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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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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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Lopes GDRS, Feitosa ACR, Suaid FF, Matos JDMD, Vasconcelos JELD, Vaz SLDA, Andrade VC, Nishioka RS, Guerra SMG. Evaluation of peri-implant condition in periodontally compromised patients. J Indian Prosthodont Soc 2019; 19:283-289. [PMID: 31649436 PMCID: PMC6803800 DOI: 10.4103/jips.jips_197_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 06/30/2019] [Accepted: 08/25/2019] [Indexed: 12/04/2022] Open
Abstract
Aims: The aim of the study is to evaluate the profile of peri-implant tissues in periodontally compromised patients. Settings and Design: In vivo – cross sectional study design. Materials and Methods: Fifty-eight implants were evaluated, clinically and radiographically, installed in seven individuals treated by the same team of professionals, during the years 1997 and 2005 in a private dental clinic in Vitória, ES, Brazil; that time of data collection, all implants were at least 10 years of functional loading. The variables related to the dental implants evaluated were: visible Plaque Index, Gingival Bleeding Index (GBI), probing pocket depth, bleeding on probing, and bone level, to relate them to the classification of dental implants. Statistical Analysis Used: The Chi-square and Kruskal–Wallis test were adopted. Results: The total of 58 implants were classified: 11 (18.9%) as healthy and 12 (20.7%) as clinically stable. The other 35 implants (60.4%) had some type of peri-implant inflammation, 20 of them (34.5%) were diagnosed with peri-implant mucositis and 15 (25.9%) with peri-implantitis. Among the variables studied, the results showed statistically significant differences for implant location (P = 0.001) and GBI (P = 0.03). Most of the maxillary implants (85.7%) were classified for some type of peri-implant disease. For the implants which resulted in Score 1 for GBI, most of them (75.0%) were also classified for some type of peri-implant disease. Conclusions: Dental implants placed in periodontally compromised patients may have high long-term survival rates. However, most implants were classified with some type of peri-implant inflammation.
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Affiliation(s)
| | | | - Fabrícia Ferreira Suaid
- Department of Periodontics, Federal University of Espiírito Santo (Ufes), Vitória, ES, Brazil
| | - Jefferson David Melo De Matos
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), São José dos Campos, SP, Brazil
| | | | | | - Valdir Cabral Andrade
- Department of Dentistry, Federal University of Juiz de Fora, Governador Valadares, MG, Brazil
| | - Renato Sussumu Nishioka
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), São José dos Campos, SP, Brazil
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Pettersson M, Pettersson J, Molin Thorén M, Johansson A. Effect of cobalt ions on the interaction between macrophages and titanium. J Biomed Mater Res A 2019; 106:2518-2530. [PMID: 29708655 PMCID: PMC6175091 DOI: 10.1002/jbm.a.36447] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 04/12/2018] [Accepted: 04/25/2018] [Indexed: 12/12/2022]
Abstract
Inflammation and bone reduction around dental implants are described as peri‐implantitis and can be caused by an inflammatory response against bacterial products and toxins. Titanium (Ti) forms aggregates with serum proteins, which activate and cause release of the cytokine interleukin (IL‐1β) from human macrophages. It was hypothesized that cobalt (Co) ions can interact in the formation of pro‐inflammatory aggregates, formed by titanium. To test this hypothesis, we differentiated THP‐1 cells into macrophages and exposed them to Ti ions alone or in combination with Co ions to investigate if IL‐1β release and cytotoxicity were affected. We also investigated aggregate formation, cell uptake and human biopsies with inductively coupled plasma atomic emission spectroscopy and electron microscopy. Co at a concentration of 100 µM neutralized the IL‐1β release from human macrophages and affected the aggregate formation. The aggregates formed by Ti could be detected in the cytosol of macrophages. In the presence of Co, the Ti‐induced aggregates were located in the cytosol of the cultured macrophages, but outside the lysosomal structures. It is concluded that Co can neutralize the Ti‐induced activation and release of active IL‐1β from human macrophages in vitro. Also, serum proteins are needed for the formation of metal‐protein aggregates in cell medium. Furthermore, the structures of the aggregates as well as the localisation after cellular uptake differ if Co is present in a Ti solution. Phagocytized aggregates with a similar appearance seen in vitro with Ti present, were also visible in a sample from human peri‐implant tissue. © 2018 The Authors Journal of Biomedical Materials Research Part A Published by Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A:2518–2530, 2018.
