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Li H, Wang Y, Zhang D, Chen T, Hu A, Han X. Glycemic fluctuation exacerbates inflammation and bone loss and alters microbiota profile around implants in diabetic mice with experimental peri-implantitis. Int J Implant Dent 2021; 7:79. [PMID: 34401982 PMCID: PMC8368769 DOI: 10.1186/s40729-021-00360-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The impact of glycemic fluctuation under diabetic condition on peri-implantitis in diabetic patients remains unclear. We hypothesized that glycemic fluctuation has greater adverse effect on experimental peri-implantitis, compared with sustained high blood glucose in diabetes. RESULTS Maxillary left first and second molars of diabetic db/db mice were extracted and were replaced with one dental implant in the healed edentulous space. Glycemic control or fluctuation were managed by constant or interrupted oral administration of rosiglitazone to these mice. Meanwhile, experimental peri-implantitis was induced by ligation around implants. After 14 weeks, inflammatory responses, and peri-implant bone loss, together with oral microbiota profile were analyzed. Diabetic mice with glycemic fluctuation showed greater peri-implant bone loss, inflammatory cell infiltration, and osteoclastogenesis, compared with mice with sustained hyperglycemia. Compared to sustained hyperglycemia, glycemic fluctuation led to further increase in IL-1β, TNFα, RANKL, TLR2/4, IRAK1, and TRAF6 mRNA expression in peri-implant gingival tissues. Both rosiglitazone-induced glycemic control and glycemic fluctuation caused microbiota profile change in diabetic mice compared to that in uncontrolled hyperglycemic mice. CONCLUSIONS This study suggests that glycemic fluctuation may aggravate peri-implantitis inflammation and bone loss, which may be associated with a shift in peri-implant microbial profile towards dysbiotic changes and the activation of TLR2/4-IRAK1-TRAF6 signaling.
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Affiliation(s)
- Hao Li
- Department of Prosthodontics, the Affiliated Hospital of Stomatology, Guangxi Medical University, 10 Shuangyong Road, Nanning, 530021, People's Republic of China
- Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, 02142, USA
| | - Yufeng Wang
- Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, 02142, USA
- Department of Oral Mucosal Diseases, Ninth People's Hospital, College of Stomatology, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Dong Zhang
- Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, 02142, USA
- Department of Oral Surgery, Qilu Hospital of Shandong University, Jinan, 250012, People's Republic of China
| | - Tsute Chen
- Department of Microbiology, The Forsyth Institute, 245 First Street, Cambridge, 02142, USA
- Department of Oral Medicine, Infection and Immunity, Harvard University School of Dental Medicine, 188 Longwood Avenue, Boston, 02115, USA
| | - Arthur Hu
- Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, 02142, USA
| | - Xiaozhe Han
- Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, 02142, USA.
- Department of Oral Medicine, Infection and Immunity, Harvard University School of Dental Medicine, 188 Longwood Avenue, Boston, 02115, USA.
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Gehrke P, Burg S, Peters U, Beikler T, Fischer C, Rupp F, Schweizer E, Weigl P, Sader R, Smeets R, Schäfer S. Bacterial translocation and microgap formation at a novel conical indexed implant abutment system for single crowns. Clin Oral Investig 2021; 26:1375-1389. [PMID: 34401947 PMCID: PMC8816325 DOI: 10.1007/s00784-021-04112-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/27/2021] [Indexed: 10/26/2022]
Abstract
OBJECTIVES A conometric concept was recently introduced in which conical implant abutments hold the matching crown copings by friction alone, eliminating the need for cement or screws. The aim of this in vitro study was to assess the presence of microgap formation and bacterial leakage at the Acuris conometric restorative interface of three different implant abutment systems. MATERIAL AND METHODS A total of 75 Acuris samples of three implant-abutment systems (Ankylos, Astra Tech EV, Xive) were subjected to microbiological (n = 60) and scanning electron microscopic (SEM) investigation (n = 15). Bacterial migration into and out of the conical coupling system were analyzed in an anaerobic workstation for 48, 96, 144, and 192 h. Bacterial DNA quantification using qrt-PCR was performed at each time point. The precision of the conometric coupling and internal fit of cemented CAD/CAM crowns on corresponding Acuris TiN copings were determined by means of SEM. RESULTS qrt-PCR results failed to demonstrate microbial leakage from or into the Acuris system. SEM analysis revealed minute punctate microgaps at the apical aspect of the conometric junction (2.04 to 2.64 µm), while mean cement gaps of 12 to 145 µm were observed at the crown-coping interface. CONCLUSIONS The prosthetic morse taper connection of all systems examined does not allow bacterial passage. Marginal integrity and internal luting gap between the ceramic crown and the coping remained within the clinically acceptable limits. CLINICAL RELEVANCE Conometrically seated single crowns provide sufficient sealing efficiency, relocating potential misfits from the crown-abutment interface to the crown-coping interface.
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Affiliation(s)
- Peter Gehrke
- Department of Postgraduate Education, Center for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt, 60528, Frankfurt am Main, Germany. .,Private Practice for Oral Surgery and Implant Dentistry, Bismarckstraße 27, 67059, Ludwigshafen, Germany.
| | - Simon Burg
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251Hamburg, Germany
| | - Ulrike Peters
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Carsten Fischer
- Dental Laboratory, Sirius Ceramics, 60528, Frankfurt am Main, Germany
| | - Frank Rupp
- Section Medical Materials Science and Technology, University Hospital Tuebingen, 72076, Tuebingen, Germany
| | - Ernst Schweizer
- Section Medical Materials Science and Technology, University Hospital Tuebingen, 72076, Tuebingen, Germany
| | - Paul Weigl
- Department of Postgraduate Education, Center for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt, 60528, Frankfurt am Main, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center, University Hospital, Goethe University Frankfurt, 60528, Frankfurt am Main, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251Hamburg, Germany.,Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Hospital Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Sogand Schäfer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251Hamburg, Germany
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Casula L, Poli A, Clemente T, Artuso G, Capparé P, Gherlone EF. Prevalence of peri-implantitis in a sample of HIV-positive patients. Clin Exp Dent Res 2021; 7:1002-1013. [PMID: 34288560 PMCID: PMC8638315 DOI: 10.1002/cre2.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 06/25/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study aimed to assess the prevalence of peri-implantitis in human immunodeficiency virus (HIV)-positive patients and the presence of a possible correlation between the immunological profile and serological values, of peri-implantitis, and of possible differences between all-on-4 and single crown/bridge prostheses. SUBJECTS AND METHODS This retrospective study included 58 adult HIV-positive patients (222 implants) with either all-in-4 prostheses or single crowns/bridges on at least one dental implant loaded for more than a year who were followed for 3 year (mean follow-up). Data pertaining to the probing pocket depth (PPD), bleeding on probing, and immunological and systemic profile were collected. RESULTS Patients with single crown/bridge implant rehabilitation showed higher prevalence of peri-implantitis (34%) than patients with all-on-4 rehabilitation (0%) (p = 0.012). Patients with all-on-4 rehabilitation were significantly older than those with single crowns/bridges (p = 0.004). Patients with peri-implantitis had implants for a significantly longer duration than those without (p = 0.001), implying that the probability of peri-implantitis increases as the age of implant increases. CONCLUSIONS The prevalence of peri-implantitis was 26% in the HIV-positive patients population. No correlation was found between patients' immunological and serological factors and peri-implantitis. The most important risk factor for peri-implantitis and mucositis was implant age.
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Affiliation(s)
- Luca Casula
- Oral Surgery Resident, Department of Dentistry, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Poli
- BioEngineering, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Tommaso Clemente
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Paolo Capparé
- Dental School, Vita-Salute San Raffaele University, Milan, Italy
| | - Enrico F Gherlone
- Department of Dentistry, Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milan, Italy
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Wada M, Mameno T, Otsuki M, Kani M, Tsujioka Y, Ikebe K. Prevalence and risk indicators for peri-implant diseases: A literature review. JAPANESE DENTAL SCIENCE REVIEW 2021; 57:78-84. [PMID: 34158874 PMCID: PMC8203834 DOI: 10.1016/j.jdsr.2021.05.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 03/18/2021] [Accepted: 05/23/2021] [Indexed: 02/08/2023] Open
Abstract
Peri-implant diseases are known as undesirable conditions that can occur after implant therapy. Although several risk indicators are becoming clear, the causes of peri-implant diseases have not been completely investigated. The purpose of this review was to summarize the prevalence and risk indicators for peri-implant diseases by referring to current papers from various angles. Many studies have reported the varied prevalence of peri-implant mucositis (23.9%-88.0% at the patient level and 9.7%-81.0% at the implant level) and peri-implantitis (8.9%-45% at the patient level and 4.8%-23.0% at the implant level). Additionally, several studies concluded that poor oral hygiene and lack of regular maintenance were strongly correlated with the development of both peri-implant mucositis and peri-implantitis. Diabetes and a history of periodontitis were revealed as risk indicators for peri-implantitis. However, there was no definitive conclusion about the correlations between peri-implant diseases and other factors such as smoking, the shape of the implant superstructure, and the condition of the keratinized mucosa. Further studies useful for evidence-based decision-making are needed for predictable implant therapy in the long term.
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Affiliation(s)
- Masahiro Wada
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Tomoaki Mameno
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Motohiro Otsuki
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan.,Private Dental Office, Japan
| | - Misako Kani
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Yoshitaka Tsujioka
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Kazunori Ikebe
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
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Barros-Filho LA, de Oliveira GJ, Barros LA, Marcantonio E. Retrospective evaluation about morse taper versus external hexagon implants placed after maxillary sinus lift. Minerva Dent Oral Sci 2021; 71:10-15. [PMID: 34132507 DOI: 10.23736/s2724-6329.21.04533-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The objective of this study was to retrospectively evaluate the success and survival rate of implants with different types of prosthetic connections inserted in the posterior maxilla in native bone or in sinuses previously grafted with different biomaterials. METHODS A total of 310 implants inserted in 113 patients were evaluated, 87 of which were inserted in association with grafted maxillary sinuses (56 morse taper (MT) implants and 31 external hexagon (EH) implants) in 37 patients, and 223 implants were inserted in native bone areas (112 MT and 111 EH implants) in 76 patients. Peri-implant clinical analyses were performed (bleeding on probing, probing depth, clinical insertion level, peri-implant marginal level, and the presence of mobility or suppuration), and the radiographic bone level was evaluated. RESULTS Two implants were lost, yielding a survival rate of 99.35 %. The MT implants had lower probing depths and peri-implant bone levels than the EH implants in both grafted areas and native bone areas (p <0.05). No statistically significant differences in any parameter evaluated were found between implants inserted in native bone and those inserted in grafting areas. EH implants inserted in native bone areas showed higher periimplantitis rates. CONCLUSIONS It can be concluded that the MT implants connection reduce periimplant bone loss, but implants inserted in maxillary sinuses previously grafted with osteoconductive biomaterials do not predispose patients to peri-implant bone loss.
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Affiliation(s)
- Luiz A Barros-Filho
- Department of Diagnosis and Surgery, Univ. Est. Paul. - UNESP, Araraquara, Brazil
| | - Guilherme J de Oliveira
- Department of Periodontology/Implantology, Dental School, Federal University of Uberlândia - UFU, Uberlândia, Brazil
| | - Luiz A Barros
- Department of Diagnosis and Surgery, Univ. Est. Paul. - UNESP, Araraquara, Brazil
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, Univ. Est. Paul. - UNESP, Araraquara, Brazil -
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56
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Kreve S, Reis ACD. Bacterial adhesion to biomaterials: What regulates this attachment? A review. JAPANESE DENTAL SCIENCE REVIEW 2021; 57:85-96. [PMID: 34188729 PMCID: PMC8215285 DOI: 10.1016/j.jdsr.2021.05.003] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/07/2021] [Accepted: 05/23/2021] [Indexed: 12/14/2022] Open
Abstract
Bacterial adhesion to the surface of dental materials play a significant role in infections. The factors that govern microbial attachment involves different types of physical-chemical interactions and biological processes. Studying bacterial adhesion makes it possible to understand the mechanisms involved in attachment and helps in the search for technologies that promote antibacterial surfaces.
