Two teams of researchers. Two studies. One shared conviction: that the best clinical questions are the ones that keep you up at night.
There is a particular kind of scientific restlessness that tends to produce good research. It is not the ambition to publish, nor the pressure to produce. It is something closer to irritation — a clinician standing at the chair, watching a pattern they cannot explain, refusing to let it go.
This year’s André Schroeder Research Prize winners share that quality in abundance. One team — Ettore Amerio and Francesco Sparano, working together out of Barcelona and Sardinia — traced a biological mechanism behind one of implant dentistry’s most stubborn risk factors. The other — led by Franz J. Strauss at the University of Zurich — tackled a decision clinicians face daily, comparing two ways of restoring missing posterior teeth in bone-limited sites. Different problems, different methods, different corners of the world. But all three researchers describe the same starting point: a question that emerged from practice and would not be answered by the existing literature.
The André Schroeder Research Prize, awarded annually by the ITI, is among the most respected recognitions in implant dentistry. This year’s awards go to two studies — one examining the biological mechanisms by which smoking drives peri-implant disease, the other comparing two common clinical approaches to restoring missing posterior teeth in bone-limited sites. Together, they illustrate something the ITI has always held to be true: that rigorous science and daily clinical relevance are not in tension. The best research is, almost by definition, both.
“Smokers are more challenging patients — but why, exactly?”
Ettore Amerio has spent the better part of a decade looking for the answer to that question. A graduate of Genoa and a specialist trained in Turin, he completed a master’s in Periodontology and Implantology at the International University of Catalonia in Barcelona — a programme that would prove decisive. It was there, working under the mentorship of Professor Alberto Monje, that he first became absorbed by peri-implant diseases and the biology of smoking.
“The growing scientific interest in macrophage polarization as a key regulator of inflammation and regeneration,” he says, “strongly inspired the research direction.” Macrophages are the immune system’s frontline responders: cells that can pivot between a pro-inflammatory state (M1) and a pro-healing one (M2). The balance between these two phenotypes shapes how tissue responds to injury, infection, and disease. Amerio wanted to know whether smoking shifts that balance in peri-implantitis lesions — and if so, how.
The results were striking. Smokers with peri-implantitis showed a clear predominance of M1 macrophages compared to non-smokers — a persistently inflamed immune profile that offers a potential biological explanation for something clinicians have long observed but struggled to explain mechanistically. “This finding,” Amerio says, “identifies a biological mechanism — so far poorly explored in periodontal and peri-implant literature — through which smoking may negatively influence peri-implant tissue stability and disease progression.”
Francesco Sparano, who co-led the study, frames it with characteristic directness: “Smokers tend to be more challenging patients in terms of inflammation, healing and long-term stability around implants. Our study gives biological support to something clinicians often observe in daily practice.”
Sparano’s path to research is the kind that defies easy categorisation. He grew up in a family dental practice in Sardinia — which is precisely why, he says, he needed to leave. He spent time in Siena, Milan, Brazil, and eventually Barcelona, accumulating not just clinical experience but a growing curiosity about what lay beneath the surface of what he was seeing. “Research started for me from clinical curiosity,” he says. “The more I was exposed to periodontology and implant dentistry, the more I realised that good clinical practice needs a strong biological and scientific foundation.”
Both Amerio and Sparano are careful to contextualise what the study does and does not show. M2 macrophage counts, cytokine concentrations, and microbiota diversity did not differ significantly between smokers and non-smokers — a reminder, as Sparano puts it, that “peri-implantitis is a complex and multifactorial disease.” The M1 shift is not the whole story. But it is, they argue, an important piece of it — and a potential therapeutic target for the future.
What this means clinically, Sparano suggests, is more than a biological footnote. “Smoking should not be considered only as a general negative habit. In peri-implantitis lesions, it may be associated with a more pro-inflammatory local environment. This means improving prevention, communicating risk more clearly to patients, encouraging smoking cessation, selecting cases carefully and applying strict maintenance protocols.” Amerio, currently pursuing his doctorate at UIC Barcelona while lecturing at the University of Milan, sees immune modulation as a horizon worth moving toward. The study, he says, “paves the way for future preventive and treatment protocols that may complement current clinical approaches.”