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Affiliation(s)
| | - Jean Pettersson
- Analytic Chemistry, BMC, Department of Chemistry, Uppsala University, Sweden
| | | | - Anders Johansson
- Molecular Periodontology, Department of Odontology, Faculty of Medicine, Umeå University, Sweden
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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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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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Grischke J, Karch A, Wenzlaff A, Foitzik MM, Stiesch M, Eberhard J. Keratinized mucosa width is associated with severity of peri‐implant mucositis. A cross‐sectional study. Clin Oral Implants Res 2019; 30:457-465. [DOI: 10.1111/clr.13432] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 03/29/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Jasmin Grischke
- Department of Prosthetic Dentistry and Biomedical Materials Science Hannover Medical School Hannover Germany
| | - Annika Karch
- Institute for Biostatistics Hannover Medical School Hannover Germany
| | - Andreas Wenzlaff
- Department of Prosthetic Dentistry and Biomedical Materials Science Hannover Medical School Hannover Germany
| | - Magdalena Marta Foitzik
- Department of Prosthetic Dentistry and Biomedical Materials Science Hannover Medical School Hannover Germany
| | - Meike Stiesch
- Department of Prosthetic Dentistry and Biomedical Materials Science Hannover Medical School Hannover Germany
| | - Jörg Eberhard
- The School of Dentistry, Charles Perkins Centre, Westmead Centre for Oral Health The University of Sydney Sydney New South Wales Australia
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Mazel A, Belkacemi S, Tavitian P, Stéphan G, Tardivo D, Catherine JH, Aboudharam G. Peri-implantitis risk factors: A prospective evaluation. ACTA ACUST UNITED AC 2019; 10:e12398. [DOI: 10.1111/jicd.12398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 11/19/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Anthony Mazel
- UFR Odontologie; Aix-Marseille Université; Marseille France
| | - Souad Belkacemi
- Aix-Marseille Université UM63; Institut de Recherche pour le Développement IRD 198; Assistance Publique - Hôpitaux de Marseille (AP-HM), Microbes, Evolution, Phylogeny and Infection (MEΦI); Institut Hospitalo-Universitaire (IHU) - Méditerranée Infection; Marseille France
| | | | | | | | | | - Gérard Aboudharam
- UFR Odontologie; Aix-Marseille Université; Marseille France
- Aix-Marseille Université UM63; Institut de Recherche pour le Développement IRD 198; Assistance Publique - Hôpitaux de Marseille (AP-HM), Microbes, Evolution, Phylogeny and Infection (MEΦI); Institut Hospitalo-Universitaire (IHU) - Méditerranée Infection; Marseille France
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Wada M, Mameno T, Onodera Y, Matsuda H, Daimon K, Ikebe K. Prevalence of peri-implant disease and risk indicators in a Japanese population with at least 3 years in function-A multicentre retrospective study. Clin Oral Implants Res 2019; 30:111-120. [PMID: 30580459 DOI: 10.1111/clr.13397] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 12/03/2018] [Accepted: 12/04/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the prevalence of peri-implant disease and analyze risk indicators in Japanese subjects with ≥3 years of implant function. MATERIAL AND METHODS Five hundred and forty-three subjects treated with 1,613 implants were evaluated. Information was collected about the patients' physical and dental history, as well as implant details. Peri-implant evaluation included probing depth, bleeding on probing (BoP), suppuration (Sup), and keratinized tissue width. Bone loss was calculated from intra-oral radiographs taken after 1 year and more than 3 years of function. Implants were classified into three groups: healthy, peri-implant mucositis (BoP without bone loss), and peri-implantitis (BoP and/or Sup with bone loss >1 mm). These data were analyzed by multivariable multinomial logistic regression. RESULTS The prevalence of peri-implant mucositis and peri-implantitis at the subject level was 23.9% and 15.8%, respectively. An association was found between peri-implant mucositis and plaque control record (PCR) >20% and keratinized tissue width <2 mm. Peri-implantitis was associated with PCR >20%, smoking, insertion in the maxilla, and keratinized tissue width <2 mm. CONCLUSIONS Within the limitations of this study, the prevalence of peri-implant diseases was elucidated in a Japanese population. Peri-implant mucositis was associated with poor oral hygiene and less keratinized tissue. Poor oral hygiene, smoking, insertion in the maxilla, and less keratinized tissue were risk indicators for peri-implantitis.
