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Cabanes-Gumbau G, Padulles-Roig E, Kois JC, Revilla-León M. Implant-supported prostheses following the biologically oriented preparation technique (BOPT) after implantoplasty procedures: A dental technique. J Prosthet Dent 2024:S0022-3913(24)00376-7. [PMID: 39004573 DOI: 10.1016/j.prosdent.2024.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 07/16/2024]
Abstract
Esthetic concerns may appear on implant-supported prostheses after peri-implantitis treatment, such as implantoplasty procedures that includes the thread removal and surface smoothening. A technique for restoring implants that have been treated for peri-implantitis using an implantoplasty procedure combined with the detoxification of the implant surfaces is described. The technique involves the fabrication of an implant-supported prosthesis following the biologically oriented preparation technique (BOPT) and aims to solve esthetic complications after this peri-implantitis treatment approach.
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Affiliation(s)
- Guillermo Cabanes-Gumbau
- Co-Director, Program in Pathology in Implant Dentistry, Implantology Department, La Salle University, EDE Formación, Madrid, Spain; and Private practice, Vila Real, Spain
| | - Esteban Padulles-Roig
- Co-Director, Program in Pathology in Implant Dentistry, Implantology Department, La Salle University, EDE Formación, Madrid, Spain
| | - John C Kois
- Founder and Director, Kois Center, Seattle, Wash.; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, Wash.; and Private practice, Seattle, Wash
| | - Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash.; Faculty and Director, Research and Digital Dentistry, Kois Center, Seattle, Wash.; and Adjunct Professor, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass.
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2
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Monje A, Salvi GE. Diagnostic methods/parameters to monitor peri-implant conditions. Periodontol 2000 2024. [PMID: 38923148 DOI: 10.1111/prd.12584] [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: 02/06/2024] [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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Apaza-Bedoya K, Galarraga-Vinueza ME, Correa BB, Schwarz F, Bianchini MA, Magalhães Benfatti CA. Prevalence, risk indicators, and clinical characteristics of peri-implant mucositis and peri-implantitis for an internal conical connection implant system: A multicenter cross-sectional study. J Periodontol 2024; 95:582-593. [PMID: 37846763 DOI: 10.1002/jper.23-0355] [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: 06/28/2023] [Revised: 09/02/2023] [Accepted: 09/04/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Peri-implant disease prevalence is associated with a multifactorial etiology and distinct clinical characteristics of inflammation. METHODS The present study aimed to assess the prevalence of peri-implant diseases, identify related risk indicators, and associate specific clinical characteristics to peri-implant biological complications in the medium term. Peri-implant diseases were classified according to established case criteria. Patients' data, implant and/or prosthetic features, and maintenance records were collected. Clinical characteristics such as bleeding on probing (BOP), suppuration (SUPP), keratinized mucosa (KM), probing depth (PD), marginal recession (MR), and modified plaque index (mPI) were recorded. RESULTS Ninety-nine patients with 266 implants with a mean functional duration of 30.26 months were evaluated. Peri-implant mucositis and peri-implantitis prevalence totaled to 49.5% and 15.15% (patient level), respectively. Peri-implant mucositis was associated with osteoporosis (odds ratio [OR] 6.09), age (OR 0.97), diabetes mellitus (OR 3.09), cemented-retained prosthesis (OR 3.81), and partial prosthesis (OR 2.21). Peri-implantitis was associated with osteoporosis (OR 7.74) and periodontitis (OR 2.74), cemented prosthesis (OR 10.12), partial and full arch prostheses (OR 12.35 and 19.86), implant diameter (OR 3.64), abutment transmucosal height (OR 3.39), and hygiene difficulty (OR 3.14). Furthermore, mPI score 3 (OR 3.27) and PD scores (OR 1.64) were associated with peri-implant mucositis, while mPI score 3 (OR 16.42), KM (OR 1.53), PD (OR 1.81), MR (OR 2.61), and the relationship between KM and PD (OR 0.63) were associated with peri-implantitis. CONCLUSION In the medium term, peri-implant diseases were correlated with factors inherent to the patient's conditions, presurgical treatment plan, and hygiene maintenance care. The knowledge of the mentioned factors and featured clinical characteristics can be crucial for disease prevention and establishment of a superior implant therapy prognosis.
