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Ilyes I, Boariu M, Rusu D, Iorio-Siciliano V, Vela O, Boia S, Kardaras G, Șurlin P, Calniceanu H, Jentsch H, Lodin A, Stratul SI. A Single Dose of Piperacillin Plus Tazobactam Gel as an Adjunct to Professional Mechanical Plaque Removal (PMPR) in Patients with Peri-Implant Mucositis: A 6-Month Double-Blind Randomized Clinical Trial. Antibiotics (Basel) 2024; 13:269. [PMID: 38534704 DOI: 10.3390/antibiotics13030269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024] Open
Abstract
OBJECTIVES This randomized, placebo-controlled, double-masked clinical trial aimed to evaluate the clinical and microbiological efficacy of professional mechanical plaque removal (PMPR) with or without adjunctive application of piperacillin plus tazobactam gel in the treatment of peri-implant mucositis (PiM) for up to 6 months. MATERIALS AND METHODS The study included 31 patients with peri-implant mucositis (bleeding on probing (BoP) > 1 at at least one site at baseline, absence of peri-implant bone loss compared with a previous radiograph). After randomized assignment to test and control groups, patients received full-mouth supragingival scaling with or without piperacillin plus tazobactam gel. Clinical examination was performed at baseline and after 3 and 6 months, and a microbiological examination was performed at baseline and after 3 months. RESULTS After six months, both treatment modalities resulted in significant reductions and improvements in clinical parameters at the implant sites. Neither study group achieved a complete resolution of PiM (i.e., BoP ≤ 1 per implant). The number of implants with BoP decreased statistically significantly between subsequent time points (p < 0.001) in both the test and the control group. Significant BoP differences (p = 0.039) were observed between groups at 6 months (difference to baseline) following therapy. CONCLUSIONS Within the limitations of the present study, the single use of a slow-release, locally applied antibiotic combination of piperacillin and tazobactam gel, adjunctive to PMPR, showed an improvement in clinical variable of implants diagnosed with PiM. The adjunctive treatment resulted in higher BoP reduction when compared to the control, but no significant differences were observed regarding the changes in other clinical and microbiological parameters.
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Affiliation(s)
- Ioana Ilyes
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marius Boariu
- Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | | | - Octavia Vela
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Simina Boia
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Georgios Kardaras
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Petra Șurlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Horia Calniceanu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Holger Jentsch
- Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Alexandru Lodin
- Department Basis of Electronics, Faculty of Electronics, Telecommunications and Information Technology, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania
| | - Stefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Rahnama-Hezavah M, Mertowska P, Mertowski S, Skiba J, Krawiec K, Łobacz M, Grywalska E. How Can Imbalance in Oral Microbiota and Immune Response Lead to Dental Implant Problems? Int J Mol Sci 2023; 24:17620. [PMID: 38139449 PMCID: PMC10743591 DOI: 10.3390/ijms242417620] [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: 11/16/2023] [Revised: 12/09/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Dental implantology is one of the most dynamically developing fields of dentistry, which, despite developing clinical knowledge and new technologies, is still associated with many complications that may lead to the loss of the implant or the development of the disease, including peri-implantitis. One of the reasons for this condition may be the fact that dental implants cannot yield a proper osseointegration process due to the development of oral microbiota dysbiosis and the accompanying inflammation caused by immunological imbalance. This study aims to present current knowledge as to the impact of oral microflora dysbiosis and deregulation of the immune system on the course of failures observed in dental implantology. Evidence points to a strong correlation between these biological disturbances and implant complications, often stemming from improper osseointegration, pathogenic biofilms on implants, as well as an exacerbated inflammatory response. Technological enhancements in implant design may mitigate pathogen colonization and inflammation, underscoring implant success rates.
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Affiliation(s)
- Mansur Rahnama-Hezavah
- Chair and Department of Oral Surgery, Medical University of Lublin, 20-093 Lublin, Poland; (M.R.-H.); (M.Ł.)
| | - Paulina Mertowska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland; (S.M.); (E.G.)
| | - Sebastian Mertowski
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland; (S.M.); (E.G.)
| | - Julia Skiba
- Student Research Group of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Karol Krawiec
- Student Research Group of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Michał Łobacz
- Chair and Department of Oral Surgery, Medical University of Lublin, 20-093 Lublin, Poland; (M.R.-H.); (M.Ł.)
| | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland; (S.M.); (E.G.)
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Lee WW, Seo JW, Jang IS, Kwon YJ, Joung WJ, Jun JH, Kim J, Son D, Lim SW, Yun SH, Tallarico M, Park CJ. Comparison of Prophylactic Effects between Localized Biomimetic Minocycline and Systematic Amoxicillin on Implants Placed Immediately in Infected Sockets. Biomimetics (Basel) 2023; 8:461. [PMID: 37887592 PMCID: PMC10604678 DOI: 10.3390/biomimetics8060461] [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: 08/18/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 10/28/2023] Open
Abstract
This study evaluated the prophylactic effect of localized biomimetic minocycline and systemic amoxicillin on immediate implant placement at infected extraction sites. Twelve mongrels with six implants each were randomly assigned to five groups: uninfected negative control (Group N); infected with oral complex bacteria (Group P); infected and treated with amoxicillin one hour before implant placement (Group A); infected and treated with minocycline during implant placement (Group B); and infected and treated with amoxicillin one hour before implant placement and with minocycline during implant placement (Group C). Radiographic bone level, gingival index (GI), probing depth (PD), papillary bleeding index (PBI), and removal torque (RT) were recorded. There was no significant difference between Groups A, B, and C for bone loss. Group A showed the highest RT, the lowest PBI, and significantly lower GI and PD values than Group P. Group B exhibited significantly higher RT value than Group N and significantly smaller PD value than Group P at 6 w postoperatively. Localized minocycline could improve implant success by reducing bone loss and increasing RT and systemic amoxicillin could maintain the stability of the peri-implant soft tissue. However, combined use of these two antibiotics did not augment the prophylactic effect.
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Affiliation(s)
- Won-Woo Lee
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Jin-Won Seo
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Il-Seok Jang
- Osstem R&D Center, Seoul 07789, Republic of Korea
| | | | - Won-Jun Joung
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Jong-Hun Jun
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Jiyeong Kim
- Department of Pre-Medicine, College of Medicine and Biostatistics Lab, Medical Research Collaborating Center (MRCC), Hanyang University, Seoul 04763, Republic of Korea
| | - Donghee Son
- Laboratory of Biostatistical Consulting and Research, Medical Research Collaborating Center, Industry-University Cooperation Foundation, Hanyang University, Seoul 04763, Republic of Korea
| | - Seung-Weon Lim
- Division of Orthodontics, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Seo-Hyoung Yun
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Marco Tallarico
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07021 Sassari, Italy
| | - Chang-Joo Park
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
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Banu Raza F, Vijayaragavalu S, Kandasamy R, Krishnaswami V, Kumar V A. Microbiome and the inflammatory pathway in peri-implant health and disease with an updated review on treatment strategies. J Oral Biol Craniofac Res 2023; 13:84-91. [PMID: 36504486 PMCID: PMC9730223 DOI: 10.1016/j.jobcr.2022.11.005] [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: 03/12/2022] [Revised: 08/30/2022] [Accepted: 11/25/2022] [Indexed: 12/04/2022] Open
Abstract
Crestal bone preservation around the dental implant for aesthetic and functional success is widely researched and documented over a decade. Several etiological factors were put forth for crestal bone loss; of which biofilm plays a major role. Biofilm is formed by the colonization of wide spectra of bacteria inhabited around dental implants. Bacterial adherence affects the regulators of bone growth and an early intervention preserves the peri-implant bone. Primary modes of therapy stated in early literature were either prevention or treatment of infection caused by biofilm. This narrative review overviews the microbiome during different stages of peri-implant health, the mechanism of bone destruction, and the expression of the biomarkers at each stage. Microbial contamination and the associated biomarkers varied depending on the stage of peri-implant infection. The comprehensive review helps in formulating a research plan, both in diagnostics and treatment aspects in improving peri-implant health.
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Key Words
- Antibiotics
- Biomarkers
- CD14, Cluster of Differentiation 14
- CSF, Colony-Stimulating Factor
- Gene expression
- IL, Interleukins
- MMP 8, Matrix MetalloProteinase 8
- Microbiota
- OPG, Osteoprotegerin
- PSMB 2, Proteasome subunit beta type-2
- Peri-implant
- RANK, Receptor Activator of Nuclear factor Kappa-Β
- RANKL, Receptor Activator of Nuclear factor Kappa-ΒLigand
- TIMP, Tissue inhibitor of Metalloproteinase
- TNF, Tumor Necrosis Factor
- TWEAK, TNF-related weak inducer of apoptosis
- VEGF, Vascular Endothelial Growth Factor
- sRANKL, soluble Receptor Activator of Nuclear Factor-κB Ligand
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Affiliation(s)
- Fathima Banu Raza
- Department of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | | | - Ruckmani Kandasamy
- Centre for Excellence in Nanobio Translational REsearch (CENTRE), Department of Pharmaceutical Technology, University College of Engineering, Anna University, BIT Campus, Tiruchirappalli, Tamil Nadu, India
| | - Venkateshwaran Krishnaswami
- Centre for Excellence in Nanobio Translational REsearch (CENTRE), Department of Pharmaceutical Technology, University College of Engineering, Anna University, BIT Campus, Tiruchirappalli, Tamil Nadu, India
| | - Anand Kumar V
- Department of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
- Corresponding author. Department of Prosthodontics, Faculty of Dental Sciences, SRIHER (DU), Porur, Chennai, Tamil Nadu, India.
