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McCracken G, Asuni A, Ritchie M, Vernazza C, Heasman P. Failing to meet the goals of periodontal recall programs. What next? Periodontol 2000 2017; 75:330-352. [DOI: 10.1111/prd.12159] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Surgical Treatment of Implants Affected by Periimplantitis After 15 Years of Loading: A Case Report. IMPLANT DENT 2017; 25:288-92. [PMID: 26910186 DOI: 10.1097/id.0000000000000398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this case report is to describe the surgical treatment of 2 implants affected by periimplantitis after 15 years of loading. MATERIALS AND METHODS The treatment included mechanical and chemical decontamination with topical application of tetracycline associated with a regenerative approach. Both defects were filled with particulate autogenous bone from tuber and covered with resorbable collagen membrane. RESULTS The follow-up of 30 and 13 months of the implants 24 and 14, respectively, showed an absence of clinical signs of periimplant inflammation and near-complete bone regeneration. CONCLUSIONS The therapy approach was effective in eliminating periimplant inflammation and promoting bone gain around the implants.
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Valente NA, Calascibetta A, Patianna G, Mang T, Hatton M, Andreana S. Thermodynamic Effects of 3 Different Diode Lasers on an Implant-Bone Interface: An Ex-Vivo Study With Review of the Literature. J ORAL IMPLANTOL 2016; 43:94-99. [PMID: 28001482 DOI: 10.1563/aaid-joi-d-16-00188] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study is to assess the increase of temperature following laser irradiation with 810 nm, 980 nm, and 1064 nm diode laser wavelengths, of an implant under conditions that more closely replicate those of the human body. A 4 × 14 mm machined surface implant was placed in a porcine rib to replicate the conductivity of heat given by the bone. A peri-implant vertical defect was made that was 2 mm wide and 2 mm deep to simulate bone resorption. Two thermocouples were positioned crestally and apically on the implant surface. The tip of the laser was kept 3 mm away from the surface and continuously moved in an up-and-down and side-to-side fashion, inside the defect for 60 seconds. Initial temperatures and the time needed to reach an increase of 10°C were recorded. The experiment was repeated at room temperature and in a 37°C water bath with the following settings: 0.6 W, 0.8 W, 1 W continuous and repeated in pulsed. A critical increase of temperature of more than 10°C is reached with all lasers at 0.8 W and 1 W in continuous mode at room temperature. Only the 1064 nm diode laser reached the critical increase at 0.8 W in pulsed mode. No critical increase of temperature was registered with other settings and when the bone block was placed in a 37°C water bath. The results of this study suggest that use of these diode lasers does not cause a harmful increase in temperature when used under conditions similar to those of the human body.
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Affiliation(s)
- Nicola Alberto Valente
- 1 Department of Periodontics and Endodontics, State University of New York at Buffalo, Buffalo, NY
| | | | | | - Thomas Mang
- 4 Department of Oral and Maxillofacial Surgery, State University of New York at Buffalo, Buffalo, NY
| | - Michael Hatton
- 5 Department of Oral Diagnostic Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Sebastiano Andreana
- 6 Department of Restorative Dentistry, State University of New York at Buffalo, Buffalo, NY
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Hamdan N, Batista FC, Batista EL. Surgical Management of a Severe Early Implant Complication: A 19-Year Follow-Up Case Report. Clin Adv Periodontics 2016; 6:203-207. [PMID: 31535477 DOI: 10.1902/cap.2016.160010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 04/18/2016] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Reports on long-term response to treatment of different implant complications with a span of more than 15 years are scarce. This case report presents a patient with early severe bone loss around an unloaded dental implant, with treatment and 19-year follow up. CASE PRESENTATION A 60-year-old male non-smoker with no known systemic contributory history presented for replacement of the mandibular right first molar. The tooth was replaced with a titanium plasma-sprayed (TPS) implant using a non-submerged healing approach. Eight weeks post-surgery the patient reported discomfort in the area, followed by swelling, suppuration, and deep probing depths (PDs). A full-thickness flap revealed a bone defect that was thoroughly debrided until its deepest extension. The implant surface was scaled and subjected to air-powder treatment, followed by rubbing the TPS surface with a cotton pellet soaked in HCl-tetracycline. Guided bone regeneration was accomplished with use of an allograft followed by placement of a non-resorbable membrane. Follow-up after 19 years showed stability of the bone gain and reduction of PDs. CONCLUSION The 19-year successful long-term result calls attention to the potential benefit of the combined anti-infective/regenerative approach and lasting effects of surgical management of early implant complications.
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Affiliation(s)
- Nader Hamdan
- Currently, Division of Periodontics, Department of Clinical Sciences Faculty of Dentistry, Dalhousie University, Halifax, NS; previously, Division of Periodontics, Department of Oral Diagnostics and Surgical Sciences, College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB
| | - Felipe Correa Batista
- Division of Oral and Maxillofacial Surgery, Lutheran University of Brazil, Canoas, RS, Brazil
| | - Eraldo L Batista
- Division of Periodontics, Department of Oral Diagnostics and Surgical Sciences, College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba.,Department of Oral Biology, College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba
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Ramanauskaite A, Daugela P, Faria de Almeida R, Saulacic N. Surgical Non-Regenerative Treatments for Peri-Implantitis: a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2016; 7:e14. [PMID: 27833739 PMCID: PMC5100639 DOI: 10.5037/jomr.2016.7314] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 08/30/2016] [Indexed: 11/25/2022]
Abstract
Objectives The purposes of the present study were 1) to systematically review the literature on the surgical non-regenerative treatments of peri-implantitis and 2) to determine a predictable therapeutic option for the clinical management of peri-implantitis lesions. Material and Methods The study search was performed on primary database MEDLINE and EMBASE from 2005 until 2016. Sequential screenings at the title, abstract, and full-text levels were performed. Clinical human studies in the English language that had reported changes in probing depth (PD) and/or bleeding on probing (BOP) and/or radiologic marginal bone level changes after peri-implantitis surgical non-regenerative treatment at 6-month follow-up or longer were included accordingly PRISMA guidelines. Results The first electronic and hand search resulted in 765 citations. From 16 full-text articles reviewed, 6 were included in this systematic review. Surgical non-regenerative methods were found to be efficient in reducing clinical parameters. BOP and PD values were significantly decreased following implantoplasty and systematic administration of antibacterials, but not after local application of chemical compounds or diode laser. Similarly, significant improvement in clinical and radiographic parameters was found only after implantoplasty compared with resective surgery alone. We found significant heterogeneity in study designs and treatments provided among the pooled studies. All of the studies revealed an unclear or high risk of bias. Conclusions Surgical non-regenerative treatment of peri-implantitis was found to be effective to reduce the soft tissue inflammation and decrease probing depth. More randomized controlled clinical trials are needed to assess the efficacy of surgical non-regenerative therapy of peri-implantitis.
