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Rakic M, Tatic Z, Radovanovic S, Petkovic-Curcin A, Vojvodic D, Monje A. Resolution of peri-implant mucositis following standard treatment: A prospective split-mouth study. J Periodontol 2024; 95:842-852. [PMID: 38041803 DOI: 10.1002/jper.23-0507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Peri-implant mucositis (PIM) is a pathological precursor of peri-implantitis, but its pattern of conversion to peri-implantitis is unclear and complicated to diagnose clinically, while none of the available protocols yield complete disease resolution. The aim of this study was the evaluation of PIM responsiveness to standard anti-infective mechanical treatment (AIMT) at clinical and biomarker levels, and estimation of the diagnostic capacity of bone markers as surrogate endpoints and predictors. METHODS Systemically healthy outpatients presenting one implant exhibiting clinical signs of inflammation confined within the soft tissue (PIM) and one healthy control (HC) implant at a non-adjacent position were included. Clinical parameters and peri-implant crevicular fluid samples were collected baseline and 6 months following mechanical therapy, to assess the levels of RANKL, OPG, and IGFBP2. PIM clustering was performed using machine learning algorithms. RESULTS Overall, 38 patients met the inclusion criteria. Therapy resulted in the reduction of all clinical and biological indicators, but respective values remained significantly higher compared to HC. Clinical examination noted 30% disease resolution at the 6-month follow-up, while 43% showed no active bone resorption. OPG showed positive prognostic value for treatment outcome, while the clustering based on active bone resorption did not differ in terms of therapeutic effectiveness. CONCLUSION AIMT is effective in reducing the clinical and biological indicators of PIM, but complete clinical resolution was achieved in only 30% of the cases. Around one third of PIM patients exhibited active bone resorption bellow clinical detectability that was not associated with disease progression and poor treatment responsiveness.
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Affiliation(s)
- Mia Rakic
- Facultad de Odontologia, Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, Universidad Complutense de Madrid, Madrid, Spain
| | - Zoran Tatic
- Department of Oral Implantology, Military Medical Academy, Belgrade, Serbia
| | - Sandro Radovanovic
- Faculty of Organizational Sciences, University of Belgrade, Belgrade, Serbia
| | | | - Danilo Vojvodic
- Institute for Medical Research, Military Medical Academy, Belgrade, Serbia
| | - Alberto Monje
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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Monje A, Salvi GE. Diagnostic methods/parameters to monitor peri-implant conditions. Periodontol 2000 2024; 95:20-39. [PMID: 38923148 DOI: 10.1111/prd.12584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/18/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024]
Abstract
The diagnostic accuracy of clinical parameters, including visual inspection and probing to monitor peri-implant conditions, has been regarded with skepticism. Scientific evidence pointed out that primary diagnostic tools (chairside) seem to be highly specific, while their sensitivity is lower compared with their use in monitoring periodontal stability. Nonetheless, given the association between pocket depth at teeth and implant sites and the aerobic/anaerobic nature of the microbiome, it seems plausible for pocket probing depth to be indicative of disease progression or tissue stability. In addition, understanding the inflammatory nature of peri-implant diseases, it seems reasonable to advocate that bleeding, erythema, ulceration, and suppuration might be reliable indicators of pathology. Nevertheless, single spots of bleeding on probing may not reflect peri-implant disease, since implants are prone to exhibit bleeding related to probing force. On the other side, bleeding in smokers lacks sensitivity owing to the decreased angiogenic activity. Hence, the use of dichotomous scales on bleeding in the general population, in contrast to indices that feature profuseness and time after probing, might lead to false positive diagnoses. The definitive distinction between peri-implant mucositis and peri-implantitis, though, relies upon the radiographic evidence of progressive bone loss that can be assessed by means of two- and three-dimensional methods. Accordingly, the objective of this review is to evaluate the existing clinical and radiographic parameters/methods to monitor peri-implant conditions.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, University of Bern, Bern, Switzerland
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Madi M, Tabassum A, Attia D, Al Muhaish L, Al Mutiri H, Alshehri T, Zakaria O, Aljandan B. Knowledge and attitude of dental students regarding etiology, diagnosis, and treatment of peri-implantitis. J Dent Educ 2024; 88:100-108. [PMID: 37870085 DOI: 10.1002/jdd.13397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 09/06/2023] [Accepted: 10/12/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE The objective of this study was to assess the level of knowledge and attitude of dental students about the etiology, diagnosis, and management of peri-implantitis. METHODS An online cross-sectional study that targeted senior undergraduate dental students at the College of Dentistry was conducted. A closed-ended survey consisting of 28 questions was designed. Three sections were created: 1) participants' characteristics; 2) Knowledge of peri-implantitis etiology, risk factors, diagnosis, and complications; 3) The use of antibiotics in peri-implantitis, diagnosis, and treatment methods. SPSS version 22 (IBM Corp.) was used for data analysis. Counts and percentages were calculated for correct answers in each section. RESULTS A total of 267 dental students responded to the questionnaire. The majority of the participants (81.6%) were knowledgeable about peri-implantitis being an inflammatory reaction, and a lesser percentage (77.9%) knew that bacterial plaque is an etiologic factor for peri-implant diseases. 82.0% of the participants identified smoking as a risk factor, followed by periodontitis (80.5%). Regarding implant complications, 57.3% of the participants considered implant mobility as a definitive indication for implant removal. More than half of the participants reported using crater-like bone defects surrounding implants to diagnose peri-implantitis. The most commonly used antibiotic was amoxicillin (34.1%), followed by amoxicillin combined with metronidazole (26.9%). CONCLUSION Most participants had a basic understanding of the etiology and risk factors of peri-implantitis. On the other hand, more courses addressing peri-implantitis diagnosis are needed.
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Affiliation(s)
- Marwa Madi
- Department of Preventive Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Afsheen Tabassum
- Department of Preventive Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Dina Attia
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Luba Al Muhaish
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hadeel Al Mutiri
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Turki Alshehri
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Osama Zakaria
- Department of Biomedical Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Badr Aljandan
- Department of Biomedical Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Satpathy A, Grover V, Kumar A, Jain A, Gopalakrishnan D, Grover HS, Kolte A, Melath A, Khatri M, Dani N, Thakur R, Tiwari V, Yadav VS, Thomas B, Chahal GS, Bhasin MT, Pandit N, Lawande SA, Manjunath RGS, Sachdeva S, Bhardwaj A, Pradeep AR, Nichani AS, Singh B, Ganesh PR, Deshpande NC, Reddy SSP, Raj SC. Indian Society of Periodontology Good Clinical Practice Recommendations for Peri-implant Care. J Indian Soc Periodontol 2024; 28:6-31. [PMID: 38988964 PMCID: PMC11232813 DOI: 10.4103/jisp.jisp_124_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 04/10/2024] [Accepted: 04/18/2024] [Indexed: 07/12/2024] Open
Abstract
Current implant therapy is a frequently employed treatment for individuals who have lost teeth, as it offers functional and biological advantages over old prostheses. Concurrently, active exploration of intervention strategies aims to prevent the progression of peri-implant diseases and manage the existing peri-implant tissue damage. Indian Society of Periodontology has recognized the need for systematic documents to update the everyday clinical practice of general dental practitioners and has provided evidence-based consensus documents, namely good clinical practice recommendations from time to time to raise the oral health-related awareness and standards of oral health-care delivery across the country. The current clinical practice recommendations focused on peri-implant care to bridge the gap between academic theory and clinical practice by compiling evidence-based suggestions for preventing and treating peri-implant diseases. Twenty-eight subject experts across the country prepared these recommendations after a thorough literature review and group discussions. The document has been prepared in three sections covering peri-implant health and maintenance, peri-implant mucositis, and peri-implantitis. It will be a quick and concise reference for oral implant practitioners in patient management. The guidelines provide distinct definitions, signs, and symptoms, treatment required; recall visit specifications for plausible clinical case situations, and home-care recommendations regarding maintaining peri-implant health. The document advocates combined efforts of oral implant practitioners and the population at large with evidence-based, integrated, and comprehensive peri-implant care. By providing accessible, applicable guidance, these guidelines would empower dental professionals to uphold the well-being of implant patients and ensure the long-term success of implant therapy.
