1
|
Hart I, Wells C, Tsigarida A, Bezerra B. Effectiveness of mechanical and chemical decontamination methods for the treatment of dental implant surfaces affected by peri-implantitis: A systematic review and meta-analysis. Clin Exp Dent Res 2024; 10:e839. [PMID: 38345466 PMCID: PMC10847712 DOI: 10.1002/cre2.839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 12/20/2023] [Accepted: 12/30/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE To assess which decontamination method(s) used for the debridement of titanium surfaces (disks and dental implants) contaminated with bacterial, most efficiently eliminate bacterial biofilms. MATERIAL AND METHODS A systematic search was conducted in four electronic databases between January 1, 2010 and October 31, 2022. The search strategy followed the PICOS format and included only in vitro studies completed on either dental implant or titanium disk samples. The assessed outcome variable consisted of the most effective method(s)-chemical or mechanical- removing bacterial biofilm from titanium surfaces. A meta-analysis was conducted, and data was summarized through single- and multi-level random effects model (p < .05). RESULTS The initial search resulted in 5260 articles after the removal of duplicates. After assessment by title, abstract, and full-text review, a total of 13 articles met the inclusion criteria for this review. Different decontamination methods were assessed, including both mechanical and chemical, with the most common method across studies being chlorhexidine (CHX). Significant heterogeneity was noted across the included studies. The meta-analyses only identified a significant difference in biofilm reduction when CHX treatment was compared against PBS. The remaining comparisons did not identify significant differences between the various decontamination methods. CONCLUSIONS The present results do not demonstrate that one method of decontamination is superior in eliminating bacterial biofilm from titanium disk and implant surfaces.
Collapse
Affiliation(s)
- Iain Hart
- Department of Periodontology, Eastman Institute for Oral HealthUniversity of RochesterRochesterNew YorkUSA
| | - Christine Wells
- Statistical Methods and Data AnalyticsUCLA Office of Advanced Research ComputingLos AngelesCaliforniaUSA
| | - Alexandra Tsigarida
- Department of Periodontology, Eastman Institute for Oral HealthUniversity of RochesterRochesterNew YorkUSA
| | - Beatriz Bezerra
- Section of Periodontics, Division of Regenerative and Reconstructive SciencesUCLA School of DentistryLos AngelesCaliforniaUSA
| |
Collapse
|
2
|
Revisiting Periodontal Disease in Dogs: How to Manage This New Old Problem? Antibiotics (Basel) 2022; 11:antibiotics11121729. [PMID: 36551385 PMCID: PMC9774197 DOI: 10.3390/antibiotics11121729] [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: 11/10/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/04/2022] Open
Abstract
Periodontal disease (PD) is one of the most prevalent oral inflammatory diseases in dogs. PD onset begins with the formation of a polymicrobial biofilm (dental plaque) on the surface of the teeth, followed by a local host inflammatory response. To manage this disease, several procedures focusing on the prevention and control of dental plaque establishment, as well as on the prevention of local and systemic PD-related consequences, are essential. The removal of dental plaque and the inhibition of its formation can be achieved by a combination of dental hygiene homecare procedures including tooth brushing, the application of different oral products and the use of specific diet and chew toys, and regular professional periodontal procedures. Additionally, in some cases, periodontal surgery may be required to reduce PD progression. Associated with these measures, host modulation therapy, antimicrobial therapy, and other innovative therapeutic options may be useful in PD management. Moreover, PD high prevalence and its relation with potential local and systemic consequences reinforce the need for investment in the development of new preventive measures, treatments, and oral procedures to improve the control of this disease in dogs. Knowledge on the specific guidelines and diversity of the available products and procedures are fundamental to apply the most adequate treatment to each dog with PD.