Bacterial attachment to biomaterials is of great interest to the medical and dental field due to its impact on dental implants, dental prostheses, and others, leading to the need to introduce methods for biofilm control and mitigation of infections. Biofilm adhesion is a multifactorial process and involves characteristics relevant to the bacterial cell as well as biological, chemical, and physical properties relative to the surface of biomaterials. Bacteria encountered different environmental conditions during their growth and developed interspecies communication strategies, as well as various mechanisms to detect the environment and facilitate survival, such as chemical sensors or physical detection mechanisms. However, the factors that govern microbial attachment to surfaces are not yet fully understood. In order to understand how bacteria interact with surfaces, as well as to characterize the physical-chemical properties of bacteria adhesins, and to determine their interrelation with the adhesion to the substrate, in recent years new techniques of atomic force microscopy (AFM) have been developed and helped by providing quantitative results. Thus, the purpose of this review is to gather current studies about the factors that regulate microbial adhesion to surfaces in order to offer a guide to studies to obtain technologies that provide an antimicrobial surface.
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Affiliation(s)
- Simone Kreve
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Andréa C Dos Reis
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Ribeirão Preto, SP, Brazil
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Brescansin FN, Prochnow C, Guilardi LF, Kleverlaan CJ, Bacchi A, Valandro LF, Pereira GKR. Effect of different surface treatments on optical, colorimetric, and surface characteristics of a lithium disilicate glass-ceramic. J ESTHET RESTOR DENT 2021; 33:1017-1028. [PMID: 34105868 DOI: 10.1111/jerd.12793] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/19/2021] [Accepted: 05/25/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the effect of surface treatments on optical, colorimetric, and surface characteristics of lithium disilicate glass-ceramic. MATERIALS AND METHODS Specimens (n = 5, IPS e.max CAD) were randomly allocated to the following treatments: mirror-polished: SiC papers; as-cut: mimicking CAD-CAM milling; ground: 90-120 μm-grit diamond bur; ground polished: ground, finished (46-30 μm-grit diamond bur), polished (diamond cups, brush and diamond paste); ground glazed: ground, glazed; ground polished glazed: association of methods. CIELAB color coordinates were obtained by a spectrophotometer. CIEDE2000 color differences (ΔE00 ) and the translucency parameter (TP00 ) were calculated. Light transmittance was assessed with a colorimeter. Surface characteristics (topography and roughness) were analyzed. Statistical differences for each condition and outcome were detected using one-way ANOVA with Tukey's post-hoc test (α = 0.05). RESULTS TP00 data show statistical reduction after grinding (p < 0.05), which was only restored with polishing (solely or with glazing). ΔE00 shows that grinding results in perceptible variations in color (above 0.81), which were restored after all post-processing protocols (exception to only glaze application in contact with a black background). Light transmittance data corroborated such performance. Polishing and glazing reduced roughness and improved surface topography. CONCLUSION Grinding statistically increased roughness, reduced translucency, light transmittance through the ceramic, and resulted on color differences. On contrary, polishing (followed or not by glazing) reduced roughness and enhanced ceramic translucency and light transmittance. Glaze also reduced roughness, but it still presented reduced translucency. The positioning (facing up or down) of the ceramic treated surface influenced the considered outcomes. CLINICAL SIGNIFICANCE Grinding with diamond burs results in a deleterious impact to the optical, colorimetric and surface characteristics of lithium disilicate ceramic. Thus, polishing (followed or not by glazing) is recommended for optical and topographical enhancements when lithium disilicate monolithic restorations require occlusal adjustments.
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Affiliation(s)
| | - Catina Prochnow
- MSciD and PhD Post-Graduate Program in Oral Science (Prosthodontic Unit), Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Luís Felipe Guilardi
- MSciD and PhD Post-Graduate Program in Oral Science (Prosthodontic Unit), Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Cornelis Johannes Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ataís Bacchi
- MSciD Post-Graduate Program in Dentistry, Paulo Picanço School of Dentistry, Fortaleza, Brazil
| | - Luiz Felipe Valandro
- MSciD and PhD Post-Graduate Program in Oral Science (Prosthodontic Unit), Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Gabriel Kalil Rocha Pereira
- MSciD and PhD Post-Graduate Program in Oral Science (Prosthodontic Unit), Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Brazil
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AlJasser RN, AlSarhan MA, Alotaibi DH, AlOraini S, Ansari AS, Habib SR, Zafar MS. Analysis of Prosthetic Factors Affecting Peri-Implant Health: An in vivo Retrospective Study. J Multidiscip Healthc 2021; 14:1183-1191. [PMID: 34079276 PMCID: PMC8164962 DOI: 10.2147/jmdh.s312926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/04/2021] [Indexed: 12/31/2022] Open
Abstract
Objective To investigate and compare the various restorative and prosthetic parameters affecting peri-implant tissues’ health following dental implant placement and functional loading. Methods A total of 484 dental implants (length>6mm, non-turned, 2–3 piece, titanium – Straumann) were evaluated for patients (male=271; female=213). Study variables such as patient’s age, gender, implant restoration/crown type, crown retention, and implant crown status were assessed against various periodontal parameters (periodontal pocket depth (PPD), plaque index (PI), bleeding on probing (BOP), gingival color, and crestal bone level). All the data were analyzed using the SPSS software. Results Out of all the investigated dental implants, 201 (42%) of the implants investigated presented with BOP > one-site of the peri-implant mucosa (peri-implant mucositis), 115 (23.76%) presented with peri-implant marginal bone loss. PPD value was significantly lower in good crown status (p<0.0001). Majority of the patients with good crown status had no plaque accumulation based on the PI scores (52.7%). Only 35% of the patients whose crown status was good were having BOP when compared with 65% who did not have any BOP recorded. Gingival color (pale pink and red) showed statistically significant association with crown type (porcelain fused to metal v/s all ceramic) (p=0.005). Most of patients with crown status good had no change in their radiographic findings (94%) compared to only 6% who had implant threads exposed (p<0.0001). Conclusion Optimal design of Implant prosthetic factors are vital for avoiding the development of peri-implant mucositis/peri-implantitis and must be considered during treatment planning while restoring dental implants.
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Affiliation(s)
- Reham N AlJasser
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed A AlSarhan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Dalal H Alotaibi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Saleh AlOraini
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdul Sadekh Ansari
- Dental University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Syed Rashid Habib
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah, 41311, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, 44000, Pakistan
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Kadkhodazadeh M, Amid R, Moscowchi A. Management of extensive peri-implant defects with titanium meshes. Oral Maxillofac Surg 2021; 25:561-568. [PMID: 33779869 DOI: 10.1007/s10006-021-00955-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/03/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Peri-implantitis is a biofilm-induced pathological condition, and different approaches have been proposed to manage this condition. This study introduces a surgical technique in accordance with the concept of guided bone regeneration for implants with extensive peri-implant defects. METHODS This pilot study was conducted on 7 patients with 11 implants (4 females and 3 males; 32 to 61 years). In this technique, we used a titanium mesh, a combination of autogenous bone, allogenic graft material, and acellular dermal matrix to reconstruct the peri-implant defects. All implants were placed submerged, and the second-stage surgery was conducted after 8 months. Soft tissue augmentation and vestibuloplasty were performed in the second-stage surgery, if required. RESULTS The mean function time of implants was 60.5 ± 29.4 months. The mean baseline probing pocket depth was 5.7 ± 1.4 mm, and soft tissue recession was observed at two sites (18%). The mean recession and keratinized tissue width (KTW) values were 0.4 ± 0.8 mm and 3 ± 1.6 mm, respectively. The mean marginal bone loss and bone gain were 4.4 ± 1.2 mm and 2.9 ± 0.9 mm, respectively, which showed a significant improvement. CONCLUSION Our preliminary evaluations showed favorable results in terms of radiographic defect fill and soft tissue condition. It appears that this technique may lead to promising outcomes in cautiously selected patients seeking to retain their failing implants. However, long-term results following functional loading are required before recommending this technique for daily practice.
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Affiliation(s)
- Mahdi Kadkhodazadeh
- Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd, Evin, Shahid Chamran Highway, 1983963113, Tehran, Iran
| | - Reza Amid
- Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd, Evin, Shahid Chamran Highway, 1983963113, Tehran, Iran
| | - Anahita Moscowchi
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd, Evin, Shahid Chamran Highway, 1983963113, Tehran, Iran.
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Vagia P, Papalou I, Burgy A, Tenenbaum H, Huck O, Davideau JL. Association between periodontitis treatment outcomes and peri-implantitis: A long-term retrospective cohort study. Clin Oral Implants Res 2021; 32:721-731. [PMID: 33714224 DOI: 10.1111/clr.13741] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 01/21/2021] [Accepted: 03/01/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Retrospectively evaluate the association of periodontal treatment outcomes and the prevalence of peri-implant diseases around tissue-level implants. MATERIALS AND METHODS Eighty-six patients with 260 tissue-level implants attending supporting periodontal and implant therapy for more than 3 years were evaluated. Clinical and radiographic periodontal and implant data were recorded at initial examination (T0), before implant placement (T1) and at final re-examination (T2). Two definitions of peri-implantitis severity, PIBE and PIKA, were used corresponding to the presence of periodontal pocket ≥5 mm or ≥6 mm with bleeding on probing or suppuration and radiographic signs of a bone level ≥2 mm, or ≥3 mm during implant follow-up, respectively. Analyses were performed at patient level. RESULTS The mean implant follow-up per patient was 9.4 years and 38.0% of patients had implant for at least 10 years. Two implants were lost due to peri-implantitis. The prevalence of patients with PIKA and PIBE was 15.1% and 12.8%, respectively. Residual periodontal pockets, clinical attachment loss and bone loss/age at T2 were more pronounced in patients with PIKA and PIBE. Cox regression analysis adjusted with the number of implants per patient showed that residual pockets at T1 were independently associated with PIKA and PIBE. Initial diagnosis of severe periodontitis was associated with PIBE incidence. CONCLUSIONS The present study showed that periodontal conditions before implant placement are a risk indicator for peri-implantitis incidence. During implant follow-up, the severity of periodontal status appeared to be a reliable indicator of patient susceptibility to peri-implantitis.
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Affiliation(s)
- Panagiota Vagia
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Ioanna Papalou
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Alexandre Burgy
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Henri Tenenbaum
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Olivier Huck
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Jean-Luc Davideau
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
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Peri-Implantitis: A Clinical Update on Prevalence and Surgical Treatment Outcomes. J Clin Med 2021; 10:jcm10051107. [PMID: 33800894 PMCID: PMC7962026 DOI: 10.3390/jcm10051107] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 02/06/2023] Open
Abstract
Dental implants may be considered a reliable routine procedure in clinical practice for the replacement of missing teeth. Results from long-term studies indicate that implant-supported dental prostheses constitute a predictable treatment method for the management of fully and partially edentulous patients. Implants and their restorations, however, are not free from biological complications. In fact, peri-implantitis, defined as progressive bone loss associated to clinical inflammation, is not a rare finding nowadays. This constitutes a concern for clinicians and patients given the negative impact on the quality of life and the sequelae originated by peri-implantitis lesions. The purpose of this narrative review is to report on the prevalence of peri-implantitis and to overview the indications, contraindications, complexity, predictability and effectiveness of the different surgical therapeutic modalities to manage this disorder.
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Implant survival and biologic complications of implant fixed complete dental prostheses: An up to 5-year retrospective study. J Prosthet Dent 2021; 128:375-381. [PMID: 33618859 DOI: 10.1016/j.prosdent.2020.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 12/12/2022]
Abstract
STATEMENT OF PROBLEM Limited information is available on the association between prosthesis-associated risk factors and biologic complications for patients with implant fixed complete dental prostheses (IFCDPs). PURPOSE The purpose of this retrospective study was to assess the implant survival and biologic complications of IFCDPs up to 5 years of follow-up. MATERIAL AND METHODS Patients who had received IFCDPs between August 1, 2009 and August 1, 2014 were identified through an electronic health record review. Those who consented to participate in the study attended a single-visit study appointment. Clinical and radiographic examinations, intraoral photographs, and peri-implant hard and soft tissues parameters were assessed. Only prostheses which could be removed during the study visit were included. Associations between biologic complications and prosthetic factors, such as time with prosthesis in place, prosthesis material, number of implants, cantilever length, and type of prosthesis retention, were assessed. RESULTS A total of 37 participants (mean ±standard deviation age 62.35 ±10.39 years) with 43 IFCDPs were included. None of the implants had failed, leading to an implant survival of 100% at 5.1 ±2.21 years. Ten of the prostheses were metal-ceramic (Group MC) and 33 were metal-acrylic resin (Group MR). Minor complications were more frequent than major ones. Considering minor complications, peri-implant mucositis was found in 53% of the implant sites, more often in the maxilla (P=.001). The most common major biologic complication was peri-implantitis, which affected 4.0% of the implants, more often in the mandible (P=.025). Peri-implant soft tissue hypertrophy was present 2.79 times more often (95% CI: 1.35 - 5.76, P<.003) around implants supporting metal-acrylic resin prostheses than metal-ceramic ones, with the former type also showing significantly more plaque accumulation (P<.003). CONCLUSIONS Biologic complications such as soft tissue hypertrophy and plaque accumulation were more often associated with metal-acrylic resin prostheses. Peri-implant mucositis occurred more often under maxillary IFCDPs, while peri-implantitis appeared more common around mandibular implants.