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Affiliation(s)
- Anurag Satpathy
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Vishakha Grover
- Department of Periodontology, Dr. HSJ Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, Manipur, India
| | - Ashish Kumar
- Department of Periodontology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Ashish Jain
- Department of Periodontology, Dr. HSJ Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, Manipur, India
| | - Dharmarajan Gopalakrishnan
- Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | | | - Abhay Kolte
- Department of Periodontology and Implantology, Ranjeet Deshmukh Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Anil Melath
- Department of Periodontics, Mahe Institute of Dental Sciences and Hospital, Chalakkara, Puducherry, India
| | - Manish Khatri
- Department of Periodontology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Nitin Dani
- Private Practitioner, Nashik, Maharashtra, India
| | - Roshani Thakur
- Department of Periodontics, Saraswati Dhanvantari Dental College and Hospital, Parbhani, Maharashtra, India
| | - Vaibhav Tiwari
- Department of Periodontology, Government Dental College, Raipur, Chhattisgarh, India
| | - Vikender Singh Yadav
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Biju Thomas
- Department of Periodontology, AB Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be university), Mangalore, Karnataka, India
| | - Gurparkash Singh Chahal
- Department of Periodontology, Dr. HSJ Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, Manipur, India
| | - Meenu Taneja Bhasin
- Department of Periodontics, Sudha Rustagi Dental College, Faridabad, Uttar Pradesh, India
| | - Nymphea Pandit
- Department of Periodontology, D.A.V Dental College and Hospital, Yamunanagar, Haryana, India
| | | | - R G Shiva Manjunath
- Department of Periodontology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Surinder Sachdeva
- Department of Periodontology, M.M. College of Dental Sciences and Research, MM Deemed to be University, Mullana, Punjab, India
| | - Amit Bhardwaj
- Department of Periodontology, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
| | - Avni Raju Pradeep
- Department of Periodontology, Government Dental College, Bengaluru, Karnataka, India
| | - Ashish Sham Nichani
- Department of Periodontology, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Baljeet Singh
- Department of Periodontology and Implantology, Himachal Dental College, Sunder Nagar, Himachal Pradesh, India
| | - P R Ganesh
- Department of Periodontology, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Neeraj Chandrahas Deshpande
- Department of Periodontology, K. M. Shah Dental College, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | | | - Subash Chandra Raj
- Department of Periodontology, S.C.B Dental College and Hospital, Cuttack, Odisha, India
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Selimović A, Bunæs DF, Lie SA, Lobekk MA, Leknes KN. Non-surgical treatment of peri-implantitis with and without erythritol air-polishing a 12-month randomized controlled trial. BMC Oral Health 2023; 23:240. [PMID: 37095488 PMCID: PMC10125257 DOI: 10.1186/s12903-023-02973-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 04/17/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND A variety of interventions have been explored in the non-surgical management of peri-implantitis. In spite of extensive testing of various study protocols, effective treatments largely remain unavailable. The objective of the present 12-month single-centre, examiner-masked, randomized controlled clinical trial was to explore whether a low-abrasive erythritol air-polishing system produces added clinical benefit when used adjunctive to conventional non-surgical management of peri-implantitis and to record any associated patient-centered outcomes. METHODS Forty-three patients with mild to severe peri-implantitis including at least one implant either received ultrasonic/curette subgingival instrumentation and erythritol air-polishing (test) or ultrasonic/curette instrumentation only (control) at baseline and at 3, 6, 9, and 12 months. Probing depth (PD), bleeding on probing (BoP), dental plaque, suppuration (SUP), crestal bone level (CBL), and peri-implant crevicular fluid (PCF) were recorded at baseline, 6 and 12 months. Visual Analogue Scale (VAS) scores were collected immediately following subgingival interventions at all time-points. RESULTS A reduction in PD was observed from baseline to 6 months for the test (p = 0.006) and control (p < 0.001) and from baseline to 12 months for the control (p < 0.001). No intergroup differences were observed for primary outcome variables PD or CBL over time (p > 0.05). At 6 months, a intergroup difference in PCF was observed in favor of the test (p = 0.042). Moreover, a reduction in SUP from baseline to 6 and 12 months was observed in the test (p = 0.019). Overall, patients in the control group experienced less pain/discomfort compared with the test (p < 0.05), females reporting more pain/discomfort than males (p = 0.005). CONCLUSIONS This study confirms that conventional non-surgical management of peri-implantitis produces limited clinical improvement. It is shown that an erythritol air-polishing system may not produce added clinical benefits when used adjunctive to conventional non-surgical management. In other words, neither approach effectively resolved peri-implantitis. Moreover, the erythritol air-polishing system produced added pain/discomfort particularly in female patients. TRIAL REGISTRATION The clinical trial was prospectively registered in ClinicalTrials.gov with registration NCT04152668 (05/11/2019).
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Affiliation(s)
- Armin Selimović
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19, N-5009, Bergen, Norway
| | - Dagmar F Bunæs
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19, N-5009, Bergen, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19, N-5009, Bergen, Norway
| | | | - Knut N Leknes
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19, N-5009, Bergen, Norway.
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Sadowsky SJ. Peri-implantitis after 40 years: Evidence, mechanisms, and implications: A mapping review. J Prosthet Dent 2023:S0022-3913(23)00114-2. [PMID: 36935269 DOI: 10.1016/j.prosdent.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 03/19/2023]
Abstract
STATEMENT OF PROBLEM The high prevalence of peri-implantitis (PI) continues to plague patients and the disease is resistant to present treatment regimens. An analysis of the available research is lacking. PURPOSE Given the abundance and diversity of research on the topic of PI, the purpose of this mapping review was to synthesize the literature on the prevention of PI, the histopathology of the disease, the state of present therapeutics, and any emerging treatments. MATERIAL AND METHODS An extensive literature search was undertaken by using the electronic databases of PubMed, Web of Science, and Science Direct. The keyword strings were peri-implantitis, dental implant, risk assessment, histopathology, prosthesis design, and treatment. The filters applied were time interval from 2000 to 2002; language, English. RESULTS A total of 3635 articles were taken from PubMed, 3686 articles from Web of Science, and 2450 articles from Science Direct. After applying the inclusion and exclusion criteria to the titles and abstracts of selected investigations, 214 studies were retrieved. CONCLUSIONS The evidence reflects a concerning incidence of PI, without a predictable treatment protocol. An in-depth patient risk assessment considering risk modification, emphasis on surgical and restorative expertise, and strict recall and maintenance is essential to minimize PI.
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Affiliation(s)
- Steven J Sadowsky
- Professor, Preventive and Restorative Department, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, Calif.
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Djuran B, Tatic Z, Perunovic N, Pejcic N, Vukovic J, Petkovic-Curcin A, Vojvodic D, Rakic M. Underdiagnosis in Background of Emerging Public Health Challenges Related to Peri-Implant Diseases: An Interventional Split-Mouth Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010477. [PMID: 36612810 PMCID: PMC9819861 DOI: 10.3390/ijerph20010477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/25/2022] [Accepted: 12/27/2022] [Indexed: 06/02/2023]
Abstract
Peri-implant diseases are an emerging public health problem, and it's considered that limitations of standard diagnostics play the role herein. The study objective was the estimation of pathological bone resorption at clinical and biological level in patients with peri-implant mucositis (PIM) and peri-implantitis (PI) before and 6 months after standard treatment and to compare them with healthy controls (HC). The split-mouth interventional study included 60 patients affected with PIM or PI. Patients that also presented at least one more HC were enrolled in the study and underwent standard non-surgical and surgical treatment, respectively. Standard clinical parameters and soluble levels of RANKL were measured in peri-implant crevicular fluid baseline and 6 months following treatment. Clinical parameters and RANKL significantly decreased following treatment in PIM and PI. However, bleeding on probing and probing depth remained significantly increased when compared to HC. RANKL answered requests for biomarker of peri-implant diseases, its baseline levels were significantly increased in PIM and PI, they decreased following treatment and reached HC in peri-implantitis, while in PIM RANKL remained significantly increased. Presence of pathological bone resorption in patients lacked its clinical signs, and respective persistence following treatment suggest the need for biomarker-supported diagnosis for timely diagnosis of peri-implantitis and appropriate orientation of respective management strategies.
