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Carrillo de Albornoz A, Montero E, Alonso-Español A, Sanz M, Sanz-Sánchez I. Treatment of peri-implantitis with a flapless surgical access combined with implant surface decontamination and adjunctive systemic antibiotics: A retrospective case series study. J Clin Periodontol 2024; 51:968-980. [PMID: 38690660 DOI: 10.1111/jcpe.13993] [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: 11/25/2023] [Revised: 03/26/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024]
Abstract
AIM To evaluate the effectiveness of a flapless surgical approach in the treatment of peri-implantitis and to explore the factors influencing its outcome. MATERIALS AND METHODS The present retrospective study evaluated patients with at least one implant diagnosed with peri-implantitis and treated with a flapless surgical access, with or without systemic antimicrobials, curettage and, when needed, prostheses modification. Clinical and radiographic parameters were assessed at baseline and at 3 months and at least 12 months. The primary outcome was disease resolution (≤1 bleeding sites, probing depth [PD] ≤5 mm, no bone loss >0.5 mm). Multilevel regression analyses were used to identify predictors influencing the probability of attaining disease resolution. RESULTS One hundred and seventeen patients with 338 implants were included. Disease resolution was attained in 54.4% of the 338 implants receiving flapless surgical access. At the end of the follow-up period, 111 patients (94.9%) with 295 implants (87.3%) did not require any further treatment, with 81.4% of these implants presenting PD ≤ 5 mm. History of periodontitis and PD at baseline were identified as negative predictors, while compliance with supportive peri-implant care, a machined surface and the adjunctive use of systemic azithromycin or metronidazole were identified as positive predictive factors for disease resolution. CONCLUSIONS A flapless surgical approach led to disease resolution in 54.4% of the implants with peri-implantitis. Several risk/protective predictors for disease resolution were identified.
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Affiliation(s)
- Ana Carrillo de Albornoz
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
| | - Eduardo Montero
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
| | | | - Mariano Sanz
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
| | - Ignacio Sanz-Sánchez
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
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Hong I, Koo KT, Oh SY, Park HW, Sanz-Martín I, Cha JK. Comprehensive treatment protocol for peri-implantitis: an up-to date narrative review of the literature. J Periodontal Implant Sci 2024; 54:54.e2. [PMID: 38290998 DOI: 10.5051/jpis.2303360168] [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: 07/24/2023] [Revised: 10/19/2023] [Accepted: 11/02/2023] [Indexed: 02/01/2024] Open
Abstract
This narrative review describes up-to-date treatment options for peri-implantitis and proposes a treatment protocol and flowchart based on the current scientific evidence. Peri-implantitis treatment should be based on the phased treatment protocol for periodontitis, which is a continuous flow of decisions for extraction, nonsurgical and surgical treatments with step-by-step re-evaluation. The protocol's goals are to fulfill the success criteria for peri-implantitis treatment (probing depth of ≤5 mm, and absence of bleeding on probing, suppuration, and progressive bone loss) and to halt disease progression. Fixtures with peri-implantitis can initially be classified as failed or failing. A failed implant needs to be removed. In contrast, nonsurgical and surgical treatments can be applied to a failing implant. Nonsurgical treatment should be the initial treatment for failing implants; however, sole nonsurgical treatment was regarded as inefficient for peri-implantitis. Recent studies have found that the adjunctive use of antibiotics to nonsurgical debridement increased the success of nonsurgical treatment for peri-implantitis. Surgical treatments can be classified into resective, access, and reconstructive surgeries. The technique should be selected according to the patient's bone defect configuration, which relate to regenerative potential. Various combinations of decontamination methods (e.g., mechanical, chemical, and pharmacological approaches) are required to achieve absolute surface decontamination. Clinicians should select an appropriate surface decontamination strategy according to the purpose of surgery. After signs of disease disappear and its progression is halted through active peri-implantitis treatment, it is necessary to enroll patients into maintenance programs. Compliance of patients with the maintenance program reduces the recurrence of peri-implantitis and sustains clinical success after treatment. Maintenance visits should include professional plaque control and hygiene care reinforcement for patients, and their interval should be set according to individual peri-implantitis risk. Clinicians should remind that peri-implantitis treatment is not a single procedure, but rather a continuing cycle of treatment and re-evaluation.
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Affiliation(s)
- Inpyo Hong
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sang-Yoon Oh
- Private practice, Mapo Acro Dental Clinic, Seoul, Korea
| | | | - Ignacio Sanz-Martín
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Private Practice, Lausanne, Switzerland
- Postgraduate Program in Periodontology, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.
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Mayer Y, Khoury J, Horwitz J, Ginesin O, Canullo L, Gabay E, Giladi HZ. A novel nonsurgical therapy for peri-implantitis using focused pulsed electromagnetic field: A pilot randomized double-blind controlled clinical trial. Bioelectromagnetics 2023; 44:144-155. [PMID: 37655846 DOI: 10.1002/bem.22481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/06/2023] [Accepted: 07/18/2023] [Indexed: 09/02/2023]
Abstract
Pulsed electromagnetic field (PEMF) therapy modulates the immune response and is successfully used in orthopedics to treat osteoarthritis and improve bone regeneration. This may suggest that this treatment may consequently reduce peri-implant soft tissue inflammation and marginal bone loss. To compare clinical, radiographic, and immunological results following nonsurgical treatment for peri-implantitis with or without PEMF therapy. Patients with peri-implantitis were included: pocket probing depth (PPD) between 6 and 8 mm with bleeding on probing (BOP); crestal bone loss between 3 and 5 mm. A novel healing abutment that contained active (test) or inactive (control) PEMF was connected. PEMF was administered via the abutment at exposure ratio of 1/500-1/5000, intensity: 0.05-0.5 mT, frequency: 10-50 kHz for 30 days. Nonsurgical mechanical implant surface debridement was performed. Patients were examined at baseline, 1 and 3 months. Clinical assessment included: plaque index, BOP, PPD, recession, and bone crest level which was radiography measured. Samples of peri-implant crevicular fluid were taken to analyze interleukin-1β (IL-1β). Twenty-three patients (34 implants; 19 control, 15 test) were included. At the follow-up, mean crestal bone loss was lower in the test group at 1 and 3 months (2.48 mm vs. 3.73 mm, p < 0.05 and 2.39 vs. 3.37, p < 0.01). IL-1β levels were also lower in the test group at 2 weeks (72.86 pg/mL vs. 111.7, p < 0.05). Within all the limitation of this preliminary study, the test group improved clinical parameters after a short-term period compared to the control group.
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Affiliation(s)
- Yaniv Mayer
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Juan Khoury
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
| | - Jacob Horwitz
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ofir Ginesin
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Luigi Canullo
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, Genova, Italy
| | - Eran Gabay
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Hadar Z Giladi
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Elsadek MF. Effectiveness of two photosensitizer-mediated photodynamic therapy for treating moderate peri-implant infections in type-II diabetes mellitus patients: A randomized clinical trial. Photodiagnosis Photodyn Ther 2023; 43:103643. [PMID: 37270045 DOI: 10.1016/j.pdpdt.2023.103643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 05/27/2023] [Accepted: 05/31/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE This study evaluated the impact of Fox Green (FG) against methylthioninium chloride (MTC)-facilitated photodynamic therapy (PDT) as an adjunctive to manual scaling (MS) on the peri‑implant clinical and cytokine parameters in type-2 diabetes mellitus (DM) patients with peri‑implantitis. METHODS Patients were divided into group-A comprising 13 patients who received adjunctive FG-PDT using a diode laser (wavelength: 810 nm; irradiation power: 300 mW; irradiation time: 30 s; fluence: 56 Jcm-2), group-B comprising 12 patients who received adjunctive MTC-PDT using a diode laser (wavelength: 660 nm; irradiation power: 100 mW; irradiation time: 120 s/site; fluence: 30 Jcm-2), and group-C comprising 13 patients who received MS alone [control group]). After diagnosing the diabetics with peri‑implantitis (established on eligibility criteria), a structured questionnaire was used to gather the information of the participants. Plaque (PS) and bleeding scores (BS), along with peri‑implant probing scores (PPS) and peri‑implant bone loss (PIBL), together with immunological variables (interleukin [IL]-6, tumor necrosis factor-alpha [TNF-α], and advanced glycation end products [AGEs]) were measured in all study group participants at baseline, 3-month, and 6-month follow-ups. RESULTS A significant reduction was observed for PS, BS, and PPS within all tested groups at each follow-up visits compared from their baseline values (p<0.05). However, a substantial decrease in PIBL was observed in all study group patients at 6-month follow-up as compared to 3-month follow-up (p<0.05). Regarding the levels of IL-6 and TNF-α, a substantial reduction was observed in all study groups until 6-month from their baseline scores (p<0.05). However, no changes were observed in the levels of AGEs in any group at either visit (p>0.05). CONCLUSION In DM patients with periimplantitis, adjunctive FG-PDT and MTC-PDT exhibited comparable outcomes in terms of peri‑implant clinical as well as pro-inflammatory characteristics than MS alone among peri‑implantitis patients with DM.
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Affiliation(s)
- Mohamed Farouk Elsadek
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia.
