 days; and (4) no antibiotics dental programs, patient care and service. The successful candidate will
be proficient in all phases of surgical and prosthetic implant dentistry.
(100 participants). The overall body of evidence was con- In addition, he/she will be a dynamic educator with both significant
administrative and research experience. Candidates must possess a
sidered to be of moderate quality. The meta-analyses of the dental degree and be eligible for either a NYS license or a restricted
six trials showed a statistically significant higher number NYS faculty license to practice dentistry. Advanced specialty training is
highly desirable. Intramural and extramural practice opportunities are
of participants experiencing implant failures in the group available, dependent upon licensure.
not receiving antibiotics (RR 0.33; 95% CI 0.16 to 0.67, NYU offers an excellent benefits package. Salary and academic rank
P value .002, heterogeneity: Tau(2) 0.00; Chi(2) 2.87, will be commensurate with qualifications and experience. Applicants
should send a letter of intent and curriculum vitae no later than
df = 5 (P value .57); I(2) 0%). The number needed to treat December 15, 2013 to: Dr. Steven P. Engebretson, Chair, Department
for one additional beneficial outcome (NNTB) to prevent of Periodontology and Implant Dentistry, New York University College
of Dentistry, 345 East 24th Street, Suite 3W, New York, NY 10010.
one person having an implant failure is 25 (95% CI 14 to
100), based on an implant failure rate of 6% in participants
not receiving antibiotics. There was borderline statistical
significance for prosthesis failures (RR 0.44; 95% CI 0.19
to 1.00), with no statistically significant differences for NYU is an Equal Opportunity/Affirmative Action Employer.

The International Journal of Oral & Maxillofacial Implants 1459

© 2 0 1 3 BY Q UIN TESSEN CE PUBLISHIN G C O , IN C. PRIN TIN G O F T HIS D O CUMEN T IS RESTRIC TED T O PERSO N AL USE O NLY.
N O PART MAY BE REPRO DUCED OR TRA NSMIT TED IN A NY F ORM WIT H O UT WRIT TEN PERMISSIO N FRO M T HE PUBLISHER.

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