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Metabolic Conditions and Peri-Implantitis. Antibiotics (Basel) 2022; 12:antibiotics12010065. [PMID: 36671266 PMCID: PMC9854649 DOI: 10.3390/antibiotics12010065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 01/01/2023] Open
Abstract
Dental implants to replace lost teeth are a common dentistry practice nowadays. Titanium dental implants display a high success rate and improved safety profile. Nevertheless, there is an increasing peri-implantitis (PI), an inflammatory disease associated with polymicrobial infection that adversely affects the hard and soft tissues around the implant. The present review highlights the contribution of different metabolic conditions to PI. The considerations of both local and systemic metabolic conditions are crucial for planning successful dental implant procedures and during the treatment course of PI. Un- or undertreated PI can lead to permanent jaw bone suffering and dental implant losses. The common mediators of PI are inflammation and oxidative stress, which are also the key mediators of most systemic metabolic disorders. Chronic periodontitis, low-grade tissue inflammation, and increased oxidative stress raise the incidence of PI and the underlying systemic metabolic conditions, such as obesity, diabetes mellitus, or harmful lifestyle factors (cigarette smoking, etc.). Using dental biomaterials with antimicrobial effects could partly solve the problem of pathogenic microbial contamination and local inflammation. With local dentistry considering factors, including oral microbiota and implant quality control, the inclusion of the underlying systemic metabolic conditions into the pre-procedure planning and during the treatment course should improve the chances of successful outcomes.
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Shrivastava PK, Mahmood A, Datta S, Sengar P, Sybil D. Tetracycline impregnated bone grafts in the management of peri-implantitis and guided bone regeneration around dental implants: A systematic review. Saudi Dent J 2022; 34:689-698. [PMID: 36570584 PMCID: PMC9767836 DOI: 10.1016/j.sdentj.2022.11.003] [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: 05/27/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
Background Rehabilitation of dental arches with the help of dental implants has been revolutionary and a significant part of research is devoted to increasing its success rate. One of the most common causes of failure of dental implants is peri-implantitis caused due to microbial invasion. Newer strategies are being adapted for the treatment of peri-implantits and recent surgical management with the help of antibiotic-impregnated bone grafts shows a promising future. Aim and objectives This study aimed to test the efficacy of bone grafts incorporating tetracycline and its derivatives in the treatment of peri-implantits and guided bone regeneration with the estimation of clinical and radiographic parameters. Methods A thorough search was made on eminent databases such as PubMed, Embase, Scopus, and Cochrane Library database for published literature on tetracycline impregnated bone grafts used either in the management of peri-implantitis or for guided bone regeneration around dental implants.The measures of outcome were clinical attachment loss or probing depth around dental implants and radiographic bone height. Results Nine potentially eligible full-text published articles including case reports, case series, observational studies, and randomized controlled trials were selected for review. Most of the studies reviewed; reported a reduction in probing depth and an increase in bone height and density after placement of tetracycline bone grafts around the dental implant. Conclusion The incorporation of tetracycline into the bone grafts shows promising results as an agent of local delivery around dental implants in the management of peri-implantitis and for guided bone regeneration. Future trials are required to produce a body of evidence and to facilitate the translation of this procedure into clinical practice.
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Affiliation(s)
| | - Arifa Mahmood
- Bachelor of Dental Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi 110025, India
| | - Shubham Datta
- Bachelor of Dental Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi 110025, India
| | - Poonam Sengar
- Bachelor of Dental Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi 110025, India
| | - Deborah Sybil
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi 110025, India,Corresponding author at: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jamia Millia Islamia, Maulana Mohammad Ali Jauhar Marg, Jamia Nagar, New Delhi 110025, India.
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Ghavimi MA, Shahi S, Maleki Dizaj S, Sharifi S, Noie Alamdari A, Jamei Khosroshahi AR, Khezri K. Antimicrobial effects of nanocurcumin gel on reducing the microbial count of gingival fluids of implant‒abutment interface: A clinical study. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2022; 14:114-118. [PMID: 36714080 PMCID: PMC9871187 DOI: 10.34172/japid.2022.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/14/2022] [Indexed: 01/09/2023]
Abstract
Background. This clinical study aimed to prepare and evaluate the effect of antimicrobial nanocurcumin gel on reducing the microbial counts of gingival fluids of the implant‒abutment interface in patients referred to the Tabriz Faculty of Dentistry for the placement of two dental implants. Methods. Fifteen patients applying for at least two dental implants were included in the study. During the uncovering session, nanocurcumin gel was placed in one implant, and no substance was placed in another (the control group). Then, in three sessions, implantation sessions (10 days after the repair abutment closure session), prosthesis delivery (15 days after the implantation session), and one month after prosthesis delivery, the patients' gingival fluid was sampled and cultured to determine bacterial counts in the gingival fluid by colony-forming units (CFU/mL). T-test was used for statistical analysis of data, and statistical significance was set at P<0.05. Results. This study showed that nanocurcumin gel significantly reduced the CFU/mL of gingival fluid in all three sampling stages compared to the control group. Conclusion. According to the results of this study, the application of antimicrobial nanocurcumin gel inside the implant fixture could reduce the microbial counts of gingival fluids.
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Affiliation(s)
- Mohammad Ali Ghavimi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahriar Shahi
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Solmaz Maleki Dizaj
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding authors: Solmaz Maleki Dizaj, E-mail: & Simin Sharifi, E-mail:
| | - Simin Sharifi
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding authors: Solmaz Maleki Dizaj, E-mail: & Simin Sharifi, E-mail:
| | - Ali Noie Alamdari
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Reza Jamei Khosroshahi
- Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Khadijeh Khezri
- Deputy of Food and Drug Administration, Urmia University of Medical Sciences, Urmia, Iran,Department of Nursing, Khoy University of Medical Sciences, Khoy, Iran
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Alovisi M, Carossa M, Mandras N, Roana J, Costalonga M, Cavallo L, Pira E, Putzu MG, Bosio D, Roato I, Mussano F, Scotti N. Disinfection and Biocompatibility of Titanium Surfaces Treated with Glycine Powder Airflow and Triple Antibiotic Mixture: An In Vitro Study. MATERIALS 2022; 15:ma15144850. [PMID: 35888317 PMCID: PMC9319194 DOI: 10.3390/ma15144850] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 01/16/2023]
Abstract
The aim of this in vitro study was to compare three disinfection protocols of biofilm-coated machined (MAC) and acid etched (SLA) commercial pure Grade 4 Titanium disks. Samples were infected with a vial of polymicrobial biofilm to simulate peri-implantitis in vitro. Seventeen MAC and twenty SLA titanium disks were randomly assigned to: (1) glycine powder air-flow (GYPAP) for 1 min; (2) a local delivered triple paste antibiotic composed by a gel mixture with ciprofloxacin, metronidazole, and clarithromycin (3MIX) for 1 h; and (3) a combination of both (GYPAP + 3MIX). Biocompatibility of the titanium disks after each treatment protocol was assessed by measurement of adhesion and growth of adipose-derived mesenchymal stem cells (ASCs) after 24 and 72 h. A confocal laser scanning microscope (CLSM) assessed the antibacterial effect of each treatment. Data of the antibacterial efficacy and cell viability were presented as mean with standard deviation and calculated by one-way ANOVA with multiple comparisons via Bonferroni tests. Results were considered significant with p < 0.05. The higher cell viability was achieved by the 3MIX and GYPAP combination on the SLA surfaces after 72 h. CLSM analysis showed a mean ratio of dead bacteria statistically higher in the 3MIX + GYPAP group compared with the GYPAP and 3MIX subgroups (p < 0.05). In conclusion, data showed that the combination of GYPAP and 3MIX could be preferred to the other protocols, especially in presence of SLA titanium surface.
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Affiliation(s)
- Mario Alovisi
- Department of Surgical Sciences, CIR Dental School, University of Turin, Via Nizza 230, 10126 Turin, Italy; (M.A.); (I.R.); (F.M.); (N.S.)
| | - Massimo Carossa
- Department of Surgical Sciences, CIR Dental School, University of Turin, Via Nizza 230, 10126 Turin, Italy; (M.A.); (I.R.); (F.M.); (N.S.)
- Correspondence:
| | - Narcisa Mandras
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (N.M.); (J.R.); (L.C.); (E.P.)
| | - Janira Roana
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (N.M.); (J.R.); (L.C.); (E.P.)
| | - Massimo Costalonga
- Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Lorenza Cavallo
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (N.M.); (J.R.); (L.C.); (E.P.)
| | - Enrico Pira
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (N.M.); (J.R.); (L.C.); (E.P.)
| | - Maria Grazia Putzu
- Unit of Occupational Medicine and Hospital Occupational Unit, A.O.U Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (M.G.P.); (D.B.)
| | - Davide Bosio
- Unit of Occupational Medicine and Hospital Occupational Unit, A.O.U Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (M.G.P.); (D.B.)
| | - Ilaria Roato
- Department of Surgical Sciences, CIR Dental School, University of Turin, Via Nizza 230, 10126 Turin, Italy; (M.A.); (I.R.); (F.M.); (N.S.)
| | - Federico Mussano
- Department of Surgical Sciences, CIR Dental School, University of Turin, Via Nizza 230, 10126 Turin, Italy; (M.A.); (I.R.); (F.M.); (N.S.)
| | - Nicola Scotti
- Department of Surgical Sciences, CIR Dental School, University of Turin, Via Nizza 230, 10126 Turin, Italy; (M.A.); (I.R.); (F.M.); (N.S.)