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Sicilia A, Gallego L, Sicilia P, Mallo C, Cuesta S, Sanz M. Crestal bone loss associated with different implant surfaces in the posterior mandible in patients with a history of periodontitis. A retrospective study. Clin Oral Implants Res 2021; 32:88-99. [PMID: 33210774 DOI: 10.1111/clr.13682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/26/2020] [Accepted: 10/25/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To retrospectively assess the interproximal bone loss (CBL) in external hexagon implants (EHI), with different surface micro-topography, placed in the posterior mandible in patients with a history of periodontitis undergoing supportive periodontal care. MATERIAL AND METHODS 268 consecutive patients received 755 EHI implants in the mandibular molar region between 2007 and 2015 with the following surface characteristics: 72 turned, 145 hybrids (double acid-etched/turned), and 538 anodized. CBL was yearly evaluated by analysing calibrated digital periapical radiographs, with a follow-up of 1-6 years. Data on implant survival were also calculated. RESULTS At 6 years (53 patients), the mean CBL was 1.34/1.42 mm at patient/implant level, respectively (range: 0-5.2 mm). Significantly higher CBL was detected in anodized implants than in turned and hybrid implants (1.92/1.46/1.02 mm) (p < .01). The maximum CBL values were found in 2 anodized implants at 4 years (6.3 and 8.1 mm). CBL ≥2 mm was detected in 18% of implants at 3 years and 35% at 6 (p < 2.2 × 10-16 ), this prevalence being 2.6 times higher in the anodized than in the hybrid and turned group (40%/15.6%, p < .0094). At 6 years, 25 anodized implants presented CBL ≥3 mm (18%). 6 anodized implants (5 patients) were removed between 4 and 5 years. CONCLUSION A significant higher CBL was observed in anodized, compared to hybrid and turned implants, when placed in the mandibular molar region of periodontal patients, with a follow-up of 1 to 6 years.
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Affiliation(s)
- Alberto Sicilia
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Luis Gallego
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Pelayo Sicilia
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Carmen Mallo
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Susana Cuesta
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Mariano Sanz
- Faculty of Odontology, ETEP Research Group, University Complutense of Madrid, Madrid, Spain
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Romandini M, Lima C, Pedrinaci I, Araoz A, Soldini MC, Sanz M. Prevalence and risk/protective indicators of peri-implant diseases: A university-representative cross-sectional study. Clin Oral Implants Res 2020; 32:112-122. [PMID: 33210772 DOI: 10.1111/clr.13684] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/21/2020] [Accepted: 11/10/2020] [Indexed: 12/15/2022]
Abstract
AIM To evaluate the prevalence of peri-implant diseases and to identify risk/protective indicators of peri-implantitis. MATERIALS AND METHODS Two hundred and forty randomly selected patients from a university clinic database were invited to participate. Those who accepted, once data from their medical and dental history were collected, were examined clinically and radiographically to assess the prevalence of peri-implant health and diseases. Peri-implantitis was defined as the presence of BoP/SoP together with radiographic bone levels (BL) ≧2 mm. An intermediate peri-implant health category between peri-implant mucositis and peri-implantitis was also identified, defined by the presence of BoP/SoP together with 1 mm ≦BL < 2 mm. A multilevel multivariate logistic regression analysis was carried out to identify those factors associated either positively (risk) or negatively (protective) with peri-implantitis. RESULTS Ninety-nine patients with a total of 458 dental implants were analyzed. The prevalences of pre-periimplantitis and of peri-implantitis were, respectively, 31.3% and 56.6% at patient-level, while 31.7% and 27.9% at implant level. The following factors were identified as risk indicators for peri-implantitis: smoking (OR = 3.59; 95% CI: 1.52-8.45), moderate/severe periodontitis (OR = 2.77; 95% CI: 1.20-6.36), <16 remaining teeth (OR = 2.23; 95% CI: 1.05-4.73), plaque (OR = 3.49; 95% CI: 1.13-10.75), implant malposition (too vestibular: OR = 2.85; 95% CI: 1.17-6.93), implant brand (Nobel vs. Straumann: OR = 4.41;95% CI: 1.76-11.09), restoration type (bridge vs. single crown: OR = 2.47; 95% CI: 1.19-5.12), and trauma as reason of tooth loss (vs. caries: OR = 6.51; 95% CI: 1.45-29.26). Conversely, the following factors were identified as protective indicators: interproximal flossing/brushing (OR = 0.27; 95% CI: 0.11-0.68), proton pump inhibitors (OR = 0.08; 95% CI: 0.01-0.90), and anticoagulants (OR = 0.08; 95% CI: 0.01-0.56). CONCLUSIONS Peri-implant diseases are highly prevalent among patients with dental implants in this university-based population. Several factors were identified as risk- and protective- indicators of peri-implantitis.
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Affiliation(s)
- Mario Romandini
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Cristina Lima
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ignacio Pedrinaci
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ana Araoz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | | | - Mariano Sanz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
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Kissa J, El Kholti W, Chemlali S, Kawtari H, Laalou Y, Albandar JM. Prevalence and risk indicators of peri-implant diseases in a group of Moroccan patients. J Periodontol 2020; 92:1096-1106. [PMID: 33306841 DOI: 10.1002/jper.20-0549] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND To report the prevalence of peri-implant diseases in a North African patient population, and to assess the concurrent associations of patient- and implant-level characteristics with probing depth and bone loss around dental implants METHODS: A total of 642 implants in 145 subjects were followed up for a mean 6.4 years. At the last follow-up visit the subjects were examined clinically and radiographically to assess the status of peri-implant tissues and teeth. Data analysis used the generalized linear mixed models RESULTS: The prevalence of peri-implant mucositis and peri-implantitis were 82.1% and 41.4% at the subject level, and 68.4% and 22.7% at the implant level, respectively. Inadequate plaque control, peri-implant inflammation, history of previous implant failures, and pain/discomfort at the implant site were significantly associated with both outcomes (increased probing depth and bone loss). Diabetes mellitus, inadequate implant restoration, single restorations (versus multi-unit), cement-retained restorations, and presence of occlusal wear facets on teeth were significantly associated with one of the two outcomes. Implants placed in the lower anterior jaw region had the most favorable outcome. Smoking, history of periodontitis, and type of implant surface did not show significant associations with higher frequency of peri-implant diseases in the multivariable analysis. CONCLUSIONS Peri-implant diseases are prevalent in this North African patient population. Multiple subject- and implant-level variables were associated with peri-implant diseases. Risk assessment of these effects should consist of a concurrent inclusion of these factors in multivariable analyses that also adjust for the complex variance structure of the oral environment.
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Affiliation(s)
- Jamila Kissa
- Department of Periodontology, University of Hassan II of Casablanca, Casablanca, Morocco
| | - Wafa El Kholti
- Department of Periodontology, University of Hassan II of Casablanca, Casablanca, Morocco
| | - Sihame Chemlali
- Department of Periodontology, University of Hassan II of Casablanca, Casablanca, Morocco
| | | | | | - Jasim M Albandar
- Department of Periodontology and Oral Implantology, School of Dentistry, Temple University, Philadelphia, PA, USA
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Stacchi C, Troiano G, Rapani A, Lombardi T, Sentineri R, Speroni S, Berton F, Di Lenarda R. Factors influencing the prevalence of peri-implantitis in implants inserted in augmented maxillary sinuses: A multicenter cross-sectional study. J Periodontol 2020; 92:1117-1125. [PMID: 33246354 DOI: 10.1002/jper.20-0483] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/09/2020] [Accepted: 11/15/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Peri-implantitis is widely recognized as a major cause of late implant failure, both in pristine and regenerated bone. The present study aims to evaluate the prevalence of peri-implantitis in implants inserted in augmented maxillary sinuses and to analyze possible risk factors. METHODS A cross-sectional study was conducted in four centers including patients who underwent lateral or transcrestal sinus augmentation and received dental implants. Clinical and anamnestic data were collected using a standardized form. Univariate and multivariate logistic regression analyses have been performed for both implant-level and patient-level variables. Subsequently, a multilevel logistic mixed-effect model was built to analyze variables correlated with the occurrence of peri-implantitis. RESULTS A total of 156 patients (61 males and 95 females; mean age: 60.9 ± 11.6 years) with 315 implants inserted into augmented maxillary sinuses with a follow-up ranging from 1 to 18 years were evaluated. Seven implants in seven patients were previously lost for peri-implantitis (2.2% and 4.5% at implant- and patient-level, respectively); 250 implants showed no signs of peri-implant diseases (79.4%), 34 implants presented mucositis (10.8%), and 24 implants exhibited peri-implantitis (7.6%). Corresponding data evaluated at patient-level were 125 (80.1%), 17 (10.9%), and 14 (9.0%), respectively. At the multilevel analysis, history of periodontitis, sinus elevation with lateral approach, and one-stage sinus floor elevation significantly correlated with the occurrence of peri-implantitis (P <0.001). CONCLUSIONS History of periodontitis confirmed its well-known role as a risk factor for peri-implant pathologies. In addition, both lateral window technique and one-stage sinus floor elevation seemed to represent significant risk factors for peri-implantitis.
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Affiliation(s)
- Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Rapani
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Teresa Lombardi
- Department of Health Sciences, University "Magna Graecia", Catanzaro, Italy
| | | | | | - Federico Berton
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Roberto Di Lenarda
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Ustaoğlu G, Erdal E. Relationship between risk markers for cardiovascular disease and peri-implant diseases. Int J Implant Dent 2020; 6:73. [PMID: 33236168 PMCID: PMC7686405 DOI: 10.1186/s40729-020-00273-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023] Open
Abstract
Background The aim of this paper is to explore the serum biochemical parameters also known as risk markers for cardiovascular system, in individuals who have received dental implant treatment, and to reveal risk factors for peri-implant diseases. Methods The study included 58 subjects with peri-implantitis, 49 subjects with peri-implant mucositis, and 49 healthy subjects. All the subjects were assessed in terms of both peri-implant clinical parameters—probing depth (PD), bleeding on probing (BOP), the type of prosthesis, gingival index (GI), keratinized mucosa width (KMW), and plaque index (PI)—and serum biochemical parameters (e.g., LDL cholesterol, HDL cholesterol, triglyceride, total cholesterol, vitamin D, uric acid, white blood cell (WBC), neutrophil, hemoglobin (Hb), and platelet counts). Results KMW was the lowest in the peri-implantitis group. Compared with the other groups, the peri-implantitis group showed significantly higher levels of triglyceride, uric acid, and WBC. The peri-implantitis group had the lowest level of vitamin D. Triglyceride and uric acid levels had positive correlations with peri-implant clinical parameters. Conclusion High levels of triglyceride and uric acid may pose a risk for both peri-implant diseases and cardiovascular diseases. Prior to dental implant surgery, patients’ serum biochemical parameters should be checked.