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López-Valverde N, López-Valverde A, Blanco-Rueda JA. Efficacy of adjuvant metronidazole therapy on peri-implantitis: a systematic review and meta-analysis of randomized clinical studies. Front Cell Infect Microbiol 2023; 13:1149055. [PMID: 37287463 PMCID: PMC10242105 DOI: 10.3389/fcimb.2023.1149055] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/02/2023] [Indexed: 06/09/2023] Open
Abstract
Peri-implant diseases are pathological conditions that affect the survival of dental implants. Etiological studies are limited, accepting a prevalence of 20% at the implant level and 24% at the patient level. The benefits of adjuvant metronidazole are controversial. A systematic review and meta-analysis of RCTs according to PRISMA and PICOS was performed with an electronic search over the last 10 years in MEDLINE (PubMed), WOS, Embase, and Cochrane Library. The risk of bias was measured using the Cochrane Risk of Bias tool and the methodological quality using the Jadad scale. Meta-analysis was performed with RevMan version 5.4.1, based on mean difference and standard deviation, with 95% confidence intervals; the random-effects model was selected, and the threshold for statistical significance was defined as p < 0.05. A total of 38 studies were collected and five were selected. Finally, one of the studies was eliminated because of unanalyzable results. All studies reached a high methodological quality. A total of 289 patients were studied with follow-up periods from 2 weeks to 1 year. Statistical significance was only found, with respect to the use of adjunctive metronidazole, in the pooled analysis of the studies (p = 0.02) and in the analysis of the radiographic values reported on peri-implant marginal bone levels, in the studies with a 3-month follow-up (p = 0.03). Discrepancies in the use of systemic metronidazole require long-term randomized clinical trials (RCTs) to determine the role of antibiotics in the treatment of peri-implantitis.
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Affiliation(s)
- Nansi López-Valverde
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, Universidad Alcalá de Henares, Madrid, Spain
| | - Antonio López-Valverde
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - José Antonio Blanco-Rueda
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
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Alsayed H, Bukhari IA, Alsaif R, Vohra F. Efficacy of indocyanine green and methylene blue mediated-photodynamic therapy on peri-implant outcomes among diabetics with peri-implant mucositis. Photodiagnosis Photodyn Ther 2023; 42:103344. [PMID: 36841279 DOI: 10.1016/j.pdpdt.2023.103344] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND This study aimed to assess the efficacy of indocyanine green (ICG)-mediated versus methylene blue (MB)-mediated photodynamic therapy (PDT) as an adjunct to conventional mechanical debridement (MD) on the peri‑implant clinical, radiographic, microbiological, and immunological outcomes among diabetics with peri‑implant mucositis (pi-M). METHODS For this 3-month follow-up study, diabetics having pi-M were randomly divided into 3 groups: group-I (n = 20) subjects received only MD; group-II (n = 20) participants received ICG-mediated adjunct PDT; and group-III (n = 20) subjects received MB-mediated adjunct PDT. Peri-implant clinical (i.e., plaque index [PI], bleeding on probing [BOP], probing depth [PD]), radiographic (crestal bone loss [CBL]), microbiological (Fusobacterium nucleatum [F. nucleatum], Tannerella forsythia [T. forsythia], Prevotella intermedia [P. intermedia], Porphyromonas gingivalis [P. gingivalis], Aggregatibacter actinomycetemcomitans [A. actinomycetemcomitans]), and immunological (interleukin [IL]-6, IL-1β, tumor necrosis factor-alpha [TNF-α]) outcomes were assessed at baseline and 3-month follow-up. RESULTS Mean changes between baseline and 3-month follow-up in peri‑implant clinico-radiographic parameters were significantly different between control (PI: 12.42±21.80%; BOP: 12.10±19.30%; PD: 0.45±0.41 mm; CBL: 1.10±1.02 mm) and test groups (ICG-mediated PDT [PI: 26.55±25.80%; BOP: 28.77±29.24%; PD: 0.84±0.62 mm; CBL: 1.98±1.85 mm] and MB-mediated PDT [PI: 27.24±26.15%; BOP: 27.71±28.16%; PD: 0.85±0.63 mm; CBL: 1.95±1.80 mm]), however comparable differences were observed in peri‑implant PI, BOP, PD, and CBL between group-II and group-III participants (p>0.05). The proportions of T. forsythia were significantly reduced in group-II (4.78 × 104 colony-forming unit per milliliter [CFU/mL]) and group-III (4.76 × 104 CFU/mL) as compared to group-I (-4.40 × 103 CFU/mL) at 3-month follow-up (p = 0.02). No statistically significant differences were observed between the study groups regarding the proportions of the other assessed target bacterial species. For IL-6 (group-I: 210±108; group-II: 298±165; group-III: 277±121 pg/mL; p = 0.03), IL-1β (group-I: 101±95; group-II: 84±98; group-III: 86±74 pg/mL; p = 0.02), and TNF-α (group-I: 336±121; group-II: 385±210; group-III: 366±198 pg/mL; p = 0.03) peri‑implant sulcular fluid [PISF] levels, all three study groups demonstrated statistically significant reduction at 3-month follow-up. CONCLUSIONS ICG-mediated and MB-mediated adjunctive PDT showed statistically significant improvements in peri‑implant clinical, radiographic, microbiological, and immunological parameters as compared to conventional MD alone at 3-month follow-up among diabetics with pi-M. However, comparable outcomes were demonstrated by ICG-mediated and MB-mediated adjunctive PDT regarding the assessed peri‑implant parameters.
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Affiliation(s)
- Hussain Alsayed
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, P. O. Box 60169, Riyadh 11545, Saudi Arabia.
| | - Ishfaq A Bukhari
- Department of Pharmacology, Kentucky College of Osteopathic Medicine, University of Pikeville, Pikeville, KY 41501, USA
| | - Rawan Alsaif
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, P. O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, P. O. Box 60169, Riyadh 11545, Saudi Arabia.
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Vilarrasa J, Soldini MC, Pons R, Valles C, Blasi G, Monje A, Nart J. Outcome indicators of non-surgical therapy of peri-implantitis: a prospective case series analysis. Clin Oral Investig 2023:10.1007/s00784-023-04918-2. [PMID: 36786958 DOI: 10.1007/s00784-023-04918-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/05/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES This study aims to identify patient and implant indicators influencing the non-surgical therapeutic outcomes of peri-implantitis at 6 months of follow-up. METHODS This case series involved patients with at least one implant diagnosed with peri-implantitis according to the 2017 World Workshop criteria. Non-surgical therapy consisted of mechanical debridement of the peri-implant pockets combined with metronidazole 500 mg 3 times a day for 7 days. At baseline and at 6 months, clinical and radiographic variables were collected to calculate treatment success (probing pocket depth reduction to 5 mm without bleeding on probing or < 5 mm irrespective of bleeding on probing at all implant sites, and lack of bone loss progression). The primary outcome was treatment success (%) at 6 months. The influence of the patient and implant/prosthetic variables upon disease resolution was assessed through simple and multiple logistic regression analyses at patient and implant level, using generalized estimation equations models. RESULTS A total of 74 patients and 107 implants were analyzed at 6 months. Disease resolution was established in 25.7% of the patients and 24.1% of the implants. Patients with stage IV and grade C periodontitis, inadequate oral hygiene at baseline, and wide diameter (≥ 4.5 mm) presented significantly greater treatment failure, whereas smokers and former smokers demonstrated a tendency toward failure. At 6 months, there was a significant decrease in probing pocket depth and bleeding on probing of 1.08 ± 1.06 mm and 14%, respectively. Radiographically, a significant gain in marginal bone level of 0.43 ± 0.56 mm was observed. CONCLUSION Disease resolution after non-surgical treatment of peri-implantitis is negatively influenced by the loss of support of the adjacent periodontium, poor baseline oral hygiene, and wide diameter implants (≥ 4.5 mm). CLINICAL RELEVANCE This study helps to discriminate the clinical situations in which non-surgical treatment is less likely to achieve treatment success at short term.
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Affiliation(s)
- Javi Vilarrasa
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Maria Costanza Soldini
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Ramón Pons
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain.
| | - Cristina Valles
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Gonzalo Blasi
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain.,Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, MI, USA.,Department of Periodontology, University of Bern, Bern, Switzerland
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
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Fischer KR, Büchel J, Gubler A, Liu CC, Sahrmann P, Schmidlin PR. Nonsurgical cleaning potential of deep-threaded implants and titanium particle release: A novel in vitro tissue model. Clin Oral Implants Res 2023; 34:416-425. [PMID: 36757141 DOI: 10.1111/clr.14045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/19/2022] [Accepted: 01/06/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVES To measure the efficiency of three cleaning modalities on two implant designs with similar diameters but different thread depths as well as the presence of titanium particles. METHODS Sixty dyed implants (30 × 4.8 apically tapered (ATAP) and 30 × 5.0 fully tapered (FTAP)) were fixed in plastic models. The horizontal bone defects were surrounded with porcine soft tissue. Three instrumentation modalities were used to clean for 150 s: Curette (CUR), ultrasonic scaler (US), and air powder waterjet device (APWJ) with erythritol powder. Afterward, implants were photographed and scanning electron microscopic (SEM) images were taken. Titanium in the soft tissues was quantified in dissolved samples and histologically confirmed. RESULTS For ATAP and FTAP implants, the percentage of the cleaned surface was 26.4 ± 3.0 and 17.1 ± 2.4% for CUR, 33.7 ± 3.8% and 28.1 ± 2.3% for US, and 45.5 ± 4.1% and 24.7 ± 3.8% for APWJ, respectively. SEM images showed significant implant surface changes, especially after instrumentation with CUR and US, whereas APWJ had little to no effect. Most titanium residues were found after cleaning ATAP implants with CUR (152.0 ± 75.5), followed by US (89.5 ± 73.8) and APWJ (0.3 ± 0.8). For the FTAP implants, respective values accounted for 129.5 ± 58.6 μg and 67.0 ± 14.4 μg for CUR and US, respectively. No titanium residues were detected on ATAP with APWJ. CONCLUSION Based on in vitro data, erythritol-powered APWJ still appears to be the most efficient and gentle cleaning method. All three instruments, however, were found to have unprocessed areas depending on different implant designs, hence, clinical relevance for non-surgical approaches remains challenging and warrants further improvement.
