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Abuhajar E, Salim NA, Satterthwaite JD, Silikas N, Anweigi LM. Effect of bioceramic powder abrasion on different implant surfaces. J Prosthodont 2024. [PMID: 38594924 DOI: 10.1111/jopr.13857] [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: 10/29/2022] [Accepted: 03/26/2024] [Indexed: 04/11/2024] Open
Abstract
PURPOSE Bioceramic coatings have been shown to promote bone repair, which aids in the early integration of implants. This study aimed to evaluate the influence of air abrasion with a bioceramic abrasive on the surface characteristics of different implant materials and surfaces. The dissolution of the applied treatment from the surfaces over 3 weeks was also assessed. MATERIALS AND METHODS Discs of three alloys used for dental implants were studied and compared: two types of commercially pure titanium (CpTi)/ (CpTi SLActive) and titanium-zirconia (TiZr). The tested surfaces were: CpTi control (CpC), sandblasted (SB), sandblasted and acid-etched (SBE), and CpTi SLActive®, (TiZr) Roxolid®. Three discs from each group underwent air abrasion with apatite bioceramic powders, 95% hydroxyapatite (HA)/5% calcium oxide (CaO), and 90% hydroxyapatite (HA)/10% calcium oxide (CaO). The treated discs were surface characterized by optical profilometry to obtain surface roughness, scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS) to compare element weight percentages of titanium, calcium, and phosphate. Dissolution was assessed using inductively coupled plasma optic emission spectrometry (ICP-OES). RESULTS Bioceramic powders were deposited on all tested surfaces leading to changes in surface characteristics. The only statistically significant differences between the material groups for surface roughness were found with 95% HA/5% CaO powder in the Sp and Rp parameters (p = 0.03 and 0.04, respectively). There were no significant differences in the Ca and P wt% between all groups and powders 95% HA/5% CaO and 90% HA/10% CaO (p = 0.14, 0.18, and p = 0.15, 0.12, respectively). A non-uniform dispersion of the treatment on the surface layer was visible on all treated surfaces. The bioceramic powder continued to dissolute from the tested surfaces for 3 weeks. CONCLUSION Bioceramic abrasion modifies implant surface characteristics, although the change in surface characteristics resulting from such treatment was not influenced by the implant material or surface treatment. Air abrasion with hydroxyapatite and calcium oxide bioceramics leaves powder deposits on the treated implant surfaces that could potentially influence the healing of implants affected by peri-implantitis.
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Affiliation(s)
- Eman Abuhajar
- Faculty of Medicine, Dentistry and Oral Surgery, University of Tripoli, Tripoli, Libya
| | - Nesreen A Salim
- Prosthodontic Department, School of Dentistry, The University of Jordan, Consultant in Fixed and Removable Prosthodontics, The University of Jordan Hospital, Amman, Jordan
| | - Julian D Satterthwaite
- Division of Dentistry, School of Medical Sciences, The University of Manchester, Manchester, UK
| | - Nick Silikas
- School of Dentistry, The University of Manchester, Manchester, UK
| | - Lamyia M Anweigi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
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Jiang C, Sun Y, Li G, Zhou T, Wang Q, Zhang J, Song Y, Xu W, A L. Magnetic Hydroxyapatite-Coated Iron-Chromium Microspheres for Dental Surface Polishing and Plaque Removal. ACS APPLIED MATERIALS & INTERFACES 2024; 16:5554-5567. [PMID: 38278767 DOI: 10.1021/acsami.3c16398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
This research aimed to engineer magnetic hydroxyapatite-coated iron-chromium (HAp-FeCr) microspheres to enhance dental surface polishing and plaque elimination. Utilizing a tailored sol-gel approach, the HAp-FeCr microspheres were synthesized and exhaustively characterized via scanning electron microscopy, energy-dispersive X-ray spectroscopy, ζ-potential, X-ray diffractometry, and X-ray photoelectron spectroscopy methodologies. Key findings showcased that these microspheres retained their magnetic properties post-HAp coating, as evidenced by the magnetization curves. An innovative magnetic polishing system was developed, incorporating these microspheres and a 2000 rpm magnet. Comparative evaluations between traditional air-powder polishing and the proposed magnetic technique demonstrated the latter's superiority. Notably, the magnetic polishing led to a substantial reduction in dental plaque on the tooth surface, decreasing bacterial adhesion and early biofilm formation by Streptococcus gordonii and Lactobacillus acidophilus, where the most pronounced effects were observed in samples with elevated HAp content. A significant 60% reduction in dental plaque was achieved with the magnetic method relative to air-powder polishing. Furthermore, the HAp-FeCr microspheres' biocompatibility was verified through cytotoxicity tests and animal studies. In essence, the magnetic HAp-FeCr microspheres present a novel and efficient strategy for dental treatments, holding immense potential for improving oral health.
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Affiliation(s)
- Cong Jiang
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun 130021, China
| | - Yue Sun
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun 130021, China
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun 130021, China
| | - Gaojie Li
- Key Laboratory of Automobile Materials, Ministry of Education, College of Materials Science and Engineering, Jilin University, Changchun 130021, China
| | - Tianyu Zhou
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun 130021, China
| | - Qiqi Wang
- Department of Periodontology, School and Hospital of Stomatology, Jilin University, Changchun 130021, China
| | - Jingdan Zhang
- Department of Periodontology, School and Hospital of Stomatology, Jilin University, Changchun 130021, China
| | - Yulai Song
- Key Laboratory of Automobile Materials, Ministry of Education, College of Materials Science and Engineering, Jilin University, Changchun 130021, China
| | - Wenzhou Xu
- Department of Periodontology, School and Hospital of Stomatology, Jilin University, Changchun 130021, China
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun 130021, China
| | - Lan A
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun 130021, China
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun 130021, China
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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.
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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
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Bi J, Khoshkam V, Hunter M, Cho C, Kar K. Effect of Air Polishing on the Treatment of Peri-Implant Diseases: A Systematic Review and Meta-Analysis. J ORAL IMPLANTOL 2023; 49:616-628. [PMID: 38258587 DOI: 10.1563/aaid-joi-d-23-00114] [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] [Indexed: 01/24/2024]
Abstract
Peri-implant diseases have become one of the notable biological complications of postrehabilitation with implant-supported restorations. Effective modalities for decontamination of biofilm deposits around implant surfaces are critical for resolution of the inflammation. Air polishing is one of the recommended clinical methods for treating peri-implant diseases. This systematic review assessed clinical evidence on efficacy of using air polishing technology for the management of peri-implant diseases, including peri-implant mucositis and peri-implantitis. Four electronic databases from January 1990 to December 2022 were searched to identify the relative human randomized clinical trials that applied air polishing for nonsurgical and surgical treatment of peri-implant mucositis and peri-implantitis. Twelve articles were selected. For treating peri-implant mucositis, air polishing showed a comparable effect to ultrasonic scaling in the reduction of bleeding on probing (BOP) and probing pocket depth (PPD). The nonsurgical approach of air polishing in treating peri-implantitis varied in the reduction of BOP, PPD, and clinical attachment level (CAL) in evaluated studies. Air polishing in the surgical treatment of peri-implantitis was comparable to mechanical cleaning, implantoplasty, and the use of Ti-brush, in regards to the significant reduction of BOP, PPD, and CAL, as well as the improvement of the bone level between baseline and follow-ups. The standardized mean difference with a 95% confidence interval of the studied parameters was estimated using the random effect model; however, statistical differences were not detected between air polishing and comparative modalities in the treatment of peri-implantitis. Within the limitations of this review, the application of air polishing did not result in more favorable outcomes in the treatment of peri-implant diseases compared to other modalities.