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Affiliation(s)
- Gülbahar Ustaoğlu
- Dentistry Faculty, Department of Periodontology, Bolu Abant İzzet Baysal University, 14300, Bolu, Turkey.
| | - Emrah Erdal
- Medical Faculty, Department of Cardiology, Bolu Abant İzzet Baysal University, Bolu, Turkey
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Sordi MB, Perrotti V, Iaculli F, Pereira KCR, Magini RS, Renvert S, Gattone SA, Piattelli A, Bianchini MA. Multivariate analysis of the influence of peri-implant clinical parameters and local factors on radiographic bone loss in the posterior maxilla: a retrospective study on 277 dental implants. Clin Oral Investig 2020; 25:3441-3451. [PMID: 33155065 PMCID: PMC8137597 DOI: 10.1007/s00784-020-03666-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/28/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The aim of the present study was to investigate whether peri-implant clinical parameters (modified plaque index (mPI), bleeding and/or suppuration on probing (B/SOP)) and local factors (type of prostheses, screw emergence, platform diameter, and abutment angulation) might contribute to the development of additional bone loss and peri-implantitis around dental implants. MATERIALS AND METHODS Two hundred seventy-seven external hex connection implants placed in the posterior maxilla of 124 patients were retrospectively evaluated. They were divided into two groups: physiologic bone loss < 2 mm (PBL) or additional bone loss ≥ 2 mm (ABL). GEE logistic regression was applied to evaluate the influence of type of prostheses (implant-supported single crown (ISSC), fixed partial denture (ISFPD), and full denture (ISFD)) and clinical parameters (mPI and S/BOP) on bone loss. RESULTS Among the 277 implants, 159 (57.4%) presented PBL and 118 (42.6%) presented ABL. Within the ABL group, 20.6% implants were diagnosed with peri-implantitis. mPI significantly correlated with the type of prosthesis and the highest value of mPI (index = 3) was observed in ISFD (23.8%). Moreover, peri-implantitis was more frequently associated with ISFD (32.79%) than ISSC and ISFDP (13.79% and 13.48, respectively) CONCLUSIONS: ISFD in the posterior maxilla presented high rates of ABL and showed a higher prevalence of peri-implantitis. None of the local factors seemed to contribute to the development of these conditions. Further investigations are needed to prospectively support the results of the present study. CLINICAL RELEVANCE Patients rehabilitated with ISFD should be carefully monitored and have more frequent maintenance visits to prevent or control peri-implant bone loss.
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Affiliation(s)
- Mariane B Sordi
- Center for Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Vittoria Perrotti
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), University of Chieti-Pescara, Via dei vestini, 31, 66100, Chieti, Italy.
| | - Flavia Iaculli
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Keila C R Pereira
- Public Health Sciences, University of South of Santa Catarina, Tubarao, Brazil
| | - Ricardo S Magini
- Perio/Implantology, Department of Dentistry, Center for Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Stefan Renvert
- Oral Health Sciences, Kristianstad University School of Dentistry, Kristianstad, Sweden.,Dublin Dental Hospital, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - Stefano Antonio Gattone
- Department of Philosophical, Pedagogical and Economic-Quantitative Sciences (DiSFPEQ), University of Chieti-Pescara, Chieti, Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), University of Chieti-Pescara, Via dei vestini, 31, 66100, Chieti, Italy.,Biomaterials Engineering, Catholic University of Murcia (UCAM), Murcia, Spain.,Villaserena Foundation for Research, Città Sant'Angelo (Pescara), Italy
| | - Marco A Bianchini
- Perio/Implantology, Department of Dentistry, Center for Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil
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Abstract
Peri-implant diseases are prevalent with a weighted mean prevalence rate of 43% across Europe and 22% across South and North America. Although the main etiologic agent is bacterial biofilm, a myriad of factors influence the initiation and progression of the disease. Unfortunately, the treatment of peri-implant diseases is at best favorable in the short term with a high rate of persistent inflammation and recurrence. Therefore, it is sensible to consider and control all potential factors that may predispose an implant to peri-implant tissue inflammation in an attempt to avoid the disease. This paper reviews recent evidence on factors that may predispose implants to peri-implantitis and measures that can be taken to prevent it.
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Affiliation(s)
- Jia-Hui Fu
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, USA
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Song X, Li L, Gou H, Xu Y. Impact of implant location on the prevalence of peri-implantitis: A systematic review and meta- analysis. J Dent 2020; 103:103490. [PMID: 33007363 DOI: 10.1016/j.jdent.2020.103490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/26/2020] [Accepted: 09/27/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To evaluate scientific evidence about the impact of implant location on the prevalence of peri-implantitis at implant level. SOURCE Databases (PubMed, Embase and Cochrane) were searched until March 2020without limitations on language or publication year. Hand searches and gray literature were also included. STUDY SELECTION Clinical studies reporting data on prevalence of peri-implantitis in anterior and posterior regions at implant level, and evaluations of implants with at least 1 year of function were selected. DATA Ten studies with a low risk of bias were included. Meta-analysis was performed to estimate the pooled risk ratio. A significantly higher prevalence of peri-implantitis in anterior region compared to posterior region was found (Risk ratio: 1.34; 95 % CI: [1.07, 1.69]; p = 0.01). Meta-regression was performed to analyze the potential influence of confounding factors by calculating p-value of the coefficient. Subjects (p = 0.827), implants (p = 0.859) and age (p = 0.656) did not significantly influence the outcome. Subgroup analysis by jaw revealed significantly higher prevalence of peri-implantitis in maxillary anterior (Risk ratio: 1.37; 95 % CI: [1.10, 1.71]; p = 0.005) and mandibular anterior (Risk ratio: 1.76; 95 % CI: [1.29, 2.42]; p = 0.0004) regions compared to maxillary posterior region. No significant difference was found between maxillary anterior and mandibular posterior (Risk ratio: 1.15; 95 % CI: [0.75, 1.75]; p = 0.53) regions. A meta-analysis was precluded between mandibular anterior and mandibular posterior regions due to high statistical heterogeneity (I 2 = 76 %). CONCLUSIONS Implants in the maxillary anterior and mandibular anterior regions had a higher prevalence of peri-implantitis compared to the maxillary posterior region. CLINICAL SIGNIFICANCE Practitioners should strictly grasp the indications for patients missing anterior teeth and make comprehensive treatment planning.
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Affiliation(s)
- Xiao Song
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, 136 Hanzhong Road, Nanjing 210029, China
| | - Lu Li
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, 136 Hanzhong Road, Nanjing 210029, China; Department of Periodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing 210029, China
| | - Huiqing Gou
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, 136 Hanzhong Road, Nanjing 210029, China
| | - Yan Xu
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, 136 Hanzhong Road, Nanjing 210029, China; Department of Periodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing 210029, China.
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Saneja R, Bhattacharjee B, Bhatnagar A, Kumar PGN, Verma A. Efficacy of different lasers of various wavelengths in treatment of peri-implantitis and peri-implant mucositis: A systematic review and meta-analysis. J Indian Prosthodont Soc 2020; 20:353-362. [PMID: 33487962 PMCID: PMC7814680 DOI: 10.4103/jips.jips_144_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/22/2020] [Accepted: 09/02/2020] [Indexed: 12/31/2022] Open
Abstract
Aim Peri implant diseases lead to pathological changes in the peri implant tissues and loss of osseointegration. The purpose of this analysis is to evaluate the effect of various lasers and photodynamic therapy (PDT) on peri implant diseases compared to conventional procedures. Setting and Design This meta analysis was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. Materials and Methods A systematic search of the electronic databases such as PubMed, ICTRP, CT.gov, Embase, and Cochrane Library was done additional to manual search of peer review article on peri-implant diseases. Eleven randomized control clinical trials were included in which laser therapy and PDT were used as an interventional procedure. Results and Statistical Analysis Used Review Manager 5.03 (RevMan, Nordic Cochrane Center, Copenhagen, Denmark), and random effects model were used to assess mean difference (MD). Bivariate differential mean statistic was used in intergroup estimate with 95% confidence interval (CI). I2 test statistics was applied for heterogenity and P < 0.05 was considered significant statistically. The literature search yielded a total of 113 articles among which 11 articles were included for quantitative analysis. The selected outcome PD reported MD -0.01 with 95% CI (-0.13, 0.16), P = 0.84, and CAL reported MD -0.09 with 95% CI (-0.32, 0.14), P = 0.45, respectively. Conclusion Laser treatment as an adjunctive therapy or monotherapy in peri implantitis does not show any superior effects than conventional measures as per evidence. However, cases with peri implant mucositis have shown far more promising results with laser therapy compared to peri implantitis.
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Affiliation(s)
- Ritu Saneja
- Department of Prosthodontics, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Bappaditya Bhattacharjee
- Department of Prosthodontics, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Atul Bhatnagar
- Department of Prosthodontics, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - P G Naveen Kumar
- Department of Public Health Dentistry, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Arju Verma
- Department of Prosthodontics, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Lu RJ, Xing HL, Liu CJ, Shu Y, Guo B, Chu XY, Wang CF, Feng L, Yu KT. Antibacterial peptides inhibit MC3T3-E1 cells apoptosis induced by TNF-α through p38 MAPK pathway. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:943. [PMID: 32953743 PMCID: PMC7475433 DOI: 10.21037/atm-20-5338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Antimicrobial peptides (AMP), as a small molecular polypeptide with a broad antibacterial spectrum and high efficiency, have attracted more and more attention. Few pieces of research on the effect of the antimicrobial peptide on osteoblast under inflammatory conditions have so far been reported. The main aim of this work was to investigate the antiapoptosis effect of the antimicrobial peptide on MC3T3-E1 cells induced by TNF-α and its related mechanism. Methods Rat MC3T3-E1 cells were co-cultured with different concentrations of antibacterial peptide DP7 and TNF-α.MTS assay, cell scratch test, alkaline phosphatase activity, and alizarin red staining assay were used to determine osteoblast viability in this experiment. Annexin V-FITC/PI double staining cells and flow cytometry were used to analyze apoptosis and Western blot assay detection to show mitogen-activated protein kinase (MAPK) protein expression in rat MC3T3-E1 cells. Then, Realtime polymerase chain reaction (PCR) was used to examine the caspase-3 gene expression. Also, ELISA detection was used to clarify the anti-apoptotic effect of the p38 MAPK inhibitor, SB203580, on cells’ apoptosis. Results Antimicrobial peptide could promote the proliferation, migration, and osteogenic ability of MC3T3-E1 cells induced by TNF-α, but inhibit cell apoptosis rate (P<0.05), and the effect was concentration-dependent. Western blot results showed after TNF-αtreatment, the expression of p-p38 MAPK in the MC3T3-E1 cells increased after TNF-α and antimicrobial peptide cotreatment, TNF-α induced p-p38 MAPK phosphorylation was inhibited, and the difference was statistically significant (P<0.05). Realtime PCR results showed that the gene expression of caspase-3 mRNA was up-regulated after TNF-α treatment, while their expression was down-regulated after cultured with TNF-α and antimicrobial peptide. Elisa's analysis showed that cell apoptosis increased after TNF-α treatment alone, and cell apoptosis was reduced to the normal levels when combined with antimicrobial peptide, and cell apoptosis induced by TNF-α was partially abolished when combined with SB203580. Conclusions Antimicrobial peptide DP7 could inhibit MC3T3-E1 cells apoptosis induced by TNF-α, and the effect was concentration-dependent. The antiapoptosis activation of the antimicrobial peptide on MC3TE-E1 cells may be related to the inhibition of the p38 MAPK pathway.
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Affiliation(s)
- Rong-Jian Lu
- Department of Stomatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - He-Lin Xing
- Department of Prosthodontics, Beijing Stomatological Hospital and School of Stomatology, Capital Medical University, Beijing, China
| | - Chao-Jun Liu
- CheerLand Clinical Laboratory Co., Ltd., Beijing, China
| | - Yao Shu
- Department of Stomatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Biao Guo
- Department of Stomatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiao-Yang Chu
- Department of Stomatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Chun-Fang Wang
- Department of Stomatology, Qingdao West Coast New Area Central Hospital, Qingdao, China
| | - Lin Feng
- Department of Stomatology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Kai-Tao Yu
- Department of Stomatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
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73
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Schuldt L, Bi J, Owen G, Shen Y, Haapasalo M, Häkkinen L, Larjava H. Decontamination of rough implant surfaces colonized by multispecies oral biofilm by application of leukocyte- and platelet-rich fibrin. J Periodontol 2020; 92:875-885. [PMID: 32853401 DOI: 10.1002/jper.20-0205] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/19/2020] [Accepted: 08/10/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Decontamination of biofilm-infected rough implant surfaces is challenging. Platelet rich blood products have been shown to have anti-microbial properties against periodontal pathogens. Our aim was to investigate the effect of a potential biological implant surface disinfectant, leukocyte- and platelet-rich fibrin (L-PRF), on a mature oral multispecies biofilm on a rough titanium surface. METHODS Sandblasted, large grit, acid-etched (SLA) titanium disks were inoculated with subgingival dental plaque and cultured anaerobically for 21 days. The L-PRF membranes were collected from 12 donors in three trials (four donors in each trial). The disks were rinsed with 0.9% NaCl and exposed to the cell-rich portion of the L-PRF membranes for 48 hours followed by scanning electron microscope (SEM) analysis immediately or after rinsing with 0.9% NaCl prior to fixation. The presence of platelet factor-4 in the rinse samples was analyzed by Western blotting. Remaining bacteria were quantified from SEM images of the implant surfaces and their numbers statistically compared. RESULTS The L-PRF-treated samples without rinsing displayed numerous cells with multiple pseudopodia in immediate contact with bacteria that appeared perforated and increased in size. The cells were identified as platelets based on morphological criteria and by positive reaction for platelet factor-4 by Western blotting. After post-treatment rinsing, the L-PRF-treated disks displayed a significant reduction in bacterial counts (in average 92% reduction). CONCLUSION Application of L-PRF significantly reduced bacterial counts on contaminated SLA titanium surface, most likely through anti-microbial action by platelets.
