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Chiang YC, Sirinirund B, Rodriguez A, Velasquez D, Chan HL. Operating microscope-assisted reconstructive strategy for peri-implantitis: A case series report. Clin Adv Periodontics 2024; 14:149-156. [PMID: 37724638 DOI: 10.1002/cap.10265] [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: 06/05/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Treating peri-implantitis with reconstructive means has been largely unpredictable due to access limitations for surface decontamination, unfavorable bony topography, difficulty in achieving wound stability, and inferior soft tissue qualities. A microsurgical approach with the use of the operating microscope (OM) that provides adjustable higher magnification (∼5-30 times) and coaxial illumination, coupled with the use of microsurgical instruments, may overcome, or alleviate some of the abovementioned obstacles, resulting in more predictable outcomes. METHODS Three patients received reconstructive therapy for correcting peri-implant defects under OM in private practice settings. After precise incisions to preserve soft tissue volume, the flaps were dissected prudently from underlying granulomatous tissues, which were subsequently removed, followed by controlled flap releasing under ∼10-15x magnification. Surface decontamination was performed using a piezoelectric ultrasonic device, air polishing, and hand instruments at ∼30x magnification. The biomaterial selections were dehydrated human de-epithelialized amnion-chorion membrane with mineralized allograft particulates in two cases and xenografts in one case, based on the surgeons' preference. Wound closure followed the non-submerged approach. RESULTS These cases demonstrated uneventful soft tissue healing, favorable radiographic bone fill, and disease resolution with follow-ups ranging from 2 to 4 years. CONCLUSIONS Preliminary data suggest encouraging outcomes after the microsurgical approach following biological as well as biomechanical principles for peri-implant defect reconstruction.
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Affiliation(s)
- Yi-Chen Chiang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Benyapha Sirinirund
- Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Amanda Rodriguez
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Diego Velasquez
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Private Practice, Fenton, Michigan, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Division of Periodontology, The Ohio State University College of Dentistry, Columbus, Ohio, USA
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Kadkhodazadeh M, Amid R, Amirinasab O, Amirbandeh O, Moscowchi A. Risk Indicators of Peri-Implant Diseases in Public and Private Clinics: A Multicenter Study. Int J Dent 2024; 2024:7061682. [PMID: 39184234 PMCID: PMC11344646 DOI: 10.1155/2024/7061682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 07/26/2024] [Accepted: 08/06/2024] [Indexed: 08/27/2024] Open
Abstract
Methods Patients examined during postloading maintenance visits were included in this study. The presence of peri-implant mucositis, peri-implantitis and several patient- and implant-related independent variables was recorded. Statistical analysis was performed using the logistic regression analysis. The odds ratios (OR) of the potential association between each variable and the occurrence of peri-implant diseases were evaluated. Results Among the 114 participants with 403 implants, peri-implantitis was found in at least one implant of nine individuals (7.89%), and a total of 13 implants were affected by peri-implantitis (3.22%). The univariate regression analysis revealed a statistically significant association between arch (OR = 4.81; 95% CI = 1.27-31.36) and soft tissue thickness (OR = 4.07; 95% CI = 1.33-13.73) with the occurrence of peri-implantitis. The multivariate analysis confirmed the significant impact of soft tissue thickness (OR = 3.60; 95% CI = 1.16-12.24). Conclusion The occurrence of peri-implant diseases can be influenced by various factors. However, in order to accurately identify risk indicators, it is necessary to conduct long-term prospective studies.