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Affiliation(s)
- Masahiro Wada
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Tomoaki Mameno
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Japan
| | | | | | | | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Japan
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NOVAES JUNIOR AB, RAMOS UD, RABELO MDS, FIGUEREDO GB. New strategies and developments for peri-implant disease. Braz Oral Res 2019; 33:e071. [DOI: 10.1590/1807-3107bor-2019.vol33.0071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 11/22/2022] Open
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COSGAREA R, SCULEAN A, SHIBLI JA, SALVI GE. Prevalence of peri-implant diseases – a critical review on the current evidence. Braz Oral Res 2019; 33:e063. [DOI: 10.1590/1807-3107bor-2019.vol33.0063] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 11/22/2022] Open
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Pettersson M, Pettersson J, Johansson A, Molin Thorén M. Titanium release in peri-implantitis. J Oral Rehabil 2018; 46:179-188. [PMID: 30325523 DOI: 10.1111/joor.12735] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 10/05/2018] [Accepted: 10/10/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the titanium (Ti) content of biopsies from patients with severe peri-implantitis or controls without Ti exposure. BACKGROUND Peri-implantitis is considered to be an infectious disease, but recent studies have shown that Ti can aggravate inflammation in combination with bacterial products. The Ti content of peri-implantitis and periodontitis (controls) tissue is unknown. METHODS Thirteen patients referred for peri-implantitis and eleven for periodontitis treatment were included in the study. Disease severity was obtained from dental records. Biopsies were taken from both groups and chemically analysed with inductively coupled plasma mass spectrometry for Ti content. Additionally, two patients with peri-implantitis and two with periodontitis were recruited and their biopsies were analysed microscopically with light microscopy, transmission electron microscopy and scanning electron microscopy with element analysis to investigate the presence of particulate Ti. RESULTS All patients lost one or more implants despite undergoing peri-implant or treatment. Peri-implantitis tissue contained significantly higher concentrations of Ti than control samples with a mean ± SD of 98.7 ± 85.6 and 1.2 ± 0.9 μg/g, respectively. Particulate metal was identified in peri-implantitis and control biopsies, but element analyses could confirm only the presence of Ti in peri-implantitis tissue. CONCLUSION We showed that high contents of particulate and submicron Ti were present in peri-implantitis tissue. These high Ti contents in peri-implant mucosa can potentially aggravate inflammation, which might reduce the prognosis of treatment interventions.
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Affiliation(s)
- Mattias Pettersson
- Prosthetic Dentistry, Department of Odontology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Jean Pettersson
- Department of Chemistry, BMC-Analytic Chemistry, Uppsala University, Uppsala, Sweden
| | - Anders Johansson
- Molecular Periodontology, Department of Odontology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Margareta Molin Thorén
- Prosthetic Dentistry, Department of Odontology, Faculty of Medicine, Umeå University, Umeå, Sweden
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Rodrigo D, Sanz‐Sánchez I, Figuero E, Llodrá JC, Bravo M, Caffesse RG, Vallcorba N, Guerrero A, Herrera D. Prevalence and risk indicators of peri‐implant diseases in Spain. J Clin Periodontol 2018; 45:1510-1520. [DOI: 10.1111/jcpe.13017] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/13/2018] [Accepted: 09/30/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel Rodrigo
- Expert Group for Peri‐Implant DiseasesSociedad Española de Periodoncia y Osteointegración (SEPA Spanish Society of Periodontology and Osseointegration) Madrid Spain
| | - Ignacio Sanz‐Sánchez
- Expert Group for Peri‐Implant DiseasesSociedad Española de Periodoncia y Osteointegración (SEPA Spanish Society of Periodontology and Osseointegration) Madrid Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research GroupUniversity Complutense Madrid Spain
| | - Elena Figuero
- Expert Group for Peri‐Implant DiseasesSociedad Española de Periodoncia y Osteointegración (SEPA Spanish Society of Periodontology and Osseointegration) Madrid Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research GroupUniversity Complutense Madrid Spain
| | | | - Manuel Bravo
- Preventive and Community DentistryUniversity of Granada Granada Spain
| | - Raul G. Caffesse
- Expert Group for Peri‐Implant DiseasesSociedad Española de Periodoncia y Osteointegración (SEPA Spanish Society of Periodontology and Osseointegration) Madrid Spain
| | - Nuria Vallcorba
- SEPA Foundation (Fundación SEPA de Periodoncia e Implantes Dentales) Madrid Spain
| | - Adrián Guerrero
- SEPA Foundation (Fundación SEPA de Periodoncia e Implantes Dentales) Madrid Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research GroupUniversity Complutense Madrid Spain
- SEPA Foundation (Fundación SEPA de Periodoncia e Implantes Dentales) Madrid Spain
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Hashim D, Cionca N, Combescure C, Mombelli A. The diagnosis of peri‐implantitis: A systematic review on the predictive value of bleeding on probing. Clin Oral Implants Res 2018; 29 Suppl 16:276-293. [DOI: 10.1111/clr.13127] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Dena Hashim
- Division of PeriodontologyUniversity Clinics of Dental MedicineUniversity of Geneva Geneva 4 Switzerland
| | - Norbert Cionca