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Affiliation(s)
- Luisa Schuldt
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia
| | - Jiarui Bi
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia
| | - Gethin Owen
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia
| | - Ya Shen
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia
| | - Markus Haapasalo
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia
| | - Lari Häkkinen
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia
| | - Hannu Larjava
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia
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Dzalaeva F, Chikunov S, Utyuzh A, Mikhailova M, Budunova M. Assessing Safety and Clinical Effectiveness of New Approaches to Planning and Integrated Implementation of Full-Mouth Reconstruction. Eur J Dent 2020; 15:109-116. [PMID: 32898870 PMCID: PMC7902115 DOI: 10.1055/s-0040-1715989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objectives
Planning, adequate preparation, and further prosthodontic management are the most important steps in the treatment of this population of patients with dental and mandibular anomalies. The purpose of the article is the improvement of safety and clinical effectiveness of prosthodontic rehabilitation of patients after full-mouth reconstruction.
Materials and Methods
A single-center open prospective nonrandomized study, examination, and treatment of 198 patients with partial or total absence of teeth were performed. Higher safety and clinical effectiveness of the treatment were found in the patients of the main group who showed a significant reduction in the rate of complications relative to the comparison group. In the main group, the number of aesthetic defects and cases of repeated prosthetics decreased in comparison with the corresponding occurrence rate of such cases in patient groups.
Results
It showed statistically significantly reduction in the rates of occurrence of the complications when using the proposed algorithm: the rate of inflammation of the marginal periodontium and peri-implant tissues in the main group was 2.9 times less frequent and loosening of the supporting implants was 3.9 times less frequent. The rate of polymer chipping or abrasion in the area of the incisal edge or masticatory surface was two times lower in the main group of patients, short crowns were found 1.9 times less often, sores in the area of the dental pontic in the main group were 1.8 times less frequent than in the comparison group, and no fractures of bridgework were found in the main group. The frequency of neuralgic facial pain in the patients of the main group was 5.2 times less than in the comparison group, complaints about pain in the temporomandibular joint area were 8.4 times less frequent, increased abrasion of antagonist teeth was 3.9 times less frequent, and phonetics disorders were 8.4 times less frequent.
The effectiveness of the algorithm developed by us is also confirmed by the fact that the number of aesthetic defects and cases of the need for repeated prosthetic treatment was reduced in comparison with the corresponding frequency of such cases in groups of patients where standard approaches to prosthetics were applied. In particular, aesthetic defects found in the main group of patients were 2.5 times less frequent than in the comparison group, and repeated prosthetics was performed 2.7 times less frequently. Conclusion
Application of the developed comprehensive approach to planning of prosthodontic rehabilitation provides for significant reduction in the frequency of complications and aesthetic defects, as well as cases of repeated need for prosthetics.
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Affiliation(s)
- Fatima Dzalaeva
- Department of Prosthodontics, First Moscow State Medical University, Moscow, Russian Federation
| | - Sergey Chikunov
- Department of Prosthodontics, First Moscow State Medical University, Moscow, Russian Federation.,Department of Prosthodontics, Peoples Friendship University (RUDN), Moscow, Russian Federation
| | - Anatoly Utyuzh
- Department of Prosthodontics, First Moscow State Medical University, Moscow, Russian Federation
| | - Maria Mikhailova
- Department of Prosthodontics, First Moscow State Medical University, Moscow, Russian Federation
| | - Marzhanat Budunova
- Department of Prosthodontics, First Moscow State Medical University, Moscow, Russian Federation
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75
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Khan A, Sharma D. Management of Peri-Implant Diseases: A Survey of Australian Periodontists. Dent J (Basel) 2020; 8:dj8030100. [PMID: 32882900 PMCID: PMC7558189 DOI: 10.3390/dj8030100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/14/2020] [Accepted: 08/14/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND/AIM This survey-based study aims to explore the clinical management protocols of followed by Australian periodontists in relation to peri-implant diseases. MATERIALS AND METHODS A five-part online questionnaire was developed and administered through email. Descriptive statistics were used for analysis, with the univariate associations between a categorical outcome and the variables evaluated using Pearson's Chi-squared test. RESULTS The survey yielded 99 responses, resulting in a response rate of 41.8%. Most participants were male and aged 35-44 years. More than a quarter of practitioners had been placing implants for 6-10 years and almost two-fifths of practitioners placed 1-10 implants per month. The estimated prevalence of peri-implant mucositis and peri-implantitis in the general Australian population was 47% and 21%, respectively. Practitioners reported using systemic antibiotics to manage peri-implant mucositis (7%) and (72%) peri-implantitis lesions, with a combination of amoxicillin and metronidazole. Most common treatment modalities were oral hygiene instructions, nonsurgical debridement and antimicrobial gel/rinse. Surgical debridement and systemic antibiotics were also often used for peri-implantitis treatment. Practitioners preferred a 3-month clinical follow-up and 6-month radiographic evaluation. Furthermore, three-quarters of practitioners rated their management as moderately effective, although upwards of nine-tenths expressed the need for further training and awareness. CONCLUSION This study confirms a significant use of empirical treatment modalities due to lack of standard therapeutic protocol. However, some approaches followed by the specialists may provide a basis to formulate a therapeutic protocol for peri-implant disease management.
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Affiliation(s)
- Ahsen Khan
- College of Medicine and Dentistry, James Cook University, 14-88 McGregor Road, Smithfield 4878, QLD, Australia;
| | - Dileep Sharma
- Department of Periodontics, James Cook University, 14-88 McGregor Road, Smithfield 4878, QLD, Australia
- The Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, 14-88 McGregor Road, Smithfield 4878, QLD, Australia
- Correspondence:
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Geisinger ML, Calvert Grosso K, Kaur M, Abou-Arraj RV, Basma H, Ogdon D, Geurs NC. Clinical Decision Making for Primary Peri-Implantitis Prevention: Practical Applications. Clin Adv Periodontics 2020; 11:43-53. [PMID: 32702205 DOI: 10.1002/cap.10115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 07/13/2020] [Indexed: 02/06/2023]
Abstract
FOCUSED CLINICAL QUESTION When planning dental implant therapy, what risk-reduction strategies allow practitioners to select patients, sites, and restorative plans that decrease the incidence of peri-implant disease? SUMMARY With a marked increase in the number of patients receiving dental implants to treat partial or complete edentulism, it follows that the prevalence of peri-implant mucositis and peri-implantitis have increased. Risks associated with implant therapies may vary based upon underlying local, environmental, surgical, patient, prosthetic, and fixture-related factors. Furthermore, an emphasis on preventative measures and maintenance should be undertaken to avoid development and progression of peri-implant diseases. Thorough risk assessment, proper treatment planning, and early diagnosis and intervention are critical in the absence of definitive data of long-term success of treatments for peri-implant condition. Given the difficulty in intervention once peri-implantitis is established, identification of risk factors and development of treatment plans to address those factors before dental implant therapy is critical to the long-term health and success of dental implants. CONCLUSIONS A patient-centered, evidence based approach to dental implant treatment planning to reduce the risk for peri-implantitis should be undertaken. Systematic diagnosis of disease state(s) and evaluation of the etiologic and modifying risk factors for peri-implant diseases can yield more optimal outcomes to reduce peri-implantitis rates.
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Affiliation(s)
- Maria L Geisinger
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | | | - Maninder Kaur
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | - Ramzi V Abou-Arraj
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | - Hussein Basma
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | - Dorothy Ogdon
- Lister Hill Library, University of Alabama at Birmingham, Birmingham, AL
| | - Nicolaas C Geurs
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
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Abstract
Abstract
Purpose of the Review
Peri-implant diseases are inflammatory reactions to bacterial infections affecting osseointegrated dental implants. In recent years, scientific interest on this topic has increased, as demonstrated by the appearance of a large number of protocols for treating peri-implant mucositis (PIM) and peri-implantitis (PI). The aim of the present narrative review is to provide an overview of the recent (e.g., 2014–present) published protocols for the non-surgical treatment of peri-implant diseases.
Recent Findings
Several adjunctive measures for mechanical debridement have been proposed and investigated to achieve implant surface decontamination and resolution of mucosal inflammation. However, none of the adjunctive measures has been shown to significantly improve peri-implant conditions compared with non-surgical mechanical debridement alone.
Summary
Non-surgical approaches for the treatment of peri-implant diseases have been proved to be reliable in reducing clinical signs of peri-implant inflammation (e.g., BoP), although with limited capability to achieve complete disease resolution. Due to the limited benefits from the use of currently proposed adjunctive methods (e.g., chlorhexidine, lasers, photodynamic therapy, systemic probiotics) their application is not recommended until further investigations prove their clinical utility.
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Roccuzzo M, Fierravanti L, Pittoni D, Dalmasso P, Roccuzzo A. Implant survival after surgical treatment of peri‐implantitis lesions by means of deproteinized bovine bone mineral with 10% collagen: 10‐year results from a prospective study. Clin Oral Implants Res 2020; 31:768-776. [DOI: 10.1111/clr.13628] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/15/2020] [Accepted: 04/10/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Mario Roccuzzo
- Private practice Torino Italy
- Division of Maxillo‐facial SurgeryUniversity of Torino Torino Italy
- Department of Periodontics and Oral MedicineUniversity of Michigan MI USA
| | | | | | - Paola Dalmasso
- Department of Public Health and PediatricsUniversity of Torino Torino Italy
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental MedicineUniversity of Bern Bern Switzerland
- Department of Oral and Maxillofacial SurgeryCopenhagen University Hospital (Rigshospitalet) Copenhagen Denmark
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Galarraga‐Vinueza ME, Dohle E, Ramanauskaite A, Al‐Maawi S, Obreja K, Magini R, Sader R, Ghanaati S, Schwarz F. Anti‐inflammatory and macrophage polarization effects of Cranberry Proanthocyanidins (PACs) for periodontal and peri‐implant disease therapy. J Periodontal Res 2020; 55:821-829. [DOI: 10.1111/jre.12773] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/23/2020] [Accepted: 05/13/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Maria Elisa Galarraga‐Vinueza
- Department of Oral Surgery and Implantology Carolinum Johann Wolfgang Goethe‐University Frankfurt Frankfurt Germany
- Post‐Graduate Program in Implant Dentistry (PPGO) Federal University of Santa Catarina (UFSC) Florianópolis Brazil
| | - Eva Dohle
- FORM‐Lab Frankfurt Oral Regenerative Medicine Department for Oral, Cranio‐Maxillofacial and Facial Plastic Surgery Medical Center of the Goethe University Frankfurt Frankfurt Germany
| | - Ausra Ramanauskaite
- Department of Oral Surgery and Implantology Carolinum Johann Wolfgang Goethe‐University Frankfurt Frankfurt Germany
- Department of Oral Surgery Universitätsklinikum Düsseldorf Düsseldorf Germany
| | - Sara Al‐Maawi
- FORM‐Lab Frankfurt Oral Regenerative Medicine Department for Oral, Cranio‐Maxillofacial and Facial Plastic Surgery Medical Center of the Goethe University Frankfurt Frankfurt Germany
| | - Karina Obreja
- Department of Oral Surgery and Implantology Carolinum Johann Wolfgang Goethe‐University Frankfurt Frankfurt Germany
| | - Ricardo Magini
- Post‐Graduate Program in Implant Dentistry (PPGO) Federal University of Santa Catarina (UFSC) Florianópolis Brazil
| | - Robert Sader
- Department for Oral Cranio‐Maxillofacial and Facial Plastic Surgery Medical Center of the Goethe University Frankfurt Frankfurt am Main Germany
| | - Shahram Ghanaati
- FORM‐Lab Frankfurt Oral Regenerative Medicine Department for Oral, Cranio‐Maxillofacial and Facial Plastic Surgery Medical Center of the Goethe University Frankfurt Frankfurt Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology Carolinum Johann Wolfgang Goethe‐University Frankfurt Frankfurt Germany
- Department of Oral Surgery Universitätsklinikum Düsseldorf Düsseldorf Germany
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80
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Rinke S, Nordlohne M, Leha A, Renvert S, Schmalz G, Ziebolz D. Risk indicators for mucositis and peri-implantitis: results from a practice-based cross-sectional study. J Periodontal Implant Sci 2020; 50:183-196. [PMID: 32617183 PMCID: PMC7321710 DOI: 10.5051/jpis.2020.50.3.183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 03/02/2020] [Accepted: 04/01/2020] [Indexed: 11/08/2022] Open
Abstract
Purpose This practice-based cross-sectional study aimed to investigate whether common risk indicators for peri-implant diseases were associated with peri-implant mucositis and peri-implantitis in patients undergoing supportive implant therapy (SIT) at least 5 years after implant restoration. Methods Patients exclusively restored with a single implant type were included. Probing pocket depth (PPD), bleeding on probing (BOP), suppuration, and radiographic bone loss (RBL) were assessed around implants. The case definitions were as follows: peri-implant mucositis: PPD ≥4 mm, BOP, no RBL; and peri-implantitis: PPD ≥5 mm, BOP, RBL ≥3.5 mm. Possible risk indicators were compared between patients with and without mucositis and peri-implantitis using the Fisher exact test and the Wilcoxon rank-sum test, as well as a multiple logistic regression model for variables showing significance (P<0.05). Results Eighty-four patients with 169 implants (observational period: 5.8±0.86 years) were included. A patient-based prevalence of 52% for peri-implant mucositis and 18% for peri-implantitis was detected. The presence of 3 or more implants (odds ratio [OR], 4.43; 95 confidence interval [CI], 1.36-15.05; P=0.0136) was significantly associated with an increased risk for mucositis. Smoking was significantly associated with an increased risk for peri-implantitis (OR, 5.89; 95% CI, 1.27-24.58; P=0.0231), while the presence of keratinized mucosa around implants was associated with a lower risk for peri-implantitis (OR, 0.05; 95% CI, 0.01-0.25; P<0.001). Conclusions The number of implants should be considered in strategies to prevent mucositis. Furthermore, smoking and the absence of keratinized mucosa were the strongest risk indicators for peri-implantitis in patients undergoing SIT in the present study.