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Chitsazi MT, Khorramdel A, Mesforoush MA. Effect of sterile tetracycline ophthalmic ointment as an adjuvant to mechanical debridement on the treatment of peri-implantitis: A randomized controlled clinical trial. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2022; 14:26-31. [PMID: 35919448 PMCID: PMC9339719 DOI: 10.34172/japid.2022.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022]
Abstract
Background Peri-implantitis is an infectious disease that affects the tissues around dental implants, with clinical signs of inflammation and irreversible loss of supporting bone. This study aimed to compare the effect of sterile topical tetracycline ophthalmic ointment as an adjuvant to mechanical debridement with mechanical debridement alone in the treatment of peri-implantitis.
Methods In this single-blind randomized clinical trial, 32 patients (16 patients in each group) with peri-implantitis were treated topically using sterile tetracycline ophthalmic ointment. Four clinical parameters, including modified bleeding index (mBI), modified plaque index (mPI), probing depth (PD), and clinical attachment level (CAL), were measured at baseline and at 3- and 6-month follow-up intervals. Results PD reduction was statistically significant after 3 and 6 months in the test and control groups (P=0.001). Also, mPI and mBI reduction rates were significant in the test and control groups (P=0.001) after 3 and 6 months. However, in all the samples in the two groups, the mean of CAL before and after treatment was constant, with no significant difference (P>0.05). Conclusion Using sterile ocular tetracycline ointment could be an adjunctive treatment in improving and enhancing the therapeutic effects of mechanical debridement in the treatment of peri-implantitis. (IRCT20210909052418N1)
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Affiliation(s)
- Mohammad Taghi Chitsazi
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Azin Khorramdel
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Mohammad Amin Mesforoush
- Student Research Committee, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
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Xu L, Qin X, Mozaffari MS, Yan D, Sun X, Cao Y. Hybrid system with stable structure of hard/soft tissue substitutes induces re-osseointegration in a rat model of biofilm-mediated peri-implantitis. J Biomed Mater Res B Appl Biomater 2022; 110:2452-2463. [PMID: 35620882 DOI: 10.1002/jbm.b.35102] [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: 12/03/2021] [Revised: 03/19/2022] [Accepted: 05/09/2022] [Indexed: 11/07/2022]
Abstract
Re-osseointegration of an infected/contaminated dental implant poses major clinical challenges. We tested the hypothesis that the application of an antibiotic-releasing construct, combined with hard/soft tissue replacement, increases the efficacy of reconstructive therapy. We initially fabricated semi-flexible hybrid constructs of β-TCP/PHBHHx, with tetracycline (TC) (TC amounts: 5%, 10%, and 15%). Thereafter, using in vitro assays, TC release profile, attachment to rat bone marrow-derived stem cells (rBMSCs) and their viability as well as anti-bacterial activity were determined. Thereafter, regenerative efficacies of the three hybrid constructs were assessed in a rat model of peri-implantitis induced by Aggregatibacter actinomycetemcomitans biofilm; control animals received β-TCP/Bio-Gide and TC injection. Eight weeks later, maxillae were obtained for radiological, histological, and histomorphometric analyses of peri-implant tissues. Sulcus bleeding index was chronologically recorded. Serum cytokines levels of IL-6 and IL-1β were also evaluated by enzyme-linked immunosorbent assay. Substantial amounts of tetracycline, from hybrid constructs, were released for 2 weeks. The medium containing the released tetracycline did not affect the adhesion or viability of rBMSCs; however, it inhibited the proliferation of A. actinomycetemcomitans. Osteogenesis and osseointegration were more marked for the 15% hybrid construct group than the other two groups. The height of attachment and infiltration of inflammatory cells within fibrous tissue was significantly reduced in the experimental groups than the control group. Our protocol resulted in re-osseointegration on a biofilm-contaminated implant. Thus, an antibiotic releasing inorganic/organic construct may offer a therapeutic option to suppress infection and promote guided tissue regeneration thereby serving as an integrated multi-layer substitute for both hard/soft tissues.
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Affiliation(s)
- Lianyi Xu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xu Qin
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mahmood S Mozaffari
- Department of Oral Biology, Dental College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Di Yan
- Department of Oral and Maxillofacial Surgery, General Hospital, Ningxia Medical University, Yinchuan, China
| | - Xiaojuan Sun
- Department of Oral and Maxillofacial Surgery, General Hospital, Ningxia Medical University, Yinchuan, China
| | - Yingguang Cao
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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11
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Wen SC, Barootchi S, Wang HL, Huang WX. Non-submerged reconstructive approach for peri-implantitis osseous defect, with removal of implant crowns: 1-year outcomes of a prospective case series study. J Periodontol 2022; 93:1250-1261. [PMID: 35170752 DOI: 10.1002/jper.21-0502] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/24/2022] [Accepted: 01/29/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND & AIM The aim of this study was to test a non-submerged reconstructive approach for peri-implantitis osseous defects, by removing the prosthetic components, augmenting of the infraosseous bony compartment, and flap re-adaptation around the replaced healing abutments, without obtaining a primary wound closure. METHODS Twenty-nine implants in 24 patients were treated. Implant suprastructures were removed at the time of the intervention, to aid with the debridement process which included curettage, implantoplasty, air-power driven devices, and locally delivered antibiotics. The infraosseous part of peri-implant defects were augmented using a composite bone graft and an absorbable membrane to be secured around the replaced healing abutments without attempting to submerge the implants. After 8 months, direct peri-implant defect measurements were obtained to serve as the primary outcome. Secondary outcomes included of radiographic bone changes, and probing depth (PD) and bleeding on probing (BOP) changes at 12 months. RESULTS At the time of the surgical re-entry (8 months), a statistically significant clinical and radiographic defect fill was observed (average of 2.33 mm, and 1.63 mm, respectively). Approximately 3 months after crown replacement, 12 months from the surgical intervention, a significant PD (1.51 mm) and BOP (65%) reduction were also noted. CONCLUSIONS Considering its limitations, the utilized non-submerged approach (with removal of implant crowns) led to significant improvements in clinical (defect fill, PD, BOP) and radiographic outcomes. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Shih-Cheng Wen
- Lecturer, Taipei Medical University, Taipei, Taiwan.,Private Practice, Taipei County, Taiwan
| | - Shayan Barootchi
- Resident, Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Professor and program director, Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Wen-Xia Huang
- Professor and Dean, Periodontics Department, Stomatological Hospital of Xiamen Medical College, Xiamen, China
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12
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Verardi S, Valente NA. Peri-Implantitis: Application of a Protocol for the Regeneration of Deep Osseous Defects. A Retrospective Case Series. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312658. [PMID: 34886384 PMCID: PMC8656633 DOI: 10.3390/ijerph182312658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/19/2021] [Accepted: 11/29/2021] [Indexed: 11/26/2022]
Abstract
Background and aims: Peri-implantitis is a complex pathology, both in its diagnosis and in the identification of etiological causes. Although we have been studying more and more over the years to try to answer the many questions that remain regarding everything that circulates around this disease which affects implants, nothing has yet been taken as an official consensus regarding its surgical treatment. There are still many proposed protocols, each of which has been shown to have comforting results and promising prospects, but no total predictability. The aim of this case series is to assess the clinical outcomes of a mixed protocol for the regeneration of deep osseous defects. Materials and methods: The data and clinical records of 23 patients, with 29 implants affected by peri-implantitis treated surgically in private practice, were analyzed retrospectively. The method used for the surgical treatment was a mixed protocol of mechanical–chemical decontamination and bone regeneration with bovine xenograft. Results: All patients were followed for at least 2 years, averaging 28.9 months (a range of 24–38 months) with a reduction in the probing depth (PD) at one year from the initial 8.14 ± 1.156 mm to 3.72 ± 0.649 mm, and to 4.14 ± 1.093 mm at the final assessment. The differences between assessment time points were always statistically significant. The data regarding bleeding on probing (BoP) and suppuration also showed a statistically significant reduction at the final time point compared to the baseline. Only one patient, at 24 months, still showed BoP, suppuration, and a PD deeper than 5 mm, indicating a recurrence of the disease compared to the initial improvement of the PD (5 mm) at one year. Conclusions: In conclusion, within the limits of this retrospective analysis, it can be affirmed that this combined mechanical–chemical and regenerative decontamination therapy is effective in the treatment of peri-implantitis.
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Affiliation(s)
- Simone Verardi
- Department of Periodontics, University of Washington, Seattle, WA 98195, USA;
| | - Nicola Alberto Valente
- Department of Periodontology, School of Dental Medicine, University of Cagliari, 09124 Cagliari, Italy
- Department of Periodontics and Endodontics, State University of New York at Buffalo, New York, NY 14214, USA
- Correspondence:
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13
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Mehrabi A, Negahdari R, Parnia F, Garjani A. Effect of tetracycline on IL-1β and IL-6 levels of the peri-implant sulcular fluid. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2021; 13:56-60. [PMID: 35919677 PMCID: PMC9327473 DOI: 10.34172/japid.2021.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/09/2021] [Indexed: 11/29/2022]
Abstract
Background Inflammation in the implant-abutment interface is one of the main factors that can reduce implant stability. Therefore, this study investigated the effect of chlorhexidine, tetracycline, saliva, and a dry environment on the interleukin IL-1β and interleukin IL-6 levels of the gingival groove fluid at the implant-abutment interface. Methods Twenty-four (10 men and 14 women) patients referred to the Faculty of Dentistry for implant treatment, who met the inclusion criteria, were examined. Four different materials were used in each implant, including 2% chlorhexidine, 3% tetracycline, saliva, and a dry medium. Each test material was placed inside the implant screw during the anchorage session, and the healing screw was closed. Patients were then sampled in three implantation sessions and one month after prosthesis delivery. Interstitial fluid groove was used for sampling after cleaning the mouth (half an hour after three minutes of thorough brushing). The data were analyzed with SPSS 20 using ANOVA and relevant post hoc tests. Results There was a significant difference in the mean IL-6 and IL-1β levels between the four materials (P<0.05). IL-6β levels were similar in tetracycline and chlorhexidine but significantly higher than in saliva and the dry environment (P<0.05). IL-6 and IL-1β levels in the saliva were significantly higher than in the dry environment (P<0.05). Conclusion The use of tetracycline at the junction of implant and abutment reduces the inflammatory cytokines IL-6 and IL-1β.