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Affiliation(s)
- Boris Djuran
- Department of Oral Implantology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Zoran Tatic
- Department of Oral Implantology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Neda Perunovic
- Faculty of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Natasa Pejcic
- Faculty of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Jovana Vukovic
- Biocell Hospital, 11070 Beograd, Serbia
- Faculty of Biology, University of Belgrade, 11000 Belgrade, Serbia
| | | | - Danilo Vojvodic
- Institute for Medical Research, Military Medical Academy, 11000 Belgrade, Serbia
| | - Mia Rakic
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense of Madrid, 28040 Madrid, Spain
- Institute for Biological Research “Sinisa Stankovic”, University of Belgrade, 11000 Belgrade, Serbia
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Ramanauskaite A, Obreja K, Schwarz F, Jepsen K, Cosgarea R, Bunke J, Eisenbeiss AK, Schulz J, Flörke C, Eberhard C, Kocher T, Jablonowski L, Jepsen S, Holtfreter B. Reliability of probing depth assessments at healthy implant sites and natural teeth. Clin Oral Investig 2022:10.1007/s00784-022-04810-5. [DOI: 10.1007/s00784-022-04810-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/27/2022] [Indexed: 12/04/2022]
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Wang Z. Peri-implant crevicular fluid SIRT1 levels decrease in patients with peri-implant inflammatory: A prospective observational study. Transpl Immunol 2022; 74:101659. [PMID: 35781023 DOI: 10.1016/j.trim.2022.101659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND A dental Implant is a prosthetic device made of alloplastic materials implanted into the bone to provide retention and support for a dental prosthesis. Sirtuin1 (SIRT1) molecule, a nicotinamide adenine dinucleotide (NAD)-dependent histone deacetylase, regulates a variety of physiological and pathological processes, including oxidative stress, metabolism, cell proliferation, cell differentiation, inflammatory, and apoptosis. We explored whether the expression of SIRT1 correlates in patients receiving implants with peri-implant mucositis (PIM) and peri-implantitis (PI) in comparison to patients with healthy peri-implant area (PIH). METHODS A number of 198 patients with dentition defects were enrolled in the study after their implants were functional for at least 6 months. All 198 subjects were divided into 3 groups: 1) control patients with PIH healthy implants; 2) patients with PIM mucositis; and 3) patients with PI implantitis. To distinguish these three groups, peri-implant crevicular fluid (PICF) was collected by inserting a sterile paper strip into the gap around the implant and the levels of SIRT1 and cytokines were measured by the enzyme linked immunosorbent assay (ELISA). Demographic and clinical data included age, sex, Body Mass Index (BMI), probing depth (PD), plaque index (PLI), bleeding on probing (BOP), oral health impact profile (OHIP-14), history of periodontitis and the use time of implants. RESULTS The PD, PLI, OHIP-14 evaluation scores in patients with periodontitis of PIM mucositis and PI implantitis were all significantly higher than in patients with PIH healthy implants. Overall, the SIRT1 levels in PICF of the PIM and PI patients were significantly lower than of the PIH patients. In comparison with PIM patients, SIRT1 levels of the PI patients were remarkably lower than the PIH patients. Pearson's analysis showed that SIRT1 levels were negatively correlated with levels of interleukin (IL)-6, C-reactive protein (CRP) and IL-1β in patients with PIM and PI. We suggest that SIRT1 levels could serve as a potential diagnostic biomarker of PI or PIM. The PICF levels of SIRT1, CRP, IL-6, IL-1β and the history of periodontitis were the risk factors for patients with peri-implant inflammatory process. CONCLUSION The measurement of SIRT1 expression in PICF may serve as a biomarker for the ongoing inflammatory process in patients with dental implants. The low SIRT1 levels correlated with PI implantitis and PIM mucositis as well as the elevated levels of pro-inflammatory cytokines (CRP, IL-6 and IL-1β).
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Affiliation(s)
- Zhuo Wang
- Department of Stomatology, Shanghai Oriental Hospital, Shanghai 200120, China.
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10
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Amerio E, Blasi G, Valles C, Blanc V, Àlvarez G, Arredondo A, Nart J, Monje A. Impact of smoking on peri-implant bleeding on probing. Clin Implant Dent Relat Res 2022; 24:151-165. [PMID: 35313069 DOI: 10.1111/cid.13062] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 08/29/2021] [Accepted: 12/20/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Studies around natural dentition demonstrated that smoking can reduce the tendency of inflamed tissue to bleed upon probing after controlling for possible confounders. In addition, previous research suggested that smokers may present alterations of the peri-implant microbiome. AIM This study aimed at investigating the impact of smoking on: (1) peri-implant bleeding on probing (BOP; primary objective); (2) the association between BOP/bone loss and BOP/visible gingival inflammation; (3) peri-implant microbiome. METHODS Partially edentulous patients with implants restored with a single crowns were included in this study. Subjects were either smokers (≥1 cigarettes per day) or nonsmokers (never smokers). The primary outcome of this cross-sectional study was BOP and secondary outcomes included: Probing pocket depth (PPD), Modified gingival Index (mGI) and Progressive Marginal Bone Loss. In addition, microbial profiles of the subjects were assessed through sequencing of the 16S rRNA gene. Univariate and multilevel multivariate analyses by means of Generalized Estimating Equations were conducted to analyze the association between smoking and peri-implant BOP. RESULTS Overall, 27 nonsmokers and 27 smokers were included and 96.3% and 77.78% of patients presented peri-implant BOP in the nonsmoker and smoker group, respectively (p = 0.046). Smoking was inversely associated with BOP in the multivariate multilevel analysis (OR = 0.356; 95% CI: 0.193-0.660; p = 0.001) whereas a positive correlation was demonstrated for mGI > 0 (OR = 3.289; 95% CI: 2.014-5.371; p < 0.001); PPD (OR = 1.692; 95% CI: 0.263-0.883; p = 0.039) and gender (OR = 2.323; 95% CI: 1.310-4.120 p = 0.004). A decrease of BOP sensitivity in detecting visible gingival inflammation (mGI > 0) was observed in smokers. Besides, taxonomic and changes in diversity regarding the peri-implant microbiota were detected comparing the two groups. Significantly higher richness of the microbiota was demonstrated in the smoker group when implants affected by peri-implantitis were compared to either healthy implants or implants presenting mucositis. CONCLUSIONS Smoking is a potential modifier of BOP and peri-implant microbiota.
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Affiliation(s)
- Ettore Amerio
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Gonzalo Blasi
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Cristina Valles
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Vanessa Blanc
- Department of Microbiology, Dentaid Research Center, Cerdanyola del Vallès, Spain
| | - Gerard Àlvarez
- Department of Microbiology, Dentaid Research Center, Cerdanyola del Vallès, Spain
| | - Alexandre Arredondo
- Department of Microbiology, Dentaid Research Center, Cerdanyola del Vallès, Spain
| | - Jose Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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Mattheos N, Janda M, Acharya A, Pekarski S, Larsson C. Impact of design elements of the implant supracrestal complex (ISC) on the risk of peri-implant mucositis and peri-implantitis: A critical review. Clin Oral Implants Res 2021; 32 Suppl 21:181-202. [PMID: 34642979 DOI: 10.1111/clr.13823] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 07/11/2021] [Accepted: 07/20/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The aim of this review was to investigate the evidence correlating the emergence profile (EP) and emergence angle (EA), peri-implant tissue height, implant neck design, abutment and/or prosthesis material, retention and connection types with risk of peri-implant mucositis and peri-implantitis. METHODS Seven focus questions were identified, and seven electronic search queries were conducted in PubMed. Human studies reporting on bleeding on probing, probing depth or case definitions of peri-implant mucositis and peri-implantitis were included. RESULTS Emerging evidence with bone-level implants suggests a link between EA combined with convex EP and peri-implantitis. Depth of the peri-implant sulcus of ≥3 mm is shown to be reducing the effectiveness of treatment of established peri-implant mucositis. Modification of the prosthesis contour is shown to be an effective supplement of the anti-infective treatment of peri-implant mucositis. Limited evidence points to no difference with regard to the risk for peri-implant mucositis between tissue- and bone-level implants, as well as the material of the abutment or the prosthesis. Limited evidence suggests the use or not of prosthetic abutments in external connections and does not change the risk for peri-implantitis. Literature with regard to prosthesis retention type and risk for peri-implantitis is inconclusive. CONCLUSIONS Limited evidence indicates the involvement of EA, EP, sulcus depth and restricted accessibility to oral hygiene in the manifestation and/or management of peri-implant mucositis/peri-implantitis. Conclusions are limited by the lack of consensus definitions and validated outcomes measures, as well as diverse methodological approaches. Purpose-designed studies are required to clarify current observations.