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Affiliation(s)
- Kai R Fischer
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| | - Jasmin Büchel
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| | - Andrea Gubler
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| | - Chun Ching Liu
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| | - Philipp Sahrmann
- Clinic for Periodontology, Endodontology and Cariology, University Center of Dental Medicine, University of Basel, Basel, Switzerland
| | - Patrick R Schmidlin
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
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Effect of Implantoplasty on Roughness, Fatigue and Corrosion Behavior of Narrow Diameter Dental Implants. J Funct Biomater 2023; 14:jfb14020061. [PMID: 36826860 PMCID: PMC9967762 DOI: 10.3390/jfb14020061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/25/2023] Open
Abstract
Implantoplasty (IP) is used in dental implants with peri-implantitis and aims to remove threads and polish rough surfaces in order to prevent bacterial colonization. As a result of this procedure, implant strength might be compromised. We tested 20 tapered screw-shaped Ti6Al4V dental implants with a simulated bone loss of 50%. Ten implants underwent IP and 10 served as controls. Surface topography (Sa, Sz, Ssk, and Sdr) was analyzed with a confocal optical microscope. Subsequently, a minimum of four series of cyclic loads were applied with a servo-hydraulic mechanical testing machine (5 × 106 cycles at 15 Hz, between a maximal nominal value-starting at 529 N in the IP group and 735 N in the control group-and 10% of that force). We recorded the number of cycles until failure and the type of failure. Implant failure was analyzed by visual inspection and scanning electron microscopy. Open circuit potential and potenctiodynamic tests were carried out with high precision potentiostat using Hank's solution at 37 °C to evaluate the effect of the implantoplasty on the corrosion resistance. Implantoplasty significantly reduced the surface topography values (median) and interquartile range (IQR); Sa from 1.76 (IQR = 0.11) to 0.49 (IQR = 0.16), Sz from 20.98 (IQR = 8.14) to 8.19 (IQR = 4.16), Ssk from 0.01 (IQR = 0.34) to -0.74 (IQR = 0.53) and Sdr from 18.20 (IQR = 2.26) to 2.67 (IQR = 0.87). The fatigue limits of the control and implantoplasty groups were 551 N and 529 N, respectively. The scanning electron micrographs showed fatigue striations indicating fatigue failure. Besides, the fractographic analysis revealed a typical brittle intergranular fracture mechanism. The infinite life range of the dental implants evaluated was largely above the threshold of usual chewing forces. Implantoplasty seems to render a fairly smooth surface and has a limited impact on fatigue resistance. In addition, implantoplasty produces a decrease in the corrosion resistance of the implant. Corrosion current density from 0.019 μA/cm2 for as-received to 0.069 μA/cm2 in the interface smooth-roughened dental implant. These places between the machining and the rough area of the implant are the most susceptible, with the appearance of pitting.
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Wang J, Geng T, Wang Y, Yuan C, Wang P. Efficacy of antibacterial agents combined with erbium laser and photodynamic therapy in reducing titanium biofilm vitality: an in vitro study. BMC Oral Health 2023; 23:32. [PMID: 36658553 PMCID: PMC9854221 DOI: 10.1186/s12903-023-02730-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/10/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The emergence of peri-implant diseases has prompted various methods for decontaminating the implant surface. This study compared the effectiveness of three different approaches, chlorhexidine digluconate (CHX) combined with erbium-doped yttrium-aluminum-garnet (Er:YAG) laser, photodynamic therapy (PDT), and CHX only, for reducing biofilm vitality from implant-like titanium surfaces. STUDY DESIGN/MATERIALS AND METHODS The study involved eight volunteers, each receiving a custom mouth device containing eight titanium discs. The volunteers were requested to wear the device for 72 h for biofilm development. Fluorescence microscopy was used to evaluate the remaining biofilm with a two-component nucleic acid dye kit. The vital residual biofilm was quantified as a percentage of the surface area using image analysis software. Sixty-four titanium discs were assigned randomly to one of four treatment groups. RESULTS The percentage of titanium disc area covered by vital residual biofilm was 43.9% (7.7%), 32.2% (7.0%), 56.6% (3.6%), and 73.2% (7.8%) in the PDT, Er:YAG, CHX, and control groups, respectively (mean (SD)). Compared to the control group, the treatment groups showed significant differences in the area covered by residual biofilm (P < 0.001). CHX combined with Er:YAG laser treatment was superior to CHX combined with PDT, and CHX only was better than the control. CONCLUSION Within the current in vitro model's limitations, CHX combined with Er:YAG laser treatment is a valid method to reduce biofilm vitality on titanium discs.
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Affiliation(s)
- Jing Wang
- grid.417303.20000 0000 9927 0537School of Stomatology, Xuzhou Medical University, Xuzhou, China ,grid.417303.20000 0000 9927 0537Center of Implant Dentistry, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, China
| | - Tengyu Geng
- grid.417303.20000 0000 9927 0537School of Stomatology, Xuzhou Medical University, Xuzhou, China ,grid.417303.20000 0000 9927 0537Department of Prosthodontics, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yuzhuo Wang
- grid.417303.20000 0000 9927 0537School of Stomatology, Xuzhou Medical University, Xuzhou, China ,grid.417303.20000 0000 9927 0537Center of Implant Dentistry, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, China
| | - Changyong Yuan
- grid.417303.20000 0000 9927 0537School of Stomatology, Xuzhou Medical University, Xuzhou, China ,grid.417303.20000 0000 9927 0537Center of Implant Dentistry, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, China
| | - Penglai Wang
- grid.417303.20000 0000 9927 0537School of Stomatology, Xuzhou Medical University, Xuzhou, China ,grid.417303.20000 0000 9927 0537Center of Implant Dentistry, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, China
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11
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Grusovin MG, Pispero A, Del Fabbro M, Sangiorgi M, Simion M, Stefanini M, Varoni EM. Antibiotics as Adjunctive Therapy in the Non-Surgical Treatment of Peri-Implantitis: A Systematic Review and Meta-Analysis. Antibiotics (Basel) 2022; 11:1766. [PMID: 36551424 PMCID: PMC9774402 DOI: 10.3390/antibiotics11121766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
The role of antibiotics as adjunctive therapy in the non-surgical treatment of peri-implantitis is uncertain. The aim of this systematic review of randomized controlled trials was to assess the efficacy of antibiotic therapy, local or systemic, as an adjunctive to the non-surgical therapy of peri-implantitis. Primary outcomes were: implant success rate and complications, changes in radiographic bone level, probing pocket depth (PPD), probing attachment level (PAL), bleeding on probing (BOP) and peri-implantitis resolution. Six studies were included: two using topical and four systemic antibiotics. Adjunctive local antibiotics improved PPD (mean difference (MD) = 0.6 mm; 95% CI 0.42-0.78), BOP (MD = 0.15% (95% CI 0.10, 0.19)) and the success rate (risk ratio = 9.89; 95% CI 2.39-40.84). No significant difference in bone level and success rate were found with the use of systemic antibiotics, although they appeared to improve PPD (MD = 1.15 mm; 95% CI 0.31-1.99) and PAL (MD = 1.10 mm; 95% CI 0.13-2.08). Within the limitations of this review, the adjunctive local antibiotics showed improved outcomes in terms of success rate, PPD and BOP, while adjunctive systemic antibiotics improved PPD and PAL only. Peri-implantitis resolution was about 20-30% using adjunctive local antibiotics, whilst it ranged from 2% to 65% with adjunctive systemic antibiotics. Findings are still controversial, since they are based on few studies with high heterogeneity, at the uncertain or high risk of bias and involve few patients. Non-surgical debridement and maintenance periodontal support therapy remain pivotal and the adjunctive use of antibiotics for peri-implantitis cannot be routinely recommended, even considering the increasing concern on antibiotic resistance.