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Affiliation(s)
- Karin Apaza-Bedoya
- Department of Dentistry, Center for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina (UFSC), Florianopolis, Brazil
| | - Maria Elisa Galarraga-Vinueza
- School of Dentistry, Universidad de las Americas (UDLA), Quito, Ecuador
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Bruna Barbosa Correa
- Department of Dentistry, Center for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina (UFSC), Florianopolis, Brazil
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Marco Aurélio Bianchini
- Department of Dentistry, Center for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina (UFSC), Florianopolis, Brazil
| | - Cesar Augusto Magalhães Benfatti
- Department of Dentistry, Center for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina (UFSC), Florianopolis, Brazil
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Monje A, Pons R, Nart J, Miron RJ, Schwarz F, Sculean A. Selecting biomaterials in the reconstructive therapy of peri-implantitis. Periodontol 2000 2024; 94:192-212. [PMID: 37728141 DOI: 10.1111/prd.12523] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/28/2023] [Accepted: 08/21/2023] [Indexed: 09/21/2023]
Abstract
Peri-implantitis is a pathogenic inflammatory condition characterized by progressive bone loss and clinical inflammation that may compromise the stability of dental implants. Therapeutic modalities have been advocated to arrest the disorder and to establish peri-implant health. Reconstructive therapy is indicated for bone defects exhibiting contained/angular components. This therapeutic modality is based upon the application of the biological and technical principles of periodontal regeneration. Nonetheless, the comparative efficacy of reconstructive therapy and nonreconstructive modalities remains unclear. Therefore, the aim of this narrative review is to address major clinical concerns regarding the efficacy, effectiveness, and feasibility of using biomaterials in peri-implantitis therapy. In particular, the use of bone grafting materials, barrier membranes, and biologics is comprehensively explored.
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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
| | - Ramón Pons
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt, Germany
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
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Cosgarea R, Roccuzzo A, Jepsen K, Sculean A, Jepsen S, Salvi GE. Efficacy of mechanical/physical approaches for implant surface decontamination in non-surgical submarginal instrumentation of peri-implantitis. A systematic review. J Clin Periodontol 2023; 50 Suppl 26:188-211. [PMID: 36550060 DOI: 10.1111/jcpe.13762] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/02/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
AIM To evaluate the efficacy of non-surgical submarginal peri-implant instrumentation with mechanical/physical decontamination compared to non-surgical submarginal instrumentation alone or with placebo decontamination in patients with peri-implantitis. MATERIALS AND METHODS Three focused questions were addressed, and a systematic search for randomized controlled clinical trials (RCTs), controlled clinical trials, and prospective cohort studies with definitions of peri-implantitis and a minimal follow-up of 6 months was conducted. The main outcome variables were reduction in pocket probing depth (PD) and bleeding on probing (BOP). Suppuration on probing, marginal peri-implant bone level changes, patient-related outcomes and adverse events, implant survival, treatment success, and disease resolution were assessed as secondary outcomes. RESULTS Out of 239 findings, full-text articles were assessed for eligibility, and 9 (n = 9 RCTs) were included in the present review. Five studies evaluated the effects of various laser types, and in four studies efficacy of air-abrasive mechanisms and of a novel ultrasonic device was determined. At 6 months, PD reductions were observed in nine studies but only Er, Cr:YSGG laser-treated group showed statistically significant higher reductions compared to the control group. BOP was statistically significantly reduced at 6 months in two studies following the application of Er:YAG laser compared to controls. One study reported statistically significant reduction in BOP following application of air-polishing device compared to control treatment. No statistically significant differences between treatment groups were reported for the secondary outcome variables. Owing to the large heterogeneity of study designs, no meta-analysis was performed. CONCLUSIONS Available evidence on the efficacy of non-surgical submarginal peri-implant instrumentation with mechanical/physical decontamination is limited by the small number of controlled studies and the high heterogeneity of study protocols. Clinical and patient-reported benefits remain to be demonstrated.
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Affiliation(s)
- Raluca Cosgarea
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
- Department of Periodontology and Peri-implant Diseases, University of Marburg, Marburg, Germany
- School of Dental Medicine, University Iuliu-Hatieganu, Cluj-Napoca, Romania
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Karin Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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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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Gulati K, Ding C, Guo T, Guo H, Yu H, Liu Y. Craniofacial therapy: advanced local therapies from nano-engineered titanium implants to treat craniofacial conditions. Int J Oral Sci 2023; 15:15. [PMID: 36977679 PMCID: PMC10050545 DOI: 10.1038/s41368-023-00220-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/05/2023] [Accepted: 02/28/2023] [Indexed: 03/30/2023] Open
Abstract
Nano-engineering-based tissue regeneration and local therapeutic delivery strategies show significant potential to reduce the health and economic burden associated with craniofacial defects, including traumas and tumours. Critical to the success of such nano-engineered non-resorbable craniofacial implants include load-bearing functioning and survival in complex local trauma conditions. Further, race to invade between multiple cells and pathogens is an important criterion that dictates the fate of the implant. In this pioneering review, we compare the therapeutic efficacy of nano-engineered titanium-based craniofacial implants towards maximised local therapy addressing bone formation/resorption, soft-tissue integration, bacterial infection and cancers/tumours. We present the various strategies to engineer titanium-based craniofacial implants in the macro-, micro- and nano-scales, using topographical, chemical, electrochemical, biological and therapeutic modifications. A particular focus is electrochemically anodised titanium implants with controlled nanotopographies that enable tailored and enhanced bioactivity and local therapeutic release. Next, we review the clinical translation challenges associated with such implants. This review will inform the readers of the latest developments and challenges related to therapeutic nano-engineered craniofacial implants.