- Division of PeriodontologyUniversity Clinics of Dental MedicineUniversity of Geneva Geneva 4 Switzerland
| | - Christophe Combescure
- Division of Clinical EpidemiologyDepartment of Health and Community MedicineFaculty of MedicineCenter of Clinical ResearchGeneva University HospitalsUniversity of Geneva Geneva Switzerland
| | - Andrea Mombelli
- Division of PeriodontologyUniversity Clinics of Dental MedicineUniversity of Geneva Geneva 4 Switzerland
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Salvi GE, Monje A, Tomasi C. Long‐term biological complications of dental implants placed either in pristine or in augmented sites: A systematic review and meta‐analysis. Clin Oral Implants Res 2018; 29 Suppl 16:294-310. [DOI: 10.1111/clr.13123] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Giovanni E. Salvi
- Department of PeriodontologySchool of Dental MedicineUniversity of Bern Bern Switzerland
| | - Alberto Monje
- Department of Oral Surgery and StomatologySchool of Dental MedicineUniversity of Bern Bern Switzerland
| | - Cristiano Tomasi
- Department of PeriodontologyInstitute of OdontologyThe Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden
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Vitamin K and Bone Metabolism: A Review of the Latest Evidence in Preclinical Studies. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4629383. [PMID: 30050932 PMCID: PMC6040265 DOI: 10.1155/2018/4629383] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/27/2018] [Indexed: 01/09/2023]
Abstract
Bone is a metabolically active tissue that renews itself throughout one's life. Cytokines along with several hormonal, nutritional, and growth factors are involved in tightly regulated bone remodeling. Accordingly, vitamin K as a multifunctional vitamin has been recently deemed appreciable as a topic of research as it plays a pivotal role in maintenance of the bone strength, and it has been proved to have a positive impact on the bone metabolism. Vitamin K exerts its anabolic effect on the bone turnover in different ways such as promoting osteoblast differentiation, upregulating transcription of specific genes in osteoblasts, and activating the bone-associated vitamin k dependent proteins which play critical roles in extracellular bone matrix mineralization. There is also credible evidence to support the effects of vitamin k2 on differentiation of other mesenchymal stem cells into osteoblast. The main objective of the present paper is to comprehensively outline the preclinical studies on the properties of vitamin K and its effects on the bone metabolism. The evidence could shed light on further clinical studies to improve osteogenesis in bone graft surgeries.
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Dreyer H, Grischke J, Tiede C, Eberhard J, Schweitzer A, Toikkanen SE, Glöckner S, Krause G, Stiesch M. Epidemiology and risk factors of peri-implantitis: A systematic review. J Periodontal Res 2018; 53:657-681. [PMID: 29882313 DOI: 10.1111/jre.12562] [Citation(s) in RCA: 232] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2018] [Indexed: 12/13/2022]
Abstract
The purpose of this systematic review and meta-analysis was to assess the prevalence, incidence and risk factors of peri-implantitis in the current literature. An electronic search was performed to identify publications from January 1980 until March 2016 on 9 databases. The prevalence and incidence of peri-implantitis were assessed in different subgroups of patients and the prevalences were adjusted for sample size (SSA) of studies. For 12 of 111 identified putative risk factors and risk indicators, forest plots were created. Heterogeneity analysis and random effect meta-analysis were performed for selected potential risk factors of peri-implantitis. The search retrieved 8357 potentially relevant studies. Fifty-seven studies were included in the systematic review. Overall, the prevalence of peri-implantitis on implant level ranged from 1.1% to 85.0% and the incidence from 0.4% within 3 years, to 43.9% within 5 years, respectively. The median prevalence of peri-implantitis was 9.0% (SSA 10.9%) for regular participants of a prophylaxis program, 18.8% (SSA 8.8%) for patients without regular preventive maintenance, 11.0% (SSA 7.4%) for non-smokers, 7.0% (SSA 7.0%) among patients representing the general population, 9.6% (SSA 9.6%) for patients provided with fixed partial dentures, 14.3% (SSA 9.8%) for subjects with a history of periodontitis, 26.0% (SSA 28.8%) for patients with implant function time ≥5 years and 21.2% (SSA 38.4%) for ≥10 years. On a medium and medium-high level of evidence, smoking (effect summary OR 1.7, 95% CI 1.25-2.3), diabetes mellitus (effect summary OR 2.5; 95% CI 1.4-4.5), lack of prophylaxis and history or presence of periodontitis were identified as risk factors of peri-implantitis. There is medium-high evidence that patient's age (effect summary OR 1.0, 95% CI 0.87-1.16), gender and maxillary implants are not related to peri-implantitis. Currently, there is no convincing or low evidence available that identifies osteoporosis, absence of keratinized mucosa, implant surface characteristics or edentulism as risk factors for peri-implantitis. Based on the data analyzed in this systematic review, insufficient high-quality evidence is available to the research question. Future studies of prospective, randomized and controlled type including sufficient sample sizes are needed. The application of consistent diagnostic criteria (eg, according to the latest definition by the European Workshop on Periodontology) is particularly important. Very few studies evaluated the incidence of peri-implantitis; however, this study design may contribute to examine further the potential risk factors.