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Affiliation(s)
- Maria Gabriella Grusovin
- Dipartimento Odontoiatria, Università Vita Salute “S. Raffaele”, 20132 Milan, Italy
- Libera Professionista in Gorizia (Dental Private Practice), 34170 Gorizia, Italy
| | - Alberto Pispero
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, 20122 Milan, Italy
| | - Massimo Del Fabbro
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, 20122 Milan, Italy
- IRCCS Fondazione Ca’Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Matteo Sangiorgi
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna,40123 Bologna, Italy
| | - Massimo Simion
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, 20122 Milan, Italy
| | - Martina Stefanini
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna,40123 Bologna, Italy
| | - Elena Maria Varoni
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, 20122 Milan, Italy
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12
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Agarwalla SV, Ellepola K, Sorokin V, Ihsan M, Silikas N, Neto AHC, Seneviratne CJ, Rosa V. Antimicrobial-free graphene nanocoating decreases fungal yeast-to-hyphal switching and maturation of cross-kingdom biofilms containing clinical and antibiotic-resistant bacteria. BIOMATERIALS AND BIOSYSTEMS 2022; 8:100069. [PMID: 36824379 PMCID: PMC9934433 DOI: 10.1016/j.bbiosy.2022.100069] [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: 04/05/2022] [Revised: 10/23/2022] [Accepted: 10/23/2022] [Indexed: 12/05/2022] Open
Abstract
Candida albicans and methicillin-resistant Staphylococcus aureus (MRSA) synergize in cross-kingdom biofilms to increase the risk of mortality and morbidity due to high resistance to immune and antimicrobial defenses. Biomedical devices and implants made with titanium are vulnerable to infections that may demand their surgical removal from the infected sites. Graphene nanocoating (GN) has promising anti-adhesive properties against C. albicans. Thus, we hypothesized that GN could prevent fungal yeast-to-hyphal switching and the development of cross-kingdom biofilms. Herein, titanium (Control) was coated with high-quality GN (coverage > 99%). Thereafter, mixed-species biofilms (C. albicans combined with S. aureus or MRSA) were allowed to develop on GN and Control. There were significant reductions in the number of viable cells, metabolic activity, and biofilm biomass on GN compared with the Control (CFU counting, XTT reduction, and crystal violet assays). Also, biofilms on GN were sparse and fragmented, whereas the Control presented several bacterial cells co-aggregating with intertwined hyphal elements (confocal and scanning electronic microscopy). Finally, GN did not induce hemolysis, an essential characteristic for blood-contacting biomaterials and devices. Thus, GN significantly inhibited the formation and maturation of deadly cross-kingdom biofilms, which can be advantageous to avoid infection and surgical removal of infected devices.
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Affiliation(s)
| | - Kassapa Ellepola
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, USA
| | - Vitaly Sorokin
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital, National University Health System, Singapore
| | - Mario Ihsan
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nikolaos Silikas
- Dentistry, The University of Manchester, Manchester, United Kingdom
| | - AH Castro Neto
- Centre for Advanced 2D Materials, National University of Singapore, Singapore
| | - Chaminda Jayampath Seneviratne
- School of Dentistry, The University of Queensland, Australia,Co-corresponding author at: School of Dentistry, The University of Queensland, 288 Herston Road, Cnr Bramston Terrace & Herston Road Herston QLD 4006, Australia.
| | - Vinicius Rosa
- Faculty of Dentistry, National University of Singapore, Singapore,Centre for Advanced 2D Materials, National University of Singapore, Singapore,ORCHIDS: Oral Care Health Innovations and Designs Singapore, National University of Singapore, Singapore,Corresponding author at: Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, 119085, Singapore.
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13
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Luengo F, Solonko M, Sanz-Esporrín J, Sanz-Sánchez I, Herrera D, Sanz M. Clinical, Microbiological, and Biochemical Impact of the Surgical Treatment of Peri-Implantitis-A Prospective Case Series. J Clin Med 2022; 11:jcm11164699. [PMID: 36012939 PMCID: PMC9410201 DOI: 10.3390/jcm11164699] [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: 07/18/2022] [Revised: 08/01/2022] [Accepted: 08/09/2022] [Indexed: 11/24/2022] Open
Abstract
Background: The aim of this study, a prospective case series, was to evaluate the clinical, microbiological, and biochemical impact of the surgical treatment of peri-implantitis. Methods: Thirty subjects with diagnosis of peri-implantitis were treated following a surgical protocol including access flaps, surface decontamination with ultrasonics and glycine powder air-polishing, and systemic antibiotics. Disease resolution was defined by the composite outcome including presence of probing depths (PD) ≤5 mm, absence of bleeding on probing (BoP)/suppuration, and no additional radiographic bone loss (>1 mm). Regression analysis was used to evaluate the patient-, implant-, and prosthetic-related factors possibly influencing treatment outcomes. Results: Patients were evaluated at 6 months post treatment, demonstrating statistically significant reductions in PD (2.14 ± 1.07 mm) and increase in mucosal recession (1.0 ± 0.77 mm). Plaque, BoP, and suppuration were also reduced by 40.56%, 62.22%, and 7.78%, respectively. Disease resolution was achieved in 56.67% of patients. No significant changes were detected in microbiological parameters except for a significant reduction in proportions of Parvimonas micra. Similarly, the levels of the biomarker interleukin-8 in crevicular fluid were significantly lower at 6 months. Conclusions: The proposed surgical treatment of peri-implantitis demonstrated statistically significant clinical improvements although the impact on microbiological and biochemical parameters was scarce.
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Affiliation(s)
- Fernando Luengo
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
| | - Myroslav Solonko
- Section of Periodontology, Faculty of Odontology, University Complutense, 28040 Madrid, Spain
| | - Javier Sanz-Esporrín
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
| | - Ignacio Sanz-Sánchez
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
- Correspondence:
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
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14
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Montero E, Roccuzzo A, Molina A, Monje A, Herrera D, Roccuzzo M. Minimal invasiveness in the reconstructive treatment of peri-implantitis defects. Periodontol 2000 2022; 91:199-216. [PMID: 35899987 DOI: 10.1111/prd.12460] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/30/2022] [Accepted: 06/05/2022] [Indexed: 11/30/2022]
Abstract
Peri-implantitis is a plaque-associated pathologic condition occurring in tissues around dental implants, clinically characterized by increased peri-implant probing pocket depth and progressive loss of supporting bone. Consequently, to arrest further disease progression and to increase the chance to obtain re-osseointegration, surgical reconstructive procedures have been adopted. In particular, following a paradigm gathered from periodontal therapy, recent protocols have underlined the importance of a minimally invasive approach to optimize the outcomes of therapy while minimizing the risks of postoperative complications. The present review summarizes the level of evidence on the surgical reconstructive protocols focusing on the new approaches aiming to minimize surgical trauma and patients' postoperative discomfort, underlining the pros and cons of each treatment modality.
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Affiliation(s)
- Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Ana Molina
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Mario Roccuzzo
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Division of Maxillofacial Surgery, University of Torino, Torino, Italy
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15
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The Influence of Keratinized Mucosa on the Nonsurgical Therapeutic Treatment of Peri-Implantitis. J Clin Med 2022; 11:jcm11144118. [PMID: 35887880 PMCID: PMC9323539 DOI: 10.3390/jcm11144118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/08/2022] [Accepted: 07/15/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE The main objective of this study aimed to evaluate the response to treatment in implants with peri-implantitis regarding the presence or absence of keratinized mucosa. MATERIALS AND METHODS One hundred implants with peri-implantitis were treated non-surgically at the Prosthodontics and Occlusion Teaching Unit of the University of Valencia. Records were registered at day zero (recession, bleeding on probing, suppuration, probing depth, bone loss and plaque index), at 1, 3 and 6 months. RESULTS In both groups, a slight increase in recession and disappearance of suppuration took place, and no bone loss was observed during the following 6 months. However, after an initial reduction, probing depth, bleeding on probing and plaque index increased again in the group without keratinized mucosa (KM). CONCLUSIONS Implants with KM presented better results after non-surgical treatment as well as in their medium-term evolution, although it would be advisable to increase the number of samples in order to achieve greater scientific evidence and standardization in the treatment protocol. CLINICAL RELEVANCE The role of keratinized mucosa in the development of peri-implantitis has been mentioned in many publications, but less has been emphasized regarding its influence on the success of the treatment of this pathology. The presence of keratinized mucosa has been found to play a key role in the evolution of the non-surgical treatment of peri-implantitis. The amount of keratinized mucosa should be considered in the treatment of peri-implantitis, as well as when planning connective tissue grafts accompanying the decontamination of implants in the absence of keratinized mucosa.
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16
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Toledano-Osorio M, Vallecillo C, Toledano R, Aguilera FS, Osorio MT, Muñoz-Soto E, García-Godoy F, Vallecillo-Rivas M. A Systematic Review and Meta-Analysis of Systemic Antibiotic Therapy in the Treatment of Peri-Implantitis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116502. [PMID: 35682086 PMCID: PMC9180155 DOI: 10.3390/ijerph19116502] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 02/07/2023]
Abstract
Research has been conducted into the advantages of the systemic administration of antibiotics. The aim of this systematic review and meta-analysis was to assess the efficacy of systemic antibiotic administration in the treatment of peri-implantitis in terms of bleeding on probing (BoP) and probing pocket depth (PPD). Literature searches were performed across PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) to identify randomized controlled trials and observational clinical studies. After peri-implantitis treatment, PPD was reduced by 0.1 mm (p = 0.58; IC 95% [-0.24, 0.47]), indicating a non-significant effect of antibiotic administration on PPD. The BoP odds ratio value was 1.15 (p = 0.5; IC 95% [0.75, 1.75]), indicating that the likelihood of bleeding is almost similar between the test and control groups. Secondary outcomes were found, such as reduced clinical attachment level, lower suppuration and recession, less bone loss, and a reduction in total bacterial counts. In the treatment of peri-implantitis, the systemic antibiotic application reduces neither PPD nor BoP. Therefore, the systemic administration of antibiotics, in the case of peri-implantitis, should be rethought in light of the present results, contributing to address the problem of increasing antibiotic resistance.
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Affiliation(s)
- Manuel Toledano-Osorio
- Department of Stomatology, Faculty of Dentistry, University of Granada, Colegio Máximo de Cartuja s/n, 18071 Granada, Spain; (M.T.-O.); (F.S.A.); (E.M.-S.); (M.V.-R.)
| | - Cristina Vallecillo
- Department of Stomatology, Faculty of Dentistry, University of Granada, Colegio Máximo de Cartuja s/n, 18071 Granada, Spain; (M.T.-O.); (F.S.A.); (E.M.-S.); (M.V.-R.)