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Affiliation(s)
- Ausra Ramanauskaite
- Clinic of Dental and Oral Pathology, Lithuanian University of Health Sciences, Kaunas Lithuania
| | - Povilas Daugela
- Department of Oral and Maxillofacial Surgery, Kaunas University of Medicine Lithuania
| | - Ricardo Faria de Almeida
- Department of Oral Surgery and Periodontology, School of Dental Medicine, University of Porto, Porto Portugal
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, Bern Switzerland
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Ghanem A, Pasumarthy S, Ranna V, Kellesarian SV, Abduljabbar T, Vohra F, Malmstrom H. Is mechanical curettage with adjunct photodynamic therapy more effective in the treatment of peri-implantitis than mechanical curettage alone? Photodiagnosis Photodyn Ther 2016; 15:191-6. [DOI: 10.1016/j.pdpdt.2016.06.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 06/15/2016] [Accepted: 06/22/2016] [Indexed: 12/12/2022]
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Cheng Y, Gao B, Liu X, Zhao X, Sun W, Ren H, Wu J. In vivo evaluation of an antibacterial coating containing halogenated furanone compound-loaded poly(l-lactic acid) nanoparticles on microarc-oxidized titanium implants. Int J Nanomedicine 2016; 11:1337-47. [PMID: 27099494 PMCID: PMC4821396 DOI: 10.2147/ijn.s100763] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
To prevent peri-implant infection, a new antibacterial coating containing a halogenated furanone compound, (Z-)-4-bromo-5-(bromomethylene)-2(5H)-furanone-loaded poly(l-lactic acid) nanoparticles, has been fabricated. The current study was designed to evaluate the preventive effect of the antibacterial coating under a simulated environment of peri-implant infection in vivo. Microarc-oxidized titanium implants treated with minocycline hydrochloride ointment were used as positive control group, and microarc-oxidized titanium implants without any treatment were used as blank control group. Three kinds of implants were implanted in dogs’ mandibles, and the peri-implant infection was simulated by silk ligation and feeding high sugar diet. After 2-month implantation, the results showed that no significant differences were detected between the experimental and positive control groups (P>0.05), but the data of clinical measurements of the blank control group were significantly higher than those of the other two groups (P<0.05), and the bone–implant contact rate and ultimate interfacial strength were significantly lower than those of the other two groups (P<0.05). Scanning electron microscope observation and histological examination showed that more new bone was formed on the surface of the experimental and positive control groups. It can be concluded that the antibacterial coating fabricated on implants has remarkable preventive effect on peri-implant infection at the early stage.
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Affiliation(s)
- Yicheng Cheng
- Department of Prosthodontics, State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Stomatology, Bayi Hospital, Nanjing University of Chinese Medicine, Nanjing, People's Republic of China; Department of Prosthodontics, Shaanxi Key Laboratory of Stomatology, Xi'an, People's Republic of China
| | - Bo Gao
- Department of Prosthodontics, State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Prosthodontics, Shaanxi Key Laboratory of Stomatology, Xi'an, People's Republic of China
| | - Xianghui Liu
- Department of Stomatology, Bayi Hospital, Nanjing University of Chinese Medicine, Nanjing, People's Republic of China
| | - Xianghui Zhao
- Institute of Neuroscience, School of Basical Medical Science, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Weige Sun
- Department of Stomatology, Bayi Hospital, Nanjing University of Chinese Medicine, Nanjing, People's Republic of China
| | - Huifang Ren
- Department of Prosthodontics, State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Prosthodontics, Shaanxi Key Laboratory of Stomatology, Xi'an, People's Republic of China
| | - Jiang Wu
- Department of Prosthodontics, State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Prosthodontics, Shaanxi Key Laboratory of Stomatology, Xi'an, People's Republic of China
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Mensi M, Scotti E, Francetti L, Giargia M, Latronico M, Camurati A, Guarnelli M, Rotundo R. Passato, presente e futuro dei coadiuvanti locali e sistemici nel trattamento non chirurgico di perimplantiti e parodontiti: indicazioni e limiti. DENTAL CADMOS 2016. [DOI: 10.1016/s0011-8524(16)30036-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Robitaille N, Reed D, Walters J, Kumar P. Periodontal and peri-implant diseases: identical or fraternal infections? Mol Oral Microbiol 2015; 31:285-301. [DOI: 10.1111/omi.12124] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2015] [Indexed: 01/04/2023]
Affiliation(s)
- N. Robitaille
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH USA
| | - D.N. Reed
- Division of General Practice and Material Sciences
| | - J.D. Walters
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH USA
| | - P.S. Kumar
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH USA
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Faramarzi M, Goharfar Z, Pourabbas R, Kashefimehr A, Shirmohmmadi A. Microbiological and clinical effects of enamel matrix derivative and sustained-release micro-spherical minocycline application as an adjunct to non-surgical therapy in peri-implant mucosal inflammation. J Korean Assoc Oral Maxillofac Surg 2015; 41:181-9. [PMID: 26339576 PMCID: PMC4558186 DOI: 10.5125/jkaoms.2015.41.4.181] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 04/18/2015] [Accepted: 05/03/2015] [Indexed: 11/24/2022] Open
Abstract
Objectives The purpose of this study was to compare the microbial and clinical effects of mechanical debridement (MD) alone or in combination with the application of enamel matrix derivative (EMD) and sustained-release micro-spherical minocycline (MSM) for treatment of peri-implant mucosal infl ammation (PIMI). Materials and Methods Subjects with at least one implant with PIMI were included and divided into control and two different test groups. In all three groups, MD was performed. In the MSM group, following MD, MSM was placed subgingivally around the implants. In the EMD group, after MD, EMD was placed in the sulcus around the implants. Sampling of peri-implant crevicular fl uid for microbial analysis with real-time polymerase chain reaction and recording of probing depth (PD) and bleeding on probing (BOP) were performed prior to as well as two weeks and three months after treatment. Median values and interquartile range were estimated for each variable during the various assessment intervals of the study. Results In all groups, at two weeks and three months, the counts of Porphyromonas gingivalis decreased significantly compared to baseline. Levels of P. gingivalis were significantly reduced in MSM (P<0.001) and EMD (P=0.026) groups compared to the control group. Also, clinical parameters improved significantly at two weeks and three months. Reduction of PD was significant in MSM (P<0.001) and EMD (P<0.001) groups. The decrease in BOP in the MSM, EMD, and control groups was 60%, 50%, and 20%, respectively. Conclusion The use of MSM and EMD can be an adjunctive treatment for management of PIMI and improves clinical parameters and reduces P. gingivalis burden three months after treatment.