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Affiliation(s)
- Karan Gulati
- The University of Queensland, School of Dentistry, Herston, QLD, Australia
| | - Chengye Ding
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Tianqi Guo
- The University of Queensland, School of Dentistry, Herston, QLD, Australia
| | - Houzuo Guo
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huajie Yu
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
- Fourth Clinical Division, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Yan Liu
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
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8
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Monje A, Pons R, Vilarrasa J, Nart J, Wang HL. Significance of barrier membrane on the reconstructive therapy of peri-implantitis: A randomized controlled trial. J Periodontol 2022; 94:323-335. [PMID: 36399349 DOI: 10.1002/jper.22-0511] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND The objective of this trial was to investigate the clinical and radiographic significance of using a mixture of mineralized and demineralized allografts in combination (M) or not (NM) with a resorbable cross-linked barrier membrane in the reconstructive therapy of peri-implantitis defects. METHODS A two-arm randomized clinical trial was performed in patients diagnosed with peri-implantitis that exhibited contained defects. Clinical parameters were recorded at baseline (T0 ), 6 months (T1 ), and 12 months (T2 ). Radiographic parameters were recorded at T0 and T2 . A composite criterion for disease resolution was defined a priori. A generalized linear model of repeated measures with generalized estimation equation statistical methods was used. RESULTS Overall, 33 patients (nimplants = 48) completed the study. At T2 , mean disease resolution was 77.1%. The use of a barrier membrane did not enhance the probability of disease resolution at T2 (odds ratio [OR] = 1.55, p = 0.737). Conversely, the odds of disease resolution were statistically associated with the modified plaque index recorded at T0 (OR = 0.13, p = 0.006) and keratinized mucosa width (OR = 2.10, p = 0.035). Moreover, women exhibited greater odds to show disease resolution (OR = 5.56, p = 0.02). CONCLUSION Reconstructive therapy by means of a mixture of mineralized and demineralized allografts is effective in clinically resolving peri-implantitis and in gaining radiographic marginal bone level. The addition of a barrier membrane to reconstructive therapy of peri-implantitis does not seem to enhance the outcomes of contained bone defects (NCT05282667).
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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 Stomatology and Oral Surgery, University of Bern, Bern, Switzerland
| | - Ramón Pons
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Javi Vilarrasa
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Hom-Lay Wang
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Das D, Shenoy N. Peri-Implant Diseases. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2021. [DOI: 10.1055/s-0041-1736452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AbstractOsseointegrated dental implants have become an increasingly popular modality of treatment for the replacement of absent or lost teeth because of its high rates of long-term survival when used to support various types of dental prostheses. However, complications and implant failure can still occur and are considered by many clinicians as a major obstacle for implant treatment. Biological complications mainly refer to inflammatory conditions of the soft tissues and bone surrounding implants and their restorative components, which are induced by the accumulation of bacterial biofilm. Two clinical varieties may be distinguished: peri-implant mucositis and peri-implantitis. Peri-implant mucositis is a reversible, plaque-induced inflammatory lesion confined to the peri-implant soft tissue unit, whereas peri-implantitis is an extension of peri-implant mucositis to involve the bone supporting the implant. Diagnosing and managing these biological complications is of utmost importance for the implant surgeon and dental practitioner. This review encompasses the etiology, diagnostic aspects, prevention, and management of biological complications.