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Affiliation(s)
- Amir Mehrabi
- Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ramin Negahdari
- Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Feridoun Parnia
- Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Garjani
- Department of Pharmacology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
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14
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Passarelli PC, Netti A, Lopez MA, Giaquinto EF, De Rosa G, Aureli G, Bodnarenko A, Papi P, Starzyńska A, Pompa G, D’Addona A. Local/Topical Antibiotics for Peri-Implantitis Treatment: A Systematic Review. Antibiotics (Basel) 2021; 10:antibiotics10111298. [PMID: 34827236 PMCID: PMC8615130 DOI: 10.3390/antibiotics10111298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/13/2021] [Accepted: 10/22/2021] [Indexed: 11/16/2022] Open
Abstract
Most studies indicate that the mechanical removal of the bacterial biofilm from the implant surface is the central goal of peri-implantitis therapy. However, controversial results in the treatment of peri-implantitis have led to the consideration of additional strategies that include surgical approaches and chemical adjuvants. Local/topical antibiotics, such as minocycline, azithromycin, tetracycline, amoxicillin, doxycycline, and metronidazole, may improve the efficacy of the definitive treatment of the disease, but the lack of conclusive findings prevents their use in clinical practice. This systematic review aimed to evaluate the effect of local/topical antibiotics for peri-implantitis treatment. Randomised controlled studies (RCT) on patients with peri-implantitis and comparing the efficacy of local/topical antibiotics vs. placebo or mechanical debridement were included. A systematic search strategy was carried out using three registered databases (PubMed, Web of Science, and Scopus). RoB2 was used to assess risk of bias. Five RCTs were identified (n = 250 patients and 333 implants). Contrast results emerged among the included studies, and a high heterogeneity level was observed. Risk of bias revealed some concerns for three studies out of five, while one study was judged at high risk. Only one study analysed the limitations of its findings. Overall, local antibiotic use can be considered a valid approach in the treatment of peri-implantitis. Therefore, future long-term clinical trials with standardised protocols and antibiotics with similar biological activity profiles should be tested to achieve a valid and definitive conclusion.
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Affiliation(s)
- Pier Carmine Passarelli
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Gemelli Foundation for the University Policlinic, Catholic University of the “Sacred Heart”, 00168 Rome, Italy; (P.C.P.); (E.F.G.); (G.D.R.); (G.A.); (A.D.)
| | - Andrea Netti
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Gemelli Foundation for the University Policlinic, Catholic University of the “Sacred Heart”, 00168 Rome, Italy; (P.C.P.); (E.F.G.); (G.D.R.); (G.A.); (A.D.)
- Correspondence: ; Tel./Fax: +39-06-3015-4079
| | | | - Eleonora Favetti Giaquinto
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Gemelli Foundation for the University Policlinic, Catholic University of the “Sacred Heart”, 00168 Rome, Italy; (P.C.P.); (E.F.G.); (G.D.R.); (G.A.); (A.D.)
| | - Giuseppe De Rosa
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Gemelli Foundation for the University Policlinic, Catholic University of the “Sacred Heart”, 00168 Rome, Italy; (P.C.P.); (E.F.G.); (G.D.R.); (G.A.); (A.D.)
| | - Gianmarco Aureli
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Gemelli Foundation for the University Policlinic, Catholic University of the “Sacred Heart”, 00168 Rome, Italy; (P.C.P.); (E.F.G.); (G.D.R.); (G.A.); (A.D.)
| | - Alina Bodnarenko
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (A.B.); (A.S.)
| | - Piero Papi
- Department of Oral and Maxillofacial Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00161 Rome, Italy; (P.P.); (G.P.)
| | - Anna Starzyńska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (A.B.); (A.S.)
| | - Giorgio Pompa
- Department of Oral and Maxillofacial Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00161 Rome, Italy; (P.P.); (G.P.)
| | - Antonio D’Addona
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Gemelli Foundation for the University Policlinic, Catholic University of the “Sacred Heart”, 00168 Rome, Italy; (P.C.P.); (E.F.G.); (G.D.R.); (G.A.); (A.D.)
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15
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Elnagdy S, Raptopoulos M, Kormas I, Pedercini A, Wolff LF. Local Oral Delivery Agents with Anti-Biofilm Properties for the Treatment of Periodontitis and Peri-Implantitis. A Narrative Review. Molecules 2021; 26:5661. [PMID: 34577132 PMCID: PMC8467993 DOI: 10.3390/molecules26185661] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/26/2021] [Accepted: 09/10/2021] [Indexed: 02/06/2023] Open
Abstract
Despite many discoveries over the past 20 years regarding the etiopathogenesis of periodontal and peri-implant diseases, as well as significant advances in our understanding of microbial biofilms, the incidence of these pathologies continues to rise. For this reason, it was clear that other strategies were needed to eliminate biofilms. In this review, the literature database was searched for studies on locally delivered synthetic agents that exhibit anti-biofilm properties and their potential use in the treatment of two important oral diseases: periodontitis and peri-implantitis.
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Affiliation(s)
- Shorouk Elnagdy
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.); (I.K.); (A.P.); (L.F.W.)
| | - Michail Raptopoulos
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.); (I.K.); (A.P.); (L.F.W.)
| | - Ioannis Kormas
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.); (I.K.); (A.P.); (L.F.W.)
- Department of Periodontics, College of Dentistry, Texas A&M University, Dallas, TX 75246, USA
| | - Alessandro Pedercini
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.); (I.K.); (A.P.); (L.F.W.)
| | - Larry F. Wolff
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.); (I.K.); (A.P.); (L.F.W.)
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16
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Wychowański P, Starzyńska A, Adamska P, Słupecka-Ziemilska M, Sobocki BK, Chmielewska A, Wysocki B, Alterio D, Marvaso G, Jereczek-Fossa BA, Kowalski J. Methods of Topical Administration of Drugs and Biological Active Substances for Dental Implants-A Narrative Review. Antibiotics (Basel) 2021; 10:919. [PMID: 34438969 PMCID: PMC8388631 DOI: 10.3390/antibiotics10080919] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 12/15/2022] Open
Abstract
Dental implants are, nowadays, established surgical devices for the restoration of lost teeth. Considered as an alternative for traditional prosthetic appliances, dental implants surpass them in reliability and patient feedback. Local drug delivery around the implants promotes osseointegration and reduces peri-implantitis. However, there are currently no methods of a multiple, precise topical administration of drugs to the implant area. Engineering coatings on the implants, drug application on carriers during implantation, or gingival pockets do not meet all requirements of dental surgeons. Therefore, there is a need to create porous implants and other medical devices that will allow a multiple drug delivery at a controlled dose and release profile without traumatic treatment. Due to the growing demand for the use of biologically active agents to support dental implant treatment at its various stages (implant placement, long-term use of dental superstructures, treatment of the peri-implant conditions) and due to the proven effectiveness of the topical application of pharmacological biologically active agents to the implant area, the authors would like to present a review and show the methods and devices that can be used by clinicians for local drug administration to facilitate dental implant treatment. Our review concludes that there is a need for research in the field of inventions such as new medical devices or implants with gradient solid-porous structures. These devices, in the future, will enable to perform repeatable, controllable, atraumatic, and repeatable injections of active factors that may affect the improvement of osteointegration and the longer survival of implants, as well as the treatment of peri-implantitis.
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Affiliation(s)
- Piotr Wychowański
- Department of Oral Surgery, Medical University of Warsaw, 6 St. Binieckiego Street, 02-097 Warsaw, Poland;
| | - Anna Starzyńska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (B.K.S.)
| | - Paulina Adamska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (B.K.S.)
| | - Monika Słupecka-Ziemilska
- Department of Human Epigenetics, Mossakowski Medical Research Center, Polish Academy of Sciences, 5 Pawińskiego Street, 02-106 Warsaw, Poland;
| | - Bartosz Kamil Sobocki
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (B.K.S.)