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Affiliation(s)
- Jiarui Bi
- Department of Endodontics and Periodontics; Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
- Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, CA, USA
| | - Vahid Khoshkam
- Department of Endodontics and Periodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
- Private practice, El Paso, TX, USA
| | - Mylea Hunter
- Department of Endodontics and Periodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
- Private practice, Fullerton, CA, USA
| | - Christopher Cho
- Department of Endodontics and Periodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Kian Kar
- Department of Endodontics and Periodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
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Zampa EP, Kyriakidou K, Papaparaskevas J, Pepelassi E, Karoussis IK. Effect of Low-Level Laser Irradiation (810 nm) on the Proliferation and Differentiation of Osteoblast-Like Cells Cultured on SLA Titanium Discs Exposed to a Peri-implantitis Environment. J Lasers Med Sci 2023; 14:e57. [PMID: 38144939 PMCID: PMC10746885 DOI: 10.34172/jlms.2023.57] [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: 07/19/2023] [Accepted: 10/07/2023] [Indexed: 12/26/2023]
Abstract
Introduction: Elimination of inflammation and re-osseointegration are the major objectives of peri-implantitis therapy. Existing data, however, do not support any decontamination approach. Thus, the present in vitro study aims to assess whether the air-debriding decontamination method with erythritol powder restores the biocompatibility of infected titanium discs and to investigate the potent biomodulatory ability of diode laser (810 nm) irradiation to promote cell proliferation and differentiation of premature osteoblast-like cells (MG63) towards osteocytes. Methods: The experimental groups consisted of cells seeded on titanium discs exposed or not in a peri-implantitis environment with or without biomodulation. Infected discs were cleaned with airflow with erythritol powder. Cell cultures seeded on tricalcium phosphate (TCP) surfaces with or without biomodulation with a laser (810 nm) were used as controls. The study evaluated cell viability, proliferation, adhesion (SEM) at 24, 48 and 72 hours, and surface roughness changes (profilometry), as well as the effects of low-level laser therapy (LLLT) on ALP, OSC, TGF-b1, Runx2, and BMP-7 expression in MG63 cells' genetic profile on days 7, 14, and 21. Results: The MTT assay as well as the FDA/PI method revealed that cell proliferation did not show significant differences between sterile and decontaminated discs at any timepoint. SEM photographs on day 7 showed that osteoblast-like cells adhered to both sterile and disinfected surfaces, while surface roughness did not change based on amplitude parameters. The combination of airflow and LLLT revealed a biomodulated effect on the differentiation of osteoblast-like cells with regard to the impact of laser irradiation on the genetic profile of the MG63 cells. Conclusion: In all groups tested, osteoblast-like cells were able to colonize, proliferate, and differentiate, suggesting a restoration of biocompatibility of infected discs using airflow. Furthermore, photomodulation may promote the differentiation of osteoblast-like cells cultured on both sterile and disinfected titanium surfaces.
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Affiliation(s)
- Evangelia P. Zampa
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Thivon 2 Str, Goudi, 115 27, Athens, Greece
| | - Kyriaki Kyriakidou
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Thivon 2 Str, Goudi, 115 27, Athens, Greece
| | - Joseph Papaparaskevas
- Department of Microbiology, School of Medicine, National and Kapodistrian University of Athens, M.Asias 75, 115 27, Athens, Greece
| | - Eudoxie Pepelassi
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Thivon 2 Str, Goudi, 115 27, Athens, Greece
| | - Ioannis K. Karoussis
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Thivon 2 Str, Goudi, 115 27, Athens, Greece
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Chen IC, Su CY, Tu JJ, Kao DW, Fang HW. In vitro studies of factors affecting debridement of dental implants by tricalcium phosphate powder abrasive treatment. Sci Rep 2023; 13:8271. [PMID: 37217571 DOI: 10.1038/s41598-023-35053-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/11/2023] [Indexed: 05/24/2023] Open
Abstract
Peri-implantitis is a common complication characterized by inflammation in tissues surrounding dental implants due to plaque accumulation, which can lead to implant failure. While air flow abrasive treatment has been found to be effective for debriding implant surfaces, little is known about the factors that affect its cleaning capacity. This study systematically examined the cleaning capacity of air powder abrasive (APA) treatment with β-tricalcium phosphate (β-TCP) powder, using various powder jetting strengths and different particle sizes. Three sizes of β-TCP powder (S, M, and L) were prepared, and different powder settings (low, medium, and high) were tested. The cleaning capacity was determined by quantifying ink removal, which simulated biofilm removal from the implant surfaces at different time points. The results of the systematic comparisons showed that the most efficient cleaning of implant surfaces was achieved using size M particles with medium setting. Additionally, the amount of powder consumed was found to be critical to cleaning efficiency, and the implant surfaces were altered in all tested groups. These systematically analyzed outcomes may provide insights into the development of potential non-surgical strategies for treating peri-implant diseases.
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Affiliation(s)
- I-Cheng Chen
- Accelerator for Happiness and Health Industry, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei, 10608, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei, 10608, Taiwan
- High-value Biomaterials Research and Commercialization Center, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., 10608, Taipei, Taiwan
| | - Chen-Ying Su
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei, 10608, Taiwan
- High-value Biomaterials Research and Commercialization Center, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., 10608, Taipei, Taiwan
| | - Jia-Jun Tu
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei, 10608, Taiwan
| | - Daniel Wenkai Kao
- Washington Dental Group, No. 111, Sec. 3, Heping E. Rd., Da-an Dist., Taipei City, 10675, Taiwan.
- Department of Dentistry, National Yang Ming University, No. 155, Yixin Rd., Beitou Dist., Taipei City, 11221, Taiwan.
- Harvard School of Dental Medicine, Boston, 188 Longwood Ave, Boston, MA, 02115, USA.
| | - Hsu-Wei Fang
- Accelerator for Happiness and Health Industry, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei, 10608, Taiwan.
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei, 10608, Taiwan.