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Affiliation(s)
- Mahdi Kadkhodazadeh
- Dental Research CenterResearch Institute for Dental SciencesSchool of DentistryShahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of PeriodonticsSchool of DentistryShahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Amid
- Dental Research CenterResearch Institute for Dental SciencesSchool of DentistryShahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of PeriodonticsSchool of DentistryShahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Omid Amirinasab
- Dental Research CenterResearch Institute for Dental SciencesSchool of DentistryShahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Omid Amirbandeh
- Dental Research CenterResearch Institute for Dental SciencesSchool of DentistryShahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anahita Moscowchi
- Dental Research CenterResearch Institute for Dental SciencesSchool of DentistryShahid Beheshti University of Medical Sciences, Tehran, Iran
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Saleh MHA, Dias DR, Kumar P. The economic and societal impact of periodontal and peri-implant diseases. Periodontol 2000 2024. [PMID: 38693603 DOI: 10.1111/prd.12568] [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: 02/01/2024] [Accepted: 03/26/2024] [Indexed: 05/03/2024]
Abstract
Periodontal and peri-implant diseases result from a chronic inflammatory response to dysbiotic microbial communities and are characterized by inflammation in the soft tissue and the ensuing progressive destruction of supporting bone, resulting in tooth or implant loss. These diseases' high prevalence, multifactorial etiology, extensive treatment costs, and significant detriment to patients' quality-of-life underscore their status as a critical public health burden. This review delineates the economic and sociocultural ramifications of periodontal and peri-implant diseases on patient welfare and healthcare economics. We delve into the implications of diagnosis, treatment, supportive care, and managing destructive tissue consequences, contrasting these aspects with healthy patients.
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Affiliation(s)
- Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Debora R Dias
- Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil
| | - Purnima Kumar
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Wilson TG, Harrel SK, Nunn ME. The Use of Enamel Matrix Derivative during Surgical Therapy for Peri-Implantitis: A Case Series. Dent J (Basel) 2023; 12:11. [PMID: 38248219 PMCID: PMC10814786 DOI: 10.3390/dj12010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Peri-implantitis is a growing concern and currently, there is no agreement on the best method for treating this condition. This study looked at surgical intervention with the use of enamel matrix derivative (EMD) for treating this condition. A cohort of 25 (34 implants) consecutive patients treated with EMD for peri-implantitis was followed for up to 6.4 years. The survival of the implants as well as changes in clinical parameters are reported. Statistical analysis was performed using paired t tests and general estimating equations. The mean length of time implants were followed post-surgery was 3.05 ± 1.53 years. All but two of the treated implants survived in function (94%). Both failed implants were lost in the same patient, who was a heavy smoker. The changes in mean probing depth (1.94 ± 1.18 mm), change in deepest probing depth (3.12 ± 1.45 mm), and reduction in bleeding on probing (73.6 ± 43.9%) according to patient means were all highly significant (p < 0.001 for all changes). When EMD is used during surgical treatment of peri-implantitis, there is a high survival rate of implants and significant improvements in clinical parameters.
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Affiliation(s)
| | - Stephen K. Harrel
- College of Dentistry, Texas A&M University, 4510 Ridge Road, Dallas, TX 75229, USA
| | - Martha E. Nunn
- Private Practice Dentistry and Biostatistics, Omaha, NE 68178, USA;
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Corbella S, Morandi B, Calciolari E, Alberti A, Francetti L, Donos N. The influence of implant position and of prosthetic characteristics on the occurrence of peri-implantitis: a retrospective study on periapical radiographs. Clin Oral Investig 2023; 27:7261-7271. [PMID: 37910236 PMCID: PMC10713669 DOI: 10.1007/s00784-023-05303-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/02/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE The present retrospective study aimed to investigate the influence of malposition on the occurrence of peri-implantitis. MATERIALS AND METHODS The study included clinical records of systemically healthy patients with single and partial implant-supported rehabilitations and at least 1-year post-loading follow-up. The parameters collected included implant-related factors, patient-related factors, site-related factors, and prosthesis-related factors. The radiographic measurements were taken by using a dedicated software and the diagnosis of peri-implantitis was made based on all the available clinical and radiographic data. Descriptive statistics were provided for all variables. Following an exploratory approach, an implant-level analysis of factors influencing the occurrence of peri-implantitis was done through a multilevel multivariate logistic regression (mixed). RESULTS A total of 180 implants belonging to 90 subjects were randomly selected. Malposition showed no statistically significant association with the occurrence of peri-implantitis. According to the multi-level analysis, the parameters that were significantly associated with peri-implantitis included presence / history of periodontitis (OR = 5.945, 95% CI: 1.093 - 32.334, P = 0.039) and presence of an emergence profile angle ≥ 45° (OR = 9.094, 95% CI: 2.017 - 40.995, P = 0.005). CONCLUSIONS Implant malposition, as defined following Buser's criteria (2004), did not influence the occurrence of peri-implantitis in the selected cohort. Conversely, history of periodontitis and presence of a prosthetic emergence profile with an angle ≥ 45° were correlated to an increased risk of peri-implantitis.