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Affiliation(s)
- H Dreyer
- Clinic of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hanover, Germany
| | - J Grischke
- Clinic of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hanover, Germany
| | - C Tiede
- Clinic of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hanover, Germany
| | - J Eberhard
- Faculty of Dentistry and the Charles Perkins Centre, University of Sydney, Sydney, NSW,, Australia
| | - A Schweitzer
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - S E Toikkanen
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - S Glöckner
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany.,Translational Infrastructure Epidemiology, German Centre for Infection Research, Braunschweig, Germany
| | - G Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany.,Twincore, Centre for Experimental and Clinical Infections Research, Hanover, Germany.,Hannover Medical School, Hanover, Germany
| | - M Stiesch
- Clinic of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hanover, Germany
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69
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Monje A, Wang HL, Nart J. Association of Preventive Maintenance Therapy Compliance and Peri-Implant Diseases: A Cross-Sectional Study. J Periodontol 2017; 88:1030-1041. [DOI: 10.1902/jop.2017.170135] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Alberto Monje
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
- Department of Oral Surgery and Stomatology, Zahnmedizinische Kliniken (ZMK) University of Bern, Bern, Switzerland
- Department of Periodontology, International University of Catalunya, Barcelona, Spain
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - José Nart
- Department of Periodontology, International University of Catalunya, Barcelona, Spain
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70
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Lin GH, Kapila Y, Wang HL. Parameters to Define Peri-Implantitis: A Review and a Proposed Multi-Domain Scale. J ORAL IMPLANTOL 2017; 43:491-496. [PMID: 28873021 DOI: 10.1563/aaid-joi-d-17-00035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Peri-implant diseases have received much attention since dental implants are generally used in contemporary dentistry. Several contributing factors associated with the development of peri-implant diseases have also been investigated. The prevalence of peri-implantitis has been reported but with great heterogeneity because of a lack of a universally accepted classification system that could define the extent and severity of peri-implantitis. Several parameters-including radiographic bone loss, probing depth, bleeding on probing, and suppuration-have been introduced in these reports to assist with clinical diagnosis. This article provides an objective evaluation of these parameters based on currently available evidence, offers further recommendations, and proposes a multidomain scale for diagnosis of peri-implantitis. Future investigations and modifications may be needed to develop a comprehensive, evidence-based classification system that addresses the multifactorial etiology of peri-implant diseases.
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Affiliation(s)
- Guo-Hao Lin
- 1 Department of Surgical Sciences, Marquette University School of Dentistry, Milwaukee, Wis.,2 Department of Orofacial Sciences, University of California San Francisco School of Dentistry, San Francisco, Calif
| | - Yvonne Kapila
- 2 Department of Orofacial Sciences, University of California San Francisco School of Dentistry, San Francisco, Calif
| | - Hom-Lay Wang
- 3 Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Mich
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71
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Zeza B, Pilloni A, Tatakis DN, Mariotti A, Di Tanna GL, Mongardini C. Implant Patient Compliance Varies by Periodontal Treatment History. J Periodontol 2017; 88:846-853. [DOI: 10.1902/jop.2017.160528] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Blerina Zeza
- Department of Dentistry and Maxillofacial Surgery, School of Dentistry, Section of Periodontics, University of Rome, Rome, Italy
| | - Andrea Pilloni
- Department of Dentistry and Maxillofacial Surgery, School of Dentistry, Section of Periodontics, University of Rome, Rome, Italy
| | - Dimitris N. Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
| | - Angelo Mariotti
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
| | - Gian Luca Di Tanna
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, U.K
| | - Claudio Mongardini
- Department of Dentistry and Maxillofacial Surgery, School of Dentistry, Section of Periodontics, University of Rome, Rome, Italy
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72
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Wohlfahrt JC, Evensen BJ, Zeza B, Jansson H, Pilloni A, Roos-Jansåker AM, Di Tanna GL, Aass AM, Klepp M, Koldsland OC. A novel non-surgical method for mild peri-implantitis- a multicenter consecutive case series. Int J Implant Dent 2017; 3:38. [PMID: 28776288 PMCID: PMC5543013 DOI: 10.1186/s40729-017-0098-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 07/13/2017] [Indexed: 12/17/2022] Open
Abstract