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, No. 35, Keyan Road, Zhunan Town, Miaoli County, 35053, Taiwan.
- High-value Biomaterials Research and Commercialization Center, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., 10608, Taipei, Taiwan.
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Stein JM, Conrads G, Abdelbary MMH, Yekta-Michael SS, Buttler P, Glock J, Sadvandi G, Kaufmann R, Apel C. Antimicrobial efficiency and cytocompatibility of different decontamination methods on titanium and zirconium surfaces. Clin Oral Implants Res 2023; 34:20-32. [PMID: 36259118 DOI: 10.1111/clr.14014] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/18/2022] [Accepted: 10/13/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the efficiency of different implant-decontamination methods regarding biofilm modification and potential cytotoxic effects. Therefore, the amount of biofilm reduction, cytocompatibility, and elementary surface alterations were evaluated after decontamination of titanium and zirconium surfaces. MATERIAL AND METHODS Titanium and zirconium disks were contaminated with a newly developed high-adherence biofilm consisting of six microbial species. Decontaminations were performed using titanium curette, stainless steel ultrasonic scaler (US), glycine (GPAP) and erythritol (EPAP) powder air-polishing, Er:YAG laser, 1% chlorhexidine (CHX), 10% povidone-iodine (PVI), 14% doxycycline (doxy), and 0.95% NaOCl solution. Microbiologic analysis was done using real-time qPCR. For assessment of cytocompatibility, a multiplex assay for the detection of cytotoxicity, viability, and apoptosis on human gingival fibroblasts was performed. X-ray photoelectron spectroscopy (XPS) was used to evaluate chemical alterations on implant surfaces. RESULTS Compared with untreated control disks, only GPAP, EPAP, US, and Er:YAG laser significantly reduced rRNA counts (activity) on titanium and zirconium (p < .01), whereas NaOCl decreased rRNA count on titanium (p < .01). Genome count (bacterial presence) was significantly reduced by GPAP, EPAP, and US on zirconium only (p < .05). X-ray photoelectron spectroscopy analyses revealed relevant re-exposure of implant surface elements after GPAP, EPAP, and US treatment on both materials, however, not after Er:YAG laser application. Cytocompatibility was impaired by CHX, PVI, doxy, and NaOCl. CHX and PVI resulted in the lowest viability and doxy in the highest apoptosis. CONCLUSIONS Within the limits of this in vitro study, air-polishing methods and ultrasonic device resulted in effective biofilm inactivation with surface re-exposure and favorable cytocompatibility on titanium and zirconium. Chemical agents, when applied on implant surfaces, may cause potential cytotoxic effects.
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Affiliation(s)
- Jamal M Stein
- Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany.,Private Practice, Aachen, Germany
| | - Georg Conrads
- Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University Hospital, Aachen, Germany
| | - Mohamed M H Abdelbary
- Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University Hospital, Aachen, Germany
| | | | - Patricia Buttler
- Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany
| | - Joanna Glock
- Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany
| | - Gelareh Sadvandi
- Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany
| | - Robert Kaufmann
- DWI - Leibnitz-Institut für Interaktive Materialien, Aachen, Germany
| | - Christian Apel
- Department of Biohybrid & Medical Textiles (BioTex), Institute of Applied Medical Engineering, RWTH Aachen University & Hospital, Germany
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Alkan İİ, Akkaya HÜ, Sağlam M. The effectiveness of scaling and root planing with combined application of air polishing and Nd:YAG laser in periodontal pockets of stage III grade C periodontitis patients: a single-blinded randomized clinical trial. Clin Oral Investig 2022; 26:5459-5469. [PMID: 35505199 DOI: 10.1007/s00784-022-04513-x] [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: 02/17/2022] [Accepted: 04/24/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Evaluating the efficiency of combined air polishing and Nd:YAG laser application in addition to scaling and root planning (SRP) in treatment of periodontal pockets of stage III grade C periodontitis patients was the aim of this clinical trial. MATERIALS AND METHODS Twenty-four systemically healthy, stage III grade C periodontitis patients were recruited for this clinical trial. In this split-mouth study, the quadrants were randomly allocated to either SRP with combined air polishing (erythritol/chlorhexidine powder) and Nd:YAG laser (2 W, 200 mJ/pulse, 10 Hz) therapy (test group) or SRP alone (control group). A masked examiner recorded clinical parameters such as plaque index (PI), gingival index (GI), bleeding on probing (%) (BOP %), probing depth (PD), and clinical attachment level (CAL) on periodontal charts at baseline, 1 month and 3 months after treatment. RESULTS The clinical parameters had significantly reduced 1 and 3 months after treatment compared to baseline for both study groups (p < 0.05). Considering PI, GI, and BOP (%) parameters, there were no significant differences between the study groups at any time points (p > 0.05). While PD and CAL reductions were similar in study groups for moderately deep pockets (5 to 6 mm) (p > 0.05), PD and CAL reductions were significantly greater in test group compared to control group for deep pockets (PD ≥ 7 mm) (p < 0.05). CONCLUSIONS The present clinical trial demonstrated that SRP with combined application of air polishing and Nd:YAG laser may be advantageous in sites where mechanical debridement alone cannot access, such as deep pockets in the short term. Long-term, well-designed future studies including clinical, biochemical, and microbiological analyses are needed to determine the effectiveness of this procedure. CLINICAL RELEVANCE SRP with combined application of air polishing and Nd:YAG laser provided more reductions in probing depth and clinical attachment level parameters in deep pockets compared to SRP alone.
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Affiliation(s)
- İsmet İlke Alkan
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey.,Private Practice, Karabağlar, İzmir, Turkey
| | - Hazal Üstünel Akkaya
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey
| | - Mehmet Sağlam
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey.
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9
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Jaeggi M, Gyr S, Astasov-Frauenhoffer M, Zitzmann NU, Fischer J, Rohr N. Influence of different zirconia surface treatments on biofilm formation in vitro and in situ. Clin Oral Implants Res 2022; 33:424-432. [PMID: 35137461 PMCID: PMC9304171 DOI: 10.1111/clr.13902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/10/2022] [Accepted: 01/30/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine if the surface treatment of zirconia affects biofilm formation in an in vitro three-species biofilm model and in situ. MATERIAL AND METHODS Zirconia surfaces considered for the transmucosal portion of a zirconia implant were compared with polished pure titanium grade 4 (Tp). Discs 13 mm in diameter of either polished (Zp), polished and heat-treated (Zpt), machined (Zm), machined and heat-treated (Zmt) and sandblasted, etched and heat-treated (Z14) zirconia were fabricated. Surface roughness and wettability of specimens was measured. Biofilm formation was evaluated by safranin staining and scanning electron microscopy (SEM) using a three-species model, and intraorally with 16 volunteers carrying oral splints in two independent experiments. Relative biofilm formation was compared with Kruskal-Wallis followed by Bonferroni post-hoc test (α=0.05). RESULTS In vitro biofilm formation with optical density values on Zp (0.14±0.01), Zpt (0.14±0.02), Zm (0.13±0.01) and Zmt (0.13±0.01) was significantly lower than on Tp (0.21±0.05) and Z14 (0.20±0.04) (p<0.05). In situ biofilm formation was significantly higher on Z14 (0.56±0.45) (p<0.05), while no significant differences in optical density were observed among Zp (0.25±0.20), Zm (0.36±0.34) and Tp (0.28±0.22). SEM analysis supported quantitative findings. CONCLUSIONS In the in vitro three-species biofilm model differences in material and surface roughness affected biofilm formation. In situ biofilm formation was mainly affected by the surface roughness of the specimens. Polishing of zirconia is recommended to reduce biofilm formation while heat-treatment has no significant effect.