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Affiliation(s)
- Sven Rinke
- Department of Prosthodontics, University Medical Center Goettingen, Goettingen, Germany
| | - Marc Nordlohne
- Private Practice, Weilburg, Germany.,Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Andreas Leha
- Department of Medical Statistics, Georg-August-University, Goettingen, Germany
| | - Stefan Renvert
- School of Health and Society, Kristianstad University, Kristianstad, Sweden
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
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81
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Gunpinar S, Meraci B, Karas M. Analysis of risk indicators for prevalence of peri-implant diseases in Turkish population. Int J Implant Dent 2020; 6:19. [PMID: 32430762 PMCID: PMC7237556 DOI: 10.1186/s40729-020-00215-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 03/31/2020] [Indexed: 02/07/2023] Open
Abstract
Background The aim of this cross-sectional study was (1) to determine the prevalence of peri-implant mucositis and peri-implantitis and (2) to reveal the risk indicators associated with peri-implant diseases. The second point was to investigate the role of keratinized mucosa on peri-implant health. Materials and methods Three hundred and eighty-two subjects who were treated with 1415 dental implants between 2011–2017 were clinically evaluated. Patients’ medical and dental history, as well as implant details, were recorded. Peri-implant examination included probing pocket depth (PPD), bleeding on probing (BoP), plaque index (PI), gingival index (GI), and keratinized tissue width. Furthermore, the patient (sex, age, and smoking) and implant/prosthesis-related factors (surface characteristic, time in function, design of prosthesis etc.) were evaluated. Implants were classified into three groups: healthy, peri-implant mucositis, and peri-implantitis. Uni- and multi-variate regression analyses were utilized for statistics. Results 41.1% (n = 157) and 36.9% (n = 84) of patients had mucositis and peri-implantitis, respectively. 53.6% (n = 758) of implants (95%CI 80.2–90.4) had mucositis, and 21.7% (n = 307) had peri-implantitis. Patients with a maintenance < 2/year (OR = 2.576), having periodontitis (OR = 3.342) and higher PI (OR = 3.046) had significant associations with the development of peri-implant mucositis. Significant ORs were determined for peri-implantitis with patients having maintenance < 2/year (OR = 2.048), having number of implants ≥ 4 (OR = 2.103), diagnosed with periodontitis (OR = 3.295), and higher PI (OR = 7.055). Keratinized tissue width < 2 mm (ORs = 5389/8.013), PPD (ORs = 1.570/8.338), PI (ORs = 6.726/5.205), and BoP (ORs = 3.645/4.353) independent variables were significantly associated with both peri-implant mucositis and peri-implantitis at implant level, respectively. Conclusions Within the limits of this study, the prevalence of mucositis and peri-implantitis was shown to be high in Turkish population. Furthermore, increased risk for peri-implantitis was identified in patients having maintenance < 2/year, presence of periodontitis, poor plaque control, and having number of implants ≥ 4. Less keratinized tissue (< 2 mm), PPD, and BoP were also risk indicators for peri-implantitis development.
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Affiliation(s)
- Sadiye Gunpinar
- Department of Periodontology, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey.
| | - Bilge Meraci
- Department of Periodontology, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Mert Karas
- Department of Periodontology, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
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Tsigarida A, Chochlidakis K, Fraser D, Lampraki E, Einarsdottir ER, Barmak AB, Papaspyridakos P, Ercoli C. Peri-Implant Diseases and Biologic Complications at Implant-Supported Fixed Dental Prostheses in Partially Edentulous Patients. J Prosthodont 2020; 29:429-435. [PMID: 32180293 DOI: 10.1111/jopr.13165] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This is a single center, retrospective study to assess the prevalence of peri-implant disease and biologic complications in a cohort of partially edentulous subjects in relation to selected prosthetic factors. MATERIALS AND METHODS Subjects previously treated with one or more implant-supported fixed dental prosthesis (ISFDPs) were recalled for a comprehensive examination. Clinical and radiographic records were taken and questionnaires were administered. The prevalence of implant failure, peri-implant disease and other biologic complications were correlated with selected prosthetic, clinical and patient-related factors using chi-square and multiple regression analyses. RESULTS A convenience sample of 71 subjects with 100 prostheses supported by 222 dental implants were enrolled in the study. The mean follow-up time after prosthesis delivery was 3.3 ± 1.5 years (range of 1-9 years). The cumulative implant survival rate was 99.1%. Peri-implantitis was the most frequent major biologic complication (5% of implants), while the most frequent minor biologic complication was peri-implant mucositis (84.10% of implants). A diagnosis of peri-implant mucositis was more likely associated with cement-retained prostheses compared to screw-retained prostheses (OR 6.8, 95% CI 1.1-78.6, p = 0.045) and for short-span prostheses (≤3 prosthetic units) (OR 2.3, 95% CI 1.1-5.0, p = 0.034). Subject-reported quality of life measures were high regardless of the existence of major and/or minor complications, but decreased with increasing number of minor and total biologic complications. CONCLUSIONS Peri-implant mucositis and other minor biologic complications were highly prevalent. The distribution of the observed complications differed based on the method of prosthesis retention and the number of prosthetic units replaced.
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Affiliation(s)
- Alexandra Tsigarida
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, NY
| | | | - David Fraser
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, NY
| | | | | | | | - Panos Papaspyridakos
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, NY.,Department of Prosthodontics, Tufts School of Dental Medicine, Boston, MA
| | - Carlo Ercoli
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, NY
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Salivary Levels of Titanium, Nickel, Vanadium, and Arsenic in Patients Treated with Dental Implants: A Case-Control Study. J Clin Med 2020; 9:jcm9051264. [PMID: 32349296 PMCID: PMC7288178 DOI: 10.3390/jcm9051264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 04/19/2020] [Accepted: 04/23/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Recent articles have hypothesized a possible correlation between dental implants dissolution products and peri-implantitis. The null hypothesis tested in this case-control study was that there would be no differences in salivary concentrations of titanium (Ti), vanadium (V), nickel (Ni) and arsenic (As) ions among patients with dental implants, healthy (Group A) or affected by peri-implantitis (Group B), compared to subjects without implants and/or metallic prosthetic restorations (Group C). Methods: Inductively coupled plasma mass spectrometry was used to analyze saliva samples. One-way repeated-measure analysis of variance (ANOVA) was used to identify statistically significant differences in the salivary level of Ti, V, Ni and As between the three groups. Results: A total of 100 patients were enrolled in the study (42 males and 58 females), distributed in three groups: 50 patients in Group C, 26 patients in Group B and 24 patients Group B. In our study, concentrations of metallic ions were higher in Group A and B, compared to the control group, with the exception of vanadium. However, there were no statistically significant differences (p > 0.05) for metallic ions concentrations between Group A and Group B. Conclusions: Based on our results, there are no differences in titanium or other metals concentrations in saliva of patients with healthy or diseased implants.
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84
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Galárraga-Vinueza ME, Tangl S, Bianchini M, Magini R, Obreja K, Gruber R, Schwarz F. Histological characteristics of advanced peri-implantitis bone defects in humans. Int J Implant Dent 2020; 6:12. [PMID: 32211972 PMCID: PMC7093613 DOI: 10.1186/s40729-020-00208-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 02/19/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Inflammatory osteolysis is the clinical hallmark of peri-implantitis. The morphology of the remaining peri-implant bone and the level of osseointegration, however, remain unknown. Our aim was to characterize advanced peri-implantitis bone defects in humans. METHODS Four patients (3 female and 1 male) were diagnosed with peri-implantitis. A total of 5 implants with machined surfaces and a mean loading time of 12 ± 6 years were removed due to advanced bone loss. The defect extension, the peri-implant bone density (bone area per tissue area in percentage), bone-to-implant contact (%), and the number of filled and empty osteocyte lacunae were calculated based on undecalcified histological specimens. RESULTS The defect extension was on average 4.2 mm (95% CI 0.8-3.4). Remaining peri-implant bone showed a high density of 85.5% (95% CI 79.1-91.3) and covered in total 74% (95% CI 70.5-77.5) of the implant surface. Filled and empty osteocyte lacunae density was on average 191 and 165/mm2 (95% CI 132-251; 103-225), respectively. Histology further revealed signs of ongoing bone formation and resorption. CONCLUSION There are signs that suggest that once the original cortical bone is lost due to peri-implantitis, the remaining apical trabecular bone is reinforced and transformed into cortical bone that might take over the functional load.
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Affiliation(s)
- Maria Elisa Galárraga-Vinueza
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
- Post-Graduate Program in Implant Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Stefan Tangl
- Core Facility Hard Tissue and Biomaterial Research, Karl Donath Laboratory, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Marco Bianchini
- Post-Graduate Program in Implant Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Ricardo Magini
- Post-Graduate Program in Implant Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Karina Obreja
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
| | - Reinhard Gruber
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, Vienna, Austria.
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
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85
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Aldulaijan HA, Cohen RE, Stellrecht EM, Levine MJ, Yerke LM. Relationship between hypothyroidism and periodontitis: A scoping review. Clin Exp Dent Res 2020; 6:147-157. [PMID: 32067402 PMCID: PMC7025985 DOI: 10.1002/cre2.247] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/20/2019] [Accepted: 08/25/2019] [Indexed: 12/11/2022] Open
Abstract
AIM The objective of this study was to assess the existing literature to determine if a relationship exists between hypothyroidism and periodontitis. METHODS We used a modified approach to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses by searching five databases in addition to the gray literature. Keywords in the title and abstract fields, as well as subject headings for both periodontal disease and hypothyroidism, were used to search the existing literature for publications relevant to evaluation of the thyroid-periodontitis relationship. RESULTS The authors screened 847 unique publications which, after applying inclusion and exclusion criteria, yielded 29 publications, which were further analyzed for relevance and applicability. Most of the included papers were cross-sectional studies and retrospective chart reviews. Following critical analysis, four publications, including one abstract, were used to further assess the hypothyroid-periodontitis relationship. CONCLUSIONS There are very few high-quality studies describing the potential association between hypothyroidism and periodontitis. In general, and among the included papers with the fewest confounding factors, a positive relationship between hypothyroidism and periodontitis was found. Further well-controlled, prospective clinical and immunologic studies will be required to confirm that relationship.