- Correspondence: ; Tel.: +34-958-243-789
| | - Raquel Toledano
- Independent Researcher, 18071 Granada, Spain; (R.T.); (M.T.O.)
| | - Fátima S. Aguilera
- Department of Stomatology, Faculty of Dentistry, University of Granada, Colegio Máximo de Cartuja s/n, 18071 Granada, Spain; (M.T.-O.); (F.S.A.); (E.M.-S.); (M.V.-R.)
| | - María T. Osorio
- Independent Researcher, 18071 Granada, Spain; (R.T.); (M.T.O.)
| | - Esther Muñoz-Soto
- Department of Stomatology, Faculty of Dentistry, University of Granada, Colegio Máximo de Cartuja s/n, 18071 Granada, Spain; (M.T.-O.); (F.S.A.); (E.M.-S.); (M.V.-R.)
| | - Franklin García-Godoy
- Health Science Center, College of Dentistry, University of Tennessee, 875 Union Avenue, Memphis, TN 38103, USA;
| | - Marta Vallecillo-Rivas
- Department of Stomatology, Faculty of Dentistry, University of Granada, Colegio Máximo de Cartuja s/n, 18071 Granada, Spain; (M.T.-O.); (F.S.A.); (E.M.-S.); (M.V.-R.)
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17
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Butera A, Maiorani C, Gallo S, Pascadopoli M, Venugopal A, Marya A, Scribante A. Evaluation of Adjuvant Systems in Non-Surgical Peri-Implant Treatment: A Literature Review. Healthcare (Basel) 2022; 10:healthcare10050886. [PMID: 35628025 PMCID: PMC9140356 DOI: 10.3390/healthcare10050886] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 04/30/2022] [Accepted: 05/05/2022] [Indexed: 02/04/2023] Open
Abstract
Can the use of lasers, ozone, probiotics, glycine and/or erythritol, and chlorhexidine in combination with non-surgical peri-implant treatment have additional beneficial effects on the clinical parameters? Objectives: The non-surgical treatment of peri-implant pathologies is based on mechanical debridement to eliminate bacterial biofilm and reduce tissue inflammation; some additional therapies have been studied to achieve more detailed clinical results. Materials and methods: A literature search for publications until January 2022 was conducted. The research question is formulated following the Problem, Intervention, Comparison/Control, and Outcome. Studies investigating adjunctive therapies were included. Results: In total, 29 articles were included. Most of the studies did not show any additional benefit of these therapies in the evaluation of bleeding on probing, probing pocket depth, or plaque index; among the proposed treatments, the use of laser was the one most studied in the literature, with the achievement of a reduction of bleeding and pocket depth. More studies would be needed to assess the benefit of other therapies. Conclusions: This review showed no significant improvements in the state of health in support of mechanical debridement therapy. However, the few benefits found would deserve to be considered in new clinical studies.
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Affiliation(s)
- Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Correspondence: (A.B.); (C.M.); (M.P.)
| | - Carolina Maiorani
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Correspondence: (A.B.); (C.M.); (M.P.)
| | - Simone Gallo
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (S.G.); (A.S.)
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (S.G.); (A.S.)
- Correspondence: (A.B.); (C.M.); (M.P.)
| | - Adith Venugopal
- Department of Orthodontics, Saveetha Institute of Medical and Technical Science, Saveetha Dental College, Saveetha University, Chennai 600077, India;
| | - Anand Marya
- Department of Orthodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh 12211, Cambodia;
- Center for Transdisciplinary Research, Saveetha Institute of Medical and Technical Science, Saveetha Dental College, Saveetha University, Chennai 600077, India
| | - Andrea Scribante
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (S.G.); (A.S.)
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18
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Butera A, Maiorani C, Gallo S, Pascadopoli M, Venugopal A, Marya A, Scribante A. Evaluation of Adjuvant Systems in Non-Surgical Peri-Implant Treatment: A Literature Review. Healthcare (Basel) 2022. [PMID: 35628025 DOI: 10.3390/healthcare10050886.pmid:35628025;pmcid:pmc9140356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Can the use of lasers, ozone, probiotics, glycine and/or erythritol, and chlorhexidine in combination with non-surgical peri-implant treatment have additional beneficial effects on the clinical parameters? Objectives: The non-surgical treatment of peri-implant pathologies is based on mechanical debridement to eliminate bacterial biofilm and reduce tissue inflammation; some additional therapies have been studied to achieve more detailed clinical results. Materials and methods: A literature search for publications until January 2022 was conducted. The research question is formulated following the Problem, Intervention, Comparison/Control, and Outcome. Studies investigating adjunctive therapies were included. Results: In total, 29 articles were included. Most of the studies did not show any additional benefit of these therapies in the evaluation of bleeding on probing, probing pocket depth, or plaque index; among the proposed treatments, the use of laser was the one most studied in the literature, with the achievement of a reduction of bleeding and pocket depth. More studies would be needed to assess the benefit of other therapies. Conclusions: This review showed no significant improvements in the state of health in support of mechanical debridement therapy. However, the few benefits found would deserve to be considered in new clinical studies.
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Affiliation(s)
- Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Carolina Maiorani
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Simone Gallo
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Adith Venugopal
- Department of Orthodontics, Saveetha Institute of Medical and Technical Science, Saveetha Dental College, Saveetha University, Chennai 600077, India
| | - Anand Marya
- Department of Orthodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh 12211, Cambodia
- Center for Transdisciplinary Research, Saveetha Institute of Medical and Technical Science, Saveetha Dental College, Saveetha University, Chennai 600077, India
| | - Andrea Scribante
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
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19
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Polymeri A, van der Horst J, Anssari Moin D, Wismeijer D, Loos BG, Laine ML. Non-surgical peri-implantitis treatment with or without systemic antibiotics; a randomized controlled clinical trial. Clin Oral Implants Res 2022; 33:548-557. [PMID: 35238084 PMCID: PMC9314590 DOI: 10.1111/clr.13914] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 11/29/2022]
Abstract
Objectives To assess the adjunctive effect of systemic amoxicillin (AMX) and metronidazole (MTZ) in patients receiving non‐surgical treatment (NST) for peri‐implantitis (PI). Materials and methods Thirty‐seven patients were randomized into an experimental group treated with NST plus AMX + MTZ (N = 18) and a control group treated with NST alone (N = 19). Clinical parameters were evaluated at 12 weeks post‐treatment. The primary outcome was the change in peri‐implant pocket depth (PIPD) from baseline to 12 weeks, while secondary outcomes included bleeding on probing (BoP), suppuration on probing (SoP), and plaque. Data analysis was performed at patient level (one target site per patient). Results All 37 patients completed the study. Both groups showed a significant PIPD reduction after NST. The antibiotics group showed a higher mean reduction in PIPD at 12 weeks, compared with the control group (2.28 ± 1.49 mm vs. 1.47 ± 1.95 mm), however, this difference did not reach statistical significance. There was no significant effect of various potential confounders on PIPD reduction. Neither treatment resulted in significant improvements in BoP at follow‐up; 30 of 37 (81%) target sites still had BoP after treatment. Only two implants, one in each group, exhibited a successful outcome defined as PIPD < 5 mm, and absence of BoP and SoP. Conclusions Non‐surgical treatment was able to reduce PIPD at implants with PI. The adjunctive use of systemic AMX and MTZ did not show statistically significant better results compared to NST alone. NST with or without antibiotics was ineffective to completely resolve inflammation around dental implants.
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Affiliation(s)
- A Polymeri
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
| | - J van der Horst
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
| | - D Anssari Moin
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
| | - D Wismeijer
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands.,TPE, Private practice, Ellecom, the Netherlands
| | - B G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
| | - M L Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
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20
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Atieh MA, Almatrooshi A, Shah M, Hannawi H, Tawse-Smith A, Alsabeeha NHM. Airflow for initial nonsurgical treatment of peri-implantitis: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2022; 24:196-210. [PMID: 35156296 DOI: 10.1111/cid.13072] [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: 11/12/2021] [Revised: 12/13/2021] [Accepted: 01/23/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Nonsurgical treatment of peri-implantitis may help in reducing microbial load and inflammatory parameters. The potential clinical benefits of using different treatment approaches, in the initial nonsurgical treatment phase, particularly the airflow, are still not clear. The aim of this systematic review and meta-analyses was to evaluate the outcomes of nonsurgical treatment of peri-implantitis using airflow method in terms of changes in periodontal parameters, peri-implant marginal bone level, postoperative pain/discomfort, and patient satisfaction. METHODS Electronic databases were searched to identify randomized controlled trials (RCTs) that compared airflow with mechanical debridement using ultrasonic/curettes. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Data were analyzed using a statistical software program. RESULTS A total of 316 studies were identified, of which, five RCTs with 288 dental implants in 174 participants were included. Overall meta-analysis showed more reduction in probing pocket depths at 1-3 months (mean difference [MD] -0.23; 95% confidence interval [CI] -0.50-0.05; p = 0.10) and 6 months (MD -0.04; 95% CI -0.34 to 0.27; p = 0.80) in favor of airflow, but the difference was not statistically significant. The use of airflow was associated with significant reduction in bleeding on probing and increase in peri-implant mucosal recession. The differences in plaque score, peri-implant marginal bone level changes, and patient reported outcomes between airflow and mechanical debridement were not statistically significant. CONCLUSIONS The short-term clinical and radiographic outcomes following nonsurgical treatment of peri-implantitis using airflow or mechanical debridement were comparable. The airflow has short-term positive effects on reducing bleeding on probing. Further evidence from RCTs are still required to substantiate the current findings.