- International Research Agenda 3P—Medicine Laboratory, Medical University of Gdańsk, 3a Marii Skłodowskiej-Curie Street, 80-210 Gdańsk, Poland
| | - Agnieszka Chmielewska
- Faculty of Material Science and Engineering, Warsaw University of Technology, 141 Wołoska Street, 02-507 Warsaw, Poland;
- Department of Materials Science and Engineering, The Ohio State University, 140 W 19th Ave, Columbus, OH 43210, USA
| | - Bartłomiej Wysocki
- Center of Digital Science and Technology, Cardinal Stefan Wyszyński University in Warsaw, Woycickiego 1/3 Street, 01-938 Warsaw, Poland;
- Additive Manufacturing Research Center, College of Engineering, Youngstown State University, Youngstown, OH 44555, USA
| | - Daniela Alterio
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20141 Milan, Italy; (D.A.); (G.M.); (B.A.J.-F.)
| | - Giulia Marvaso
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20141 Milan, Italy; (D.A.); (G.M.); (B.A.J.-F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 7 Festa del Perdono Street, 20112 Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20141 Milan, Italy; (D.A.); (G.M.); (B.A.J.-F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 7 Festa del Perdono Street, 20112 Milan, Italy
| | - Jan Kowalski
- Department of Periodontology and Oral Medicine, Medical University of Warsaw, 6 St. Binieckiego Street, 02-097 Warsaw, Poland;
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Wehner C, Laky M, Shokoohi-Tabrizi HA, Behm C, Moritz A, Rausch-Fan X, Andrukhov O. Effects of Er:YAG laser irradiation of different titanium surfaces on osteoblast response. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2021; 32:22. [PMID: 33675441 PMCID: PMC7936964 DOI: 10.1007/s10856-021-06493-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 02/15/2021] [Indexed: 06/12/2023]
Abstract
The aim of this in vitro study was to evaluate the effects of erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiation on titanium surface topography and the proliferation and differentiation of osteoblasts using standard clinical treatment settings. Er:YAG laser irradiation at two levels ((1): 160 mJ, pulse at 20 Hz; (2): 80 mJ, pulse at 20 Hz) was applied to moderately rough and smooth titanium disks before MG-63 osteoblast-like cells were cultured on these surfaces. Titanium surface and cell morphology were observed by scanning electron microscopy. Cell proliferation/viability was measured by CCK-8 test. Gene expression of alkaline phosphatase (ALP), osteocalcin (OC), osteoprotegerin (OPG), receptor activator of nuclear factor kappa-B ligand (RANKL), and collagen type 1 was measured by qPCR, and OPG and OC protein production was determined by enzyme-linked immunosorbent assay. Treatment with Er:YAG laser at 160 mJ/20 Hz markedly caused heat-induced fusion of titanium and cell condensation on moderately rough surfaces, but not in smooth surfaces. MG-63 proliferation/viability decreased after 5 days in moderately rough surfaces. The expression of ALP, OC, OPG, and collagen type 1 was unaffected by laser treatment at 160 mJ/20. Laser irradiation at 80 mJ/20 Hz enhanced RANKL gene expression after 5 days in moderately rough surfaces. Study results suggest that Er:YAG laser irradiation at clinically relevant setting has no essential effect on osteogenic gene and protein expression of osteoblasts. However, surface structure, cell attachment, and proliferation are influenced by both treatment protocols, which implies that caution should be taken in the clinical treatment of peri-implant diseases when Er:YAG laser is used.
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Affiliation(s)
- Christian Wehner
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Markus Laky
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Hassan Ali Shokoohi-Tabrizi
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Christian Behm
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Andreas Moritz
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Xiaohui Rausch-Fan
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Oleh Andrukhov
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
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Guler B, Uraz A, Hatipoğlu H, Yalım M. Chemical Evaluation of Energy Dispersive X-ray Spectroscopy Analysis of Different Failing Dental Implant Surfaces: A Comparative Clinical Trial. MATERIALS 2021; 14:ma14040986. [PMID: 33669886 PMCID: PMC7923284 DOI: 10.3390/ma14040986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/08/2021] [Accepted: 02/16/2021] [Indexed: 11/29/2022]
Abstract
The aim of the present study is to compare two different implant surface chemistries of failing dental implants. Sixteen patients (mean age: 52 ± 8.27 with eight females and eight males) and 34 implants were included in the study. Group-I implants consisted of a blasted/etched surface with a final process surface, while Group-II implants consisted of the sandblasted acid etching (SLA) method. The chemical surface analysis was performed by the energy dispersive X-ray spectroscopy (EDX) method from coronal, middle, and apical parts of each implant. Titanium (Ti) element values were found to be 20.22 ± 15.7 at.% in Group I and 33.96 ± 13.62 at.% in Group-II in the middle of the dental implants. Aluminum (Al) element values were found to be 0.01 ± 0.002 in Group-I and 0.17 ± 0.28 at.% in Group II in the middle of the dental implants, and statistically significant differences were found between the groups for the Al and Ti elements in the middle of the dental implants (p < 0.05). There was a statistically significant difference for the Ti, Al, O, Ca, Fe, P, and Mg elements in the coronal, middle, and apical parts of the implants in the intragroup evaluation (p < 0.05). It is reported that different parts of the implants affected by peri-implant inflammation show different surface chemistries, from coronal to apical, but there is no difference in the implants with different surfaces.
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Affiliation(s)
- Berceste Guler
- Department of Periodontology, Faculty of Dentistry, Kütahya Health Sciences University, Kütahya 43100, Turkey;
- Correspondence:
| | - Ahu Uraz
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara 06500, Turkey; (A.U.); (M.Y.)
| | - Hasan Hatipoğlu
- Department of Periodontology, Faculty of Dentistry, Kütahya Health Sciences University, Kütahya 43100, Turkey;
| | - Mehmet Yalım
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara 06500, Turkey; (A.U.); (M.Y.)
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Kormas I, Pedercini C, Pedercini A, Raptopoulos M, Alassy H, Wolff LF. Peri-Implant Diseases: Diagnosis, Clinical, Histological, Microbiological Characteristics and Treatment Strategies. A Narrative Review. Antibiotics (Basel) 2020; 9:antibiotics9110835. [PMID: 33266370 PMCID: PMC7700146 DOI: 10.3390/antibiotics9110835] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 12/14/2022] Open
Abstract
Since the use of dental implants is continuously increasing, it is imperative for dental practitioners to understand the nature and treatment of peri-implant diseases. The purpose of this manuscript is to comprehensively review peri-implant diseases, their characteristics, as well as their non-surgical and surgical treatment. To that end, the current literature was searched and a narrative review was conducted. It is essential that the case definitions described in the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions are used to diagnose and classify peri-implant health, peri-implant mucositis and peri-implantitis. While recent epidemiologic studies on peri-implant diseases exist, there is great heterogeneity in the definition of these conditions. Several risk factors and indicators are reported in the literature, with smoking and diabetes being the most universally accepted. In peri-implant mucositis, non-surgical treatment seems to be sufficient. However, for the treatment of peri-implantitis, a surgical approach, which includes open-flap debridement, apically positioned flap and guided bone regeneration, is considered more appropriate. A great variety of adjuncts to mechanical treatment have been reported with controversial results. Finally, studies comparing results from different peri-implantitis treatments are warranted in randomized controlled clinical trials in order to provide stronger evidence-based approaches.
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Affiliation(s)
- Ioannis Kormas
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (A.P.); (M.R.); (H.A.); (L.F.W.)
- Correspondence: ; Tel.: +1-585-298-4698
| | - Chantal Pedercini
- School of Oral Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | - Alessandro Pedercini
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (A.P.); (M.R.); (H.A.); (L.F.W.)
| | - Michail Raptopoulos
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (A.P.); (M.R.); (H.A.); (L.F.W.)
| | - Hatem Alassy
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (A.P.); (M.R.); (H.A.); (L.F.W.)
| | - Larry F. Wolff
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (A.P.); (M.R.); (H.A.); (L.F.W.)
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Machtei EE, Romanos G, Kang P, Travan S, Schmidt S, Papathanasiou E, Tatarakis N, Tandlich M, Liberman LH, Horwitz J, Bassir SH, Myneni S, Shiau HJ, Shapira L, Donos N, Papas A, Meyle J, Giannobile WV, Papapanou PN, Kim DM. Repeated delivery of chlorhexidine chips for the treatment of peri-implantitis: A multicenter, randomized, comparative clinical trial. J Periodontol 2020; 92:11-20. [PMID: 33111988 DOI: 10.1002/jper.20-0353] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/15/2020] [Accepted: 09/20/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Peri-implantitis is a challenging condition to manage and is frequently treated using non-surgical debridement. The local delivery of antimicrobial agents has demonstrated benefit in mild to moderate cases of peri-implantitis. This study compared the safety and efficacy of chlorhexidine gluconate 2.5 mg chip (CHX chips) as an adjunctive treatment to subgingival debridement in patients afflicted with peri-implantitis. METHODS A multicenter, randomized, single-blind, two-arm, parallel Phase-3 study was conducted. Peri-implantitis patients with implant pocket depths (IPD) of 5-8 mm underwent subgingival implant surface debridement followed by repeated bi-weekly supragingival plaque removal and chlorhexidine chips application (ChxC group) for 12 weeks, or similar therapy but without application of ChxC (control group). All patients were followed for 24 weeks. Plaque and gingival indices were measured at every visit whereas IPD, recession, and bleeding on probing were assessed at 8, 12, 16, 24 week. RESULTS A total of 290 patients were included: 146 in the ChxC group and 144 in the control. At 24 weeks, a significant reduction in IPD (P = 0.01) was measured in the ChxC group (1.76 ± 1.13 mm) compared with the control group (1.54 ± 1.13 mm). IPD reduction of ≥2 mm was found in 59% and 47.2% of the implants in the ChxC and control groups, respectively (P = 0.03). Changes in gingival recession (0.29 ± 0.68 mm versus 0.15 ± 0.55 mm, P = 0.015) and relative attachment gain (1.47 ± 1.32 mm and 1.39 ± 1.27 mm, P = 0.0017) were significantly larger in the ChxC group. Patients in the ChxC group that were < 65 years exhibited significantly better responses (P < 0.02); likewise, non-smokers had similarly better response (P < 0.02). Both protocols were well tolerated, and no severe treatment-related adverse events were recorded throughout the study. CONCLUSIONS Patients with peri-implantitis that were treated with an intensive treatment protocol of bi-weekly supragingival plaque removal and local application of chlorhexidine chips had greater mean IPD reduction and greater percentile of sites with IPD reduction of ≥2 mm as compared with bi-weekly supra-gingival plaque removal.