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Affiliation(s)
- Hajer A. Aldulaijan
- Department of Periodontics and EndodonticsUniversity at Buffalo, State University of New York, School of Dental MedicineBuffaloNew York
- Present address:
Department of Periodontics and Community DentistryKing Saud University, College of DentistryRiyadhSaudi Arabia
| | - Robert E. Cohen
- Department of Periodontics and EndodonticsUniversity at Buffalo, State University of New York, School of Dental MedicineBuffaloNew York
| | - Elizabeth M. Stellrecht
- Department of Periodontics and EndodonticsUniversity at Buffalo, State University of New York, School of Dental MedicineBuffaloNew York
| | - Michael J. Levine
- Department of Periodontics and EndodonticsUniversity at Buffalo, State University of New York, School of Dental MedicineBuffaloNew York
| | - Lisa M. Yerke
- Department of Periodontics and EndodonticsUniversity at Buffalo, State University of New York, School of Dental MedicineBuffaloNew York
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86
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Yi Y, Koo K, Schwarz F, Ben Amara H, Heo S. Association of prosthetic features and peri‐implantitis: A cross‐sectional study. J Clin Periodontol 2020; 47:392-403. [DOI: 10.1111/jcpe.13251] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 12/11/2019] [Accepted: 01/04/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Yuseung Yi
- Department of Prosthodontics Seoul National University Dental Hospital Seoul Korea
| | - Ki‐Tae Koo
- Department of Periodontology and Dental Research Institute Translational Research Laboratory for Tissue Engineering (TTE) College of Dentistry Seoul National University Seoul Korea
| | - Frank Schwarz
- Department of Oral Surgery and Implantology Goethe‐University Frankfurt Frankfurt Germany
| | - Heithem Ben Amara
- Department of Periodontology and Dental Research Institute Translational Research Laboratory for Tissue Engineering (TTE) College of Dentistry Seoul National University Seoul Korea
| | - Seong‐Joo Heo
- Department of Prosthodontics Seoul National University Dental Hospital Seoul Korea
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87
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Kao RT, Curtis DA, Kim DM, Lin G, Wang C, Cobb CM, Hsu Y, Kan J, Velasquez D, Avila‐Ortiz G, Yu S, Mandelaris GA, Rosen PS, Evans M, Gunsolley J, Goss K, Ambruster J, Wang H. American Academy of Periodontology best evidence consensus statement on modifying periodontal phenotype in preparation for orthodontic and restorative treatment. J Periodontol 2020; 91:289-298. [DOI: 10.1002/jper.19-0577] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/20/2019] [Accepted: 12/20/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Richard T. Kao
- Orofacial Sciences University of California San Francisco San Francisco CA
- Private practice Cupertino CA
| | - Donald A. Curtis
- Preventive and Restorative Dental Science University of California San Francisco San Francisco CA
| | - David M. Kim
- Oral Medicine Infection and Immunity Harvard School of Dental Medicine Boston MA
| | - Guo‐Hao Lin
- Orofacial Sciences University of California San Francisco San Francisco CA
| | - Chin‐Wei Wang
- Periodontics and Oral Medicine University of Michigan Ann Arbor MI
| | - Charles M. Cobb
- Department of Periodontology University of Missouri‐Kansas City Kansas City MO
| | - Yung‐Ting Hsu
- Department of Periodontics University of Washington Seattle WA
| | - Joseph Kan
- Department of Restorative Dentistry Loma Linda University Loma Linda CA
| | - Diego Velasquez
- Periodontics and Oral Medicine University of Michigan Ann Arbor MI
- Private practice Fenton MI
| | - Gustavo Avila‐Ortiz
- Department of Periodontics University of Iowa College of Dentistry Iowa City IA
| | - Shan‐Huey Yu
- Periodontics and Oral Medicine University of Michigan Ann Arbor MI
| | - George A. Mandelaris
- Periodontics and Oral Medicine University of Michigan Ann Arbor MI
- Private practice Chicago IL
| | - Paul S. Rosen
- Private practice Yardley PA
- Periodontics University of Maryland Baltimore MD
| | | | - John Gunsolley
- Department of Periodontology Virginia Commonwealth University Richmond VA
| | - Katie Goss
- American Academy of Periodontology Chicago IL
| | | | - Hom‐Lay Wang
- Periodontics and Oral Medicine University of Michigan Ann Arbor MI
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88
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Renvert S, Persson GR, Pirih FQ, Camargo PM. Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations. J Periodontol 2019; 89 Suppl 1:S304-S312. [PMID: 29926953 DOI: 10.1002/jper.17-0588] [Citation(s) in RCA: 176] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/04/2018] [Accepted: 02/01/2018] [Indexed: 11/08/2022]
Abstract
The objective of this review is to identify case definitions and clinical criteria of peri-implant healthy tissues, peri-implant mucositis, and peri-implantitis. The case definitions were constructed based on a review of the evidence applicable for diagnostic considerations. In summary, the diagnostic definition of peri-implant health is based on the following criteria: 1) absence of peri-implant signs of soft tissue inflammation (redness, swelling, profuse bleeding on probing), and 2) the absence of further additional bone loss following initial healing. The diagnostic definition of peri-implant mucositis is based on following criteria: 1) presence of peri-implant signs of inflammation (redness, swelling, line or drop of bleeding within 30 seconds following probing), combined with 2) no additional bone loss following initial healing. The clinical definition of peri-implantitis is based on following criteria: 1) presence of peri-implant signs of inflammation, 2) radiographic evidence of bone loss following initial healing, and 3) increasing probing depth as compared to probing depth values collected after placement of the prosthetic reconstruction. In the absence of previous radiographs, radiographic bone level ≥3 mm in combination with BOP and probing depths ≥6 mm is indicative of peri-implantitis.
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Affiliation(s)
- Stefan Renvert
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - G Rutger Persson
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,Departments of Periodontics and Oral Medicine, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Flavia Q Pirih
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Paulo M Camargo
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
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89
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Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Periodontol 2019; 89 Suppl 1:S267-S290. [PMID: 29926957 DOI: 10.1002/jper.16-0350] [Citation(s) in RCA: 402] [Impact Index Per Article: 80.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/14/2017] [Accepted: 09/24/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVES This narrative review provides an evidence-based overview on peri-implantitis for the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. METHODS A literature review was conducted addressing the following topics: 1) definition of peri-implantitis; 2) conversion from peri-implant mucositis to peri-implantitis, 3) onset and pattern of disease progression, 4) characteristics of peri-implantitis, 5) risk factors/indicators for peri-implantitis, and 6) progressive crestal bone loss in the absence of soft tissue inflammation. CONCLUSIONS 1)Peri-implantitis is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant connective tissue and progressive loss of supporting bone. 2)The histopathologic and clinical conditions leading to the conversion from peri-implant mucositis to peri-implantitis are not completely understood. 3)The onset of peri-implantitis may occur early during follow-up and the disease progresses in a non-linear and accelerating pattern. 4a)Peri-implantitis sites exhibit clinical signs of inflammation and increased probing depths compared to baseline measurements. 4b)At the histologic level, compared to periodontitis sites, peri-implantitis sites often have larger inflammatory lesions. 4c)Surgical entry at peri-implantitis sites often reveals a circumferential pattern of bone loss. 5a)There is strong evidence that there is an increased risk of developing peri-implantitis in patients who have a history of chronic periodontitis, poor plaque control skills, and no regular maintenance care after implant therapy. Data identifying "smoking" and "diabetes" as potential risk factors/indicators for peri-implantitis are inconclusive. 5b)There is some limited evidence linking peri-implantitis to other factors such as: post-restorative presence of submucosal cement, lack of peri-implant keratinized mucosa and positioning of implants that make it difficult to perform oral hygiene and maintenance. 6)Evidence suggests that progressive crestal bone loss around implants in the absence of clinical signs of soft tissue inflammation is a rare event.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Alberto Monje
- Department of Oral Surgery and Stomatology, ZMK School of Dentistry, University of Bern, Bern, Switzerland.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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90
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Cortellini S, Favril C, De Nutte M, Teughels W, Quirynen M. Patient compliance as a risk factor for the outcome of implant treatment. Periodontol 2000 2019; 81:209-225. [PMID: 31407429 DOI: 10.1111/prd.12293] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Peri-implantitis can be explained using a multicausality model. Many factors are involved in the etiology of peri-implantitis, but patient compliance also plays a key role. Oral hygiene, attending recall visits, smoking behavior, and therapy comprehension are relevant factors that contribute to peri-implant health. The clinician should create the most optimal conditions for patients to facilitate adequate oral self-care and to help patients improve their oral hygiene skills. Implementation of a supportive periodontal therapy program is mandatory to control inflammation and plaque accumulation, as well as to keep the incidence of peri-implant diseases low. Patient compliance, including plaque control and dental follow-up, must be optimal. Consequently, precautions must be taken with patients treated with dental implants.
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Affiliation(s)
- Simone Cortellini
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Charlotte Favril
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Mathieu De Nutte
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Wim Teughels
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Marc Quirynen
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
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91
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Lin G, Curtis DA, Kapila Y, Velasquez D, Kan JY, Tahir P, Avila‐Ortiz G, Kao RT. The significance of surgically modifying soft tissue phenotype around fixed dental prostheses: An American Academy of Periodontology best evidence review. J Periodontol 2019; 91:339-351. [DOI: 10.1002/jper.19-0310] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Guo‐Hao Lin
- Department of Orofacial Sciences School of Dentistry University of California San Francisco San Francisco CA
| | - Donald A. Curtis
- Department of Preventive and Restorative Dental Sciences School of Dentistry University of California San Francisco San Francisco CA
| | - Yvonne Kapila
- Department of Orofacial Sciences School of Dentistry University of California San Francisco San Francisco CA
| | - Diego Velasquez
- Graduate Periodontics Department of Periodontics & Oral Medicine School of Dentistry University of Michigan Ann Arbor MI
| | - Joseph Y.K. Kan
- Department of Restorative Dentistry School of Dentistry Loma Linda University Loma Linda CA
| | - Peggy Tahir
- University of California San Francisco Library CA
| | - Gustavo Avila‐Ortiz
- Department of Periodontics College of Dentistry University of Iowa Iowa City IA
| | - Richard T. Kao
- Department of Orofacial Sciences School of Dentistry University of California San Francisco San Francisco CA
- Private Practice Cupertino CA
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92
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Renvert S, Persson GR, Pirih FQ, Camargo PM. Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations. J Clin Periodontol 2019; 45 Suppl 20:S278-S285. [PMID: 29926496 DOI: 10.1111/jcpe.12956] [Citation(s) in RCA: 178] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/04/2018] [Accepted: 02/01/2018] [Indexed: 12/26/2022]
Abstract
The objective of this review is to identify case definitions and clinical criteria of peri-implant healthy tissues, peri-implant mucositis, and peri-implantitis. The case definitions were constructed based on a review of the evidence applicable for diagnostic considerations. In summary, the diagnostic definition of peri-implant health is based on the following criteria: 1) absence of peri-implant signs of soft tissue inflammation (redness, swelling, profuse bleeding on probing), and 2) the absence of further additional bone loss following initial healing. The diagnostic definition of peri-implant mucositis is based on following criteria: 1) presence of peri-implant signs of inflammation (redness, swelling, line or drop of bleeding within 30 seconds following probing), combined with 2) no additional bone loss following initial healing. The clinical definition of peri-implantitis is based on following criteria: 1) presence of peri-implant signs of inflammation, 2) radiographic evidence of bone loss following initial healing, and 3) increasing probing depth as compared to probing depth values collected after placement of the prosthetic reconstruction. In the absence of previous radiographs, radiographic bone level ≥3 mm in combination with BOP and probing depths ≥6 mm is indicative of peri-implantitis.