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Affiliation(s)
- Dipanjan Das
- Department of Periodontics, AB Shetty Memorial Institute of Dental Sciences, Nitte (deemed to be) University, Derlakatte, Mangalore, India
| | - Nina Shenoy
- Department of Periodontics, AB Shetty Memorial Institute of Dental Sciences, Nitte (deemed to be) University, Derlakatte, Mangalore, India
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Milinkovic I, Djinic Krasavcevic A, Nikolic N, Aleksic Z, Carkic J, Jezdic M, Jankovic S, Milasin J. Notch down-regulation and inflammatory cytokines and RANKL overexpression involvement in peri-implant mucositis and peri-implantitis: A cross-sectional study. Clin Oral Implants Res 2021; 32:1496-1505. [PMID: 34546593 DOI: 10.1111/clr.13850] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/01/2021] [Accepted: 07/07/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Notch signaling pathway, known to influence bone resorption in several oral diseases, has not been analyzed in peri-implantitis yet. Therefore, the aims of the present study were to determine the levels of Notch cascade, bone remodeling mediators, and pro-inflammatory cytokines, in conjunction with clinical parameters, in subjects with peri-implant mucositis and peri-implantitis. MATERIAL AND METHODS Clinical parameters: peri-implant probing depth, bleeding on probing, suppuration on probing, and plaque index (PI) were recorded. Samples were collected from 130 participants, divided into peri-implantitis (PI), peri-implant mucositis (PM), and healthy implants (HI) group. Relative expression levels (REL) of Notch 1, Notch 2, Jagged 1, Hes 1, Hey 1, TNF-α, IL-17, IL-1β, IL-6, RANKL, and OPG mRNA were determined by reverse transcriptase-real-time polymerase chain reaction. Quantitation of Notch 1, Il-17, and IL-6 proteins was performed using ELISA assays. RESULTS All clinical parameters were significantly higher in PI compared to HI. Significant decrease of Notch 1, and higher REL of Hey 1, IL-1β, IL-6, and RANKL were found in PI compared to HI. PM showed significant increase of IL-1β REL in comparison with HI. In PI versus PM, significantly higher REL was found for Hey 1, TNF-α, IL-17, IL-1β, IL-6, and RANKL. Additionally, higher protein concentrations of IL-6 and IL-17 were detected in PI versus PM and versus HI group. CONCLUSION The combined effect of Notch 1 down-regulation and elevated expression of some key inflammation modulators might result in osteoclast activity increase and subsequent osteolysis in peri-implantitis.
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Affiliation(s)
- Iva Milinkovic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Ana Djinic Krasavcevic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Nadja Nikolic
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Zoran Aleksic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Carkic
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Jezdic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Sasha Jankovic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Milasin
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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11
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Qi Y, Li C, Du Y, Lin J, Li N, Yu Y. Chemokine Receptor 2 (CXCR2) Gene Polymorphisms and Their Association with the Risk of Developing Peri-Implantitis in Chinese Han Population. J Inflamm Res 2021; 14:1625-1631. [PMID: 33935510 PMCID: PMC8079253 DOI: 10.2147/jir.s304261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/11/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose This study aimed to investigate the role of chemokine receptor 2 (CXCR2) gene polymorphisms in peri-implantitis susceptibility in a Chinese Han population. Patients and Methods A total of 260 individuals were included in this study, including 127 peri-implantitis patients and 133 healthy implants. CXCR2 gene rs2230054 and rs1126580 polymorphisms in different groups were analyzed by the Chi-square test. The odds ratios (ORs) and 95% confidence intervals (95% CIs) were employed to evaluate the association between CXCR2 polymorphism and peri-implantitis susceptibility. Results The CT genotype of rs2230054 and the AG genotype and G allele of rs1126580 significantly increased in peri-implantitis patients compared with healthy implants (P < 0.05). The CT genotype of rs2230054 (OR = 1.825, 95% CI = 1.028–3.239) and the AG genotype of rs1126580 (OR = 2.223, 95% CI 1.272–3.885) carriers had a high risk to infect with peri-implantitis. Additionally, these CXCR2 gene polymorphisms have been revealed to be associated with the periodontal status of peri-implantitis patients. Conclusion The CXCR2 gene rs2230054 and rs1126580 polymorphisms were associated with the peri-implantitis susceptibility in the Chinese Han population. The CT genotype of rs2230054 and the AG genotype and G allele of rs1126580 serve as risk factors for the occurrence of peri-implantitis.