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Affiliation(s)
- Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy.
| | - Benedetta Morandi
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Centro di Odontoiatria, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Alice Alberti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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Hwang S, Lee HM, Yun PY, Kim YK. Survival analysis of implants after surgical treatment of peri-implantitis based on bone loss severity and surgical technique: a retrospective study. BMC Oral Health 2023; 23:308. [PMID: 37217906 DOI: 10.1186/s12903-023-02981-5] [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: 10/05/2022] [Accepted: 04/19/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Few trials have compared the results of surgical treatment for peri-implantitis based on severity of peri-implantitis and surgical method. This study investigated the survival rate of implants based on type of surgical method used and initial severity of peri-implantitis. Classification of severity was determined based on bone loss rate relative to fixture length. METHODS Medical records of patients who underwent peri-implantitis surgery from July 2003 to April 2021 were identified. Classification of peri-implantitis was divided into 3 groups (stage 1: bone loss < 25% (of fixture length), stage 2: 25% < bone loss < 50%, stage 3: bone loss > 50%) and performance of resective or regenerative surgery was investigated. Kaplan-Meier survival curves and Cox hazards proportional models were used to analyze the cumulative survival rate of implants. Median survival time, predicted mean survival time, hazard ratio (HR), and 95% confidence interval (CI) were calculated. RESULTS Based on Kaplan-Meier analysis, 89 patients and 227 implants were included, and total median postoperative survival duration was 8.96 years. Cumulative survival rates for stage 1, 2, and 3 were 70.7%, 48.9%, and 21.3%, respectively. The mean survival time for implants in stage 1, 2, and 3 was 9.95 years, 7.96 years, and 5.67 years, respectively, with statistically significant difference (log-rank p-value < 0.001). HRs for stage 2 and stage 3 were 2.25 and 4.59, respectively, with stage 1 as reference. Significant difference was not found in survival time between resective and regenerative surgery groups in any peri-implantitis stage. CONCLUSIONS The initial bone loss rate relative to the fixture length significantly correlated with the outcome after peri-implantitis surgery, demonstrating a notable difference in the long-term survival rate. Difference was not found between resective surgery and regenerative surgery in implant survival time. Bone loss rate could be utilized as a reliable diagnostic tool for evaluating prognosis after surgical treatment, regardless of surgical method used. TRIAL REGISTRATION Retrospectively registered. (KCT0008225).
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Affiliation(s)
- Sooshin Hwang
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi‑ro 173beon‑gil, Bundang‑gu, 13620, Seongnam, Korea
| | - Hee-Min Lee
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi‑ro 173beon‑gil, Bundang‑gu, 13620, Seongnam, Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi‑ro 173beon‑gil, Bundang‑gu, 13620, Seongnam, Korea
- Department of Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro Jongno-gu, Seoul, 03080, Korea
| | - Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi‑ro 173beon‑gil, Bundang‑gu, 13620, Seongnam, Korea.