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Affiliation(s)
- Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Martin Janda
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Aneesha Acharya
- Department of Periodontics, Dr. D. Y. Patil Dental College and Hospital, Pune, India
| | - Stephanie Pekarski
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Christel Larsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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12
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Kido R, Kido JI, Nishikawa Y, Sakamoto E, Tomotake Y, Yumoto H. Diagnosis of inflammatory peri-implant diseases using an immunochromatographic assay for calprotectin in peri-implant crevicular fluid. Int J Implant Dent 2021; 7:106. [PMID: 34623545 PMCID: PMC8498755 DOI: 10.1186/s40729-021-00386-z] [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: 08/03/2020] [Accepted: 10/03/2021] [Indexed: 02/06/2023] Open
Abstract
Background The incidence rate of peri-implant diseases is increasing with implant placement. Early detection of peri-implant diseases is important to prevent and treat these diseases, and a simple and objective diagnostic method is expected. Immunochromatographic (IC) assays are used for rapid diagnostic methods for some diseases. The aim of this clinical study was to determine the amount of calprotectin, an inflammatory marker, in peri-implant crevicular fluid (PICF) using an IC chip, and estimate the possibility of this diagnostic system. Methods Forty-six individuals with dental implants participated in a pilot study. PICF samples were collected from the peri-implant sites with or without inflammation after clinical examinations including probing depth (PD), bleeding on probing (BOP) and gingival index (GI). Calprotectin in PICF was determined by an IC chip and enzyme-linked immunosorbent assay (ELISA) for calprotectin. The density of calprotectin line on the IC chip was measured using an IC reader (IC reader value). The relationship between IC reader value and ELISA value or clinical parameters was investigated. A receiver operating characteristic (ROC) curve analysis of IC reader value of calprotectin was performed to predict inflammation in peri-implant diseases. Results IC reader value of calprotectin was significantly correlated with its ELISA value and PD. IC reader values of calprotectin in PICF samples from periodontal sites with GI-1 and GI-2, and with BOP-positive sites were significantly higher than those of PICF samples from GI-0 sites, and BOP-negative sites, respectively. The IC reader value for calprotectin in PICF samples from inflammatory diseased sites was significantly higher than that of non-diseased sites. ROC analysis suggested that the IC reader value of PICF calprotectin was useful for predicting inflammatory peri-implant diseases. Conclusion IC assay for PICF calprotectin may be a possible system for diagnosing the inflammatory peri-implant diseases.
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Affiliation(s)
- Rie Kido
- Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
| | - Jun-Ichi Kido
- Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan.
| | | | - Eijiro Sakamoto
- Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
| | - Yoritoki Tomotake
- Oral Implant Center, Tokushima University Hospital, Tokushima, Japan
| | - Hiromichi Yumoto
- Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
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13
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Khichy A, Khichy R, Singh R, Bali Y, Kaur S, Gill TK. Assessment of Levels of C-Reactive Proteins and Interleukin 6 in Patients with Peri-Implantitis: A Case-Control Study. J Pharm Bioallied Sci 2021; 13:S444-S447. [PMID: 34447130 PMCID: PMC8375811 DOI: 10.4103/jpbs.jpbs_540_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 11/28/2022] Open
Abstract
Aim: The present study was undertaken for assessing the C-reactive proteins (CRP) levels and IL-6 levels in patients with peri-implantitis. Materials and Methods: A total of 20 patients with confirmed clinical and radiographic diagnosis of peri-implantitis were included in the present study. Another set of 20 subjects who reported for routine health check-up were included as healthy controls. All the subjects were recalled in the morning and fasting (minimum of 12 h) venous blood samples were obtained. Plain vials were used for collecting the venous blood which was sent to the laboratory for biochemical analysis. In the laboratory, levels of CRP were assessed by means of latex enhanced nephelometric method, and interleukin 6 (IL-6) was assessed by means of Elisa kit. Results: Mean levels of CRPs in patients of the peri-implantitis group and the control group was found to be 0.795 mg/dL and 0.294 mg/dL respectively. Mean IL-6 levels among the patients of the peri-implantitis group and the control group was found to be 12.178 pg/ml and 6.458 pg/ml respectively. While analyzing statistically, significant results were obtained. Conclusion: Enhanced periodontal inflammation in peri-implantitis patients is accompanied by a considerable increase in the concentration of CRPs and IL-6.
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Affiliation(s)
- Aditya Khichy
- Departments of Periodontology and Oral Implantology, Baba Jaswant Singh Dental College, Hospital and Research Institute, Ludhiana, Punjab, India
| | - Ruhani Khichy
- Department of Prosthodontics, Crown and Bridges and Oral Implantology, Baba Jaswant Singh Dental College, Hospital and Research Institute, Ludhiana, Punjab, India
| | - Ravpreet Singh
- Department of Prosthodontics, Crown and Bridges and Oral Implantology, Baba Jaswant Singh Dental College, Hospital and Research Institute, Ludhiana, Punjab, India
| | - Yashika Bali
- Department of Prosthodontics, Crown and Bridges and Oral Implantology, Baba Jaswant Singh Dental College, Hospital and Research Institute, Ludhiana, Punjab, India
| | - Supreet Kaur
- Department of Prosthodontics, Crown and Bridges and Oral Implantology, Baba Jaswant Singh Dental College, Hospital and Research Institute, Ludhiana, Punjab, India
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14
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Polymeri A, Loos BG, Aronovich S, Steigmann L, Inglehart MR. Risk factors, diagnosis and treatment of peri-implantitis: A cross-cultural comparison of U.S. and European periodontists' considerations. J Periodontol 2021; 93:481-492. [PMID: 34390497 PMCID: PMC10138758 DOI: 10.1002/jper.21-0010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 07/14/2021] [Accepted: 08/11/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Peri-implantitis (PI) is a growing concern in the dental community worldwide. The study aimed to compare U.S. vs. European periodontists' considerations of risk factors, diagnostic criteria, and management of PI. MATERIALS AND METHODS 393 periodontists from the U.S. and 100 periodontists from Europe (Germany, Greece, Netherlands) responded to anonymous surveys electronically or by mail. RESULTS Compared to U.S. periodontists, European respondents were younger, more likely to be female and placed fewer implants per month (9.12 vs. 13.90;p = 0.003). Poor oral hygiene, history of periodontitis, and smoking were considered as very important risk factors by both groups (rated >4 on 5-point scale). European periodontists rated poor oral hygiene (4.64 vs. 4.45;p = 0.005) and history of periodontitis (4.36 vs. 4.10;p = 0.006) as more important and implant surface (2.91 vs. 3.18;p = 0.023), occlusion (2.80 vs. 3.75;p<0.001) and presence of keratinized tissue (3.27 vs. 3.77;p<0.001) as less important than did U.S. periodontists. Both groups rated clinical probing, radiographic bone loss, and presence of bleeding and suppuration as rather important diagnostic criteria. They rated implant exposure/mucosal recession as relatively less important with U.S. periodontists giving higher importance ratings than European periodontists (3.99 vs. 3.54;p = 0.001). Both groups nearly always used patient education, plaque control and mechanical debridement when treating PI. U.S. periodontists were more likely to use antibiotics (3.88 vs. 3.07;p<0.001), lasers (2.11 vs. 1.68;p = 0.005), allograft (3.39 vs. 2.14;p<0.001) and regenerative approaches (3.57 vs. 2.56;p<0.001), but less likely to use resective surgery (3.09 vs. 3.53;p<0.001) than European periodontists. CONCLUSIONS U.S. and European periodontists' considerations concerning risk factors, diagnosis and management of PI were evidence-based. Identified differences between the two groups can inform future educational efforts. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Angeliki Polymeri
- Department of Periodontology, University of Amsterdam and Vrije Universiteit, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Bruno G Loos
- Department of Periodontology, University of Amsterdam and Vrije Universiteit, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Sharon Aronovich
- Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI
| | - Larissa Steigmann
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
| | - Marita R Inglehart
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
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15
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González-Serrano J, López-Pintor RM, Serrano J, Torres J, Hernández G, Sanz M. Short-term efficacy of a gel containing propolis extract, nanovitamin C and nanovitamin E on peri-implant mucositis: A double-blind, randomized, clinical trial. J Periodontal Res 2021; 56:897-906. [PMID: 33904601 DOI: 10.1111/jre.12886] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 03/29/2021] [Accepted: 04/10/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine the efficacy of a gel containing propolis extract, nanovitamin C and nanovitamin E as adjuvant to mechanical debridement in the treatment of peri-implant mucositis (PM). BACKGROUND Propolis has anti-inflammatory and antibacterial effect that may improve peri-implant health. METHODS A randomized, double-blind study was performed on patients with at least one implant with PM. Participants received a professional prophylaxis and were instructed to use either test or a control gel as toothpaste three times/day for 1 month. Clinical and microbiological parameters were evaluated. PM resolution was considered in absence of bleeding on probing (BOP). Data were analysed with Mann-Whitney U, Wilcoxon signed-rank and chi-square tests. RESULTS Forty-six patients participated (23 in each group). After treatment, 26.1% of test patients showed complete PM resolution versus 0% in control group (p = .02). Significant reductions were observed in plaque index (p = .03), BOP (p = .04) and probing depths (p = .027) in test compared with control group. The reduction in Tannerella forsythia was statistically greater in test than in control group at 1-month follow-up (p = .02). Porphyromonas gingivalis was statistically reduced in test group from baseline to 1-month follow-up (p = .05). CONCLUSION Test gel clinically improved PM and showed certain antimicrobial effect after 1 month in comparison with control group. Further long-term clinical trials are required to confirm these results.