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Affiliation(s)
- Yuesun Qi
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.,Department of Stomatology, Jinshan Hospital, Fudan University, Shanghai, 200540, People's Republic of China
| | - Cheng Li
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.,Department of Stomatology, Jing'an District Institute of Dental Diseases, Shanghai, 200040, People's Republic of China
| | - Yimin Du
- Department of Stomatology, Jinshan Hospital, Fudan University, Shanghai, 200540, People's Republic of China
| | - Jichao Lin
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Nan Li
- Department of Stomatology, Jinshan Hospital, Fudan University, Shanghai, 200540, People's Republic of China
| | - Youcheng Yu
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
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12
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Monje A, Pons R, Amerio E, Wang HL, Nart J. Resolution of peri-implantitis by means of implantoplasty as adjunct to surgical therapy: A retrospective study. J Periodontol 2021; 93:110-122. [PMID: 33904175 DOI: 10.1002/jper.21-0103] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/08/2021] [Accepted: 04/18/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is a paucity of data on the effectiveness of implantoplasty as adjunct to the surgical management of peri-implantitis. PURPOSE To evaluate the resolution of peri-implantitis by means of implantoplasty as adjunct to surgical resective (RES) and reconstructive (REC) therapies and supportive maintenance. METHODS Patients that underwent surgical therapy to manage peri-implantitis with a follow-up of ≥12 months and enrolled in a regular peri-implant supportive care were recruited. RES group consisted of two interventions that included osseous recontouring and apically position flap (APF) and soft tissue conditioning (STC). REC was performed in the infra-osseous compartment of combined defects. Implant survival rate was recorded. Clinical and radiographic parameters were evaluated to define a "dogmatic" (case definition #1) and a "flexible" (case definition #2) therapeutic success. Univariate and multivariate multilevel backward logistic regression were applied for statistical analysis. RESULTS Overall, 43 patients (nimplants = 135) were retrospectively assessed. Mean observational period was ∼24 months. Implant survival rate was 97.8%, being significantly higher for APF, STC, and APF + STC (RES) when compared with REC (P = 0.01) therapy, in particular for advanced lesions (>50% of bone loss). The overall therapeutic success rate at implant-level was 66% and 79.5% for case definition #1 and #2, respectively. APF group displayed more efficient disease resolution when considered success definition #1 (72%). Contrarily, when the data were adhered to success definition #2, STC group showed a slightly higher disease resolution rate (87%). For RES group, location, favoring anterior (P = 0.04) and defect type, favoring class II (P = 0.02) displayed statistical significance for therapeutic success. For REC group, implants exhibiting a wider band of keratinized mucosa (KM) demonstrated higher therapeutic success (P = 0.008). CONCLUSION Implantoplasty as an adjunct to surgical therapy proved effective in terms of disease resolution and implant survival rate. Implant location, defect morphology as well as the buccal width of KM are indicators of therapeutic success.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology, Universidad Internacional de Catalunya, Barcelona, Spain.,Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, MI.,Private practice, Division of Periodontics, Centro de Implantología Cirugía Oral y Maxilofacial (CICOM), Badajoz, Spain
| | - Ramón Pons
- Department of Periodontology, Universidad Internacional de Catalunya, Barcelona, Spain
| | - Ettore Amerio
- Department of Periodontology, Universidad Internacional de Catalunya, Barcelona, Spain
| | - Hom-Lay Wang
- Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, MI
| | - José Nart
- Department of Periodontology, Universidad Internacional de Catalunya, Barcelona, Spain
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13
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Dukka H, Saleh MHA, Ravidà A, Greenwell H, Wang HL. Is bleeding on probing a reliable clinical indicator of peri-implant diseases? J Periodontol 2021; 92:1669-1674. [PMID: 33829501 DOI: 10.1002/jper.20-0890] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 03/09/2021] [Accepted: 03/30/2021] [Indexed: 12/12/2022]
Abstract
Bleeding on probing (BOP) is regarded as an indispensable diagnostic tool for evaluating periodontal disease activity; however, its role in peri-implant disease is more intricate. Much of the confusion about the interpretation originates from drawing parallels between periodontal and peri-implant conditions. BOP can originate from two forms of probing in implants: traumatic or pathologic induction. This, in addition to the dichotomous scale of BOP can complicate diagnosis. The objective of this commentary is to discuss the following: 1) the value of BOP as a diagnostic tool for peri-implant diseases; 2) the reasons it should be distinct from value for diagnosing periodontal and peri-implant diseases; and 3) the current best evidence on how to implement it in daily clinical practice. A comprehensive bleeding index is proposed for evaluating and monitoring peri-implant conditions. BOP should be used in addition to other parameters such as visual signs of inflammation, probing depth, and progressive bone loss before a peri-implant diagnosis is established.
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Affiliation(s)
- Himabindu Dukka
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, KY
| | - Muhammad H A Saleh
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, KY.,Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Andrea Ravidà
- Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Henry Greenwell
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, KY
| | - Hom-Lay Wang
- Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
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