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Affiliation(s)
- Stefan Renvert
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - G Rutger Persson
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,Departments of Periodontics and Oral Medicine, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Flavia Q Pirih
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Paulo M Camargo
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
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93
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Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Clin Periodontol 2019; 45 Suppl 20:S246-S266. [PMID: 29926484 DOI: 10.1111/jcpe.12954] [Citation(s) in RCA: 376] [Impact Index Per Article: 75.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/14/2017] [Accepted: 09/24/2017] [Indexed: 01/14/2023]
Abstract
OBJECTIVES This narrative review provides an evidence-based overview on peri-implantitis for the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. METHODS A literature review was conducted addressing the following topics: 1) definition of peri-implantitis; 2) conversion from peri-implant mucositis to peri-implantitis, 3) onset and pattern of disease progression, 4) characteristics of peri-implantitis, 5) risk factors/indicators for peri-implantitis, and 6) progressive crestal bone loss in the absence of soft tissue inflammation. CONCLUSIONS 1)Peri-implantitis is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant connective tissue and progressive loss of supporting bone. 2)The histopathologic and clinical conditions leading to the conversion from peri-implant mucositis to peri-implantitis are not completely understood. 3)The onset of peri-implantitis may occur early during follow-up and the disease progresses in a non-linear and accelerating pattern. 4a)Peri-implantitis sites exhibit clinical signs of inflammation and increased probing depths compared to baseline measurements. 4b)At the histologic level, compared to periodontitis sites, peri-implantitis sites often have larger inflammatory lesions. 4c)Surgical entry at peri-implantitis sites often reveals a circumferential pattern of bone loss. 5a)There is strong evidence that there is an increased risk of developing peri-implantitis in patients who have a history of chronic periodontitis, poor plaque control skills, and no regular maintenance care after implant therapy. Data identifying "smoking" and "diabetes" as potential risk factors/indicators for peri-implantitis are inconclusive. 5b)There is some limited evidence linking peri-implantitis to other factors such as: post-restorative presence of submucosal cement, lack of peri-implant keratinized mucosa and positioning of implants that make it difficult to perform oral hygiene and maintenance. 6)Evidence suggests that progressive crestal bone loss around implants in the absence of clinical signs of soft tissue inflammation is a rare event.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Alberto Monje
- Department of Oral Surgery and Stomatology, ZMK School of Dentistry, University of Bern, Bern, Switzerland.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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94
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Abstract
PURPOSE To report the prevalence of periimplant diseases (ie, periimplant mucositis and periimplantitis). MATERIAL AND METHODS A literature search was performed in MEDLINE through PubMed database of the US National Library of Medicine for articles published until March 2018 using Medical Subject Heading (MeSH) search terms complemented by free terms and in different combinations. RESULTS A wide range of prevalences of periimplant diseases has been reported in the literature. Subject-based estimated weighted mean prevalences and ranges were reported to amount to 43% (range: 19%-65%) for periimplant mucositis and to 22% (range: 1%-47%) for periimplantitis. CONCLUSION Differences in case definitions impact on extent and severity of periimplant diseases and make comparisons among studies difficult. Convenience samples rather than randomly selected population samples are often analyzed to estimate prevalence of periimplant diseases. More recent studies report implant- and subject-based prevalences of periimplant diseases.
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95
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Zandim-Barcelos DL, Carvalho GGD, Sapata VM, Villar CC, Hämmerle C, Romito GA. Implant-based factor as possible risk for peri-implantitis. Braz Oral Res 2019; 33:e067. [PMID: 31576951 DOI: 10.1590/1807-3107bor-2019.vol33.0067] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 06/11/2019] [Indexed: 11/21/2022] Open
Abstract
Peri-implantitis is currently a topic of major interest in implantology. Considered one of the main reasons of late implant failure, there is an emerged concern whether implant characteristics could trigger inflammatory lesion and loss of supporting bone. The purpose of this narrative review is to provide an evidence based overview on the influence of implant-based factors in the occurrence of peri-implantitis. A literature review was conducted addressing the following topics: implant surface topography; implant location; occlusal overload; time in function; prosthesis-associated factors (rehabilitation extension, excess of cement and implant-abutment connection); and metal particle release. Although existing data suggests that some implant-based factors may increase the risk of peri-implantitis, the evidence is still limited to consider them a true risk factor for peri-implantitis. In conclusion, further evidences are required to a better understanding of the influence of implant-based factors in the occurrence of peri-implantitis. Large population-based studies including concomitant analyses of implant- and patient-based factors are required to provide strong evidence of a possible association with peri-implantitis in a higher probability. The identification of these factors is essential for the establishment of strategies to prevent peri-implantitis.
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Affiliation(s)
- Daniela Leal Zandim-Barcelos
- Universidade Estadual Paulista - Unesp, Araraquara School of Dentistry, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | - Gabriel Garcia de Carvalho
- Universidade Estadual Paulista - Unesp, Araraquara School of Dentistry, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | - Vitor Marques Sapata
- Universidade de São Paulo - USP, Dental School, Department of Stomatology, São Paulo, Brazil
| | - Cristina Cunha Villar
- Universidade de São Paulo - USP, Dental School, Department of Stomatology, São Paulo, Brazil
| | - Christoph Hämmerle
- University of Zurich, Clinic for Fixed and Removable Prosthodontics and Dental Material Science, Zurich, Switzerland
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96
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Papi P, Di Murro B, Pranno N, Bisogni V, Saracino V, Letizia C, Polimeni A, Pompa G. Prevalence of peri‐implant diseases among an Italian population of patients with metabolic syndrome: A cross‐sectional study. J Periodontol 2019; 90:1374-1382. [DOI: 10.1002/jper.19-0077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/09/2019] [Accepted: 06/17/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Piero Papi
- Department of Oral and Maxillo‐Facial Sciences“Sapienza” University of Rome Rome Italy
| | - Bianca Di Murro
- Department of Oral and Maxillo‐Facial Sciences“Sapienza” University of Rome Rome Italy
| | - Nicola Pranno
- Department of Oral and Maxillo‐Facial Sciences“Sapienza” University of Rome Rome Italy
| | - Valeria Bisogni
- Department of Translational and Precision Medicine“Sapienza” University of Rome Rome Italy
| | - Vincenza Saracino
- Department of Translational and Precision Medicine“Sapienza” University of Rome Rome Italy
| | - Claudio Letizia
- Department of Translational and Precision Medicine“Sapienza” University of Rome Rome Italy
| | - Antonella Polimeni
- Department of Oral and Maxillo‐Facial Sciences“Sapienza” University of Rome Rome Italy
| | - Giorgio Pompa
- Department of Oral and Maxillo‐Facial Sciences“Sapienza” University of Rome Rome Italy
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97
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Di Murro B, Papi P, Letizia C, Pompa G. The prevalence of peri-implant diseases in patients with metabolic syndrome: a case-control study on an Italian population sample. MINERVA STOMATOLOGICA 2019; 68:143-149. [PMID: 31357847 DOI: 10.23736/s0026-4970.19.04243-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The correlation of peri-implantitis with systemic diseases is still highly debated and controversial in literature. The objective of this work was to evaluate the possible association between peri-implant diseases and metabolic syndrome. METHODS In this case-control study, subjects healthy or affected by metabolic syndrome, with at least one dental implant with >5 years of functional loading were screened to detect peri-implant health or diseases. A complete full mouth periodontal and peri-implant examination at six sites was performed for each implant and standardized periapical X-ray were taken to evaluate marginal bone loss. Diagnostic Criteria of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions were applied. The analysis of variance (ANOVA) was used to compare means of recorded variables between the two groups, with a P<0.05 value considered statistically significant. Sub-group analysis was performed for smoking (smokers vs. non-smokers), sex (males vs. females), implant site (maxillary vs. mandible) and type of prostheses (single crown vs. bridge). RESULTS Forty-one patients were enrolled, divided into two groups, for a total of 132 dental implants: 71 in the metabolic syndrome group and 61 in the control group. The overall prevalence of peri-implant diseases (peri-implantitis + mucositis) in the two groups was, respectively, 93% vs. 63%, with an odds ratio (OR) of 7.4462 (95% CI: 2.6092; 21.2496) for the metabolic syndrome group (P<0.001). CONCLUSIONS Despite the limited sample, our results showed a statistically significant higher prevalence of peri-implant diseases in patients with metabolic syndrome compared to healthy patients. Further longitudinal studies are needed to verify this relationship.
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Affiliation(s)
- Bianca Di Murro
- Unit of Oral Surgery, Department of Oral and Maxillo-Facial Sciences, Sapienza University, Rome, Italy
| | - Piero Papi
- Unit of Oral Surgery, Department of Oral and Maxillo-Facial Sciences, Sapienza University, Rome, Italy -
| | - Claudio Letizia
- Unit of Secondary Hypertension, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Giorgio Pompa
- Unit of Oral Surgery, Department of Oral and Maxillo-Facial Sciences, Sapienza University, Rome, Italy
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98
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Karlsson K, Derks J, Håkansson J, Wennström JL, Petzold M, Berglundh T. Interventions for peri‐implantitis and their effects on further bone loss: A retrospective analysis of a registry‐based cohort. J Clin Periodontol 2019; 46:872-879. [DOI: 10.1111/jcpe.13129] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/11/2019] [Accepted: 05/03/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Karolina Karlsson
- Department of Periodontology Institute of Odontology The Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden
| | - Jan Derks
- Department of Periodontology Institute of Odontology The Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden
| | - Jan Håkansson
- Department of Periodontology Institute of Odontology The Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden
| | - Jan L. Wennström
- Department of Periodontology Institute of Odontology The Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden
| | - Max Petzold
- Health Metrics The Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden
| | - Tord Berglundh
- Department of Periodontology Institute of Odontology The Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden
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99
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Fabris V, Reginato VF, Smaniotto C, Bacchi A, Consani RLX. Treatment of Resorbed Mandibles with Titanium Plate and Immediate Implant-Supported Prosthesis - Case Series. Braz Dent J 2019; 30:244-251. [PMID: 31166396 DOI: 10.1590/0103-6440201902397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 01/19/2019] [Indexed: 01/06/2023] Open
Abstract
Severely resorbed mandibles with only cortical bone remaining can fracture during or after implant placement. This case series presents a technique to reduce the risk or the consequences of mandibular fracture. Seven patients with only cortical mandibular bone remaining were treated with the fixation of a titanium plate in the frontal surface previously to implant placement, during the same surgical procedure. Immediate complete-arch implant supported prosthesis were installed. Patient's systemic and local conditions that could influence implant survival were registered previously to surgery and during the follow up period. Biological and biomechanical complications were recorded. The condition of peri-implant tissues was evaluated. The follow-ups ranged from 12 to 84 months. Twenty-nine implants were placed and no implant failure or other biological complication was observed. The peri-implant tissue evaluation demonstrated most implants was surrounded by keratinized tissue (89.5%). No marginal recession (implant platform cervical to gingival margin) was observed. Probing depth was normal, ranging from 0 to 3 mm. Low scores of plaque index or bleeding on probing were recorded. Biomechanical complications evolved loosening of 4 prosthetic screws and 1 fractured. The use of a titanium plate for the fixation of severely resorbed mandibles with only cortical bone remaining was a safe treatment procedure, avoiding biological and major biomechanical complications in the treatment with immediate complete-arch implant-supported prosthesis.
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Affiliation(s)
- Vinicius Fabris
- Department of Oral Surgery, IMED - Faculdade Meridional, Passo Fundo, RS, Brazil
| | | | - Carolina Smaniotto
- Graduate Program in Dentistry, IMED - Faculdade Meridional, Passo Fundo, RS, Brazil
| | - Atais Bacchi
- Graduate Program in Dentistry, IMED - Faculdade Meridional, Passo Fundo, RS, Brazil
| | - Rafael Leonardo Xediek Consani
- Department of Prosthodontics and Periodontics, Piracicaba Dental School, UNICAMP - Universidade Estadual de Campinas, Piracicaba, SP, Brazil
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100
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Vignoletti F, Di Domenico GL, Di Martino M, Montero E, de Sanctis M. Prevalence and risk indicators of peri‐implantitis in a sample of university‐based dental patients in Italy: A cross‐sectional study. J Clin Periodontol 2019; 46:597-605. [DOI: 10.1111/jcpe.13111] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 03/08/2019] [Accepted: 04/08/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Fabio Vignoletti
- Department of Periodontology Università Vita e Salute, San Raffaele Milano Italy
| | | | - Maria Di Martino
- Department of Periodontology Università Vita e Salute, San Raffaele Milano Italy
| | - Eduardo Montero
- ETEP. 1. ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - Massimo de Sanctis
- Department of Periodontology Università Vita e Salute, San Raffaele Milano Italy
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