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Affiliation(s)
- Momen A Atieh
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates.,Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Aisha Almatrooshi
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Maanas Shah
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Haifa Hannawi
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates.,Director of Dental Services Department, Emirates Health Services, Dubai, United Arab Emirates
| | - Andrew Tawse-Smith
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Nabeel H M Alsabeeha
- Ras Al-Khaimah Dental Center, Ministry of Health and Prevention, Ras al Khaimah, United Arab Emirates
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21
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Blanco C, Pico A, Dopico J, Gándara P, Blanco J, Liñares A. Adjunctive benefits of systemic metronidazole on non-surgical treatment of peri-implantitis. A randomized placebo-controlled clinical trial. J Clin Periodontol 2021; 49:15-27. [PMID: 34713471 DOI: 10.1111/jcpe.13564] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/21/2021] [Accepted: 10/01/2021] [Indexed: 11/29/2022]
Abstract
AIM To study clinical, radiographic, and microbiological outcomes after non-surgical therapy of peri-implantitis with or without adjunctive systemic metronidazole. MATERIALS AND METHODS A randomized placebo-controlled clinical trial was carried out in 32 subjects (62 implants) diagnosed with peri-implantitis. Implants received a mechanical non-surgical debridement session and systemic metronidazole or placebo. Clinical, radiographic, and microbiological outcomes were evaluated at baseline, 3, 6, and 12 months. RESULTS After 12 months, the test treatment resulted in significantly greater PPD reduction (2.53 vs. 1.02 mm) and CAL gain (2.14 vs. 0.53 mm) (p value <.05) in comparison with placebo. The test treatment also resulted in additional radiographic bone gain (2.33 vs. 1.13 mm) compared with placebo (p value <.05). There was a significantly greater decrease in Porphyromonas gingivalis, Tannerella forsythia, and Campylobacter rectus counts compared with the control group (p value <.05). At the end of follow-up, 56.3% of patients met the success criteria in the test group and 25% in the control group. CONCLUSIONS The use of systemic metronidazole as an adjunct to non-surgical treatment of peri-implantitis resulted in significant additional improvements in clinical, radiographic, and microbiological parameters after 12 months of follow-up. This study is registered in ClinicalTrials.gov (NCT03564301).
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Affiliation(s)
- Carlota Blanco
- Periodontology Unit, Faculty of Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain.,Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alex Pico
- Periodontology Unit, Faculty of Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain.,Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jose Dopico
- Periodontology Unit, Faculty of Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain.,Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Pilar Gándara
- Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain.,Oral Surgery Unit, Faculty of Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Juan Blanco
- Periodontology Unit, Faculty of Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain.,Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Antonio Liñares
- Periodontology Unit, Faculty of Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain.,Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
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22
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Park SH, Song YW, Cha JK, Lee JS, Kim YT, Shin HS, Lee DW, Lee JH, Kim CS. Adjunctive use of metronidazole-minocycline ointment in the nonsurgical treatment of peri-implantitis: A multicenter randomized controlled trial. Clin Implant Dent Relat Res 2021; 23:543-554. [PMID: 34139047 DOI: 10.1111/cid.13006] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Clinical benefits of local antibiotics as an adjunct to nonsurgical treatment of peri-implantitis have been widely reported, but most studies evaluated incipient peri-implantitis lesions, and showed incomplete treatment success rates. PURPOSE To assess the clinical and microbiological outcomes of administering metronidazole in combination with minocycline as a local adjunct to the nonsurgical treatment of peri-implantitis. MATERIALS AND METHODS One hundred and eighteen subjects with peri-implantitis were recruited in a four-center, three-arm, and 12-week randomized controlled trial. Subjects were randomly assigned to receive one of the following treatments: (a) MM-mechanical debridement + metronidazole-minocycline ointment, (b) MC-mechanical debridement + minocycline ointment, (c) NST-mechanical debridement only. RESULTS Except for four subjects who was excluded during the trial, a total of 114 patients with 114 implants (one implant per each patient) finally completed the trial and were included in the analyses. Multivariate logistic regression analysis revealed that the treatment success rates (absence of bleeding or suppuration on probing, and sites showing pocket probing depth [PPD] ≥5 mm) on at 12 weeks were higher in MM-group patients (31.6%) and MC-group patients (20.5%) compared to NST-group patients (2.7%; p = 0.011 and 0.040, respectively). Subjects with deepest PPD ≥8 mm showed a significant difference in the PPD reduction between MM and MC groups at week 4 (p = 0.025) and week 12 (p = 0.047). Detection ratio of Tannerella forsythia was significantly lower for MM group than MC group (p = 0.038). CONCLUSIONS Additive use of either MM or MC results in significantly higher treatment success rates compared to sole mechanical debridement in nonsurgical treatment of peri-implantitis. Moreover, MM contributes to a significantly greater reduction in the PPD compared to MC in deep pockets (cris.nih.go.kr KCT0004557).
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Affiliation(s)
- Seung-Hyun Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Young-Taek Kim
- Department of Periodontology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Hyun-Seung Shin
- Department of Periodontology, Dankook University College of Dentistry, Cheonan-si, Republic of Korea
| | - Dong-Won Lee
- Department of Periodontology, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | | | - Chang-Sung Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
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23
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Labban N, Shibani NA, Al-Kattan R, Alfouzan AF, Binrayes A, Assery MK. Clinical, bacterial, and inflammatory outcomes of indocyanine green-mediated photodynamic therapy for treating periimplantitis among diabetic patients: A randomized controlled clinical trial. Photodiagnosis Photodyn Ther 2021; 35:102350. [PMID: 34033934 DOI: 10.1016/j.pdpdt.2021.102350] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/14/2021] [Accepted: 05/14/2021] [Indexed: 12/20/2022]
Abstract
Background This 6-months randomized controlled clinical trial aimed to assess the efficacy of indocyanine green mediated photodynamic therapy (ICG-PDT) as an adjunct to peri‑implant manual debridement (PIMD) versus PIMD alone among Diabetes Mellitus (DM) patients in the treatment of peri‑implantitis. Methods A total of 48 DM patients having 64 implants were treated with either ICG-PDT + PIMD (n = 35 implants) or PIMD alone (n = 29 implants). Clinical (probing depth [PD], bleeding on probing [BOP], and plaque index [PI]) and radiographic (peri‑implant crestal bone loss [PCBL]) peri‑implant variables were recorded. Bacterial species including Porphyromonas gingivalis and Treponema denticola were evaluated from peri‑implant plaque biofilms. Levels of interleukin (IL)-1β and IL-6 were assessed after the collection of peri‑implant sulcular fluid. All the evaluations were carried out at baseline, 3- and 6-months. The significance level was set to p < 0.05. Results All clinical parameters significantly reduced within both treatment groups (P<0.05). Intra-group comparison indicates that there was statistically significant reduction in PD and suppuration for ICG-PDT group (P<0.05). There was a statistically significant difference in the BOP between ICG-PDT and PIMD groups at both follow-up periods (P<0.001). However, there was a significant difference for PD (P = 0.001), suppuration (P = 0.01), and PCBL (P = 0.04) on 6 months follow-up between ICG-PDT and PIMD groups, respectively. Only ICG-PDT showed a significant reduction in P. gingivalis and T. denticola on both 3 months and 6 months follow-up compared to baseline. PIMD showed a statistically significant reduction only on 3 months follow-up compared to baseline. This reduction was maintained for both the species when dental implants were treated with ICG-PDT. However, PIMD failed to maintain this reduction until 6 months. Only at 3 months assessment that both treatment groups showed statistically significant reduction in IL-1β and IL-6 with no significant difference between the groups. Both biomarkers failed to maintain the reduction in both groups and significantly increased levels for IL-1β was noted at 6 months follow up Conclusion Multiple application of indocyanine-green mediated photodynamic therapy resulted in improved clinical and microbial parameters among type 2 DM subjects in the treatment of peri‑implantitis. This clinical trial was registered in the ClinicalTrials.gov Protocol Registration and Results System with registration record number: NCT04833569.
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Affiliation(s)
- Nawaf Labban
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University. P. O. Box 60169, Riyadh 11545, Saudi Arabia.
| | - Nouf Al Shibani
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University. P. O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Reem Al-Kattan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University. P. O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Afnan F Alfouzan
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University. P. O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Abdulaziz Binrayes
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University. P. O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Mansour K Assery
- Department of Prosthodontics, Riyadh Elm University, Riyadh, Saudi Arabia
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24
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De Waal YCM, Vangsted TE, Van Winkelhoff AJ. Systemic antibiotic therapy as an adjunct to non-surgical peri-implantitis treatment: A single-blind RCT. J Clin Periodontol 2021; 48:996-1006. [PMID: 33939193 PMCID: PMC8251966 DOI: 10.1111/jcpe.13464] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/10/2021] [Accepted: 03/19/2021] [Indexed: 11/27/2022]
Abstract
Aim The aim of this single‐blind RCT was to evaluate the adjunctive clinical and microbiological effect of systemic amoxicillin (AMX) plus metronidazole (MTZ) to non‐surgical treatment of peri‐implantitis. Material and methods Patients (N = 62) with peri‐implantitis were randomly assigned to receive full‐mouth mechanical debridement and decontamination and use of chlorhexidine (control group) or combined with antibiotic therapy of AMX/MTZ (test group). Primary outcome was change in bleeding score from baseline (T0) to 3‐month follow‐up (T3). Secondary parameters were plaque, suppuration, PPD, CAL, bone level, microbiology, adverse events and need for additional surgery. Data were analysed with linear multiple regression analysis. Results 57 patients with 122 implants completed 3‐month follow‐up. Both groups showed major clinical improvements at T3 in both peri‐implant and periodontal parameters. However, no significant differences were observed between both groups for any of the primary or secondary parameters. Conclusions Systemic antibiotic therapy of AMX/MTZ does not improve clinical and microbiological outcomes of non‐surgical peri‐implantitis treatment and should not be routinely recommended. Although complete disease resolution may be difficult to achieve, meticulously performed full‐mouth non‐surgical treatment, achieving a high level of daily oral hygiene and healthy periodontal tissues, can significantly improve the starting position of the subsequent (surgical) peri‐implantitis treatment phase.