AIM The aim of the present study was to evaluate the effect on peri-implant mucosal inflammation from the use of a novel instrument made of chitosan in the non-surgical treatment of mild peri-implantitis across several clinical centers. MATERIALS AND METHODS In this 6-month multicenter prospective consecutive case series performed in six different periodontal specialist clinics, 63 implants in 63 patients were finally included. The subjects had mild peri-implantitis defined as radiographic bone loss of 1-2 mm, pocket probing depth (PPD) ≥4 mm and a positive bleeding on probing (mBoP) score. The patients were clinically examined at baseline and after 2, 4, 12 and 24 weeks, and radiographs were taken at baseline and at 3 and 6 months. Treatment of the implants with the chitosan brush seated in an oscillating dental drill piece was performed at baseline and at 3 months. Reductions in the clinical parameters (PPD and mBoP) were compared between baseline and the later examination time points. RESULTS Significant reductions in both PPD and mBoP were observed at all time points compared with the baseline clinical measurements (p < 0.001). The mean PPD and mBoP at baseline were 5.15 mm (4.97; 5.32) and 1.86 (1.78; 1.93), respectively, whereas the mean PPD and mBoP at 6 months were 4.0 mm (3.91; 4.19) and 0.64 (0.54; 0.75), respectively. Stable reductions in PPD and mBoP were evident up to 6 months after the initial treatment and 3 months after the second treatment. All 63 implants were reported to have stable radiographic levels of osseous support. CONCLUSIONS This case series demonstrated that an oscillating chitosan brush is safe to use and seems to have merits in the non-surgical treatment of dental implants with mild peri-implantitis. To measure the effectiveness of the method, a multicenter randomized clinical trial needs to be undertaken.
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Affiliation(s)
- J C Wohlfahrt
- Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Pb. 1109 Blindern, 0317, Oslo, Norway.
| | | | - B Zeza
- Department of Dental and Maxillofacial Sciences, Section of Periodontology, Sapienza, University of Rome, Rome, Italy
| | - H Jansson
- Center for Oral Health, Department of Natural Science and Biomedicine, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - A Pilloni
- Department of Dental and Maxillofacial Sciences, Section of Periodontology, Sapienza, University of Rome, Rome, Italy
| | - A M Roos-Jansåker
- Department of Periodontology, Public Dental Health Service, Kristianstad, Sweden.,Department of Periodontology, Public Specialist Dental Clinic, Karlskrona, Sweden
| | - G L Di Tanna
- Center for Primary Care and Public Health, Queen Mary University of London, London, UK
| | - A M Aass
- Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Pb. 1109 Blindern, 0317, Oslo, Norway
| | - M Klepp
- Private Practice, Stavanger, Norway
| | - O C Koldsland
- Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Pb. 1109 Blindern, 0317, Oslo, Norway
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73
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Wang X, Qin L, Lei C, Li Y, Li D. Effects of uncontrolled periodontitis on marginal bone alterations around implants: A case-control study. Clin Implant Dent Relat Res 2017; 19:654-662. [PMID: 28556531 DOI: 10.1111/cid.12503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/15/2017] [Accepted: 05/10/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Xin Wang
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology; The Fourth Military Medical University; 145 West Changle Road Xi'an China
| | - Lei Qin
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology; The Fourth Military Medical University; 145 West Changle Road Xi'an China
| | - Chi Lei
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology; The Fourth Military Medical University; 145 West Changle Road Xi'an China
| | - Yu Li
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology; The Fourth Military Medical University; 145 West Changle Road Xi'an China
| | - Dehua Li
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology; The Fourth Military Medical University; 145 West Changle Road Xi'an China
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74
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Beltrán-Partida E, Valdéz-Salas B, Moreno-Ulloa A, Escamilla A, Curiel MA, Rosales-Ibáñez R, Villarreal F, Bastidas DM, Bastidas JM. Improved in vitro angiogenic behavior on anodized titanium dioxide nanotubes. J Nanobiotechnology 2017; 15:10. [PMID: 28143540 PMCID: PMC5282661 DOI: 10.1186/s12951-017-0247-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 01/23/2017] [Indexed: 01/31/2023] Open
Abstract
Background Neovascularization over dental implants is an imperative requisite to achieve successful osseointegration onto implanted materials. The aim of this study was to investigate the effects on in vitro angiogenesis of anodized 70 nm diameter TiO2 nanotubes (NTs) on Ti6Al4V alloy synthesized and disinfected by means of a novel, facile, antibacterial and cost-effective method using super oxidized water (SOW). We also evaluated the role of the surface roughness and chemical composition of materials of materials on angiogenesis. Methods The Ti6Al4V alloy and a commercially pure Ti were anodized using a solution constituted by SOW and fluoride as electrolyte. An acid-etched Ti6Al4V was evaluated to compare the effect of micro-surface roughness. Mirror-polished materials were used as control. Morphology, roughness, chemistry and wettability were assessed by field emission scanning electron microscopy (FE-SEM), transmission electron microscopy, atomic force microscopy, energy dispersive X-ray spectroscopy (EDX) and using a professional