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Affiliation(s)
- Eli E Machtei
- Department of Periodontology, School of Graduate Dentistry, Faculty of Medicine, Technion (I.I.T.), Rambam health care campus, Haifa, Israel.,Division of Periodontology, Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Georgios Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook, New York, USA
| | - Philip Kang
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, USA
| | - Suncica Travan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Stephan Schmidt
- Department of Periodontics, Justus-Liebig University, Giessen & Avadent, Bad Homburg, Germany
| | - Evangelos Papathanasiou
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Nikolaos Tatarakis
- Center for Oral Clinical Research, Barts & The Royal London School of Medicine and Dentistry, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Moshik Tandlich
- Department of Periodontology, the Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | | | - Jacob Horwitz
- Department of Periodontology, School of Graduate Dentistry, Faculty of Medicine, Technion (I.I.T.), Rambam health care campus, Haifa, Israel
| | - Seyed Hossein Bassir
- Department of Periodontology, School of Dental Medicine, Stony Brook, New York, USA
| | - Srinivas Myneni
- Department of Periodontology, School of Dental Medicine, Stony Brook, New York, USA
| | - Harlan J Shiau
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Maryland, USA
| | - Lior Shapira
- Department of Periodontology, the Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Nikos Donos
- Center for Oral Clinical Research, Barts & The Royal London School of Medicine and Dentistry, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Athena Papas
- Division of Oral Medicine, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Joerg Meyle
- Department of Periodontics, Justus-Liebig University, Giessen & Avadent, Bad Homburg, Germany
| | - William V Giannobile
- Division of Periodontology, Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, USA
| | - David M Kim
- Division of Periodontology, Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
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21
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Efficacy of Local Minocycline Agents in Treating Peri-Implantitis: An Experimental In Vivo Study in Beagle Dogs. Pharmaceutics 2020; 12:pharmaceutics12111016. [PMID: 33114168 PMCID: PMC7690844 DOI: 10.3390/pharmaceutics12111016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/17/2020] [Accepted: 10/22/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Local delivery agents (LDA) have the advantage of delivering the antibiotics at high concentrations to the targeted sites. However, the constant flow of gingival crevicular fluids and saliva may restrict their efficacy. Therefore, the drug sustainability and pharmacodynamic properties of any proposed LDA should be evaluated. METHODS Four dental implants were placed unilaterally in the edentulous mandible of six beagle dogs. Peri-implantitis were experimentally induced using silk-ligatures. Each implant was randomly allocated to receive one of the following four treatments: (i) MC (Chitosan-alginate (CA) minocycline), (ii) MP (CA-without minocycline), (iii) PG (Polyacrylate-glycerin minocycline), and (iv) Control (mechanical debridement only). Mechanical therapies and LDAs were administered into the gingival sulcus two times at a 4-week interval. Drug sustainability as well as clinical, radiographical, and immunohistochemical (IHC) analyses were conducted to evaluate the efficacies of treatments. RESULTS Reduced mean probing depth was observed in all of the test groups after the second delivery. A minimal marginal bone level change was observed during the treatment period (MP (-0.06 ± 0.53 mm) to PG (-0.25 ± 0.42 mm)). The distribution of IHC cell marker analysis of all targeted antibodies ranged from 6.34% to 11.33%. All treatment outcomes between the test groups were comparable. A prolonged retention of LDA was observed from CA microspheres (MC and MP) at both administrations (p < 0.017) and prolonged sustainability of bacteriostatic effect was observed from MC compared to PG after the second administration (p < 0.05). CONCLUSIONS Prolonged retention of CA microspheres was observed and the longer bacteriostatic effect was observed from the MC group. Mechanical debridement with adjunct LDA therapy may impede peri-implantitis progression, however, prolonged drug action did not lead to improved treatment outcome.
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22
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Dutta SR, Passi D, Singh P, Atri M, Mohan S, Sharma A. Risks and complications associated with dental implant failure: Critical update. Natl J Maxillofac Surg 2020; 11:14-19. [PMID: 33041571 PMCID: PMC7518499 DOI: 10.4103/njms.njms_75_16] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 02/27/2017] [Accepted: 09/09/2019] [Indexed: 11/25/2022] Open
Abstract
Risks and complications have been identified with dental implant failure though there is continuous innovation in implant systems and various interceptive treatment modalities. The success rate of dental implants has increased over a period of years as a treatment option for the rehabilitation of missing teeth. The dental implants are designed that best suits the various types of bone. Endosseous implants fail due to many reasons. Different reasons for the implant failure and their contributing factors have been discussed in this review article. A better understanding of the factors responsible for the implant failure will provide clinical decision-making and may enhance the field of implant dentistry. This article summarizes the factors causing implant failure. This paper presents the results of a survey of dentists practicing implant dentistry and updates regarding their knowledge of risk factors that they consider to be important for predicting dental implant failure.
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Affiliation(s)
- Shubha Ranjan Dutta
- Department of Oral and Maxillofacial Surgery, MB Kedia Dental College, Birgunj, Nepal
| | - Deepak Passi
- Department of Dentistry, Sub-Divisional Hospital, Ranchi, Jharkhand, India
| | - Purnima Singh
- Department of Physiology, MB Kedia Dental College, Birgunj, Nepal
| | - Mansi Atri
- Department of Public Health Dentistry, E.S.I.C. Dental College and Hospital, Delhi, India
| | - Stuti Mohan
- Department of Orthodontics, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India
| | - Abhimanyu Sharma
- Department of Oral and Maxillofacial Surgery, E.S.I.C. Dental College and Hospital, Delhi, India
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Hentenaar DFM, De Waal YCM, Van Winkelhoff AJ, Meijer HJA, Raghoebar GM. Non-surgical peri-implantitis treatment using a pocket irrigator device; clinical, microbiological, radiographical and patient-centred outcomes-A pilot study. Int J Dent Hyg 2020; 18:403-412. [PMID: 32794356 PMCID: PMC7693290 DOI: 10.1111/idh.12462] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/06/2020] [Accepted: 07/27/2020] [Indexed: 11/29/2022]
Abstract
Aim The aim of this prospective cohort study was to assess the effect of a pocket irrigator/evacuator device (IED) in the non‐surgical treatment of peri‐implantitis. Material and Methods In total 24 patients having 38 implants diagnosed with peri‐implantitis were included in this study. Peri‐implant pockets were irrigated six times in three consecutive weeks. The primary outcome was bleeding on probing (BoP). Secondary outcome parameters included plaque index (Pl), suppuration on probing (SoP), probing pocket depth (PPD), marginal bone loss (MBL), presence and numbers of periodontal pathogens. Parameters were assessed at baseline and 3 months after the last treatment. Treatment pain perception was scored using the visual analog scale (VAS) after the first and last treatment. Results At 3 months, IED treatment revealed significant reduction of peri‐implant BoP (71% [±20] vs 57% [±28] [P = .014]) and peri‐implant plaque scores (10 [±14] to 5 [±9] [P = .039] [T0 vs T3 respectively]). Significant reduction in mean peri‐implant PPD from 4.92 mm (SD ± 1.28) to 4.66 mm (SD ± 1.35) (P = .041) was observed. In addition, a reduction in VAS pain score between the first and the last (6th) treatment was found (P = .039). No reduction in SoP (P = .088) was found. No changes in mean periodontal full mouth plaque, BOP, SOP and PPD levels, MBL and microbiological outcomes were found. Conclusion Beneficial clinical effects in terms of BoP, PPD and PI were found at 3 months after IED treatment. However, the IED does not seem to effectively treat peri‐implantitis in terms of disease resolution.
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Affiliation(s)
- Diederik F M Hentenaar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Yvonne C M De Waal
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arie Jan Van Winkelhoff
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Barrak I, Baráth Z, Tián T, Venkei A, Gajdács M, Urbán E, Stájer A. Effects of different decontaminating solutions used for the treatment of peri-implantitis on the growth of Porphyromonas gingivalis-an in vitro study. Acta Microbiol Immunol Hung 2020; 68:40-47. [PMID: 32845853 DOI: 10.1556/030.2020.01176] [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: 03/17/2020] [Accepted: 06/22/2020] [Indexed: 01/22/2023]
Abstract
Implants have been considered the treatment of choice to replace missing teeth, unfortunately, peri-implant disease is still an unresolved issue. Contaminated implants may be decontaminated by physical debridement and chemical disinfectants; however, there is a lack of consensus regarding the ideal techniques/agents to be used for the decontamination. The objective of our study was to compare the decontaminating efficacy of different chemical agents on a titanium surface contaminated with Porphyromonas gingivalis, a typical representative of the bacterial flora associated with peri-implantitis. Commercially pure Ti grade 4 discs with a polished surface were treated with a mouthwash containing chlorhexidine digluconate (0.1%), povidone-iodine (PVP-iodine) solution (10%) or citric acid monohydrate (40%). Qualitative and quantitative assessment of cellular growth and survival were assessed by a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay and scanning electron microscopy (SEM). Significant differences in the quantity of P. gingivalis could be observed after 6 days of incubation. A numerical, but not statistically significant (P = 0.066) decrease in the amount of living bacteria was observed in the group treated with the PVP-iodine solution as compared to the control group. The chlorhexidine (CHX)-treated group presented with significantly higher cell counts, as compared to the PVP-iodine-treated group (P = 0.032), while this was not observed compared to the control group and citric acid-treated group. Our results have also been verified by SEM measurements. Our results suggest that for P. gingivalis contamination on a titanium surface in vitro, PVP-iodine is a superior decontaminant, compared to citric acid and chlorhexidine-digulconate solution.