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Affiliation(s)
- Masumeh Faramarzi
- Department of Periodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Goharfar
- Department of Periodontics, Urmia University of Medical Sciences, Urmia, Iran
| | - Reza Pourabbas
- Department of Periodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Atabak Kashefimehr
- Department of Periodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Adileh Shirmohmmadi
- Department of Periodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Surgical Treatment of Peri-Implantitis: A 17-Year Follow-Up Clinical Case Report. Case Rep Dent 2015; 2015:574676. [PMID: 26064700 PMCID: PMC4443933 DOI: 10.1155/2015/574676] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 04/27/2015] [Indexed: 12/16/2022] Open
Abstract
The purpose of the present case report was to describe the surgical treatment of a peri-implantitis lesion associated with a regenerative approach. A 48-year-old patient came to authors' attention 36 months after the placement of a dental implant (ITI-Bonefit Straumann, Waldenburg, Switzerland) in position 46. A swelling of the peri-implant soft tissues was observed, associated with bleeding on probing and probing depth > 10 mm. A significant peri-implant bone loss was clearly visible on the periapical radiograph. A nonsurgical periodontal supportive therapy was firstly conducted to reduce the inflammation, followed by the surgical treatment of the defect. After mechanical and chemical decontamination with tetracycline solution, a regenerative approach consisting in the application of deproteinized bovine bone mineral (Bio-Oss, Geistlich Pharma AG, Wolhusen, Switzerland) and a collagen membrane (Bio-Gide, Geistlich Pharma AG, Wolhusen, Switzerland) was performed. An antibiotic therapy was associated with the treatment. The 17-year follow-up showed a physiological probing depth with no clinical signs of peri-implant inflammation and bleeding on probing. No further radiographic bone loss was observed. The treatment described in the present case report seemed to show improved clinical results up to a relevant follow-up period.
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Renvert S, Polyzois IN. Clinical approaches to treat peri-implant mucositis and peri-implantitis. Periodontol 2000 2015; 68:369-404. [DOI: 10.1111/prd.12069] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2014] [Indexed: 12/21/2022]
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John G, Sahm N, Becker J, Schwarz F. Nonsurgical treatment of peri-implantitis using an air-abrasive device or mechanical debridement and local application of chlorhexidine. Twelve-month follow-up of a prospective, randomized, controlled clinical study. Clin Oral Investig 2015; 19:1807-14. [DOI: 10.1007/s00784-015-1406-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 01/12/2015] [Indexed: 10/24/2022]
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Koukos G, Papadopoulos C, Tsalikis L, Sakellari D, Arsenakis M, Konstantinidis A. Prevalence of antibiotic resistance genes in subjects with successful and failing dental implants. A pilot study. Open Dent J 2015; 8:257-63. [PMID: 25646133 PMCID: PMC4311380 DOI: 10.2174/1874210601408010257] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 11/24/2014] [Accepted: 12/11/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To investigate the prevalence of the bacterial genes encoding resistance to beta-lactams, tetracyclines and metronidazole respectively, in subjects with successful and failing dental implants and to assess the presence of Staphylococcus aureus and the mecA gene encoding for Methicillin Resistant Staphylococcus aureus (MRSA) in the same samples. MATERIALS AND METHODOLOGY The subject sample included 20 participants with clinically healthy osseointegrated implants and 20 participants with implants exhibiting peri-implantitis. Clinical parameters were assessed with an automated probe, samples were collected from the peri-implant sulcus or pocket and analyzed with Polymerase Chain Reaction for bla TEM , tetM, tetQ and nim genes, S. aureus and MRSA using primers and conditions previously described in the literature. RESULTS Findings have shown high frequencies of detection for both groups for the tetracycline resistance genes tetM (>30%), tetQ (>65%) with no statistical differences between them (z-test with Bonferroni corrections, p<0.05). The bla TEM gene, which encodes resistance to beta-lactams, was detected in <15% of the samples. The nim gene, which encodes resistance to metronidazole, S.aureus and the mecA gene encoding for MRSA were not detected in any of the analyzed samples. CONCLUSIONS Healthy peri-implant sulci and peri-implantitis cases often harbor bacterial genes encoding for resistance to the tetracyclines and less often for beta-lactams. Thus, the antimicrobial activity of the tetracyclines and to a lower extent to beta-lactams, might be compromised for treatment of peri-implantitis. Since no metronidazole resistance genes were detected in the present study, its clinical use is supported by the current findings. S.aureus may not participate in peri-implant pathology.
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Affiliation(s)
- Georgios Koukos
- 251 General Air Force Hospital, Department of Periodontology, Athens, Greece
| | - Christos Papadopoulos
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thes-saloniki, Thessaloniki, Greece
| | - Lazaros Tsalikis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thes-saloniki, Thessaloniki, Greece
| | - Dimitra Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thes-saloniki, Thessaloniki, Greece
| | - Minas Arsenakis
- Department of Genetics and Molecular Biology, School of Biology, Aristotle University Thessaloniki, Thessaloniki, Greece
| | - Antonios Konstantinidis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thes-saloniki, Thessaloniki, Greece
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Comparison of different concentrations of tetracycline-loaded silk fibroin membranes on the guided bone regeneration in the rat calvarial defect model. Tissue Eng Regen Med 2014. [DOI: 10.1007/s13770-014-9057-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Romanos GE, Javed F, Delgado-Ruiz RA, Calvo-Guirado JL. Peri-implant diseases: a review of treatment interventions. Dent Clin North Am 2014; 59:157-78. [PMID: 25434564 DOI: 10.1016/j.cden.2014.08.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The ideal management of peri-implant diseases focuses on infection control, detoxification of implant surfaces, regeneration of lost tissues, and plaque-control regimens via mechanical debridement (with or without raising a surgical flap). However, a variety of other therapeutic modalities also have been proposed for the management of peri-implantitis. These treatment strategies encompass use of antiseptics and/or antibiotics, laser therapy, guided bone regeneration, and photodynamic therapy. The aim of this article was to review indexed literature with reference to the various therapeutic interventions proposed for the management of peri-implant diseases.