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Affiliation(s)
- Marco Jaeggi
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Sharon Gyr
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Monika Astasov-Frauenhoffer
- Department of Research, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Jens Fischer
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Nadja Rohr
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland.,Department of Research, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
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Sato H, Ishihata H, Kameyama Y, Shimpo R, Komasa S. Professional Mechanical Tooth Cleaning Method for Dental Implant Surface by Agar Particle Blasting. MATERIALS 2021; 14:ma14226805. [PMID: 34832206 PMCID: PMC8622555 DOI: 10.3390/ma14226805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/17/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022]
Abstract
Oral dysfunction due to peri-implantitis and shortened life of implants has become a major concern. Self-care and removal of oral biofilms by professional mechanical tooth cleaning (PMTC) are indispensable for its prevention. However, if the surface roughness of the implant is increased, it may result in the adhesion of biofilm in the oral cavity. Therefore, the PMTC method can serve for long-term implant management. Calcium carbonate (CaCO3) has been used as a cleaning method for implant surfaces; however, there is concern that the implant surface roughness could increase due to particle collision. Therefore, in this study, to establish a blasting cleaning method that does not adversely affect the implant surface, a new blasting cleaning method using agar particles was devised and its practical application examined. When the simulated stains were blasted with white alumina (WA) abrasive grains and CaCO3 particles, the simulated stains were almost removed, the surface roughness changed to a satin-finished surface—which was thought to be due to fine scratches—and the surface roughness increased. Most of the simulated stains were removed on the surface of the sample blasted with glycine particles and agar particles. Conversely, the gloss of the sample surface was maintained after cleaning, and the increase in surface roughness was slight.
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Affiliation(s)
- Hideaki Sato
- Department of Mechanical Engineering, Faculty of Science and Engineering, Tokyo City University, 1-28-1 Tamadutsumi, Setagaya-ku, Tokyo 158-8557, Japan; (H.S.); (Y.K.); (R.S.)
| | - Hiroshi Ishihata
- Department of Periodontology and Endodontology, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan;
| | - Yutaka Kameyama
- Department of Mechanical Engineering, Faculty of Science and Engineering, Tokyo City University, 1-28-1 Tamadutsumi, Setagaya-ku, Tokyo 158-8557, Japan; (H.S.); (Y.K.); (R.S.)
| | - Ryokichi Shimpo
- Department of Mechanical Engineering, Faculty of Science and Engineering, Tokyo City University, 1-28-1 Tamadutsumi, Setagaya-ku, Tokyo 158-8557, Japan; (H.S.); (Y.K.); (R.S.)
| | - Satoshi Komasa
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata-shi, Osaka 573-1121, Japan
- Correspondence: ; Tel.: +81-72-864-3084; Fax: +81-72-864-3184
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11
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Dhaliwal JS, Abd Rahman NA, Ming LC, Dhaliwal SKS, Knights J, Albuquerque Junior RF. Microbial Biofilm Decontamination on Dental Implant Surfaces: A Mini Review. Front Cell Infect Microbiol 2021; 11:736186. [PMID: 34692562 PMCID: PMC8531646 DOI: 10.3389/fcimb.2021.736186] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 09/09/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction After insertion into the bone, implants osseointegrate, which is required for their long-term success. However, inflammation and infection around the implants may lead to implant failure leading to peri-implantitis and loss of supporting bone, which may eventually lead to failure of implant. Surface chemistry of the implant and lack of cleanliness on the part of the patient are related to peri-implantitis. The only way to get rid of this infection is decontamination of dental implants. Objective This systematic review intended to study decontamination of microbial biofilm methods on titanium implant surfaces used in dentistry. Methods The electronic databases Springer Link, Science Direct, and PubMed were explored from their inception until December 2020 to identify relevant studies. Studies included had to evaluate the efficiency of new strategies either to prevent formation of biofilm or to treat matured biofilm on dental implant surfaces. Results and Discussion In this systematic review, 17 different groups of decontamination methods were summarized from 116 studies. The decontamination methods included coating materials, mechanical cleaning, laser treatment, photodynamic therapy, air polishing, anodizing treatment, radiation, sonication, thermal treatment, ultrasound treatment, chemical treatment, electrochemical treatment, antimicrobial drugs, argon treatment, and probiotics. Conclusion The findings suggest that most of the decontamination methods were effective in preventing the formation of biofilm and in decontaminating established biofilm on dental implants. This narrative review provides a summary of methods for future research in the development of new dental implants and decontamination techniques.
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Affiliation(s)
- Jagjit Singh Dhaliwal
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
| | - Nurul Adhwa Abd Rahman
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
| | - Long Chiau Ming
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
| | - Sachinjeet Kaur Sodhi Dhaliwal
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
| | - Joe Knights
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
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12
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John G, Schwarz F, Kravchenko A, Ommerborn MA, Becker J. Effectivity of homecare and professional biofilm removal procedures on initial supragingival biofilm on laser-microtextured implant surfaces in an ex vivo model. Int J Implant Dent 2021; 7:51. [PMID: 34018065 PMCID: PMC8137787 DOI: 10.1186/s40729-021-00326-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 03/18/2021] [Indexed: 11/23/2022] Open
Abstract
Background The aim of the current study was the evaluation of initial biofilm adhesion and development on laser-microtextured implant collar surfaces and the examination of effectivity of different biofilm management methods. Methods Initial biofilm formation was investigated on hydrophobic machined and laser-microtextured (Laser-Lok) titanium surfaces and hydrophobic machined and laser-microtextured (Laser-Lok) titanium aluminium vanadium surfaces and compared to hydrophobic smooth pickled titanium surfaces, hydrophilic smooth and acid etched titanium surfaces, hydrophobic sandblasted large grid and acid etched titanium surfaces (titanium Promote) via erythrosine staining and subsequent histomorphometrical analysis and scanning electron microscopic investigations. After decontamination procedures, performed via tooth brushing and glycine powder blasting, clean implant surface was detected via histomorphometrical analysis. Results After 24 h mean initial plaque area was detected in the following descending order: smooth pickled titanium > titanium Promote > hydrophilic smooth and acid etched titanium > Laser-Lok titanium > Laser-Lok titanium aluminium vanadium. The same order was determined after 48 h of biofilm formation. After glycine powder blasting all samples depicted almost 100% clean implant surface. After tooth brushing, Laser-Lok titanium (67.19%) and Laser-Lok titanium aluminium vanadium (69.80%) showed significantly more clean implant surface than the other structured surfaces, hydrophilic smooth and acid etched titanium (50.34%) and titanium Promote (33.89%). Smooth pickled titanium showed almost complete clean implant surface (98.84%) after tooth brushing. Conclusions Both Laser-Lok surfaces showed less initial biofilm formation after 24 and 48 h than the other implant surfaces. In combination with the significant higher clean implant surfaces after domestic decontamination procedure via tooth brushing, both Laser-Lok surfaces could be a candidate for modified implant and abutment designs, especially in transmucosal areas.