Collapse
|
3
|
The benefit of antimicrobial photodynamic therapy to mechanical debridement in the treatment of smokers with peri-implant diseases: a systematic review and meta-analysis. Lasers Med Sci 2022; 37:3051-3066. [PMID: 35896900 DOI: 10.1007/s10103-022-03592-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 06/09/2022] [Indexed: 10/16/2022]
Abstract
Antimicrobial photodynamic therapy (aPDT) has been proposed as an adjunctive treatment strategy for peri-implant diseases. This systematic review aimed to determine whether aPDT as an adjunct to mechanical debridement has an additional benefit for smokers with peri-implant diseases. Randomized controlled trials (RCTs), which evaluated the clinical outcomes of mechanical debridement alone versus mechanical debridement + aPDT among smokers, were considered eligible to be included. The primary outcome was bleeding on probing (BOP) and secondary outcomes included probing depth (PD), plaque index (PI), and crestal bone loss (CBL). Meta-analyses using a random-effects model were conducted to calculate the mean difference (MD) with a 95% confidence interval (CI). The quality of evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation (GRADE). A total of four RCTs (188 participants) were included. The aPDT group showed significantly improved PD (MD = - 1.26, 95% CI = - 2.19 to - 0.32, p = 0.008) and PI (MD = - 10.6%, 95% CI = - 14.46 to - 6.74%, p = 0.0001) compared with mechanical debridement group at 3-month follow-up. No significant difference in bleeding on probing (BOP) was observed at 3-month follow-up (MD = - 0.60%, 95% CI = - 2.36 to 1.16%, p = 0.50). The subgroup analyses on photosensitizers demonstrated significant differences between the two groups on PD (MD = - 1.23, 95% CI = - 2.41 to - 0.05, p = 0.04) and PI (MD = - 12.33, 95% CI = - 14.74 to - 9.92, p < 0.00001) by the use of methylene blue (MB). Within the limitation of this study, compared with mechanical debridement alone, combined use of aPDT was more effective in reducing PD and PI in smokers at 3-month follow-up. MB was a predictable photosensitizer for aPDT. However, the findings should be interpreted with caution due to the limited number of included studies, methodological deficiencies, and heterogeneity between studies.
Collapse
|
4
|
Choe R, Balhaddad AA, Fisher JP, Melo MAS, Huang HC. Photodynamic Therapy for Biomodulation and Disinfection in Implant Dentistry: Is It Feasible and Effective? Photochem Photobiol 2021; 97:916-929. [PMID: 33876438 DOI: 10.1111/php.13434] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/11/2021] [Accepted: 04/13/2021] [Indexed: 12/17/2022]
Abstract
Dental implants are the most common rehabilitation and restorative treatment used to replace missing teeth. Biofilms adhere to implant surfaces to trigger implant-associated infection and inflammatory response. Clinically, the biofilm induces a local host response with the infiltration of phagocytic immune cells. The pro-inflammatory surroundings set off osteoclastogenesis, which leads to the septic loosening of the implant. The standard of dental care for implant-associated infection relies on a combination of surgery and antimicrobial therapy. Antimicrobial photodynamic therapy is a noninvasive and photochemistry-based approach capable of reducing bacterial load and modulating inflammatory responses. In this review, we explore the photobiomodulation and disinfection outcomes promoted by photodynamic therapy for implant infections, highlighting the quality of evidence on the most up-to-date studies, and discuss the major challenges on the advance of these therapeutic strategies.
Collapse
Affiliation(s)
- Robert Choe
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, USA.,Center for Engineering Complex Tissues, University of Maryland, College Park, MD, USA
| | - Abdulrahman A Balhaddad
- Dental Biomedical Sciences Ph.D. Program, University of Maryland School of Dentistry, Baltimore, MD, USA.,Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - John P Fisher
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, USA.,Center for Engineering Complex Tissues, University of Maryland, College Park, MD, USA
| | - Mary Anne S Melo
- Dental Biomedical Sciences Ph.D. Program, University of Maryland School of Dentistry, Baltimore, MD, USA.,Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Huang-Chiao Huang
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, USA.,Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| |
Collapse
|
5
|
Rojas-Paulús JE, Manfredi GGP, Salmeron S, Consolaro A, Sant'Ana ACP, Zangrando MSR, Damante CA, Greghi SLA, Rezende MLR. Citric acid, but not tetracycline, improves the microscopic pattern of healing of particulate autogenous bone grafts in critical-size defects. J Periodontol 2020; 92:678-688. [PMID: 32902871 DOI: 10.1002/jper.20-0363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/24/2020] [Accepted: 08/14/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Bone demineralization has shown to be advantageous in autogenous onlay bone grafts and in pre-osteoblasts cultures, but such procedure has never been evaluated in particulate bone grafts. This study aimed to investigate the role of two demineralizing agents in the repair of the 8-mm critical-size defects in rats' calvaria. METHODS Eighty adult male Wistar rats were randomly assigned to one of eight groups as follows: particulate autogenous bone demineralized with citric acid for 15 seconds (CA15), 30 seconds (CA30), or 60 seconds (CA60); particulate autogenous bone demineralized with tetracycline hydrochloride for 15 seconds (TCN15), 30 seconds (TCN30), or 60 seconds (TCN60); blood clot (NC), and non-demineralized autogenous bone (PC). The calvariae were harvested at 30 and 60 postoperative days (n = 5) for blinded histological and histometric analysis of the percentage area of newly formed bone within the defects. RESULTS In the NC and TCN groups, bone formation was limited to the margins of the defects at 30 postoperative days, whereas complete closure was present in all the specimens from CA15 group. Both at 30 and 60 postoperative days, histomorphometry showed significant higher area of newly formed bone in specimens demineralized with CA than in those demineralized with TCN or non-demineralized (P < 0.05). TCN appeared to impair bone neoformation, as its use produced similar or inferior results compared to blood clot. CONCLUSIONS Demineralization of particulate bone grafts with CA during 15s enhanced the regeneration of critical-size defects and may be a promising adjuvant in regenerative procedures. TCN seems to be improper for this purpose.