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Affiliation(s)
- Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, 106 Rockland Hall, Stony Brook, NY 11794-8700, USA.
| | - Fawad Javed
- Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Laboratory, College of Applied Medical Sciences, King Saud University, Derriyah, P.O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Rafael Arcesio Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, 1103 Westchester Hall, Stony Brook, NY 11794-8712, USA
| | - José Luis Calvo-Guirado
- Faculty of Medicine and Dentistry, Hospital Morales Meseguer, University of Murcia, 2° Planta Clínica Odontológica Calle Marques de los Velez S/n, Murcia 30007, Spain
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Sánchez M, Llama-Palacios A, Fernández E, Figuero E, Marín M, León R, Blanc V, Herrera D, Sanz M. An in vitro biofilm model associated to dental implants: Structural and quantitative analysis of in vitro biofilm formation on different dental implant surfaces. Dent Mater 2014; 30:1161-71. [DOI: 10.1016/j.dental.2014.07.008] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/26/2014] [Accepted: 07/15/2014] [Indexed: 12/18/2022]
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Treatment Alternatives to Negotiate Peri-Implantitis. Adv Med 2014; 2014:487903. [PMID: 26556414 PMCID: PMC4590969 DOI: 10.1155/2014/487903] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 04/26/2014] [Accepted: 04/28/2014] [Indexed: 12/15/2022] Open
Abstract
Peri-implant diseases are becoming a major health issue in dentistry. Despite the magnitude of this problem and the potential grave consequences, commonly acceptable treatment protocols are missing. Hence, the present paper reviews the literature treatment of peri-implantitis in order to explore their benefits and limitations. Treatment of peri-implantitis may include surgical and nonsurgical approaches, either individually or combined. Nonsurgical therapy is aimed at removing local irritants from the implants' surface with or without surface decontamination and possibly some additional adjunctive therapies agents or devices. Systemic antibiotics may also be incorporated. Surgical therapy is aimed at removing any residual subgingival deposits and additionally reducing the peri-implant pockets depth. This can be done alone or in conjunction with either osseous respective approach or regenerative approach. Finally, if all fails, explantation might be the best alternative in order to arrest the destruction of the osseous structure around the implant, thus preserving whatever is left in this site for future reconstruction. The available literature is still lacking with large heterogeneity in the clinical response thus suggesting possible underlying predisposing conditions that are not all clear to us. Therefore, at present time treatment of peri-implantitis should be considered possible but not necessarily predictable.
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Armas J, Culshaw S, Savarrio L. Treatment of peri-implant diseases: a review of the literature and protocol proposal. ACTA ACUST UNITED AC 2013; 40:472-4, 476-8, 480. [PMID: 23971346 DOI: 10.12968/denu.2013.40.6.472] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED Over 100,000 implants were placed in the UK in 2010. As the numbers of patients with implant-retained prostheses increases, operators are encountering an increasing number of biological implant complications, most commonly peri-implant mucositis and peri-implantitis. The effective management of these complications is crucial to maintain patients' oral health. In particular, in contrast to common periodontal infections, some peri-implant infections may benefit from surgical intervention as a first line approach. CLINICAL RELEVANCE This article reviews the literature on the treatment options for peri-implant mucositis and peri-implantitis and proposes a protocol for their treatment.
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Affiliation(s)
- Joshé Armas
- Glasgow Dental Hospital and School, 378 Sauchiehall Street, Glasgow G2 3JZ, UK
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Ertugrul AS, Tekin Y, Alpaslan NZ, Bozoglan A, Sahin H, Dikilitas A. Comparison of peri-implant crevicular fluid levels of adrenomedullin and human beta defensins 1 and 2 from mandibular implants with different implant stability quotient levels in nonsmoker patients. J Periodontal Res 2013; 49:480-8. [PMID: 23898869 DOI: 10.1111/jre.12127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE To achieve satisfactory osseointegration, primary stability and healthy peri-implant tissue must be available. In this study, our objective was to compare the adrenomedullin, human beta-defensin (hBD)-1 and hBD-2 levels in implants with different implant stability quotient (ISQ) values and with different peri-implant tissue health values in the peri-implant crevicular fluid. MATERIAL AND METHODS Thirty patients with 60 endosseous osseointegrated implants were included in this study. Following the completion of the osseointegration process, these implants were divided into two main groups: a group of 15 implants with peri-implantitis (peri-implantitis: 40 ≤ ISQ ≤ 80 peri-implantitis, n = 15) and a group of 45 implants with healthy peri-implant tissue. The healthy peri-implant tissue group was further divided into three subgroups according to their ISQ values (Healthy-60: 60 ≤ ISQ ≤ 70, healthy peri-implant, n = 15; Healthy-80: 71 ≤ ISQ ≤ 80, healthy peri-implant, n = 15; and Healthy-100: 81 ≤ ISQ ≤ 100, healthy peri-implant, n = 15). The levels of adrenomedullin, hBD-1 and hBD-2 in the peri-implant crevicular fluid were assessed using ELISAs. RESULTS When the peri-implant clinical measurements were compared within groups, they were found to be highest in the peri-implantitis group and lowest in the Healthy-100 group. The adrenomedullin, hBD-1 and hBD-2 levels in the peri-implant crevicular fluid of the peri-implantitis group were found to be significantly higher than those in the Healthy-60, Healthy-80 and Healthy-100 groups. When only the healthy peri-implant tissue groups were evaluated, the adrenomedullin, hBD-1 and hBD-2 levels in the peri-implant crevicular fluid of the Healthy-60 group were found to be significantly higher than those in the Healthy-80 and Healthy-100 groups. The lowest adrenomedullin, hBD-1 and hBD-2 levels were observed in the Healthy-100 group. CONCLUSION In cases of peri-implantitis, higher adrenomedullin, hBD-1 and hBD-2 levels were observed. These results indicate the presence of a tissue response to prevent the creation of a pathological environment in the peri-implant tissue. In groups with healthy peri-implant tissues, the ISQ value decreases as the adrenomedullin, hBD-1 and hBD-2 levels increase. This condition is thought to be caused by increased dental plaque accumulation and bone resorption in addition to increased lateral implant movements and colonization of microorganisms in the microcavities between the implant elements.