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Affiliation(s)
- Gordon John
- Department of Oral Surgery and Central Admittance, Westdeutsche Kieferklinik, Heinrich Heine University Düsseldorf, Moorenstr. 5, D-40225, Düsseldorf, Germany.
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
| | - Alexandra Kravchenko
- Department of Operative Dentistry, Periodontology and Endodontology, Heinrich Heine University, Düsseldorf, Germany
| | - Michelle Alicia Ommerborn
- Department of Operative Dentistry, Periodontology and Endodontology, Heinrich Heine University, Düsseldorf, Germany
| | - Jürgen Becker
- Department of Oral Surgery and Central Admittance, Westdeutsche Kieferklinik, Heinrich Heine University Düsseldorf, Moorenstr. 5, D-40225, Düsseldorf, Germany
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13
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Di Tinco R, Bertani G, Pisciotta A, Bertoni L, Bertacchini J, Colombari B, Conserva E, Blasi E, Consolo U, Carnevale G. Evaluation of Antimicrobial Effect of Air-Polishing Treatments and Their Influence on Human Dental Pulp Stem Cells Seeded on Titanium Disks. Int J Mol Sci 2021; 22:ijms22020865. [PMID: 33467097 PMCID: PMC7830275 DOI: 10.3390/ijms22020865] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/11/2021] [Accepted: 01/14/2021] [Indexed: 12/20/2022] Open
Abstract
Dental implants are one of the most frequently used treatment options for tooth replacement, and titanium is the metal of choice due to its demonstrated superiority in resisting corrosion, lack of allergic reactions and mechanical strength. Surface roughness of titanium implants favors the osseointegration process; nevertheless, its topography may provide a suitable substrate for bacterial biofilm deposition, causing peri-implantitis and leading to implant failure. Subgingival prophylaxis treatments with cleansing powders aimed to remove the bacterial accumulation are under investigation. Two different air-polishing powders—glycine and tagatose—were assayed for their cleaning and antimicrobial potential against a Pseudomonas biofilm and for their effects on human dental pulp stem cells (hDPSCs), seeded on sandblasted titanium disks. Immunofluorescence analyses were carried out to evaluate cell adhesion, proliferation, stemness and osteogenic differentiation. The results demonstrate that both the powders have a great in vitro cleaning potential in the early period and do not show any negative effects during hDPSCs osteogenic differentiation process, suggesting their suitability for enhancing the biocompatibility of titanium implants. Our data suggest that the evaluated cleansing systems reduce microbial contamination and allow us to propose tagatose as an adequate alternative to the gold standard glycine for the air-polishing prophylaxis treatment.
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Affiliation(s)
- Rosanna Di Tinco
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (G.B.); (A.P.); (L.B.); (J.B.); (B.C.); (E.C.); (E.B.); (U.C.)
| | - Giulia Bertani
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (G.B.); (A.P.); (L.B.); (J.B.); (B.C.); (E.C.); (E.B.); (U.C.)
| | - Alessandra Pisciotta
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (G.B.); (A.P.); (L.B.); (J.B.); (B.C.); (E.C.); (E.B.); (U.C.)
| | - Laura Bertoni
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (G.B.); (A.P.); (L.B.); (J.B.); (B.C.); (E.C.); (E.B.); (U.C.)
| | - Jessika Bertacchini
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (G.B.); (A.P.); (L.B.); (J.B.); (B.C.); (E.C.); (E.B.); (U.C.)
| | - Bruna Colombari
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (G.B.); (A.P.); (L.B.); (J.B.); (B.C.); (E.C.); (E.B.); (U.C.)
| | - Enrico Conserva
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (G.B.); (A.P.); (L.B.); (J.B.); (B.C.); (E.C.); (E.B.); (U.C.)
- Operative Unit of Dentistry and Maxillofacial Surgery, Department Integrated Activity-Specialist Surgeries, University-Hospital of Modena, 41125 Modena, Italy
| | - Elisabetta Blasi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (G.B.); (A.P.); (L.B.); (J.B.); (B.C.); (E.C.); (E.B.); (U.C.)
| | - Ugo Consolo
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (G.B.); (A.P.); (L.B.); (J.B.); (B.C.); (E.C.); (E.B.); (U.C.)
- Operative Unit of Dentistry and Maxillofacial Surgery, Department Integrated Activity-Specialist Surgeries, University-Hospital of Modena, 41125 Modena, Italy
| | - Gianluca Carnevale
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (G.B.); (A.P.); (L.B.); (J.B.); (B.C.); (E.C.); (E.B.); (U.C.)
- Correspondence:
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14
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Batalha VC, Bueno RA, Fronchetti Junior E, Mariano JR, Santin GC, Freitas KMS, Ortiz MAL, Salmeron S. Dental Implants Surface in vitro Decontamination Protocols. Eur J Dent 2020; 15:407-411. [PMID: 33285571 PMCID: PMC8382458 DOI: 10.1055/s-0040-1721550] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective
The number of patients rehabilitated with dental implants has contributed to increased incidence of peri-implant diseases. Due to complex and difficult treatment, peri-implantitis is a challenge and an efficient clinical protocol is not yet established. Aim of this study was to evaluate the efficacy of two protocols for
in vitro
decontamination of dental implants surface.
Materials and Methods
Twenty titanium implants (BioHE-Bioconect) were used. Implants were divided into five groups (
n
= 4). NC group (negative control): sterile implants; PC group (positive control): biofilm contaminated implants; S group: biofilm contaminated implants, brushed with sterile saline; SB group: biofilm contaminated implants, brushed with sterile saline and treated with air-powder abrasive system with sodium bicarbonate (1 minute); and antimicrobial photodynamic therapy (aPDT) group: biofilm contaminated implants, brushed with sterile saline and treated with antimicrobial photodynamic therapy (red laser + toluidine blue O). The implants were contaminated
in vitro
with subgingival biofilm and distributed in groups PC, S, SB, and aPDT. Each group received the respective decontamination treatment, except groups NC and PC. Then, all implants were placed in tubes containing culture medium for later sowing and counting of colony-forming units (CFUs).