digital camera. Bovine coronary artery endothelial cells (BCAECs) were seeded over the experimental surfaces for several incubation times. Cellular adhesion, proliferation and monolayer formation were evaluated by means of SEM. BCAEC viability, actin stress fibers and vinculin cellular organization, as well as the angiogenic receptors vascular endothelial growth factor 2 (VEGFR2) and endothelial nitric oxide synthase (eNOS) were measured using fluorescence microscopy. Results The anodization process significantly increased the roughness, wettability and thickness of the oxidized coating. EDX analysis demonstrated an increased oxygen (O) and decreased carbon (C) content on the NTs of both materials. Endothelial behavior was solidly supported and improved by the NTs (without significant differences between Ti and alloy), showing that endothelial viability, adhesion, proliferation, actin arrangement with vinculin expression and monolayer development were evidently stimulated on the nanostructured surface, also leading to increased activation of VEGFR2 and eNOS on Ti6Al4V-NTs compared to the control Ti6Al4V alloy. Although the rougher alloy promoted BCAECs viability and proliferation, filopodia formation was poor. Conclusion The in vitro results suggest that 70 nm diameter NTs manufactured by anodization and cleaned using SOW promotes in vitro endothelial activity, which may improve in vivo angiogenesis supporting a faster clinical osseointegration process.
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Affiliation(s)
- Ernesto Beltrán-Partida
- Department of Biomaterials and Tissue Engineering, Faculty of Dentistry Mexicali, Autonomous University of Baja California (UABC), Ave. Zotoluca and Chinampas St., 21040, Mexicali, Baja California, Mexico.,Department of Corrosion and Materials, Engineering Institute, Autonomous University of Baja California (UABC), Blvd. Benito Juarez and Normal St., 21280, Mexicali, Baja California, Mexico
| | - Benjamín Valdéz-Salas
- Department of Corrosion and Materials, Engineering Institute, Autonomous University of Baja California (UABC), Blvd. Benito Juarez and Normal St., 21280, Mexicali, Baja California, Mexico.
| | - Aldo Moreno-Ulloa
- Department of Biomedical Innovation, Center for Scientific Research and Higher Education of Ensenada (CICESE), Ensenada, Baja California, Mexico
| | - Alan Escamilla
- Department of Corrosion and Materials, Engineering Institute, Autonomous University of Baja California (UABC), Blvd. Benito Juarez and Normal St., 21280, Mexicali, Baja California, Mexico
| | - Mario A Curiel
- Department of Corrosion and Materials, Engineering Institute, Autonomous University of Baja California (UABC), Blvd. Benito Juarez and Normal St., 21280, Mexicali, Baja California, Mexico
| | - Raúl Rosales-Ibáñez
- Laboratory of Basic Sciences, Faculty of Stomatology, Autonomous University of San Luis Potosi (UASLP), San Luis Potosí, Mexico
| | - Francisco Villarreal
- School of Medicine, University of California San Diego (UCSD), 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - David M Bastidas
- National Centre for Metallurgical Research (CENIM), CSIC, Ave. Gregorio del Amo 8, 28040, Madrid, Spain
| | - José M Bastidas
- National Centre for Metallurgical Research (CENIM), CSIC, Ave. Gregorio del Amo 8, 28040, Madrid, Spain
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Maeno M, Lee C, Kim D, Da Silva J, Nagai S, Sugawara S, Nara Y, Kihara H, Nagai M. Function of Platelet-Induced Epithelial Attachment at Titanium Surfaces Inhibits Microbial Colonization. J Dent Res 2017; 96:633-639. [DOI: 10.1177/0022034516688888] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to evaluate the barrier function of platelet-induced epithelial sheets on titanium surfaces. The lack of functional peri-implant epithelial sealing with basal lamina (BL) attachment at the interface of the implant and the adjacent epithelium allows for bacterial invasion, which may lead to peri-implantitis. Although various approaches have been reported to combat bacterial infection by surface modifications to titanium, none of these have been successful in a clinical application. In our previous study, surface modification with protease-activated receptor 4–activating peptide (PAR4-AP), which induced platelet activation and aggregation, was successful in demonstrating epithelial attachment via BL and epithelial sheet formation on the titanium surface. We hypothesized that the platelet-induced epithelial sheet on PAR4-AP–modified titanium surfaces would reduce bacterial attachment, penetration, and invasion. Titanium surface was modified with PAR4-AP and incubated with platelet-rich plasma (PRP). The aggregated platelets released collagen IV, a critical BL component, onto the PAR4-AP–modified titanium surface. Then, human gingival epithelial cells were seeded on the modified titanium surface and formed epithelial sheets. Green fluorescent protein (GFP)–expressing Escherichia coli was cultured onto PAR4-AP–modified titanium with and without epithelial sheet formation. While Escherichia coli accumulated densely onto the PAR4-AP titanium lacking epithelial sheet, few Escherichia coli were observed on the epithelial sheet on the PAR4-AP surface. No bacterial invasion into the interface of the epithelial sheet and the titanium surface was observed. These in vitro results indicate the efficacy of a platelet-induced epithelial barrier that functions to prevent bacterial attachment, penetration, and invasion on PAR4-AP–modified titanium.