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Affiliation(s)
- A S Ertugrul
- Department of Periodontology, Faculty of Dentistry, Yuzuncu Yil University, Van, Turkey
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Irshad M, Scheres N, Crielaard W, Loos BG, Wismeijer D, Laine ML. Influence of titanium on in vitro fibroblast-Porphyromonas gingivalis
interaction in peri-implantitis. J Clin Periodontol 2013; 40:841-9. [DOI: 10.1111/jcpe.12136] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2013] [Indexed: 01/29/2023]
Affiliation(s)
- Muhammad Irshad
- Department of Preventive Dentistry; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - Nina Scheres
- Department of Preventive Dentistry; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - Wim Crielaard
- Department of Preventive Dentistry; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - Bruno G. Loos
- Department of Periodontology; ACTA; University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - Daniel Wismeijer
- Department of Oral Function and Restorative Dentistry; Section of Oral Implantology and Prosthodontics; Research Institute MOVE; ACTA; University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - Marja L. Laine
- Department of Periodontology; ACTA; University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
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Javed F, Alghamdi AST, Ahmed A, Mikami T, Ahmed HB, Tenenbaum HC. Clinical efficacy of antibiotics in the treatment of peri-implantitis. Int Dent J 2013; 63:169-76. [PMID: 23879251 DOI: 10.1111/idj.12034] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The aim of the present study was to review the pertinent literature with reference to the clinical efficacy of antibiotics in the treatment of peri-implantitis. METHODS To address the focused question 'Are locally and systemically delivered antibiotics useful in the treatment of peri-implantitis?' PubMed/Medline and Google-scholar databases were explored from 1992 until February 2013 using a combination of the following keywords: 'antibiotic,' 'dental implant,' 'inflammation,', 'peri-implantitis' and 'treatment'. Letters to the editor, case-reports and unpublished data were excluded. RESULTS Ten studies were included. In six studies, peri-implantitis was treated using a non-surgical approach (scaling and root planing), whereas in four studies, a surgical approach was adopted for treating peri-implantitis. In three studies systemic antibiotics were administered and in six studies locally delivered antibiotics were used for treatment. One study used the oral route for antibiotic delivery. In three studies, minocycline hydrochloride was locally delivered as an adjunctive therapy to non-surgical mechanical debridement of infected sites. Nine studies reported that traditional peri-implantitis treatment with adjunct antibiotic therapy reduces gingival bleeding, suppuration and peri-implant pocket depth. In one study, despite surgical debridement of infected sites and systemic antibiotic cover, nearly 40% of the implants failed to regain stability. There was no placebo or control group in eight out of the nine studies included. CONCLUSION The significance of adjunctive antibiotic therapy in the treatment of peri-implantitis remains debatable.
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Affiliation(s)
- Fawad Javed
- College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
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Bassetti M, Schär D, Wicki B, Eick S, Ramseier CA, Arweiler NB, Sculean A, Salvi GE. Anti-infective therapy of peri-implantitis with adjunctive local drug delivery or photodynamic therapy: 12-month outcomes of a randomized controlled clinical trial. Clin Oral Implants Res 2013; 25:279-287. [DOI: 10.1111/clr.12155] [Citation(s) in RCA: 141] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2013] [Indexed: 01/16/2023]
Affiliation(s)
- Mario Bassetti
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Dorothee Schär
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Beat Wicki
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Sigrun Eick
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Christoph A. Ramseier
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
| | | | - Anton Sculean
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Giovanni E. Salvi
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
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Dhir S. Biofilm and dental implant: The microbial link. J Indian Soc Periodontol 2013; 17:5-11. [PMID: 23633764 PMCID: PMC3636945 DOI: 10.4103/0972-124x.107466] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Accepted: 09/12/2012] [Indexed: 11/24/2022] Open
Abstract
Mouth provides a congenial environment for the growth of the microorganisms as compared to any other part of the human body by exhibiting an ideal nonshedding surface. Dental plaque happens to be a diverse community of the microorganisms found on the tooth surface. Periodontal disease and the peri-implant disease are specific infections that are originating from these resident microbial species when the balance between the host and the microbial pathogenicity gets disrupted. This review discusses the biofilms in relation to the peri-implant region, factors affecting its presence, and the associated treatment to manage this complex microbial colony. Search Methodology: Electronic search of the medline was done with the search words: Implants and biofilms/dental biofilm formation/microbiology at implant abutment interface/surface free energy/roughness and implant, periimplantitis/local drug delivery and dental implant. Hand search across the journals - clinical oral implant research, implant dentistry, journal of dental research, international journal of oral implantology, journal of prosthetic dentistry, perioodntology 2000, journal of periodontology were performed. The articles included in the review comprised of in vivo studies, in vivo (animal and human) studies, abstracts, review articles.
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Affiliation(s)
- Sangeeta Dhir
- Department of Periodontology and Oral Implantology, Sudha Rustagi College of Dental Sciences and Research, Kheri More, Bhopani, Faridabad, Haryana, India
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Donos N, Laurell L, Mardas N. Hierarchical decisions on teeth vs. implants in the periodontitis-susceptible patient: the modern dilemma. Periodontol 2000 2012; 59:89-110. [PMID: 22507062 DOI: 10.1111/j.1600-0757.2011.00433.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
It is estimated that advanced periodontitis typically affects about 10% of most adult populations studied. These individuals can be considered highly susceptible to periodontitis and often present difficulties for clinicians in therapeutic decision making, especially when dental implants are involved. Poor plaque control and smoking are well established risk factors for periodontitis, as well as for peri-implant disease. Long-term follow-up studies have clearly demonstrated that treatment of periodontal disease, even if advanced, can be successful in arresting disease progression and preventing (or at least significantly delaying) tooth loss. With the increasing development of implant dentistry, traditional well documented and evidence-based therapies to treat periodontal diseases may sometimes not be used to their full potential. Instead, there appears to be an increasing tendency to extract periodontally compromised teeth and replace them with implants, as if implants can solve the problem. However, peri-implant diseases are prevalent, affecting between 28% and 56% of people with implants, and (at the implant level) 12-43% of implants. A history of periodontal disease, smoking and poor oral hygiene are all risk factors for developing peri-implantitis. Unlike periodontitis, there are currently no predictable means for treating peri-implantitis, although resective surgery seems to be the most effective technique. Consequently, if implant treatment is considered in patients who are susceptible to periodontitis, it should be preceded by appropriate and adequate periodontal treatment or re-treatment to control the condition, and should be followed by a stringent supportive maintenance program to prevent the development of peri-implant disease. The decision whether implant treatment should be performed should be based on an assessment of the patient's risk profile at the subject level, as well as at the site level.
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Irshad M, van der Reijden WA, Crielaard W, Laine ML. In vitro invasion and survival of Porphyromonas gingivalis in gingival fibroblasts; role of the capsule. Arch Immunol Ther Exp (Warsz) 2012; 60:469-76. [PMID: 22949096 DOI: 10.1007/s00005-012-0196-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 07/23/2012] [Indexed: 11/28/2022]
Abstract
Porphyromonas gingivalis is a Gram-negative, anaerobic bacterium involved in periodontitis and peri-implantitis that can invade and survive inside host cells in vitro. P. gingivalis can invade human gingival fibroblasts (GF), but no data are available about the role of P. gingivalis' capsule in GF invasion. In the current study, we aimed to determine the ability of three strains of P. gingivalis (encapsulated wild type W83, non-encapsulated HG91 and the non-encapsulated insertional isogenic knockout mutant of W83, ΔEpsC) to invade GF and the ability of internalized P. gingivalis to survive in vitro antibiotic treatment. The ability of P. gingivalis strains to invade GF was tested using an antibiotic protection assay at multiplicity of infection (MOI) 100 and 1000. The survival of internalized P. gingivalis cells was further analyzed by subsequent in vitro treatment with either metronidazole or amoxicillin alone or a combination of metronidazole and amoxicillin and anaerobic culture viability counts. All strains of P. gingivalis used in this study were able to invade GFs. The non-encapsulated mutant of W83 (ΔEpsC mutant) was significantly more invasive than the wild type W83 at MOI 100 (p value 0.025) and MOI 1000 (p value 0.038). Furthermore, internalized P. gingivalis was able to resist in vitro antibiotic treatment. As demonstrated by the differences in invasion efficiencies of P. gingivalis strain W83 and its isogenic mutant ΔEpsC, the capsule of P. gingivalis makes it less efficient in invading gingival fibroblasts. Moreover, internalized P. gingivalis can survive antibiotic treatment in vitro.