Statistical Analysis
One-way analysis of variance and Tukey tests were performed, at 5% significance level.
Results
Significantly fewer CFUs were observed in the aPDT group (19.38 × 10
5
) when compared with groups SB (26.88 × 10
5
), S (47.75 × 10
5
), and PC (59.88 × 10
5
) (
p
< 0.01). Both the aPDT and SB groups were statistically different from the NC group (
p
< 0.01).
Conclusion
Proposed protocols, using air-powder abrasive system with sodium bicarbonate and aPDT, showed to be efficacious in the decontamination of dental implants surface
in vitro
.
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Affiliation(s)
- Vanessa Coelho Batalha
- Department of Periodontics and Implant Dentistry, Ingá University Center-Uningá, Maringá, Brazil
| | - Raquel Abreu Bueno
- Department of Periodontics and Implant Dentistry, Ingá University Center-Uningá, Maringá, Brazil
| | - Edemar Fronchetti Junior
- Department of Periodontics and Implant Dentistry, Ingá University Center-Uningá, Maringá, Brazil
| | | | | | | | | | - Samira Salmeron
- Department of Periodontics and Implant Dentistry, Ingá University Center-Uningá, Maringá, Brazil
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15
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Balderrama ÍDF, Stuani VDT, Cardoso MV, Oliveira RC, Lopes MMR, Greghi SLA, Adriana Campos Passanezi S. The influence of implant surface roughness on decontamination by antimicrobial photodynamic therapy and chemical agents: A preliminary study in vitro. Photodiagnosis Photodyn Ther 2020; 33:102105. [PMID: 33217567 DOI: 10.1016/j.pdpdt.2020.102105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/06/2020] [Accepted: 11/13/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this preliminary study was to analyze the effectiveness of three different protocols of decontamination on five commercial moderate rough implants. MATERIAL AND METHODS The types of implants investigated were: Neoporos Drive CM (CM; Neodent®), Drive CM Acqua (ACQ; Neodent®), SLActive (SLA; Straumann®), Osseotite (OT; Biomet 3i®) and Nanotite (NT; Biomet 3i®). Implant surface properties (n = 2/type of implant; control groups) were analyzed by scanning electron microscopy (SEM) images to determine surface roughness parameters (SRP) and energy disperse X-ray spectrometry to determine the chemical composition. Implants were then inoculated with Aggregatibacter actinomycetencomitans in vitro (n = 6/type of implant;experimental groups) and the contaminated areas were determined in SEM images (500x magnifications). Decontamination of implants was performed in duplicate by three protocols: antimicrobial photodynamic therapy (aPDT), EDTA associated with citric acid (EDTA + CA) and 0.12 % chlorhexidine (CHX). The remaining contaminated area (rCtA) was determined in SEM images (500x magnifications). All quantitative analysis through SEM images were analyzed in ImageJ® software for two-dimensional parameters. RESULTS No significant differences were found in SRP among implants (control group), except for Rv (lowest valley) between SLA vs. OT (p=0.0031; Kruskal Wallis post hoc Dunn). NT implants showed highest contaminated area vs. ACQ implants (68.19 % ± 8.63 % and 57.32 % ± 5.38 %, respectively; p = 0.0016, Tukey's test). SRP after decontamination showed statistical difference for Ra (arithmetical mean deviation) for all decontamination groups when compared to control (p < 0.05; ANOVA with post-hoc Tukey's multiple comparisons test), only CM implants showed statistical difference when compared decontamination protocols to control with highest modification of SRP for EDTA + AC group. For decontamination analysis, for applicability of different protocols in the same type of implant, only SLA showed statistical significant difference for aPDT vs. EDTA + CA (p = 0.0114; ANOVA with post-hoc Tukey's multiple comparisons test) with lowest rCTA for aPDT, however for ACQ implants the aPDT showed lowest rCTA with no statistical difference (p > 0.05; ANOVA with post-hoc Tukey's multiple comparisons test). No statistical difference was observed between the decontamination protocols at other implant types. CONCLUSION It can be suggested that the chemical-physical characteristics of dental implants can be effected by the process of contamination and decontamination by aPDT and chemical agents.
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Affiliation(s)
- Ísis de Fátima Balderrama
- Department of Diagnosis and Surgery, Araraquara School of Dentistry, Sao Paulo State University, Araraquara, SP, Brazil; Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil.
| | - Vitor de Toledo Stuani
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil.
| | - Matheus Völz Cardoso
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil.
| | - Rodrigo Cardoso Oliveira
- Department of Biological Science, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil.
| | | | - Sebastião Luiz Aguiar Greghi
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil.
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16
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Pranno N, Cristalli MP, Mengoni F, Sauzullo I, Annibali S, Polimeni A, La Monaca G. Comparison of the effects of air-powder abrasion, chemical decontamination, or their combination in open-flap surface decontamination of implants failed for peri-implantitis: an ex vivo study. Clin Oral Investig 2020; 25:2667-2676. [PMID: 32975703 PMCID: PMC8060238 DOI: 10.1007/s00784-020-03578-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/07/2020] [Indexed: 12/01/2022]
Abstract
Objectives To compare, using an ex vivo model, the biofilm removal of three surface decontamination methods following surgical exposure of implants failed for severe peri-implantitis. Materials and methods The study design was a single-blind, randomized, controlled, ex vivo investigation with intra-subject control. Study participants were 20 consecutive patients with at least 4 hopeless implants, in function for >12 months and with progressive bone loss exceeding 50%, which had to be explanted. Implants of each patient were randomly assigned to the untreated control group or one of the three decontamination procedures: mechanical debridement with air-powder abrasion, chemical decontamination with hydrogen peroxide and chlorhexidine gluconate, or combined mechanical-chemical decontamination. Following surgical exposure, implants selected as control were retrieved, and afterwards, test implants were decontaminated according to allocation and carefully explanted with a removal kit. Microbiological analysis was expressed in colony-forming-units (CFU/ml). Results A statistically significant difference (p < 0.001) in the concentrations of CFU/ml was found between implants treated with mechanical debridement (531.58 ± 372.07) or combined mechanical-chemical decontamination (954.05 ± 2219.31) and implants untreated (37,800.00 ± 46,837.05) or treated with chemical decontamination alone (29,650.00 ± 42,596.20). No statistically significant difference (p = 1.000) was found between mechanical debridement used alone or supplemented with chemical decontamination. Microbiological analyses identified 21 microbial species, without significant differences between control and treatment groups. Conclusions Bacterial biofilm removal from infected implant surfaces was significantly superior for mechanical debridement than chemical decontamination. Clinical relevance The present is the only ex vivo study based on decontamination methods for removing actual and mature biofilm from infected implant surfaces in patients with peri-implantitis.