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Affiliation(s)
- Ibrahim Barrak
- 1Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Szeged, Kálvária sugárút 57., 6720,Szeged, Hungary
| | - Zoltán Baráth
- 2Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 64-66.,Szeged, Hungary
| | - Tamás Tián
- 3Department of Periodontology, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 64-66.,Szeged, Hungary
| | - Annamária Venkei
- 4Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, Semmelweis utca 6., 6725, Szeged, Hungary
| | - Márió Gajdács
- 5Institute Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Eötvös utca 6.,Szeged, Hungary
- 6Institute of Medical Microbiology, Faculty of Medicine, Semmelweis University, Nagyvárad tér 4., 1089, Budapest, Hungary
| | - Edit Urbán
- 7Department of Public Health, Faculty of Medicine, University of Szeged, Dóm tér 10., 6720, Szeged, Hungary
- 8Institute of Translational Medicine, University of Pécs, Medical School, Szigeti utca 12., 7624, Pécs, Hungary
| | - Anette Stájer
- 2Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 64-66.,Szeged, Hungary
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Antibacterial and Osteogenic Activity of Titania Nanotubes Modified with Electrospray-Deposited Tetracycline Nanoparticles. NANOMATERIALS 2020; 10:nano10061093. [PMID: 32492912 PMCID: PMC7353255 DOI: 10.3390/nano10061093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/06/2020] [Accepted: 05/28/2020] [Indexed: 01/09/2023]
Abstract
The nanotubular surface of titanium implants is known to have superior osteogenic activity but is also vulnerable to failure because of induced bacterial attachment and consequent secondary infection. Here, the problem was attempted to be solved by depositing nanosized tetracycline (TC)-loaded particles in poly(lactic-co-glycolic acid) on titania nanotubes (TNTs) using the electrospray deposition method. The antibacterial effect of the newly formed TNT surface was considered using the common pathogen Staphylococcus aureus. Maintenance of the biocompatibility and osteogenic characteristics of TNTs has been tested through cytotoxicity tests and osteogenic gene expression/extra-cellular matrix mineralization, respectively. The results showed that TNTs were successfully formed by anodization, and the characterization of TC deposited on the TNTs was controlled by varying the spraying parameters such as particle size and coating time. The TC nanoparticle-coated TNTs showed antibacterial activity against Staphylococcus aureus and biocompatibility with MC3T3-E1 pre-osteoblasts, while the osteogenic activity of the TNT structure was preserved, as demonstrated by osteocalcin and osteopontin gene expression, as well as Alizarin red staining. Hence, this study concluded that the electrosprayed TC coating of TNTs is a simple and effective method for the formation of bactericidal implants that can maintain osteogenic activity.
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Almohareb T, Alhamoudi N, Al Deeb M, Bin-Shuwaish MS, Mokeem SA, Saad Shafqat S, Vohra F, Abduljabbar T. Clinical efficacy of photodynamic therapy as an adjunct to mechanical debridement in the treatment of per-implantitis with abscess. Photodiagnosis Photodyn Ther 2020; 30:101750. [DOI: 10.1016/j.pdpdt.2020.101750] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/16/2020] [Accepted: 03/20/2020] [Indexed: 12/17/2022]
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Sahrmann P, Gilli F, Wiedemeier DB, Attin T, Schmidlin PR, Karygianni L. The Microbiome of Peri-Implantitis: A Systematic Review and Meta-Analysis. Microorganisms 2020; 8:microorganisms8050661. [PMID: 32369987 PMCID: PMC7284896 DOI: 10.3390/microorganisms8050661] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 12/30/2022] Open
Abstract
This review aimed to systematically compare microbial profiles of peri-implantitis to those of periodontitis and healthy implants. Therefore, an electronic search in five databases was conducted. For inclusion, studies assessing the microbiome of peri-implantitis in otherwise healthy patients were considered. Literature was assessed for consistent evidence of exclusive or predominant peri-implantitis microbiota. Of 158 potentially eligible articles, data of 64 studies on 3730 samples from peri-implant sites were included in this study. Different assessment methods were described in the studies, namely bacterial culture, PCR-based assessment, hybridization techniques, pyrosequencing, and transcriptomic analyses. After analysis of 13 selected culture-dependent studies, no microbial species were found to be specific for peri-implantitis. After assessment of 28 studies using PCR-based methods and a meta-analysis on 19 studies, a higher prevalence of Aggregatibacter actinomycetemcomitans and Prevotella intermedia (log-odds ratio 4.04 and 2.28, respectively) was detected in peri-implantitis biofilms compared with healthy implants. Actinomyces spp., Porphyromonas spp. and Rothia spp. were found in all five pyrosequencing studies in healthy-, periodontitis-, and peri-implantitis samples. In conclusion, the body of evidence does not show a consistent specific profile. Future studies should focus on the assessment of sites with different diagnosis for the same patient, and investigate the complex host-biofilm interaction.
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Affiliation(s)
- Philipp Sahrmann
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland; (F.G.); (T.A.); (P.R.S.); (L.K.)
- Correspondence: ; Tel.: +41-44-634-3412
| | - Fabienne Gilli
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland; (F.G.); (T.A.); (P.R.S.); (L.K.)
| | - Daniel B. Wiedemeier
- Statistical Services, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland;
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland; (F.G.); (T.A.); (P.R.S.); (L.K.)
| | - Patrick R. Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland; (F.G.); (T.A.); (P.R.S.); (L.K.)
| | - Lamprini Karygianni
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland; (F.G.); (T.A.); (P.R.S.); (L.K.)
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Medina-Cruz D, Mostafavi E, Vernet-Crua A, Cheng J, Shah V, Cholula-Diaz JL, Guisbiers G, Tao J, García-Martín JM, Webster TJ. Green nanotechnology-based drug delivery systems for osteogenic disorders. Expert Opin Drug Deliv 2020; 17:341-356. [PMID: 32064959 DOI: 10.1080/17425247.2020.1727441] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: Current treatments for osteogenic disorders are often successful, however they are not free of drawbacks, such as toxicity or side effects. Nanotechnology offers a platform for drug delivery in the treatment of bone disorders, which can overcome such limitations. Nevertheless, traditional synthesis of nanomaterials presents environmental and health concerns due to its production of toxic by-products, the need for extreme and harsh raw materials, and their lack of biocompatibility over time.Areas covered: This review article contains an overview of the current status of treating osteogenic disorders employing green nanotechnological approaches, showing some of the latest advances in the application of green nanomaterials, as drug delivery carriers, for the effective treatment of osteogenic disorders.Expert opinion: Green nanotechnology, as a potential solution, is understood as the use of living organisms, biomolecules and environmentally friendly processes for the production of nanomaterials. Nanomaterials derived from bacterial cultures or biomolecules isolated from living organisms, such as carbohydrates, proteins, and nucleic acids, have been proven to be effective composites. These nanomaterials introduce enhancements in the treatment and prevention of osteogenic disorders, compared to physiochemically-synthesized nanostructures, specifically in terms of their improved cell attachment and proliferation, as well as their ability to prevent bacterial adhesion.
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Affiliation(s)
- David Medina-Cruz
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
| | - Ebrahim Mostafavi
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
| | - Ada Vernet-Crua
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
| | - Junjiang Cheng
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
| | - Veer Shah
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
| | | | - Gregory Guisbiers
- Department of Physics and Astronomy, University of Arkansas at Little Rock, Little Rock, AR, USA
| | - Juan Tao
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
| | | | - Thomas J Webster
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
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Xu Z, Krajewski S, Weindl T, Loeffler R, Li P, Han X, Geis-Gerstorfer J, Wendel HP, Scheideler L, Rupp F. Application of totarol as natural antibacterial coating on dental implants for prevention of peri-implantitis. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 110:110701. [PMID: 32204015 DOI: 10.1016/j.msec.2020.110701] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 01/08/2020] [Accepted: 01/27/2020] [Indexed: 12/11/2022]
Abstract
Peri-implantitis is the most important issue threatening the long-term survival rate of dental implants. Various efforts have been made to reduce implant surface plaque formation, which is one of the essential causes of peri-implantitis. In our study, we applied the natural antibacterial agent totarol as a coating on experimental silicon wafer and titanium implant surfaces. To analyze the interaction between the totarol coating and the oral primary colonizer S. gordonii and isolates of mixed oral bacteria, samples were incubated in a model system simulating the oral environment and analyzed by Live/Dead staining, crystal violet staining and scanning electron microscopy (SEM). After 4 d, 8 d, 12 d, 16 d, and 24 d salivary incubation, the stability and antibacterial efficiency of totarol coating was evaluated through SEM. The results indicated that totarol coatings on both silicon wafer and Ti surfaces caused efficient contact killing and an inhibition effect towards S. gordonii and mixed oral bacterial film growth after 4 h, 8 h, 24 h, and 48 h incubation. After longtime salivary incubation of 12 d, the bactericidal effect started to weaken, but the anti-adhesion and inhibition effect to biofilm development still exist after 24 d of salivary incubation. The application of a totarol coating on implant or abutment surfaces is a promising potential prophylactic approach against peri-implantitis.
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Affiliation(s)
- Zeqian Xu
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, Tübingen D-72076, Germany.
| | - Stefanie Krajewski
- University Hospital Tübingen, Department of Thoracic, Cardiac and Vascular Surgery, Calwerstr. 7/1, D-72076 Tübingen, Germany
| | | | - Ronny Loeffler
- Center for Light-Matter Interaction, Sensors and Analytics (LISA(+)), Eberhard Karls University Tübingen, Auf der Morgenstelle 15, D-72076 Tübingen, Germany
| | - Ping Li
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, Tübingen D-72076, Germany
| | - Xingting Han
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, Tübingen D-72076, Germany
| | - Jürgen Geis-Gerstorfer
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, Tübingen D-72076, Germany
| | - Hans-Peter Wendel
- University Hospital Tübingen, Department of Thoracic, Cardiac and Vascular Surgery, Calwerstr. 7/1, D-72076 Tübingen, Germany
| | - Lutz Scheideler
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, Tübingen D-72076, Germany
| | - Frank Rupp
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, Tübingen D-72076, Germany.