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Affiliation(s)
- Muhammad Irshad
- Section of Preventive Dentistry, Department of Conservative and Preventive Dentistry, Academic Centre for Dentistry Amsterdam, ACTA, University of Amsterdam and Vrije University Amsterdam, Amsterdam, The Netherlands
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Local delivery of small and large biomolecules in craniomaxillofacial bone. Adv Drug Deliv Rev 2012; 64:1152-64. [PMID: 22429663 DOI: 10.1016/j.addr.2012.03.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 02/08/2012] [Accepted: 03/05/2012] [Indexed: 12/18/2022]
Abstract
Current state of the art reconstruction of bony defects in the craniomaxillofacial (CMF) area involves transplantation of autogenous or allogenous bone grafts. However, the inherent drawbacks of this approach strongly urge clinicians and researchers to explore alternative treatment options. Currently, a wide interest exists in local delivery of biomolecules from synthetic biomaterials for CMF bone regeneration, in which small biomolecules are rapidly emerging in recent years as an interesting adjunct for upgrading the clinical treatment of CMF bone regeneration under compromised healing conditions. This review highlights recent advances in the local delivery small and large biomolecules for the clinical treatment of CMF bone defects. Further, it provides a perspective on the efficacy of biomolecule delivery in CMF bone regeneration by reviewing presently available reports of pre-clinical studies using various animal models.
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Schär D, Ramseier CA, Eick S, Arweiler NB, Sculean A, Salvi GE. Anti-infective therapy of peri-implantitis with adjunctive local drug delivery or photodynamic therapy: six-month outcomes of a prospective randomized clinical trial. Clin Oral Implants Res 2012; 24:104-10. [DOI: 10.1111/j.1600-0501.2012.02494.x] [Citation(s) in RCA: 115] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Dorothee Schär
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern; Switzerland
| | - Christoph A. Ramseier
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern; Switzerland
| | - Sigrun Eick
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern; Switzerland
| | | | - Anton Sculean
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern; Switzerland
| | - Giovanni E. Salvi
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern; Switzerland
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83
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Nguyen-Hieu T, Borghetti A, Aboudharam G. Peri-implantitis: from diagnosis to therapeutics. ACTA ACUST UNITED AC 2012; 3:79-94. [DOI: 10.1111/j.2041-1626.2012.00116.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Esposito M, Grusovin MG, Worthington HV. Interventions for replacing missing teeth: treatment of peri-implantitis. Cochrane Database Syst Rev 2012; 1:CD004970. [PMID: 22258958 PMCID: PMC6786958 DOI: 10.1002/14651858.cd004970.pub5] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND One of the key factors for the long-term success of oral implants is the maintenance of healthy tissues around them. Bacterial plaque accumulation induces inflammatory changes in the soft tissues surrounding oral implants and it may lead to their progressive destruction (peri-implantitis) and ultimately to implant failure. Different treatment strategies for peri-implantitis have been suggested, however it is unclear which are the most effective. OBJECTIVES To identify the most effective interventions for treating peri-implantitis around osseointegrated dental implants. SEARCH METHODS We searched the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE. Handsearching included several dental journals. We checked the bibliographies of the identified randomised controlled trials (RCTs) and relevant review articles for studies outside the handsearched journals. We wrote to authors of all identified RCTs, to more than 55 dental implant manufacturers and an Internet discussion group to find unpublished or ongoing RCTs. No language restrictions were applied. The last electronic search was conducted on 9 June 2011. SELECTION CRITERIA All RCTs comparing agents or interventions for treating peri-implantitis around dental implants. DATA COLLECTION AND ANALYSIS Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. We contacted the authors for missing information. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals (CI). Heterogeneity was to be investigated including both clinical and methodological factors. MAIN RESULTS Fifteen eligible trials were identified, but six were excluded. The following interventions were compared in the nine included studies: different non-surgical interventions (five trials); adjunctive treatments to non-surgical interventions (one trial); different surgical interventions (two trials); adjunctive treatments to surgical interventions (one trial). Follow-up ranged from 3 months to 4 years. No study was judged to be at low risk of bias.Statistically significant differences were observed in two small single trials judged to be at unclear or high risk of bias. After 4 months, adjunctive local antibiotics to manual debridement in patients who lost at least 50% of the bone around implants showed improved mean probing attachment levels (PAL) of 0.61 mm (95% confidence interval (CI) 0.40 to 0.82) and reduced probing pockets depths (PPD) of 0.59 mm (95% CI 0.39 to 0.79). After 4 years, patients with peri-implant infrabony defects > 3 mm treated with Bio-Oss and resorbable barriers gained 1.4 mm more PAL (95% CI 0.24 to 2.56) and 1.4 mm PPD (95% CI 0.81 to 1.99) than patients treated with a nanocrystalline hydroxyapatite. AUTHORS' CONCLUSIONS There is no reliable evidence suggesting which could be the most effective interventions for treating peri-implantitis. This is not to say that currently used interventions are not effective.A single small trial at unclear risk of bias showed the use of local antibiotics in addition to manual subgingival debridement was associated with a 0.6 mm additional improvement for PAL and PPD over a 4-month period in patients affected by severe forms of peri-implantitis. Another small single trial at high risk of bias showed that after 4 years, improved PAL and PPD of about 1.4 mm were obtained when using Bio-Oss with resorbable barriers compared to a nanocrystalline hydroxyapatite in peri-implant infrabony defects. There is no evidence from four trials that the more complex and expensive therapies were more beneficial than the control therapies which basically consisted of simple subgingival mechanical debridement. Follow-up longer than 1 year suggested recurrence of peri-implantitis in up to 100% of the treated cases for some of the tested interventions. As this can be a chronic disease, re-treatment may be necessary. Larger well-designed RCTs with follow-up longer than 1 year are needed.