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Affiliation(s)
- José González-Serrano
- Department of Dental Clinical Specialities, ORALMED research group, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Rosa María López-Pintor
- Department of Dental Clinical Specialities, ORALMED research group, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Julia Serrano
- Department of Dental Clinical Specialities, ORALMED research group, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Jesús Torres
- Department of Dental Clinical Specialities, ORALMED research group, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Gonzalo Hernández
- Department of Dental Clinical Specialities, ORALMED research group, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Mariano Sanz
- Department of Dental Clinical Specialities, School of Dentistry, Complutense University of Madrid, Madrid, Spain
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16
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Conte A, Ghiraldini B, Denófrio PHF, Ribeiro FV, Pimentel SP, Casati MZ, Corrêa MG, Cirano FR. Could implant position influence the peri-implant parameters in edentulous mandibles of diabetics rehabilitated with overdentures? A split-mouth randomized study. Int J Oral Maxillofac Surg 2021:S0901-5027(21)00088-6. [PMID: 33715937 DOI: 10.1016/j.ijom.2021.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 12/15/2020] [Accepted: 02/07/2021] [Indexed: 10/21/2022]
Abstract
This randomized controlled trial assessed the impact of crestal level position of implants installed in type 2 diabetes mellitus (T2DM) patients rehabilitated with overdentures. Twenty-two mandibular edentulous T2DM patients were submitted to implant placement for retention of an overdenture. By means of a split-mouth design, two implants were installed: one at supracrestal level (SL) and one at crestal level (CL). Clinical, immunoenzymatic and tomographic analyses were performed at prosthesis placement (baseline) and after 6, 12 and 24 months following implant loading. Increased peri-implant probing depths were detected in CL implants when compared with SL implants at all time-points (baseline P=0.047; 6 months P=0.014; 12 months P=0.027; 24 months P=0.036). Indeed, augmented clinical attachment levels were also detected in CL implants when compared with SL implants at all time-points (baseline P=003; 6 months P=0.045; 12 months P=0.029; 24 months P=0.026). CL implants demonstrated increased amounts of interleukin-6 (IL-6) at 6 months (P=0.043) and higher IL-17 (P=0.021), IL-21 (P=0.034) and tumour necrosis factor alpha (TNF-α) concentrations (P=0.030) at 24 months in comparison with SL implants. CL group revealed enhanced bone loss from baseline to 6 (P=0.032), 12 (P=0.043) and 24 months (P=0.028) when compared with SL. In conclusion, this study showed that implants placed supracrestally in T2DM patients rehabilitated with overdentures demonstrated lower bone loss and better clinical parameters with beneficial modulation of peri-implant immunoinflammatory biomarkers when compared with implants positioned at crestal level.
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Affiliation(s)
- A Conte
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil
| | - B Ghiraldini
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil
| | - P H F Denófrio
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil
| | - F V Ribeiro
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil
| | - S P Pimentel
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil
| | - M Z Casati
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil
| | - M G Corrêa
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil
| | - F R Cirano
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil.
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17
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Romandini M, Berglundh J, Derks J, Sanz M, Berglundh T. Diagnosis of peri-implantitis in the absence of baseline data: A diagnostic accuracy study. Clin Oral Implants Res 2021; 32:297-313. [PMID: 33340418 DOI: 10.1111/clr.13700] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/04/2020] [Accepted: 12/08/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The aim of the present study was to evaluate the diagnostic accuracy of clinical and radiographic evaluations made at a single time point during follow-up in identifying (a) a history of peri-implant bone loss and (b) the presence of peri-implantitis. MATERIAL & METHODS 427 patients provided with implant-supported reconstructions 9 years earlier were evaluated clinically by Probing Pocket Depth, Bleeding or Suppuration on Probing (PPD, BoP & SoP) and radiographically. Bone levels were assessed relative to the most coronal point of the intra-osseous part of the implant. A history of bone loss and diagnosis of peri-implantitis was confirmed through baseline documentation (direct evidence). Diagnostic accuracy of radiographic bone levels at 9 years and clinical findings (indirect evidence/secondary case definition) in identifying a history of bone loss and peri-implantitis were evaluated through correlation and multilevel regression analyses as well as receiver operating characteristic curves. Results were expressed as sensitivity/specificity and area under the curve (AUC). RESULTS Bone levels observed at 9 years were highly accurate in identifying pronounced bone loss (>2 mm; AUC = 0.96; 95% CI 0.95-0.98). In the absence of baseline documentation, a secondary case definition based on the presence of BoP/SoP & bone level ≥ 1 mm (indirect evidence) provided the overall best diagnostic accuracy (AUC = 0.80; 95% CI 0.77-0.82) in identifying peri-implantitis cases (direct evidence: BoP/SoP & bone loss > 0.5 mm). Moderate/severe peri-implantitis (BoP/SoP & bone loss > 2 mm) was most accurately identified by the combination of BoP/SoP & bone level ≥ 2 mm (AUC = 0.93; 95% CI 0.91-0.96). Sensitivity of the secondary case definition suggested by the 2017 World Workshop of Periodontology (WWP) (BoP/SoP ≥ 1 site & bone level ≥ 3 mm & PPD ≥ 6 mm) was low. CONCLUSIONS The present results underline the importance of baseline documentation for the correct diagnosis of peri-implantitis, especially in its early/incipient forms. The secondary case definition of peri-implantitis suggested at the 2017 WWP demonstrated a high level of specificity but low sensitivity. Moderate/severe peri-implantitis was most accurately identified by the combination of BoP/SoP & bone level ≥ 2 mm.