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Affiliation(s)
- Yvonne C M De Waal
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tine E Vangsted
- Parodontologische Kliniek Den Haag, The Hague, The Netherlands
| | - Arie Jan Van Winkelhoff
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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25
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Wagner TP, Pires PR, Rios FS, de Oliveira JAP, Costa RDSA, Cunha KF, Silveira HLD, Pimentel S, Casati MZ, Rosing CK, Haas AN. Surgical and non-surgical debridement for the treatment of peri-implantitis: a two-center 12-month randomized trial. Clin Oral Investig 2021; 25:5723-5733. [PMID: 33725166 DOI: 10.1007/s00784-021-03874-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare surgical (ST) and non-surgical (NST) debridement for the treatment of peri-implantitis in a two-center randomized trial. MATERIALS AND METHODS Forty-five individuals with 63 implants with probing depth (PPD) ≥5mm, bleeding on probing (BOP), and radiographic bone loss ≥2mm were included. In the NST (30 implants), submucosal debridement was performed. In the ST (33 implants), a mucoperiosteal flap was raised and surfaces were decontaminated only by debridement as performed in NST. Clinical parameters and radiographs were compared at baseline and after 12 months. Means and standard errors were reported. RESULTS PPD considering all implant sites reduced significantly in NST from 4.14±0.25 to 3.25±0.18mm. In ST, PPD also significantly changed (3.74±0.22 to 3.00±0.29mm). No significant differences were observed between the two groups. For deep sites (≥7mm), PPD was 7.82±0.20mm at baseline and reduced to 5.10±0.30mm in NST, while in ST group, it was 7.11±0.11mm and changed to 5.22±0.91mm (between-groups p value=0.51). BOP significantly reduced from ~60 to 35% of all sites in both groups, without significant differences between them. When sites with radiographic bone level ≥3mm at baseline were analyzed, there was a significant difference between groups in bone gain after 12 months in favor of ST (ST=0.78±0.30mm compared to NST=0.25mm±0.13; p=0.03). CONCLUSIONS Surgical and non-surgical debridement for the treatment of peri-implantitis present similar clinical outcomes. Bone levels were better improved in ST than NST for sites with higher initial bone loss. CLINICAL RELEVANCE The treatment of peri-implantitis is still a challenge in clinical practice, since less than half of affected implants achieve health after surgical or non-surgical debridement. Considering the lack of clinically relevant differences between these two treatments, non-surgical debridement should be considered the first therapeutic choice for peri-implantitis, mainly mild to moderate cases.
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Affiliation(s)
- Tassiane Panta Wagner
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90030-035, Brazil
| | | | - Fernando Silva Rios
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90030-035, Brazil
| | - Joao Augusto Peixoto de Oliveira
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90030-035, Brazil
| | - Ricardo Dos Santos Araujo Costa
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90030-035, Brazil
| | - Kelly F Cunha
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90030-035, Brazil
| | | | - Suzana Pimentel
- Periodontology, Faculty of Dentistry, Paulista University, São Paulo, Brazil
| | - Marcio Zaffalon Casati
- Periodontology, Faculty of Dentistry, Paulista University, São Paulo, Brazil.,Periodontology, Faculty of Dentistry, University of Campinas, Piracicaba, Brazil
| | - Cassiano Kuchenbecker Rosing
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90030-035, Brazil
| | - Alex Nogueira Haas
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90030-035, Brazil.
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26
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Romandini M, Lima C, Pedrinaci I, Araoz A, Soldini MC, Sanz M. Prevalence and risk/protective indicators of peri-implant diseases: A university-representative cross-sectional study. Clin Oral Implants Res 2020; 32:112-122. [PMID: 33210772 DOI: 10.1111/clr.13684] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/21/2020] [Accepted: 11/10/2020] [Indexed: 12/15/2022]
Abstract
AIM To evaluate the prevalence of peri-implant diseases and to identify risk/protective indicators of peri-implantitis. MATERIALS AND METHODS Two hundred and forty randomly selected patients from a university clinic database were invited to participate. Those who accepted, once data from their medical and dental history were collected, were examined clinically and radiographically to assess the prevalence of peri-implant health and diseases. Peri-implantitis was defined as the presence of BoP/SoP together with radiographic bone levels (BL) ≧2 mm. An intermediate peri-implant health category between peri-implant mucositis and peri-implantitis was also identified, defined by the presence of BoP/SoP together with 1 mm ≦BL < 2 mm. A multilevel multivariate logistic regression analysis was carried out to identify those factors associated either positively (risk) or negatively (protective) with peri-implantitis. RESULTS Ninety-nine patients with a total of 458 dental implants were analyzed. The prevalences of pre-periimplantitis and of peri-implantitis were, respectively, 31.3% and 56.6% at patient-level, while 31.7% and 27.9% at implant level. The following factors were identified as risk indicators for peri-implantitis: smoking (OR = 3.59; 95% CI: 1.52-8.45), moderate/severe periodontitis (OR = 2.77; 95% CI: 1.20-6.36), <16 remaining teeth (OR = 2.23; 95% CI: 1.05-4.73), plaque (OR = 3.49; 95% CI: 1.13-10.75), implant malposition (too vestibular: OR = 2.85; 95% CI: 1.17-6.93), implant brand (Nobel vs. Straumann: OR = 4.41;95% CI: 1.76-11.09), restoration type (bridge vs. single crown: OR = 2.47; 95% CI: 1.19-5.12), and trauma as reason of tooth loss (vs. caries: OR = 6.51; 95% CI: 1.45-29.26). Conversely, the following factors were identified as protective indicators: interproximal flossing/brushing (OR = 0.27; 95% CI: 0.11-0.68), proton pump inhibitors (OR = 0.08; 95% CI: 0.01-0.90), and anticoagulants (OR = 0.08; 95% CI: 0.01-0.56). CONCLUSIONS Peri-implant diseases are highly prevalent among patients with dental implants in this university-based population. Several factors were identified as risk- and protective- indicators of peri-implantitis.
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Affiliation(s)
- Mario Romandini
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Cristina Lima
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ignacio Pedrinaci
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ana Araoz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | | | - Mariano Sanz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
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27
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Romandini M, Lima C, Pedrinaci I, Araoz A, Costanza Soldini M, Sanz M. Clinical signs, symptoms, perceptions, and impact on quality of life in patients suffering from peri-implant diseases: a university-representative cross-sectional study. Clin Oral Implants Res 2020; 32:100-111. [PMID: 33210787 DOI: 10.1111/clr.13683] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/22/2020] [Accepted: 11/10/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To study the symptoms and perception reported by patients with peri-implant diseases, as well as their signs and their potential impact on the oral health quality of life. MATERIAL AND METHODS Two hundred and forty randomly selected patients were invited to participate. As part of the history assessment, the patient OHIP-14Sp was evaluated together with, for each implant, the patient perception regarding the peri-implant health status and the history of pain, spontaneous discomfort, bleeding, suppuration, swelling, and discomfort during brushing. As part of the clinical examination, the following potential signs of peri-implant diseases were collected: probing pocket depth (PPD), mucosal dehiscence (MD), extent of BoP, presence of SoP, and visual signs of redness and swelling. Those parameters were analyzed in relation to the actual peri-implant health diagnosis. RESULTS Ninety-nine patients with a total of 458 dental implants were studied. Even in case of peri-implantitis, 88.9% of the implants were perceived by the patients as healthy. The total OHIP-14Sp sum score did not differ in relation to the peri-implant health diagnosis. Increased reports of spontaneous discomfort, bleeding, swelling, and discomfort during brushing were observed in presence of disease. However, only a minor proportion of implants with peri-implant diseases presented symptoms. PPD ≥ 6 mm was more frequent in diseased than in healthy implants (p < .01), while PPD ≥ 8 in pre-peri-implantitis/peri-implantitis than in healthy/mucositis implants (p < .01). Implants with peri-implantitis showed higher MD than implants without peri-implantitis (p < .01). CONCLUSION Peri-implant diseases are in most cases asymptomatic and not perceived by the patients. Despite being unable to accurately discriminate between peri-implant mucositis and peri-implantitis, PPD and MD resulted as the only two clinical signs associated with pre-peri-implantitis/peri-implantitis.