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Affiliation(s)
- Marco Esposito
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3, Oxford RoadManchesterUKM13 9PL
| | | | - Helen V Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3, Oxford RoadManchesterUKM13 9PL
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Aljateeli M, Fu JH, Wang HL. Managing Peri-Implant Bone Loss: Current Understanding. Clin Implant Dent Relat Res 2011; 14 Suppl 1:e109-18. [DOI: 10.1111/j.1708-8208.2011.00387.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Baek SH, Shon WJ, Bae KS, Kum KY, Lee WC, Park YS. Evaluation of the safety and efficiency of novel metallic ultrasonic scaler tip on titanium surfaces. Clin Oral Implants Res 2011; 23:1269-74. [DOI: 10.1111/j.1600-0501.2011.02302.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2011] [Indexed: 11/28/2022]
Affiliation(s)
- Seung-Ho Baek
- Dental Research Institute and School of Dentistry; Department of Conservative Dentistry; Seoul National University; Seoul; Korea
| | - Won-Jun Shon
- Dental Research Institute and School of Dentistry; Department of Conservative Dentistry; Seoul National University; Seoul; Korea
| | - Kwang-Shik Bae
- Dental Research Institute and School of Dentistry; Department of Conservative Dentistry; Seoul National University; Seoul; Korea
| | - Kee-Yeon Kum
- Dental Research Institute and School of Dentistry; Department of Conservative Dentistry; Seoul National University; Seoul; Korea
| | - Woo-Cheol Lee
- Dental Research Institute and School of Dentistry; Department of Conservative Dentistry; Seoul National University; Seoul; Korea
| | - Young-Seok Park
- Dental Research Institute and School of Dentistry; Department of Oral Anatomy; Seoul National University; Seoul; Korea
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Bone Regeneration around Dental Implants as a Treatment for Peri-Implantitis: A Review of the Literature. ACTA ACUST UNITED AC 2011. [DOI: 10.4028/www.scientific.net/jbbte.11.21] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This manuscript discusses peri-implantitis around dental implants and the current methodologies of surgical and non-surgical approaches towards treating peri-implantitis. Mechanical, chemical cleansing and reactivation of infected implant surface along with recent advances like the use of Laser and Photodynamic therapy (PDT) have also been reviewed in this literature. Bone regenerative treatment methods for the treatment of peri-implantitis using non-resorbable membranes (Guided Bone Regeneration), autogenous bone grafts and bone substitute materials with recombinant human bone morphogenetic protein-2 (rhBMP-2) and other growth factors have also been reviewed in this manuscript.
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Efficiency and Thermal Changes during Implantoplasty in Relation to Bur Type. Clin Implant Dent Relat Res 2011; 15:292-6. [DOI: 10.1111/j.1708-8208.2011.00366.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Park JB. Treatment of peri-implantitis with deproteinised bovine bone and tetracycline: a case report. Gerodontology 2011; 29:145-9. [PMID: 21457295 DOI: 10.1111/j.1741-2358.2011.00470.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective of this study is to evaluate the use of tetracycline in a patient with peri-implantitis. BACKGROUND Tetracycline is widely used in regeneration procedures owing to its positive effect with bone graft material, regeneration of extraction socket bone and its traditional antibacterial effect. However, there have been limited reports on bone graft procedures combined with tetracycline application in peri-implantitis. MATERIALS AND METHODS The detoxification procedure was performed with chlorhexidine and tetracycline, and the defect area was grafted with a 4:1 volume ratio combination of deproteinised bovine bone mixed with tetracycline. RESULTS Soft tissue healing was uneventful, and the treatment yielded improved clinical results with a reduced probing depth. CONCLUSIONS Tetracycline was used in the treatment of peri-implantitis by burnishing the implant surface and applying tetracycline in conjunction with an osseous graft to the defect area. The treatment of peri-implantitis with tetracycline seemed to show improved clinical results up to the follow-up period.
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Affiliation(s)
- Jun-Beom Park
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, Ann Arbor, MI, USA.
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Mombelli A, Décaillet F. The characteristics of biofilms in peri-implant disease. J Clin Periodontol 2011; 38 Suppl 11:203-13. [DOI: 10.1111/j.1600-051x.2010.01666.x] [Citation(s) in RCA: 251] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Serino G, Turri A. Outcome of surgical treatment of peri-implantitis: results from a 2-year prospective clinical study in humans. Clin Oral Implants Res 2011; 22:1214-20. [DOI: 10.1111/j.1600-0501.2010.02098.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chitosan Coatings Deliver Antimicrobials From Titanium Implants: A Preliminary Study. IMPLANT DENT 2011; 20:56-67. [DOI: 10.1097/id.0b013e3182087ac4] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Renvert S, Lindahl C, Roos Jansåker AM, Persson GR. Treatment of peri-implantitis using an Er:YAG laser or an air-abrasive device: a randomized clinical trial. J Clin Periodontol 2010; 38:65-73. [DOI: 10.1111/j.1600-051x.2010.01646.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Persson GR, Samuelsson E, Lindahl C, Renvert S. Mechanical non-surgical treatment of peri-implantitis: a single-blinded randomized longitudinal clinical study. II. Microbiological results. J Clin Periodontol 2010; 37:563-73. [PMID: 20507380 DOI: 10.1111/j.1600-051x.2010.01561.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Peri-implantitis is common in patients with dental implants. We performed a single-blinded longitudinal randomized study to assess the effects of mechanical debridement on the peri-implant microbiota in peri-implantitis lesions. MATERIALS AND METHODS An expanded checkerboard DNA-DNA hybridization assay encompassing 79 different microorganisms was used to study bacterial counts before and during 6 months following mechanical treatment of peri-implantitis in 17 cases treated with curettes and 14 cases treated with an ultrasonic device. Statistics included non-parametric tests and GLM multivariate analysis with p<0001 indicating significance and 80% power. RESULTS At selected implant test sites, the most prevalent bacteria were: Fusobacterium nucleatum sp., Staphylococci sp., Aggregatibacter actinomycetemcomitans, Helicobacter pylori, and Tannerella forsythia. 30 min. after treatment with curettes, A. actinomycetemcomitans (serotype a), Lactobacillus acidophilus, Streptococcus anginosus, and Veillonella parvula were found at lower counts (p<0.001). No such differences were found for implants treated with the ultrasonic device. Inconsistent changes occurred following the first week. No microbiological differences between baseline and 6-month samples were found for any species or between treatment study methods in peri-implantitis. CONCLUSIONS Both methods failed to eliminate or reduce bacterial counts in peri-implantitis. No group differences were found in the ability to reduce the microbiota in peri-implantitis.
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Affiliation(s)
- G Rutger Persson
- Department of Periodontology, University of Bern, Bern, Switzerland.