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ALHarthi SS, Divakar DD, Alwahibi A, BinShabaib MS. Effect of mechanical instrumentation with adjunct photodynamic therapy on salivary TNFα levels and clinical periodontal and peri‑implant status in patients with depression: A randomized controlled trial. Photodiagnosis Photodyn Ther 2022; 40:103042. [PMID: 35908682 DOI: 10.1016/j.pdpdt.2022.103042] [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: 07/20/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The aim of the present randomized controlled trial was to assess the effect of mechanical instrumentation (MI) with adjunct photodynamic therapy (PDT) on salivary tumor necrosis factor-alpha (TNFα) levels and clinical periodontal and peri‑implant status in patients with depression. MATERIALS AND METHODS In groups 1 and 2, individuals with periodontal and peri‑implant diseases with and without depression, respectively were included. Group-3 comprised of systemically healthy individuals with a healthy periodontal and peri‑implant status. In groups 1 and 2, patients in the test- and control groups received MI with and without PDT respectively. Periodontal and peri‑implant probing depth and plaque and gingival indices were measured. Radiographic evaluation was done at baseline. Whole salivary tumor necrosis factor alpha (TNFα) in peri‑implant sulcular fluid were measured at baseline. The clinical and immunological parameters were reassessed at 120 days' follow-up. Level of significance was set at P<0.05. RESULTS Thirty-four, 36 and 37 implants were in function in groups 1, 2 and 3, respectively. At baseline, periodontal and peri‑implant clinical parameters and TNFα levels were significantly higher in groups 1 (P<0.05) and 2 (P<0.05) than Group-3. At 4-months follow-up, there was no difference in periodontal and peri‑implant clinical parameters in the test- and control groups among individuals in groups 1 and 3. In Group-2, there was a significant reduction in periodontal (P<0.05) and peri‑implant (P<0.05) clinical parameters at 4-months follow-up than baseline. In Group-2, there was no significant difference in these parameters among patients in the test- and control-groups. CONCLUSION In patients with depression clinical periodontal and peri‑implant status is poorer and salivary TNFα levels are higher after MI with or without PDT. In healthy patients, PDT offers no additional benefits in the treatment of periodontal inflammation.
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Affiliation(s)
- Shatha S ALHarthi
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Darshan D Divakar
- Department of Oral Medicine and Radiology, Sharavathi Dental College and Hospital, Shivamogga, Karnataka 577204, India; Department of Oral Medicine and Radiology, Faculty of Dentistry, Levy Mwanawasa Medical University (LMMU), Ministry of Health, Lusaka 10101, Zambia
| | - Abdulrahman Alwahibi
- Department of Psychiatry, College of Medicine, King Saud University, Medical City, Riyadh, Saudi Arabia
| | - Munerah S BinShabaib
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
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Diaz P, Gonzalo E, Villagra LJG, Miegimolle B, Suarez MJ. What is the prevalence of peri-implantitis? A systematic review and meta-analysis. BMC Oral Health 2022; 22:449. [PMID: 36261829 PMCID: PMC9583568 DOI: 10.1186/s12903-022-02493-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 10/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Peri-implantitis is a usual finding but estimates of its prevalence fluctuate very much. This may be due to the wide variety of disease definitions. This systematic review aims to estimate the overall prevalence of peri-implantitis and the effect of different study designs, function times and use of probing depth on prevalence rate. Methods Following electronic and manual searches of the literature published from January 2005 to December 2021, data were extracted from the studies fitting the study criteria. Fifty-seven articles were included in this study. Results Prevalence of peri-implantitis was 19.53% (95% CI 12.87–26.19) at the patient-level, and 12.53% (95% CI 11.67–13.39) at the implant-level and it remains highly variable even following restriction to the clinical case definition. The use of probing depth like diagnostic criteria affected the prevalence data. Conclusion The results indicate that it remains essential the identification of the diagnostic markers for more accurate disease classification.