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Affiliation(s)
- Mario Romandini
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Cristina Lima
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ignacio Pedrinaci
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ana Araoz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | | | - Mariano Sanz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
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Monje A, Eick S, Buser D, Salvi GE. Microbial and host-derived biomarker changes during ligature-induced and spontaneous peri-implantitis in the Beagle dog. J Periodontal Res 2020; 56:93-100. [PMID: 32885473 DOI: 10.1111/jre.12797] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/01/2020] [Accepted: 08/07/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate microbial and host-derived biomarker changes during experimental peri-implantitis in the Beagle dog. BACKGROUND Limited data exist on the microbial and biomarker changes during progressive bone loss as result of experimental peri-implantitis. METHODS In total, 36 implants (ndogs = 6) were assessed over 3 episodes of ligature-induced peri-implantitis followed by a period of spontaneous progression. Implants with hybrid (H) and completely rough (R) surface designs were used. Clinical and radiographic parameters were recorded at 4 timepoints. Peri-implant sulcus fluid was collected from the buccal and lingual aspects of the implants. The presence of 7 bacterial species and 2 host-derived biomarkers was assessed during the study period. RESULTS Total bacterial counts were significantly correlated with marginal bone loss (MBL) (r = .21; P = .009). Further, Phorphyromonas gulae (Pg) and Tannerella forsythia (Tf) were commonly correlated with MBL, suppuration (SUP) and the sulcular bleeding index scores (mSBI) (P < .05). Other bacteria were further correlated with SUP, mSBI, and MBL. While the analyzed bacteria dropped, Prevotella intermedia (Pi) further increased during the spontaneous progressive phase (P < .05). Total bacterial load did not differ significantly between H and R implants. Host-derived IL-10 was undetected along the study period. IL-1β positively correlated with probing pocket depth (r = .18; P = .03). During spontaneous progression, H implants displayed statistically significant lower levels of IL-1β (P = .003). CONCLUSION Experimental peri-implantitis is associated with an increase in bacterial counts. While Pg and Tf are associated with ligature-induced disease progression, Pi augmented its load during the spontaneous progressive phase. IL-1β is associated with pocket probing depth and influenced by implant surface characteristics during the spontaneous progression phase.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology, Universidad Internacional de Catalunya, Barcelona, Spain.,Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sigrun Eick
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Daniel Buser
- Department of Stomatology and Oral Surgery, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, University of Bern, Bern, Switzerland
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Nonsurgical Treatment of Peri-Implantitis: Case Series. Dent J (Basel) 2020; 8:dj8030078. [PMID: 32727061 PMCID: PMC7557973 DOI: 10.3390/dj8030078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/02/2020] [Accepted: 07/07/2020] [Indexed: 11/30/2022] Open
Abstract
Peri-implantitis is one of the most important biological complication of dental implants. It has inflammatory nature, proved association with plaque accumulation in peri-implant tissues, and can be progressive on background of several factors, like comorbidity factors and bad habits. The prophylaxis and different methods of treatment were discussed during last 30 years, and surgical and nonsurgical techniques have their foes, benefits, and disadvantages. In this article, we describe the case series of various nonsurgical treatments of peri-implantitis with the use of protocols based on the application of local antibiotics (doxycycline, lincomycin, and erythromycin), mechanical and chemical debridement of dental implant surface, and mini-invasive regenerative technique with injections of bovine collagen. All these three cases demonstrated good results with the maintenance of bone level and absence of clinical signs of inflammation for at least a year according to the X-ray imaging (bone defect volume) and clinic assessments (probing depth, bleeding or suppuration, mucosa color, and pain presence).
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30
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Merli M, Bernardelli F, Giulianelli E, Carinci F, Mariotti G, Merli M, Pini-Prato G, Nieri M. Short-term comparison of two non-surgical treatment modalities of peri-implantitis: Clinical and microbiological outcomes in a two-factorial randomized controlled trial. J Clin Periodontol 2020; 47:1268-1280. [PMID: 32678954 DOI: 10.1111/jcpe.13345] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 06/26/2020] [Accepted: 07/07/2020] [Indexed: 11/26/2022]
Abstract
AIM To compare the efficacy of two different therapies (amino acid glycine abrasive powder and a desiccant material) and their combination in the non-surgical treatment of peri-implantitis. MATERIALS AND METHODS This was an examiner-blind randomized clinical trial, with 2-factorial design with a follow-up of 6 months. The combination of the two factors resulted in four interventions: (a) non-surgical debridement alone (C); (b) non-surgical debridement and a desiccant material (H); (c) non-surgical debridement and glycine powder (G); and (d) non-surgical debridement, desiccant material and glycine powder (HG). RESULTS Sixty-four patients with peri-implantitis were randomized, 16 for each intervention. After six months, two implants failed in the G intervention. Mean pocket depth reduction was higher in patients treated with the desiccant material (estimated difference: 0.5 mm; 95% CI from 0.1 to 0.9 mm, p = .0229) while there was no difference in the patients treated with glycine powder (estimated difference: 0.1 mm; 95% CI from -0.3 to 0.5 mm, p = .7333). VAS for pain during intervention and VAS for pain after one week were higher for patients treated with glycine powder (p = .0056 and p = .0339, respectively). The success criteria and other variables did not reveal differences between interventions. CONCLUSIONS In this 6-month follow-up study, pocket reduction was more pronounced in patients using the desiccant material. Pain was higher in patients using glycine. All the interventions resulted in low success rate.
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Affiliation(s)
- Mauro Merli
- University Politecnica delle Marche, Ancona, Italy.,Clinica Merli, Rimini, Italy
| | | | | | | | | | | | | | - Michele Nieri
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Kotsailidi EA, Michelogiannakis D, Al-Zawawi AS, Javed F. Surgical or non-surgical treatment of peri-implantitis — what is the verdict?,. SURGERY IN PRACTICE AND SCIENCE 2020. [DOI: 10.1016/j.sipas.2020.100010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
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32
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Mayer Y, Ginesin O, Horwitz J. A nonsurgical treatment of peri-implantitis using mechanic, antiseptic and anti-inflammatory treatment: 1 year follow-up. Clin Exp Dent Res 2020; 6:478-485. [PMID: 32185910 PMCID: PMC7453777 DOI: 10.1002/cre2.286] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/01/2020] [Accepted: 03/03/2020] [Indexed: 12/12/2022] Open
Abstract
Aims The study's aim was to assess the clinical outcome 6 and 12 months after a nonsurgical treatment of peri‐implantitis per se or in conjunction with a combination of local antiseptic and anti‐inflammatory treatment. Materials and methods Included were 69 patients with periodontitis, with 106 implants, diagnosed with peri‐implantitis. Peri‐implantitis was defined as radiographic bone loss ≥3 mm, probing depth (PD) ≥ 6 mm, with bleeding on probing. Group M peri‐implantitis was treated with ultrasonic debridement and soft tissue curettage. Group P had additional implant surface treatment with rotatory hand piece composed of chitosan bristle, soft tissue curettage combined with application of 0.95% hypochlorite and 1 mg minocycline HCl. Results After 6 months, both groups demonstrated significant reduction of mean plaque index, PD, and clinical attachment level (0.71 ± 0.57, 0.81 ± 0.55; 4.77 ± 0.73 mm, 4.42 ± 0.5 mm; 5.03 ± 0.86 mm, 5.13 ± 0.73 mm; respectively) and bleeding on probing. After 6 and 12 months, group P showed significantly better PD results compared to group M. The bleeding was significantly less in group P after 12 months (15.3% ± 6.2, 25.1% ± 8.2, respectively). Conclusions Adjunctive treatment with local antiseptic and anti‐inflammatories during mechanical phase was positively associated with inflammation reduction and connective tissue reattachment.
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Affiliation(s)
- Yaniv Mayer
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.,Periocenter Ltd., Haifa, Israel
| | - Ofir Ginesin
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.,Periocenter Ltd., Haifa, Israel
| | - Jacob Horwitz
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
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Gong L, Geng H, Zhang X, Gao P. Comparison of the structure and function of a chimeric peptide modified titanium surface. RSC Adv 2019; 9:26276-26282. [PMID: 35530988 PMCID: PMC9070349 DOI: 10.1039/c9ra05127a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 08/12/2019] [Indexed: 01/02/2023] Open
Abstract
Peri-implantitis is a plaque-initiating infectious disease that can be prevented by interfering with the initial bacterial attachment. At present, surface modification of implants using antimicrobial peptides can interfere with the adhesion of streptococci. In this study, the structure and function of chimeric peptides were compared to get a strategy to modify a Ti surface. Compared to the antimicrobial activity with a fragment of hBD-3, the bifunctional and multifunctional chimeric peptides retain their antimicrobial function. All peptides showed antimicrobial activity against streptococcus in biofilm and planktonic conditions. The results demonstrate significant improvement in reducing bacterial colonization onto titanium surfaces. According to the results of structure analysis, the antimicrobial activity of tyrosine in hBD3-3 was stronger than that of the alpha helix in bifunctional or multifunctional chimeric peptides. Rigid connections were proved to avoid functional domain changes due to the interaction of charges. These results indicated that the endogenous peptide fragments modifying the Ti surface could provide an environmentally friendly approach to reduce or prevent the occurrence of peri-implant diseases. The antimicrobial activity of Tyr structure in hBD3-3 is stronger than that of the α-helix structure in multifunctional chimeric peptides. Rigid connections avoid functional domain changes. Endogenous peptide fragments on a Ti surface could reduce peri-implant diseases.![]()
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Affiliation(s)
- Lei Gong
- Department of Esophageal Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital Tianjin 300070 PR China
| | - Hongjuan Geng
- Department of Stomatology Tianjin Hospital, 406 Jiefang South Road, Hexi District Tianjin 300211 PR China
| | - Xi Zhang
- School and Hospital of Stomatology, Tianjin Medical University 12 Observatory Road Tianjin 300070 PR China
| | - Ping Gao
- School and Hospital of Stomatology, Tianjin Medical University 12 Observatory Road Tianjin 300070 PR China
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