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Heitz-Mayfield LJA, Lang NP. Comparative biology of chronic and aggressive periodontitis vs. peri-implantitis. Periodontol 2000 2010; 53:167-81. [PMID: 20403112 DOI: 10.1111/j.1600-0757.2010.00348.x] [Citation(s) in RCA: 293] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This review was undertaken to address the similarities and dissimilarities between the two disease entities of periodontitis and peri-implantitis. The overall analysis of the literature on the etiology and pathogenesis of periodontitis and peri-implantitis provided an impression that these two diseases have more similarities than differences. First, the initiation of the two diseases is dependent on the presence of a biofilm containing pathogens. While the microbiota associated with periodontitis is rich in gram-negative bacteria, a similar composition has been identified in peri-implant diseases. However, increasing evidence suggests that S. aureus may be an important pathogen in the initiation of some cases of peri-implantitis. Further research into the role of this gram-positive facultative coccus, and other putative pathogens, in the development of peri-implantitis is indicated. While the initial host response to the bacterial challenge in peri-implant mucositis appears to be identical to that encountered in gingivitis, persistent biofilm accumulation may elicit a more pronounced inflammatory response in peri-implant mucosal tissues than in the dentogingival unit. This may be a result of structural differences (such as vascularity and fibroblast-to-collagen ratios). When periodontitis and peri-implantitis were produced experimentally by applying plaque-retaining ligatures, the progression of mucositis to peri-implantitis followed a very similar sequence of events as the development of gingivitis to periodontitis. However, some of the peri-implantitis lesions appeared to have periods of rapid progression, in which the infective lesion reached the alveolar bone marrow. It is therefore reasonable to assume that peri-implantitis in humans may also display periods of accelerated destruction that are more pronounced than that observed in cases of chronic periodontitis. From a clinical point of view the identified and confirmed risk factors for periodontitis may be considered as identical to those for peri-implantitis. In addition, patients susceptible to periodontitis appear to be more susceptible to peri-implantitis than patients without a history of periodontitis. As both periodontitis and peri-implantitis are opportunistic infections, their therapy must be antiinfective in nature. The same clinical principles apply to debridement of the lesions and the maintenance of an infection-free oral cavity. However, in daily practice, such principles may occasionally be difficult to apply in peri-implantitis treatment. Owing to implant surface characteristics and limited access to the microbial habitats, surgical access may be required more frequently, and at an earlier stage, in periimplantitis treatment than in periodontal therapy. In conclusion, it is evident that periodontitis and peri-implantitis are not fundamentally different from the perspectives of etiology, pathogenesis, risk assessment, diagnosis and therapy. Nevertheless, some difference in the host response to these two infections may explain the occasional rapid progression of peri-implantitis lesions. Consequently, a diagnosed peri-implantitis should be treated without delay.
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Esposito M, Grusovin MG, Tzanetea E, Piattelli A, Worthington HV. Interventions for replacing missing teeth: treatment of perimplantitis. Cochrane Database Syst Rev 2010:CD004970. [PMID: 20556759 DOI: 10.1002/14651858.cd004970.pub4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND One of the key factors for the long-term success of oral implants is the maintenance of healthy tissues around them. Bacterial plaque accumulation induces inflammatory changes in the soft tissues surrounding oral implants and it may lead to their progressive destruction (perimplantitis) and ultimately to implant failure. Different treatment strategies for perimplantitis have been suggested, however it is unclear which are the most effective. OBJECTIVES To identify the most effective interventions for treating perimplantitis around osseointegrated dental implants. SEARCH STRATEGY We searched the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE. Handsearching included several dental journals. We checked the bibliographies of the identified randomised controlled trials (RCTs) and relevant review articles for studies outside the handsearched journals. We wrote to authors of all identified RCTs, to more than 55 dental implant manufacturers and an Internet discussion group to find unpublished or ongoing RCTs. No language restrictions were applied. The last electronic search was conducted on 7th January 2010. SELECTION CRITERIA All RCTs comparing agents or interventions for treating perimplantitis around dental implants. DATA COLLECTION AND ANALYSIS Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. We contacted the authors for missing information. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals (CI). Heterogeneity was to be investigated including both clinical and methodological factors. MAIN RESULTS Twelve eligible trials were identified, but five were excluded. The following procedures were tested: (1) use of local antibiotics versus ultrasonic debridement; (2) benefits of adjunctive local antibiotics to debridement; (3) different techniques of subgingival debridement; (4) laser versus manual debridement and chlorhexidine irrigation/gel; (5) systemic antibiotics plus resective surgery plus two different local antibiotics with and without implant surface smoothening; and (6) nanocrystalline hydroxyapatite versus Bio-Oss and resorbable barriers. Follow-up ranged from 3 months to 4 years. The only statistically significant differences were observed in two trials judged to be at high risk of bias. After 4 months, adjunctive local antibiotics to manual debridement in patients who lost at least 50% of the bone around implants showed improved mean probing attachment levels (PAL) of 0.61 mm and reduced probing pockets depths (PPD) of 0.59 mm. After 4 years, patients with perimplant infrabony defects > 3 mm treated with Bio-Oss and resorbable barriers gained 1.4 mm more PAL and PPD than patients treated with a nanocrystalline hydroxyapatite. AUTHORS' CONCLUSIONS There is very little reliable evidence suggesting which could be the most effective interventions for treating perimplantitis. This is not to say that currently used interventions are not effective. The use of local antibiotics in addition to manual subgingival debridement was associated with a 0.6 mm additional improvement for PAL and PPD over a 4-month period in patients affected by severe forms of perimplantitis. After 4 years, improved PAL and PPD of about 1.4 mm were obtained when using Bio-Oss with resorbable barriers compared to a nanocrystalline hydroxyapatite in perimplant infrabony defects. In four trials, the control therapy which basically consisted of a simple subgingival mechanical debridement seemed to be sufficient to achieve similar results to the more complex and expensive therapies. Follow-up longer than 1 year suggested recurrence of perimplantitis up to 100% of the treated cases for some of the tested interventions. Sample sizes were very small and follow-up too short, therefore these findings have to be considered with great caution. Larger well-designed RCTs with follow-up longer than 1 year are needed.
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Affiliation(s)
- Marco Esposito
- Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Manchester, Higher Cambridge Street, Manchester, UK, M15 6FH
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Gosau M, Hahnel S, Schwarz F, Gerlach T, Reichert TE, Bürgers R. Effect of six different peri-implantitis disinfection methods onin vivohuman oral biofilm. Clin Oral Implants Res 2010; 21:866-72. [DOI: 10.1111/j.1600-0501.2009.01908.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Dashti A, Ready D, Salih V, Knowles JC, Barralet JE, Wilson M, Donos N, Nazhat SN. In vitro antibacterial efficacy of tetracycline hydrochloride adsorbed onto Bio-Oss® bone graft. J Biomed Mater Res B Appl Biomater 2010; 93:394-400. [DOI: 10.1002/jbm.b.31594] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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