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Affiliation(s)
- Pedro Diaz
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid (UCM), Pza Ramón y Cajal S/N, 28040, Madrid, Spain
| | - Esther Gonzalo
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid (UCM), Pza Ramón y Cajal S/N, 28040, Madrid, Spain.
| | - Luis J Gil Villagra
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid (UCM), Pza Ramón y Cajal S/N, 28040, Madrid, Spain
| | - Barbara Miegimolle
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid (UCM), Pza Ramón y Cajal S/N, 28040, Madrid, Spain
| | - Maria J Suarez
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid (UCM), Pza Ramón y Cajal S/N, 28040, Madrid, Spain
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Comparison of Two Risk Assessment Scores in Predicting Peri-Implantitis Occurrence during Implant Maintenance in Patients Treated for Periodontal Diseases: A Long-Term Retrospective Study. J Clin Med 2022; 11:jcm11061720. [PMID: 35330046 PMCID: PMC8948905 DOI: 10.3390/jcm11061720] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/12/2022] [Accepted: 03/17/2022] [Indexed: 12/11/2022] Open
Abstract
Background: There is a need for reliable risk assessment tools to better predict peri-implantitis occurrence. This study compared the long-term prognosis value of two models of risk assessment scoring in predicting peri-implantitis. Methods: Seventy-three patients with treated periodontitis representing 232 implants and attending long-term implant maintenance were evaluated. The Periodontal Risk Assessment (PRA) score, which combines only periodontal risk factors/indicators, and the Implant Risk Assessment (IRA) score, which combines both periodontal and implant risk factors/indicators, were calculated during implant maintenance. Peri-implantitis was defined by the presence of probing depth ≥6 mm with bleeding on probing/suppuration and bone level ≥3 mm. Analyses were performed at the patient level. Results: The mean implant follow-up was 6.5 years. Peri-implantitis incidence was 17.8%, and high-risk PRA and IRA percentages were 36.9% and 27.3%, respectively. High-risk PRA and IRA were significantly associated with peri-implantitis incidence, with hazard ratio (HR) = 4.8 and 3.65, respectively. Risk factors/indicators considered separately showed reduced associations with peri-implantitis. Conclusions: The PRA score combining periodontal parameters and IRA score combining both periodontal and implant parameters have comparable value in predicting peri-implantitis. These scores could allow practicians to intercept the risk of peri-implantitis and to manage follow-up modalities in patients with treated periodontitis.
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Influence of Periodontitis, Implant, and Prosthesis Characteristics on the Peri-Implant Status: A Cross-Sectional Study. Int J Dent 2022; 2022:9984871. [PMID: 35178092 PMCID: PMC8843979 DOI: 10.1155/2022/9984871] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/18/2022] [Indexed: 01/10/2023] Open
Abstract
Background The association between peri-implant diseases and the periodontal, implant, and prosthesis characteristics has been characterized in various ways. Purpose The aim of this study was to evaluate the link between the peri-implant and periodontal status and the influence of implant and prosthesis parameters during implant follow-up. Materials and Methods One hundred and seven patients with a total of 310 implants that had at least one year of function who were attending periodontal and implant maintenance at a university clinic setting were included in this cross-sectional study. The demographic, periodontal, peri-implant tissue, implant, and prosthesis parameters were recorded. A pocket depth > 4 mm with bleeding on probing defined periodontal/peri-implant soft tissue diseased sites. Analyses were performed at the patient and implant levels using univariable and multivariable mixed regression analysis. Results The mean implant follow-up was 7.22 years. At the patient level, the bleeding on probing and pocket depth measurements were more pronounced around the implant than around the teeth. The opposite was observed for plaque and the clinical attachment levels. At the implant level, multivariable analysis showed that the periodontal and corresponding peri-implant tissue parameters, such as diseased sites, were closely related. The implant location, bone level, and number were selectively associated with the implant bone level, while cemented retention and emergence restoration profile influenced the implant pocket depth. Conclusions The present study suggested that clinical peri-implant and periodontal soft tissue statuses were different, which could be a consequence of the initial implant and prosthesis healing process. However, during implant follow-up, the peri-implant parameters were predominantly associated with their corresponding periodontal parameters regardless of an association with the implant and prosthesis characteristics. This trial is registered with ClinicalTrials.gov ID: NCT03841656.