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Affiliation(s)
- Mario Romandini
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Jessica Berglundh
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - 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
| | - Tord Berglundh
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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18
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van der Moolen PL, Post BJ, Slot DE, van der Weijden FA. Outcome of peri-implant maintenance care in patients with an implant-supported lower denture-A 3.5-year retrospective analysis. Clin Implant Dent Relat Res 2021; 23:236-243. [PMID: 33463040 PMCID: PMC8247953 DOI: 10.1111/cid.12963] [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: 07/09/2020] [Revised: 10/05/2020] [Accepted: 10/30/2020] [Indexed: 12/20/2022]
Abstract
Background Implant‐supported overdentures represent a successful treatment for edentulous patients. As early diagnosis, detection and supportive care are considered key factors for the prevention of peri‐implant diseases, consistent maintenance of these implants is becoming increasingly relevant. Purpose This retrospective analysis evaluated a cohort of edentulous patients with a mandibular implant‐supported overdenture over a period of 3.5 years during which the peri‐implant tissues were assessed. Materials and Methods A total of 108 patients that had consistently adhered to the annual maintenance appointments was selected. The clinical peri‐implant pocket probing depth (PiPPD) and peri‐implant bleeding on probing score (PiBOP) were investigated. Data from the 3.5‐year follow‐up were compared to data from the baseline assessment. Results A 100% implant survival was reported after 3.5 years. The mean PiBOP showed a significant decrease over time (P = .028). The mean PiPPD was found significantly deeper for male patients both at baseline (P = .004) and 3.5‐year follow‐up (P < .001). Besides, the PiPPD for locator anchorages was found significantly deeper compared to ball anchorages at the 3.5‐year follow‐up (P = .026). Conclusion In those patients that adhered to the annual maintenance visits during the 3.5 years after implant surgery a stable peri‐implant condition was observed. As future consideration, the comparison of the clinical outcomes of patients participating in the maintenance program with those that did not would make this observation even more meaningful.
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Affiliation(s)
- Pieter Leo van der Moolen
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ben Jeroen Post
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dagmar Else Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Fridus August van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Clinic for Implantology Utrecht, Utrecht, The Netherlands
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19
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Romandini M, Lima C, Pedrinaci I, Araoz A, Costanza Soldini M, Sanz M. Clinical signs, symptoms, perceptions, and impact on quality of life in patients suffering from peri-implant diseases: a university-representative cross-sectional study. Clin Oral Implants Res 2020; 32:100-111. [PMID: 33210787 DOI: 10.1111/clr.13683] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/22/2020] [Accepted: 11/10/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To study the symptoms and perception reported by patients with peri-implant diseases, as well as their signs and their potential impact on the oral health quality of life. MATERIAL AND METHODS Two hundred and forty randomly selected patients were invited to participate. As part of the history assessment, the patient OHIP-14Sp was evaluated together with, for each implant, the patient perception regarding the peri-implant health status and the history of pain, spontaneous discomfort, bleeding, suppuration, swelling, and discomfort during brushing. As part of the clinical examination, the following potential signs of peri-implant diseases were collected: probing pocket depth (PPD), mucosal dehiscence (MD), extent of BoP, presence of SoP, and visual signs of redness and swelling. Those parameters were analyzed in relation to the actual peri-implant health diagnosis. RESULTS Ninety-nine patients with a total of 458 dental implants were studied. Even in case of peri-implantitis, 88.9% of the implants were perceived by the patients as healthy. The total OHIP-14Sp sum score did not differ in relation to the peri-implant health diagnosis. Increased reports of spontaneous discomfort, bleeding, swelling, and discomfort during brushing were observed in presence of disease. However, only a minor proportion of implants with peri-implant diseases presented symptoms. PPD ≥ 6 mm was more frequent in diseased than in healthy implants (p < .01), while PPD ≥ 8 in pre-peri-implantitis/peri-implantitis than in healthy/mucositis implants (p < .01). Implants with peri-implantitis showed higher MD than implants without peri-implantitis (p < .01). CONCLUSION Peri-implant diseases are in most cases asymptomatic and not perceived by the patients. Despite being unable to accurately discriminate between peri-implant mucositis and peri-implantitis, PPD and MD resulted as the only two clinical signs associated with pre-peri-implantitis/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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20
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Chaparro A, Atria P, Realini O, Monteiro LJ, Betancur D, Acuña-Gallardo S, Ramírez V, Bendek MJ, Pascual A, Nart J, Beltrán V, Sanz A. Diagnostic potential of peri-implant crevicular fluid microRNA-21-3p and microRNA-150-5p and extracellular vesicles in peri-implant diseases. J Periodontol 2020; 92:11-21. [PMID: 33185898 DOI: 10.1002/jper.20-0372] [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: 05/22/2020] [Revised: 09/17/2020] [Accepted: 09/20/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND To explore the diagnostic usefulness of extracellular vesicles (EVs), and their subpopulations (micro-vesicles and exosomes), and microRNAs (miRNA-21-3p, miRNA-150-5p, and miRNA-26a-5p) in peri-implant crevicular fluid (PICF) of subjects with healthy, peri-implant mucositis and peri-implantitis implants. METHODS A total of 54 patients were enrolled into healthy, peri-implant mucositis, and peri-implantitis groups. PICF samples were collected, EVs subpopulations (MVs and Exo) were isolated and characterized by nanoparticle tracking analysis and transmission electron microscopy. The expression of miRNA-21-3p, miRNA-150-5p and miRNA-26a-5p was quantified by qRT-PCR. Logistic regression models and accuracy performance tests were estimated. RESULTS PICF samples show the presence of EVs delimited by a bi-layered membrane, in accordance with the morphology and size (< 200 nm). The concentration of PICF-EVs, micro-vesicles and exosomes was significantly increased in peri-implantitis implants compared to healthy implants (P = 0.023, P = 0.002, P = 0.036, respectively). miRNA-21-3p and miRNA-150-5p expression were significantly downregulated in patients with peri-implantitis in comparison with peri-implant mucositis sites (P = 0.011, P = 0.020, respectively). The reduced expression of miRNA-21-3p and miRNA-150-5p was associated with peri-implantitis diagnosis (OR:0.23, CI 0.08-0.66, P = 0.007 and OR:0.07, CI 0.01-0.78, P = 0.031, respectively). The model which included the miRNA-21-3p and miRNA-150-5p expression had a sensitivity of 93.3%, a specificity of 76.5%, a positive predictive value of 77.8%, and a negative predictive value of 92.9%. The positive and negative likelihood ratios were 3.97 and 0.09, respectively. The area under the receiver operating characteristics curve for the model was 0.84. CONCLUSIONS An increase concentration of EVs with a downregulation expression of miRNA-21-3p and miRNA-150-5p could be related with the peri-implantitis development.
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Affiliation(s)
- Alejandra Chaparro
- Department of Periodontology, Centro de Investigación e Innovación Biomédica (CIIB), Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
| | - Pablo Atria
- Department of Periodontology, Centro de Investigación e Innovación Biomédica (CIIB), Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
| | - Ornella Realini
- Department of Periodontology, Centro de Investigación e Innovación Biomédica (CIIB), Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
| | - Lara J Monteiro
- Department of Obstetrics and Gynecology, Centro de Investigación e Innovación Biomédica (CIIB), Faculty of Medicine, Universidad de los Andes, Santiago, Chile
| | - Daniel Betancur
- Department of Periodontology, School of Dentistry, Universidad de Concepción, Concepción, Chile
| | - Stephanie Acuña-Gallardo
- Department of Obstetrics and Gynecology, Centro de Investigación e Innovación Biomédica (CIIB), Faculty of Medicine, Universidad de los Andes, Santiago, Chile
| | - Valeria Ramírez
- Department of Statistics and Epidemiology, Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
| | - María José Bendek
- Department of Periodontology, Centro de Investigación e Innovación Biomédica (CIIB), Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
| | - Andrés Pascual
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - José Nart
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Victor Beltrán
- Centre of Investigation and Innovation in Clinical Dentistry, Faculty of Dentistry, Universidad de la Frontera, Temuco, Chile
| | - Antonio Sanz
- Department of Periodontology, Centro de Investigación e Innovación Biomédica (CIIB), Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
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Parvini P, Obreja K, Becker K, Galarraga ME, Schwarz F, Ramanauskaite A. The prevalence of peri-implant disease following immediate implant placement and loading: a cross-sectional analysis after 2 to 10 years. Int J Implant Dent 2020; 6:63. [PMID: 33073302 PMCID: PMC7569077 DOI: 10.1186/s40729-020-00259-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022] Open
Abstract
Background To evaluate the prevalence of peri-implant disease after immediate implant placement and loading. Material and methods This cross-sectional analysis included a total of 47 patients with 64 implants exhibiting a mean loading time of 2 to 10 years (4.23 ± 1.7 years). The surgical and prosthetic procedures were standardized in all patients. Peri-implant health and disease was assessed based on the established case definitions. Results The prevalence of peri-implant health, peri-implant mucositis, and peri-implantitis amounted to 38.3%, 57.5%, and 4.2% of the patients, respectively. Mucosal recession of 1 mm was present at 4 (6%) implants. No suppuration, pain, or implant failures were reported. Ordinal logistic regression revealed that reduced keratinized mucosa height was significantly associated with the diagnosis of peri-implant mucositis and peri-implantitis (OR = 0.514, P = 0.0125). Conclusion Immediate implant placement and loading was associated with high success rates at 2 to 10 years.