For Sparano, now back in Sardinia working in private practice while maintaining his collaboration with Barcelona, the award carries a particular resonance. “Receiving this recognition from the ITI has been a great honor for the whole team,” he says — and you sense he means it precisely as stated: the team, not just himself.
“Two implants or one? It depends — but perhaps not in the way you’d expect.”
Franz J. Strauss arrived at his research question from a different direction entirely. Born in Chile, trained in periodontology there, he spent years in private practice and hospital settings before a growing interest in research led him to apply for the Osteology Research Scholarship — a decision that took him to Vienna, to a PhD at the Medical University, and eventually to what is now his base at the Clinic of Reconstructive Dentistry at the University of Zurich.
“In my opinion,” he says, when asked what it takes to become a researcher, “it really comes down to two key elements: persistence and mentorship.” It’s a characteristically spare answer from someone who has clearly thought hard about what the enterprise actually demands.
His study addresses a question that arises constantly in implant practice: when a patient is missing two posterior teeth in a site with limited bone height, what is the better option — placing two short implants, or placing a single short implant supporting a cantilever restoration? Both approaches have gained traction as implant dentistry has moved toward less invasive techniques. Both are procedures his clinic’s faculty and residents perform regularly. Strauss and his team compared them not only on clinical and radiographic outcomes, but on cost-effectiveness — a dimension of implant research that remains, he notes, relatively underexplored.
The headline result is perhaps unexpected in its evenhandedness: overall, both approaches performed similarly. Clinical and radiographic outcomes were comparable. But the economic picture gave the cantilever a modest advantage. “The cantilever approach tended to be more cost-effective than placing two short implants,” Strauss says — while adding an important qualification: slightly higher rates of early complications and failures were observed in the cantilever group, most likely due to the increased mechanical loading on a single implant.
“So the take-home message,” he says, “is that both options can work well clinically, but the cantilever approach may be more cost-effective — and that is information clinicians can use.”
The clinical relevance is almost self-evident: this is a decision that plays out in consultation rooms every day. “One of the main reasons I joined the Clinic of Reconstructive Dentistry at the University of Zurich,” Strauss says, “was to focus on clinical research that is directly applicable to everyday practice.” The treatments his team studies are not theoretical. They are the same procedures his colleagues perform on patients the following morning.
For Strauss, receiving the ASRP carries a deeply personal weight. He first encountered the prize when he joined the ITI in Chile, as a young researcher for whom it represented something aspirational and remote. “Coming from South America,” he says, “I never really imagined that one day I would be in a position to receive such a prestigious award. Being part of such an outstanding team in Zurich made it possible.” The years abroad — Vienna, Switzerland, the UK, Australia — involved what he calls “many sacrifices, especially with a family.” But moments like this, he says, make him feel the journey was worth it.
What connects them
Three researchers, two studies, one prize. What connects Amerio, Sparano, and Strauss — beyond the award — is a shared conviction about what research is for.
All three describe starting from clinical reality and feeling dissatisfied with the available answers. All three credit mentorship as essential, not incidental. And all three are clear-eyed about the limits of their own findings: the M1 macrophage story needs further investigation; the cantilever data should prompt further trials. Good science, they each suggest in different ways, does not close questions — it sharpens them.
The ITI, all three note, is central to making that kind of work possible. Strauss puts it plainly: “Organizations like the ITI are essential for driving research forward. They support projects financially, but also bring together an international community of clinicians and researchers. This collaboration is key to generating meaningful evidence and making sure it actually reaches daily clinical practice.” Sparano adds a more personal note: “Through Study Clubs, courses and congresses, you have the opportunity to meet excellent clinicians and researchers from all over the world — people who are genuinely open to sharing knowledge, experience and ideas.”
Amerio, the most recently minted of the three in terms of academic career, perhaps captures the spirit most simply. Scientific curiosity, he says, needs to be combined with intellectual rigor, consistency, humility, and resilience. “Meaningful research,” he says, “is built through long-term commitment rather than short-term results.”
It is, in the end, the same quality that tends to produce good clinicians. The willingness to stay with a problem until it gives up its answer — and then to ask the next question.
Have you published your research? Apply for the 2026 André Schroeder Research Prize at iti.org/research/andre-schroeder-prize.