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Ultraviolet Treatment of Titanium to Enhance Adhesion and Retention of Oral Mucosa Connective Tissue and Fibroblasts. Int J Mol Sci 2021; 22:ijms222212396. [PMID: 34830275 PMCID: PMC8617952 DOI: 10.3390/ijms222212396] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 01/16/2023] Open
Abstract
Peri-implantitis is an unsolved but critical problem with dental implants. It is postulated that creating a seal of gingival soft tissue around the implant neck is key to preventing peri-implantitis. The objective of this study was to determine the effect of UV surface treatment of titanium disks on the adhesion strength and retention time of oral connective tissues as well as on the adherence of mucosal fibroblasts. Titanium disks with a smooth machined surface were prepared and treated with UV light for 15 min. Keratinized mucosal tissue sections (3 × 3 mm) from rat palates were incubated for 24 h on the titanium disks. The adhered tissue sections were then mechanically detached by agitating the culture dishes. The tissue sections remained adherent for significantly longer (15.5 h) on the UV-treated disks than on the untreated control disks (7.5 h). A total of 94% of the tissue sections were adherent for 5 h or longer on the UV-treated disks, whereas only 50% of the sections remained on the control disks for 5 h. The adhesion strength of the tissue sections to the titanium disks, as measured by tensile testing, was six times greater after UV treatment. In the culture studies, mucosal fibroblasts extracted from rat palates were attached to titanium disks by incubating for 24, 48, or 96 h. The number of attached cells was consistently 15–30% greater on the UV-treated disks than on the control disks. The cells were then subjected to mechanical or chemical (trypsinization) detachment. After mechanical detachment, the residual cell rates on the UV-treated surfaces after 24 and 48 h of incubation were 35% and 25% higher, respectively, than those on the control surfaces. The remaining rate after chemical detachment was 74% on the control surface and 88% on the UV-treated surface for the cells cultured for 48 h. These trends were also confirmed in mouse embryonic fibroblasts, with an intense expression of vinculin, a focal adhesion protein, on the UV-treated disks even after detachment. The UV-treated titanium was superhydrophilic, whereas the control titanium was hydrophobic. X-ray photoelectron spectroscopy (XPS) chemical analysis revealed that the amount of carbon at the surface was significantly reduced after UV treatment, while the amount of TiOH molecules was increased. These ex vivo and in vitro results indicate that the UV treatment of titanium increases the adhesion and retention of oral mucosa connective tissue as a result of increased resistance of constituent fibroblasts against exogenous detachment, both mechanically and chemically, as well as UV-induced physicochemical changes of the titanium surface.
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Rough Dental Implant Surfaces and Peri-Implantitis: Role of Phase-Contrast Microscopy, Laser Protocols, and Modified Home Oral Hygiene in Maintenance. A 10-Year Retrospective Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11114985] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The aim of this study was to evaluate two different kinds of rough implant surface and to assess their tendency to peri-implantitis disease, with a follow-up of more than 10 years. Data were obtained from a cluster of 500 implants with Ti-Unite surface and 1000 implants with Ossean surface, with a minimum follow-up of 10 years. Implants had been inserted both in pristine bone and regenerated bone. We registered incidence of peri-implantitis and other causes of implant loss. All patients agreed with the following maintenance protocol: sonic brush with vertical movement (Broxo), interdental brushes, and oral irrigators (Broxo) at least two times every day. For all patients with implants, we evaluated subgingival plaque samples by phase-contrast microscopy every 4 months for a period of more than 10-years. Ti-Unite surface implants underwent peri-implantitis in 1.6% of the total number of implants inserted and Ossean surface implants showed peri-implantitis in 1.5% of the total number of implants. The total percentage of implant lost was 4% for Ti-Unite surfaces and 3.6% for Ossean surfaces. Strict control of implants leads to low percentage of peri-implantitis even for rough surfaces dental implants.
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