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Affiliation(s)
- Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Paola Cristalli
- Department of Biotechnologies and Medical Surgical Sciences, Sapienza University of Rome, 6. Caserta St., 00161, Rome, Italy.
| | - Fabio Mengoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Ilaria Sauzullo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Susanna Annibali
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Gerardo La Monaca
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
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17
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Lollobrigida M, Fortunato L, Serafini G, Mazzucchi G, Bozzuto G, Molinari A, Serra E, Menchini F, Vozza I, De Biase A. The Prevention of Implant Surface Alterations in the Treatment of Peri-Implantitis: Comparison of Three Different Mechanical and Physical Treatments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082624. [PMID: 32290450 PMCID: PMC7215863 DOI: 10.3390/ijerph17082624] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 01/03/2023]
Abstract
The surgical treatment of peri-implantitis is currently based on the removal of biofilms from the implant surface by primary means of mechanical and physical treatments. However, such approaches often determine some alterations of the implant surface with detrimental effects on re-osseointegration. This study aims to evaluate the effects of four different mechanical and physical treatments on titanium samples with moderately rough surface. Air powder abrasion (AP) with glycine powder, a titanium brush (TB) and a diode laser at 3 W (L3) and 4 W (L4) were tested. Surface morphology, roughness and chemical composition were then assessed by scanning electron microscope (SEM), white light interferometer and X-ray photoelectron spectroscopy (XPS), respectively. The microscopic analysis revealed significant alterations in surface morphology on TB samples, while AP and L3 had only a minor or null impact. L4 samples revealed signs of overheating due to the excessive power. Nevertheless, the overall roughness of the samples was not significantly altered in terms of roughness parameters. Similarly, surface chemical composition was not significantly affected by the treatments. Among the treatments tested in this study, air powder abrasion with glycine powder and 3 W diode laser had the lowest impact on surface physicochemical properties.
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Affiliation(s)
- Marco Lollobrigida
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
- Correspondence:
| | - Lorenzo Fortunato
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Giorgio Serafini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Giulia Mazzucchi
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Giuseppina Bozzuto
- National Centre of Drug Research and Evaluation, Istituto Superiore di Sanità, 00161 Rome, Italy (A.M.)
| | - Agnese Molinari
- National Centre of Drug Research and Evaluation, Istituto Superiore di Sanità, 00161 Rome, Italy (A.M.)
| | - Emanuele Serra
- Sustainability Department, ENEA, Casaccia Research Center, 00123 Rome, Italy
| | - Francesca Menchini
- Energy Technology Department, ENEA, Casaccia Research Center, 00123 Rome, Italy
| | - Iole Vozza
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Alberto De Biase
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
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18
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Moharrami M, Perrotti V, Iaculli F, Love RM, Quaranta A. Effects of air abrasive decontamination on titanium surfaces: A systematic review of in vitro studies. Clin Implant Dent Relat Res 2019; 21:398-421. [PMID: 30838790 DOI: 10.1111/cid.12747] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/05/2019] [Accepted: 02/11/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Air abrasion (AA) is one of the decontamination methods that have demonstrated promising results in treating peri-implant diseases. PURPOSE This systematic review aimed at evaluating the in vitro effect of AA on surface change, cleaning efficacy, and biocompatibility of titanium surfaces and at comparing it with other decontamination methods. MATERIALS AND METHODS A comprehensive search was conducted up to April 2018 using PubMed, Scopus, and Google Scholar databases to identify studies on the decontamination effect of AA. All types of titanium surfaces, abrasive powders, contaminated surfaces, and measuring methods were included. RESULTS Overall, 1502 articles were identified. After screening the titles and abstracts, and carefully reading the full-texts, 48 articles published between 1989 and 2018 were selected. AA was considered almost safe, particularly for the nonmodified surfaces. Nevertheless, harder powders such as sodium bicarbonate tended to damage the surface more than glycine. AA resulted in surface change similar to plastic curettes and Er: YAG lasers. Regarding the cleaning efficacy, there was no significant difference between glycine and sodium bicarbonate, but different mixtures of calcium phosphate, hydroxyapatite, and erythritol were superior to glycine. AA was superior or equal to all other decontamination methods in cleaning. Regarding biocompatibility, AA was more successful in preserving biocompatibility for noncontaminated surfaces compared with contaminated surfaces and when used with erythritol and osteoinductive powders. CONCLUSIONS AA can efficiently remove contamination without serious damage to the surface. The main drawback of the AA method seems to be its limitation in restoring the biocompatibility of the surface.
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Affiliation(s)
| | - Vittoria Perrotti
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Flavia Iaculli
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Robert M Love
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
| | - Alessandro Quaranta
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
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Magana M, Sereti C, Ioannidis A, Mitchell CA, Ball AR, Magiorkinis E, Chatzipanagiotou S, Hamblin MR, Hadjifrangiskou M, Tegos GP. Options and Limitations in Clinical Investigation of Bacterial Biofilms. Clin Microbiol Rev 2018; 31:e00084-16. [PMID: 29618576 PMCID: PMC6056845 DOI: 10.1128/cmr.00084-16] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Bacteria can form single- and multispecies biofilms exhibiting diverse features based upon the microbial composition of their community and microenvironment. The study of bacterial biofilm development has received great interest in the past 20 years and is motivated by the elegant complexity characteristic of these multicellular communities and their role in infectious diseases. Biofilms can thrive on virtually any surface and can be beneficial or detrimental based upon the community's interplay and the surface. Advances in the understanding of structural and functional variations and the roles that biofilms play in disease and host-pathogen interactions have been addressed through comprehensive literature searches. In this review article, a synopsis of the methodological landscape of biofilm analysis is provided, including an evaluation of the current trends in methodological research. We deem this worthwhile because a keyword-oriented bibliographical search reveals that less than 5% of the biofilm literature is devoted to methodology. In this report, we (i) summarize current methodologies for biofilm characterization, monitoring, and quantification; (ii) discuss advances in the discovery of effective imaging and sensing tools and modalities; (iii) provide an overview of tailored animal models that assess features of biofilm infections; and (iv) make recommendations defining the most appropriate methodological tools for clinical settings.