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Affiliation(s)
- Puria Parvini
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt am Main, Germany
| | - Karina Obreja
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt am Main, Germany
| | - Kathrin Becker
- Department of Orthodontics, Westdeutsche Kieferklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
| | | | - Frank Schwarz
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt am Main, Germany
| | - Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt am Main, Germany
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Monje A, Vera M, Muñoz-Sanz A, Wang HL, Nart J. Suppuration as diagnostic criterium of peri-implantitis. J Periodontol 2020; 92:216-224. [PMID: 32729628 DOI: 10.1002/jper.20-0159] [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: 03/16/2020] [Revised: 05/17/2020] [Accepted: 05/19/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Suppuration (SUP) as a diagnostic parameter for monitoring dental implants is not yet well understood. The retrospective clinical and radiographic study was therefore performed to investigate the patient, implant, and site characteristics among individuals exhibiting SUP. METHODS Demographic characteristics and clinical parameters were recorded. Radiographic features were analyzed using cone-beam computed tomography. Peri-implantitis was defined based on the consensus report of Workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions: probing depth (PD) ≥6 mm, presence of bleeding and/or SUP on gentle probing, and radiographic marginal bone loss (MBL) ≥3 mm. SUP was graded according to profuseness (dot versus line/drop) and time after probing (≥15 seconds versus <15 seconds after probing versus spontaneous). Simple binary logistic regression models were estimated using generalized estimation equations to explain the probability of SUP based on demographic, clinical, and radiographic variables. RESULTS A total of 111 eligible patients (nimplants = 501) were assessed. Of them, 57 (nimplants = 334) were diagnosed with peri-implantitis according to the established case definition, and of these individuals, 31 (nimplants = 96) presented SUP. Therefore, the prevalence of SUP was 27.92% in the total sample size and 54.38% in peri-implantitis patients. Overall, 28.74% implants displayed SUP within patients with peri-implantitis. SUP was more frequently found at buccal sites (51%) and proved less prevalent at mesio-lingual sites (16.7%). Defect morphology (OR = 6.59; P = 0.004), PD (OR = 1.63; P = 0.024), and MBL (OR = 1.35; P = 0.010) were significantly associated with the presence of SUP. Likewise, defect morphology (P = 0.02), PD (P = 0.003), and MBL (P = 0.01) were significantly correlated with the grade of SUP. CONCLUSION The presence and grade of SUP are associated with peri-implant bone loss, probing depth, and defect morphology in patients with peri-implantitis.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Maria Vera
- Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Agustín Muñoz-Sanz
- Division of Infectious Diseases, Department of Biomedical Sciences, Universidad de Extremadura, Badajoz, Spain
| | - Hom-Lay Wang
- Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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Ravidà A, Siqueira R, Saleh I, Saleh M, Giannobile A, Wang H. Lack of Clinical Benefit of Implantoplasty to Improve Implant Survival Rate. J Dent Res 2020; 99:1348-1355. [DOI: 10.1177/0022034520944158] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The objective of this study was to compare postsurgical outcomes of resective treatment for peri-implantitis with and without implant surface modification (implantoplasty [IP]). This was accomplished by a retrospective analysis with data from patients with ≥1 implant who were surgically treated for peri-implantitis by resective therapy. Patients were divided into 2 groups regarding treatment approach: IP (test) and no IP (control). Retrospective data were obtained after implant placement (T0) and the day of peri-implantitis surgical treatment (T1). Patients were then recalled (≥1 y after T1) for clinical and radiographic examination (T2). The findings were conclusive. A total of 41 patients (68 implants; mean ± SD follow-up, 41.6 ± 24.4 mo) were included in this study. The survival rate at the implant level was 90% in the test group and 81.6% in the control group ( P > 0.05). Multilevel regression analysis showed that the probability of implant failure was influenced by marginal bone loss (MBL) at T1 and not surgical modality. For example, peri-implantitis defects ≥50% and 25% to 50% MBL were 18.6 and 8.86 times more likely to lose the implant, respectively, when compared with <25% MBL. Nonetheless, MBL changes were similar in the test and control groups ( P = 0.592). Similarly, changes in bleeding on probing, probing pocket depth, and suppuration at T2 did not differ between groups ( P > 0.05). Multilevel regression analysis indicated that clinical improvement of these parameters was influenced by the number of supportive peri-implant therapy visits ( P < 0.01). The results demonstrate little difference between the procedures. Regardless of the implant surface modification (IP) being performed or not, the survival rate of implants treated for peri-implantitis was primarily influenced by the amount of bone loss at the time of treatment. Other clinical parameters (MBL, probing pocket depth, bleeding on probing, suppuration) were influenced by the frequency of supportive peri-implant therapy visits and not by the IP procedure (ClinicalTrials.gov NCT04259840).
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Affiliation(s)
- A. Ravidà
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - R. Siqueira
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - I. Saleh
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - M.H.A. Saleh
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
- Department of Periodontics, School of Dentistry, University of Louisville, Louisville, KY, USA
| | - A. Giannobile
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - H.L. Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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25
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Cheng GL, Leblebicioglu B, Li J, Chien HH. Soft tissue healing around platform-switching and platform-matching single implants: A randomized clinical trial. J Periodontol 2020; 91:1609-1620. [PMID: 32474935 DOI: 10.1002/jper.20-0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/16/2020] [Accepted: 04/08/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Implants with platform-switching (PS) design have been demonstrated to reduce marginal bone loss. However, the influence on peri-implant soft tissue healing is unclear. This study was designed to investigate its effect on peri-implant soft tissue healing after implant uncovery. METHODS Non-smokers needing two implants in different quadrants were recruited in this study. For each individual, one PS and one platform-matching (PM) implants were placed using two-stage protocol. Following 2 to 8 months of healing, all implants were uncovered and connected to the corresponding healing abutments. Clinical measurements and peri-implant crevicular fluid (PICF) were taken at 1-, 2-, 4-, and 6-week after 2nd stage surgery. The cytokine concentrations in PICF were analyzed. Peri-implant mucosa (1 × 2 × 2 mm) was harvested around the healing abutment for the analysis of gene expression at uncovery and 6-week post-uncovery. RESULTS Eighteen participants (nine males; 51.7 ± 14.9 years) were recruited. Compared to PM, PS showed significantly lower probing depth (PD) at 1- and 2-week as well as modified sulcus bleeding index (mSBI) at 1-, 4-, and 6-week (P < 0.05). Over time, a decrease in osteoprotegerin and interleukin-1β concentrations in PICF along with an increase in receptor activator of unclear factor kappa-B ligand, periostin, and peroxidasin gene expressions in peri-implant mucosa were noted within both groups (P < 0.05) without significant intergroup differences. CONCLUSION Within the limits, implants with PS design rendered significant benefits over PM design in PD and mSBI reduction during a 6-week healing. However, molecular changes within PICF and peri-implant mucosa as a response to PM and PS appear negligible.