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Affiliation(s)
- M. Maeno
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
- Department of Adhesive Dentistry, The Nippon Dental University, Chiyoda-ku, Tokyo, Japan
| | - C. Lee
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
| | - D.M. Kim
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - J. Da Silva
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
| | - S. Nagai
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
| | - S. Sugawara
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
- Department of Prosthodontics and Oral Implantology, Iwate Medical University, School of Dental Medicine, Morioka, Iwate, Japan
| | - Y. Nara
- Department of Adhesive Dentistry, The Nippon Dental University, Chiyoda-ku, Tokyo, Japan
| | - H. Kihara
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
- Department of Prosthodontics and Oral Implantology, Iwate Medical University, School of Dental Medicine, Morioka, Iwate, Japan
| | - M. Nagai
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
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Matarese G, Ramaglia L, Fiorillo L, Cervino G, Lauritano F, Isola G. Implantology and Periodontal Disease: The Panacea to Problem Solving? Open Dent J 2017; 11:460-465. [PMID: 28979575 PMCID: PMC5611775 DOI: 10.2174/1874210601711010460] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/23/2017] [Accepted: 07/17/2017] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION The specialty of periodontology has changed dramatically in recent years. With the long-standing goal of retaining teeth in a functional and esthetical state, the periodontology has developed a high level of expertise in the regeneration of bone and connective tissues that support the teeth. However, periodontists have also joined maxillofacial surgeons as the primary providers of implant surgery. METHODS The tremendous innovations of periodontists induced also by the marketplace resulted in predictable periodontal treatment outcomes for most patients by the implants led to a dramatically different marketplace in which many patients with periodontitis can be treated by the implants rather than the traditional periodontal treatment. RESULTS The aim of this article is to focus on the innovator's dilemma for periodontists today is that key elements of our rewarding contributions to dentistry in recent decades are unlikely to be part of a strong and rewarding future for the profession. CONCLUSIONS With the intriguing role of the personalized medicine approach that integrates genomic and clinical information to predict a possible predisposition, we do not suggest a reduced role for periodontists in dental implant surgery but rather a more prominent role in complex cases to achieve surgical implant needs and proper reconstruction and long-term maintenance of the patient's health.
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Affiliation(s)
- Giovanni Matarese
- Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina, Messina, Italy
| | - Luca Ramaglia
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples “Federico II”, Naples, Italy
| | - Luca Fiorillo
- Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina, Messina, Italy
| | - Gabriele Cervino
- Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina, Messina, Italy
| | - Floriana Lauritano
- Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina, Messina, Italy
| | - Gaetano Isola
- Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina, Messina, Italy
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples “Federico II”, Naples, Italy
- Address correspondence to this author at the Department of Biomedical, Odontostomatological Sciences and Morphological and Functional Images, School of Dentistry, University of Messina, Messina, Italy; Tel: +390902216904; E-mail:
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77
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Salvi G, Cosgarea R, Sculean A. Prevalence and Mechanisms of Peri-implant Diseases. J Dent Res 2016; 96:31-37. [DOI: 10.1177/0022034516667484] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- G.E. Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - R. Cosgarea
- Department of Periodontology, Philipps University Marburg, Marburg, Germany
- Department of Prosthetic Dentistry, University Iuliu Hatieganu, Cluj-Napoca, Romania
| | - A. Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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