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Affiliation(s)
- Maria Magana
- Department of Clinical Microbiology, Athens Medical School, Aeginition Hospital, Athens, Greece
| | - Christina Sereti
- Department of Clinical Microbiology, Athens Medical School, Aeginition Hospital, Athens, Greece
- Department of Microbiology, Thriassio General Hospital, Attiki, Greece
| | - Anastasios Ioannidis
- Department of Clinical Microbiology, Athens Medical School, Aeginition Hospital, Athens, Greece
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Greece
| | - Courtney A Mitchell
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Anthony R Ball
- Gliese 623b, Mendon, Massachusetts, USA
- GAMA Therapeutics LLC, Pepperell, Massachusetts, USA
| | - Emmanouil Magiorkinis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens-Goudi, Greece
| | | | - Michael R Hamblin
- Harvard-MIT Division of Health Science and Technology, Cambridge, Massachusetts, USA
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Maria Hadjifrangiskou
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - George P Tegos
- Gliese 623b, Mendon, Massachusetts, USA
- GAMA Therapeutics LLC, Pepperell, Massachusetts, USA
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20
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Tastepe CS, Lin X, Donnet M, Doulabi BZ, Wismeijer D, Liu Y. Re-establishment of Biocompatibility of the In Vitro Contaminated Titanium Surface Using Osteoconductive Powders With Air-Abrasive Treatment. J ORAL IMPLANTOL 2018; 44:94-101. [PMID: 29303415 DOI: 10.1563/aaid-joi-d-17-00128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To achieve re-osseointegration on implant surfaces exposed to peri-implant infections, treatment should re-establish biocompatibility. The aim of this study was to test whether air powder abrasive treatment (APA) using osteoconductive powders can, in addition to cleaning, increase the biocompatibility of the contaminated implant surface. Ninety-six in vitro Ca-precipitated, organic film layer-coated sandblasted and acid-etched titanium discs were treated by APA using erythritol, hydroxylapatite (HA), and biocalcium phosphate (BioCaP) powders (n = 16 per group). Six treatment modalities were created (HA or erythritol cleaning with/without BioCaP coating). MC3T3-E1cells were seeded on discs, and cell attachment, viability, proliferation, and differentiation were evaluated. Pristine discs were used as control (control 1). Contaminated and nontreated discs were used as control (control 2). The cells were stretched and attached in all test groups. The cell viability and proliferation (DNA amount) in all test groups were significantly higher than in the pristine and contaminated disc groups. There was no significant difference between the test groups. The differentiation (alkaline phosphatase activity) of the cells on treated discs was significantly higher than on the contaminated discs but lower than in the pristine group. The cell viability in control 2 was significantly lower than the control 1. The APA with osteoconductive powder on contaminated titanium surfaces promoted the cell viability, proliferation, and differentiation of the MC3T3-E1 cells. The biocompatibility of the surface was higher than that of the contaminated discs. The tested aspects of cell response, with the exception of differentiation, reached to the level of the pristine surface. The in vitro results showed that APA with osteoconductive powders could be a promising method for implant surface treatment.
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Affiliation(s)
- Ceylin S Tastepe
- 1 Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Xingnan Lin
- 1 Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,2 Affiliated Stomatological Hospital of Medical School, Nanjing University, Department of Orthodontics, Nanjing, China
| | - Marcel Donnet
- 3 E.M.S. Electro Medical Systems S.A., Research Group Dental, Nyon, Switzerland
| | - Behrouz Zandieh Doulabi
- 4 Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniel Wismeijer
- 1 Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Yuelian Liu
- 1 Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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21
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Van Weehaeghe M, De Bruyn H, Vandeweghe S. A prospective, split-mouth study comparing tilted implants with angulated connection versus conventional implants with angulated abutment. Clin Implant Dent Relat Res 2017; 19:989-996. [DOI: 10.1111/cid.12544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/06/2017] [Accepted: 08/21/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Manú Van Weehaeghe
- Department of Periodontology, Oral Implantology, Removable and Implant Prosthetics, Faculty of Medicine and Health Sciences; Ghent University; Gent Belgium
| | - Hugo De Bruyn
- Department of Periodontology, Oral Implantology, Removable and Implant Prosthetics, Faculty of Medicine and Health Sciences; Ghent University; Gent Belgium
| | - Stefan Vandeweghe
- Department of Periodontology, Oral Implantology, Removable and Implant Prosthetics, Faculty of Medicine and Health Sciences; Ghent University; Gent Belgium
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22
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Sygkounas E, Louropoulou A, Schoenmaker T, de Vries TJ, Van der Weijden FA. Influence of various air-abrasive powders on the viability and density of periodontal cells: An in vitro
study. J Biomed Mater Res B Appl Biomater 2017; 106:1955-1963. [DOI: 10.1002/jbm.b.34006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 09/07/2017] [Accepted: 09/11/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Eleftherios Sygkounas
- Department of Periodontology, Academic Center for Dentistry (ACTA); University of Amsterdam and VU Universiteit, Amsterdam; The Netherlands
| | - Anna Louropoulou
- Department of Periodontology, Academic Center for Dentistry (ACTA); University of Amsterdam and VU Universiteit, Amsterdam; The Netherlands
| | - Ton Schoenmaker
- Department of Periodontology, Academic Center for Dentistry (ACTA); University of Amsterdam and VU Universiteit, Amsterdam; The Netherlands
| | - Teun J. de Vries
- Department of Periodontology, Academic Center for Dentistry (ACTA); University of Amsterdam and VU Universiteit, Amsterdam; The Netherlands
| | - Fridus A. Van der Weijden
- Department of Periodontology, Academic Center for Dentistry (ACTA); University of Amsterdam and VU Universiteit, Amsterdam; The Netherlands
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23
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John G, Becker J, Schmucker A, Schwarz F. Non-surgical treatment of peri-implant mucositis and peri-implantitis at two-piece zirconium implants: A clinical follow-up observation after up to 3 years. J Clin Periodontol 2017; 44:756-761. [PMID: 28453869 DOI: 10.1111/jcpe.12738] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To assess the long-term clinical outcomes following non-surgical therapy of peri-implant diseases at two-piece zirconium implants. MATERIAL AND METHODS A total of 27 patients suffering from either (i) peri-implant mucositis (n = 24 implants), or (ii) peri-implantitis (n = 16 implants) completed a mean follow-up period of 32.8 ± 2.85 months (median: 34 months). The initial treatment procedures included (i) mechanical debridement + local antiseptic therapy using chlorhexidine digluconate (MD + CXH), or (ii) Er:YAG laser monotherapy (ERL). The primary outcome was disease resolution (i.e. absence of bleeding on probing (BOP) at mucositis sites/absence of BOP and probing pocket depths (PD) ≥6 mm at peri-implantitis sites). RESULTS Resolution of peri-implant mucositis and peri-implantitis was obtained in 7/14 (50.0%; p = .003) and 5/13 (38.5%; p = .001) of the patients investigated. This corresponded to 54.2% (13/24) and 50.0% (8/16) at the implant level respectively. CONCLUSION Both MD + CHX and ERL were effective on the long-term, but failed to achieve a complete disease resolution.
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Affiliation(s)
- Gordon John
- Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany
| | - Jürgen Becker
- Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany
| | - Andrea Schmucker
- Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany
| | - Frank Schwarz
- Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany
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