Collapse
Affiliation(s)
- Jefrey E Rojas-Paulús
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Gustavo G P Manfredi
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Samira Salmeron
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Alberto Consolaro
- Department of Stomatology, Division of Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Adriana C P Sant'Ana
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Mariana S R Zangrando
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Carla A Damante
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Sebastião L A Greghi
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Maria L R Rezende
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| |
Collapse
|
6
|
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.
Collapse
|
7
|
Göltz M, Koch M, Detsch R, Karl M, Burkovski A, Rosiwal S. Influence of In-Situ Electrochemical Oxidation on Implant Surface and Colonizing Microorganisms Evaluated by Scanning Electron Microscopy. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E3977. [PMID: 31801251 PMCID: PMC6926823 DOI: 10.3390/ma12233977] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 11/22/2019] [Accepted: 11/28/2019] [Indexed: 02/07/2023]
Abstract
Peri-implantitis is a worldwide increasing health problem, caused by infection of tissue and bone around an implant by biofilm-forming microorganisms. Effects of peri-implantitis treatment using mechanical debridement, air particle abrasion and electrochemical disinfection on implant surface integrity were compared. Dental implants covered with bacterial biofilm were cleaned using mechanical debridement and air particle abrasion. In addition, implants were disinfected using a novel electrochemical technique based on an array of boron-doped diamond (BDD) coated electrodes. Following treatment and preparation, the implants were inspected by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX). Mechanical debridement led to changes in surface topography destroying the manufacturer's medium-rough surface by scratch formation. Air particle abrasion led to accumulation of the abrasive used on the implant surface. With both treatment options, appearance of bacteria and yeasts was not affected. In contrast, electrochemical disinfection did not cause alterations of the implant surface but resulted in distorted microbial cells. Electrochemical disinfection of implant surfaces using BDD electrodes may constitute a promising treatment option for cleaning dental implant surfaces without negatively affecting materials and surface properties.
Collapse
Affiliation(s)
- Maximilian Göltz
- Division of Ultra-Hard Coatings, Department of Material Sciences, University of Erlangen-Nuremberg, 91058 Erlangen, Germany; (M.G.); (S.R.)
| | - Maximilian Koch
- Microbiology Division, Department of Biology, University of Erlangen-Nuremberg, 91058 Erlangen, Germany; (M.K.); (A.B.)
| | - Rainer Detsch
- Institute of Biomaterials, Department of Material Sciences, University of Erlangen-Nuremberg, 91058 Erlangen, Germany;
| | - Matthias Karl
- Department of Prosthodontics, Saarland University, 66424 Homburg/Saar, Germany
| | - Andreas Burkovski
- Microbiology Division, Department of Biology, University of Erlangen-Nuremberg, 91058 Erlangen, Germany; (M.K.); (A.B.)
| | - Stefan Rosiwal
- Division of Ultra-Hard Coatings, Department of Material Sciences, University of Erlangen-Nuremberg, 91058 Erlangen, Germany; (M.G.); (S.R.)
| |
Collapse
|
8
|
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
|