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Affiliation(s)
- Guo-Liang Cheng
- Graduate Periodontics, Department of Oral Health and Rehabilitation, School of Dentistry, University of Louisville, Louisville, Kentucky, USA.,Division of Periodontics, Department of Dentistry, Tri-Service General Hospital, Taipei, Taiwan
| | - Binnaz Leblebicioglu
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Jianrong Li
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Hua-Hong Chien
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
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Ravidà A, Saleh I, Siqueira R, Garaicoa‐Pazmiño C, Saleh MHA, Monje A, Wang H. Influence of keratinized mucosa on the surgical therapeutical outcomes of peri‐implantitis. J Clin Periodontol 2020; 47:529-539. [DOI: 10.1111/jcpe.13250] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/02/2019] [Accepted: 01/04/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Andrea Ravidà
- Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA
| | - Islam Saleh
- Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA
| | - Rafael Siqueira
- Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA
| | - Carlos Garaicoa‐Pazmiño
- Department of Periodontology School of Dentistry Oregon Health & Science University Portland OR USA
| | - Muhammad H. A. Saleh
- Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA
- Department of Periodontics University of Louisville School of Dentistry Louisville KY USA
| | - Alberto Monje
- Department Periodontology Universitat Internacional de Catalunya Barcelona Spain
| | - Hom‐Lay Wang
- Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA
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Electrochemical Disinfection of Dental Implants Experimentally Contaminated with Microorganisms as a Model for Periimplantitis. J Clin Med 2020; 9:jcm9020475. [PMID: 32050444 PMCID: PMC7074531 DOI: 10.3390/jcm9020475] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 12/16/2022] Open
Abstract
Despite several methods having been described for disinfecting implants affected by periimplantitis, none of these are universally effective and may even alter surfaces and mechanical properties of implants. Boron-doped diamond (BDD) electrodes were fabricated from niobium wires and assembled as a single instrument for implant cleaning. Chemo-mechanical debridement and air abrasion were used as control methods. Different mono-species biofilms, formed by bacteria and yeasts, were allowed to develop in rich medium at 37 °C for three days. In addition, natural multi-species biofilms were treated. Implants were placed in silicone, polyurethane foam and bovine ribs for simulating different clinical conditions. Following treatment, the implants were rolled on blood agar plates, which were subsequently incubated at 37 °C and microbial growth was analyzed. Complete electrochemical disinfection of implant surfaces was achieved with a maximum treatment time of 20 min for Candida albicans, Candida dubliniensis, Enterococcus faecalis, Roseomonas mucosa, Staphylococcus epidermidis and Streptococcus sanguinis, while in case of spore-forming Bacillus pumilus and Bacillus subtilis, a number of colonies appeared after BDD electrode treatment indicating an incomplete disinfection. Independent of the species tested, complete disinfection was never achieved when conventional techniques were used. During treatment with BDD electrodes, only minor changes in temperature and pH value were observed. The instrument used here requires optimization so that higher charge quantities can be applied in shorter treatment times.
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Rakic M, Monje A, Radovanovic S, Petkovic‐Curcin A, Vojvodic D, Tatic Z. Is the personalized approach the key to improve clinical diagnosis of peri‐implant conditions? The role of bone markers. J Periodontol 2020; 91:859-869. [DOI: 10.1002/jper.19-0283] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/09/2019] [Accepted: 08/13/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Mia Rakic
- Institute for Biological Research “Sinisa Stankovic”University of Belgrade Belgrade Serbia
- ETEP (Etiology and Therapy of Periodontal Diseases) Research GroupUniversity Complutense of Madrid Madrid Spain
| | - Alberto Monje
- Department of PeriodontologyUniversitat Internacional de Catalunya Barcelona Spain
| | - Sandro Radovanovic
- Faculty of Organizational SciencesUniversity of Belgrade Belgrade Serbia
| | | | - Danilo Vojvodic
- Institute for Medical ResearchMilitary Medical Academy Belgrade Serbia
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Is Peri-Implant Probing Causing Over-Diagnosis and Over-Treatment of Dental Implants? J Clin Med 2019; 8:jcm8081123. [PMID: 31362381 PMCID: PMC6722911 DOI: 10.3390/jcm8081123] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 07/19/2019] [Accepted: 07/25/2019] [Indexed: 12/23/2022] Open
Abstract
Pocket probing depth (PPD) and bleeding on probing (BOP) measurements are useful indices for the assessment of periodontal conditions. The same periodontal indices are commonly recommended to evaluate the dental implant/tissue interface to identify sites with mucositis and peri-implantitis, which, if not treated, are anticipated to lead to implant failure. The aim of the present narrative review is to discuss the available literature on the effectiveness of probing at dental implants for identification of peri-implant pathology. There is substantial clinical evidence that PPD and BOP measurements are very poor indices of peri-implant tissue conditions and are questionable surrogate endpoints for implant failure. On the contrary, the literature suggests that frequent disturbance of the soft tissue barrier at implants may instead induce inflammation and bone resorption. Moreover, over-diagnosis and subsequent unnecessary treatment may lead to iatrogenic damage to the implant-tissue interface. Despite this, the recommendations from recent consensus meetings are still promoting the use of probing at dental implants. For evaluation of implants, for instance at annual check-ups, the present authors recommend a clinical examination that includes (i) a visual inspection of the peri-implant tissues for the assessment of oral hygiene and the detection of potential redness, swelling, (ii) palpation of the peri-implant tissues for assessment of the potential presence of swelling, bleeding, suppuration. In addition, (iii) radiography is recommended for the assessment of crestal bone level for comparison with previous radiographs to evaluate potential progressive bone loss even if there is a need for more scientific evidence of the true value of the first two clinical testing modes.
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Faggion CM. Laser Therapy as an Adjunct Treatment for Peri-Implant Mucositis and Peri-Implantitis Provides No Extra Benefit for Most Clinical Outcomes. J Evid Based Dent Pract 2019; 19:203-206. [DOI: 10.1016/j.jebdp.2019.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Monje A, Insua A, Wang HL. Understanding Peri-Implantitis as a Plaque-Associated and Site-Specific Entity: On the Local Predisposing Factors. J Clin Med 2019; 8:E279. [PMID: 30823574 PMCID: PMC6406659 DOI: 10.3390/jcm8020279] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 12/22/2022] Open
Abstract
The prevalence of implant biological complications has grown enormously over the last decade, in concordance with the impact of biofilm and its byproducts upon disease development. Deleterious habits and systemic conditions have been regarded as risk factors for peri-implantitis. However, little is known about the influence of local confounders upon the onset and progression of the disease. The present narrative review therefore describes the emerging local predisposing factors that place dental implants/patients at risk of developing peri-implantitis. A review is also made of the triggering factors capable of inducing peri-implantitis and of the accelerating factors capable of interfering with the progression of the disease.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, 08195 Barcelona, Spain.
- Division of Periodontics, CICOM Periodoncia, 06011 Badajoz, Badajoz, Spain Santiago de Compostela, Spain.
| | - Angel Insua
- Division of Periodontics, CICOM Periodoncia, 06011 Badajoz, Badajoz, Spain Santiago de Compostela, Spain.
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA.
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Monje A, Insua A, Rakic M, Nart J, Moyano-Cuevas JL, Wang HL. Estimation of the diagnostic accuracy of clinical parameters for monitoring peri-implantitis progression: An experimental canine study. J Periodontol 2018; 89:1442-1451. [DOI: 10.1002/jper.18-0081] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/24/2018] [Accepted: 05/29/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Alberto Monje
- Department of Oral Surgery and Stomatology; ZMK School of Dentistry; Bern Switzerland
- Department of Periodontology; International University of Catalonia; Barcelona Spain
| | - Angel Insua
- Department of Oral Surgery and Implantology; University of Santiago de Compostela; Santiago de Compostela Spain
| | - Mia Rakic
- INSERM UMR-1229 RMeS, Faculty of Dental Surgery, University of Nantes, Nantes, France. Institute for Biological Research “Sinisa Stankovic,”; University of Belgrade; Belgrade Serbia
| | - Jose Nart
- Department of Periodontology; International University of Catalonia; Barcelona Spain
| | - Jose Luis Moyano-Cuevas
- Bioengineering and Health Technologies Unit; Jesús Uson Minimally Invasive Surgery Center; Cáceres Spain
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor MI
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