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Liang J, Peng X, Zhou X, Zou J, Cheng L. Emerging Applications of Drug Delivery Systems in Oral Infectious Diseases Prevention and Treatment. Molecules 2020; 25:E516. [PMID: 31991678 PMCID: PMC7038021 DOI: 10.3390/molecules25030516] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 01/17/2020] [Accepted: 01/20/2020] [Indexed: 12/27/2022] Open
Abstract
The oral cavity is a unique complex ecosystem colonized with huge numbers of microorganism species. Oral cavities are closely associated with oral health and sequentially with systemic health. Many factors might cause the shift of composition of oral microbiota, thus leading to the dysbiosis of oral micro-environment and oral infectious diseases. Local therapies and dental hygiene procedures are the main kinds of treatment. Currently, oral drug delivery systems (DDS) have drawn great attention, and are considered as important adjuvant therapy for oral infectious diseases. DDS are devices that could transport and release the therapeutic drugs or bioactive agents to a certain site and a certain rate in vivo. They could significantly increase the therapeutic effect and reduce the side effect compared with traditional medicine. In the review, emerging recent applications of DDS in the treatment for oral infectious diseases have been summarized, including dental caries, periodontitis, peri-implantitis and oral candidiasis. Furthermore, oral stimuli-responsive DDS, also known as "smart" DDS, have been reported recently, which could react to oral environment and provide more accurate drug delivery or release. In this article, oral smart DDS have also been reviewed. The limits have been discussed, and the research potential demonstrates good prospects.
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Affiliation(s)
| | | | | | - Jing Zou
- State Key Laboratory of Oral Diseases& West China School of Stomatology& National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China; (J.L.); (X.P.); (X.Z.)
| | - Lei Cheng
- State Key Laboratory of Oral Diseases& West China School of Stomatology& National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China; (J.L.); (X.P.); (X.Z.)
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31
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de Avila ED, van Oirschot BA, van den Beucken JJJP. Biomaterial-based possibilities for managing peri-implantitis. J Periodontal Res 2019; 55:165-173. [PMID: 31638267 PMCID: PMC7154698 DOI: 10.1111/jre.12707] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 08/22/2019] [Accepted: 09/18/2019] [Indexed: 12/13/2022]
Abstract
Peri‐implantitis is an inflammatory disease of hard and soft tissues around osseointegrated implants, followed by a progressive damage of alveolar bone. Oral microorganisms can adhere to all types of surfaces by the production of multiple adhesive factors. Inherent properties of materials will influence not only the number of microorganisms, but also their profile and adhesion force onto the material surface. In this perspective, strategies to reduce the adhesion of pathogenic microorganisms on dental implants and their components should be investigated in modern rehabilitation concepts in implant dentistry. To date, several metallic nanoparticle films have been developed to reduce the growth of pathogenic bacteria. However, the main drawback in these approaches is the potential toxicity and accumulative effect of the metals over time. In view of biological issues and in attempt to prevent and/or treat peri‐implantitis, biomaterials as carriers of antimicrobial substances have attracted special attention for application as coatings on dental implant devices. This review will focus on biomaterial‐based possibilities to prevent and/or treat peri‐implantitis by describing concepts and dental implant components suitable for engagement in preventing and treating this disease. Additionally, we raise important criteria referring to the geometric parameters of dental implants and their components, which can directly affect peri‐implant tissue conditions. Finally, we overview currently available biomaterial systems that can be used in the field of oral implantology.
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Affiliation(s)
- Erica D de Avila
- Regenerative Biomaterials, Radboudumc, Nijmegen, The Netherlands.,Department of Dental Materials and Prosthodontics, School of Dentistry at Araraquara, Sao Paulo State University-UNESP, Araraquara, São Paulo, Brazil
| | - Bart A van Oirschot
- Regenerative Biomaterials, Radboudumc, Nijmegen, The Netherlands.,Department of Implantology & Periodontology, Radboudumc, Nijmegen, The Netherlands
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32
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Mohammadi F, Hajmousaei M, Vaziri N, Arshad M. Bacterial Leakage at Implant-Abutment Interface With Different Intermediate Materials. J ORAL IMPLANTOL 2019; 45:451-455. [PMID: 31580765 DOI: 10.1563/aaid-joi-d-18-00313] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A gap exists at the implant-abutment interface in two-piece implants and can serve as a reservoir of bacteria and compromise the health of peri-implant tissue. This study aimed to compare the effect of different intermediate materials on bacterial leakage at the implant-abutment interface. A total of 75 implants were divided into 5 groups (n = 15) based on the material applied at the implant-abutment connection: (1) Atridox, (2) chlorhexidine, (3) Gapseal silicone, (4) saliva, and (5) no material. All the implants were inoculated with 0.1 μL of Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) suspension, and then the respective material was applied. The abutments were connected to the implants, and appropriate torque was applied as recommended by the manufacturer (Implantium, Dentium, Korea, Seoul). Bacterial leakage was determined by evaluating the turbidity of the broth. Bacterial contamination was found in all samples at different times; in groups 1, 2 and 3, contamination was noted after 7, 5, and 6 days, respectively, on average. Contamination occurred averagely after 4 days in groups 4 and 5. The present study showed that Atridox applied at the implant-abutment interface significantly delayed bacterial leakage.
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Affiliation(s)
- Farnoush Mohammadi
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Nastaran Vaziri
- School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Arshad
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Prosthodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
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Sani ES, Lara RP, Aldawood Z, Bassir SH, Nguyen D, Kantarci A, Intini G, Annabi N. An Antimicrobial Dental Light Curable Bioadhesive Hydrogel for Treatment of Peri-Implant Diseases. MATTER 2019; 1:926-944. [PMID: 31663080 PMCID: PMC6818244 DOI: 10.1016/j.matt.2019.07.019] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Dental implants constitute the standard of care to replace the missing teeth, which has led to an increase in the number of patients affected by peri-implant diseases (PIDs). Here, we report the development of an antimicrobial bioadhesive, GelAMP, for the treatment of PIDs. The hydrogel is based on a visible light-activated naturally-derived polymer (gelatin) and an antimicrobial peptide (AMP). The optimized formulation of GelAMP could be rapidly crosslinked using commercial dental curing systems. When compared to commercial adhesives, the bioadhesives exhibited significantly higher adhesive strength to physiological tissues and titanium. Moreover, the bioadhesive showed high cytocompatibility and could efficiently promote cell proliferation and migration in vitro. GelAMP also showed remarkable antimicrobial activity against Porphyromonas gingivalis. Furthermore, it could support the growth of autologous bone after sealing calvarial bone defects in mice. Overall, GelAMP could be used as a platform for the development of more effective therapeutics against PIDs.
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Affiliation(s)
- Ehsan Shirzaei Sani
- Chemical and Biomolecular Engineering Department, University of California -Los Angeles, Los Angeles, CA 90095, USA
| | - Roberto Portillo Lara
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Zapopan, JAL 44-49, México
| | - Zahra Aldawood
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Seyed Hossein Bassir
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Daniel Nguyen
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA
| | - Alpdogan Kantarci
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA
| | - Giuseppe Intini
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh, School of Dental Medicine, Pittsburgh, PA 15213, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Harvard Stem Cell Institute, Harvard University, Cambridge, MA 02115, USA
| | - Nasim Annabi
- Chemical and Biomolecular Engineering Department, University of California -Los Angeles, Los Angeles, CA 90095, USA
- Center for Minimally Invasive Therapeutics (C-MIT), California NanoSystems Institute (CNSI), University of California -Los Angeles, Los Angeles, CA 90095, USA
- Lead Contact
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34
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Shibli JA, Ferrari DS, Siroma RS, Figueiredo LCD, Faveri MD, Feres M. Microbiological and clinical effects of adjunctive systemic metronidazole and amoxicillin in the non-surgical treatment of peri-implantitis: 1 year follow-up. Braz Oral Res 2019; 33:e080. [PMID: 31576959 DOI: 10.1590/1807-3107bor-2019.vol33.0080] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 07/02/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the effects of adjunct systemic antibiotic treatment with metronidazole (MTZ) and amoxicillin (AMX) in patients receiving non-surgical subgingival debridement (NSD) for peri-implantitis. Forty subjects presenting with at least one implant with severe peri-implantitis were randomized into an experimental group [treated with NSD plus MTZ (400 mg) and AMX (500 mg) three times a day for 14 days] and a control group treated with NSD plus placebo. Clinical parameters and submucosal biofilm profiles were evaluated up to 1 year post-treatment. Overall, both treatments improved clinical parameters over time. At 1 year, mean probing depth (PD), mean clinical attachment (CA) level and proportions of red complex pathogens did not differ significantly between the two groups. In addition, mean PD and CA changes to 1-year posttreatment did not differ significantly between the two groups between baseline and 1-year post-treatment. These results suggest that the addition of MTZ and AMX to the treatment protocol of patients undergoing NSD for with severe peri-implantitis does not improve the clinical and microbiological outcomes of NSD. The fact that half of the implants in both groups did not achieve clinical success (PD < 5 mm, no BoP, no bone loss) suggest that neither of the tested protocols were effective for treating severe peri-implantitis.
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Affiliation(s)
- Jamil Awad Shibli
- Universidade de Guarulhos - UNG, Dental Research Division, Department of Periodontology and Oral Implantology, São Paulo, SP, Brazil
| | - Daniel Sanchez Ferrari
- Universidade de Guarulhos - UNG, Dental Research Division, Department of Periodontology and Oral Implantology, São Paulo, SP, Brazil
| | - Rafael Shinoske Siroma
- Universidade de Guarulhos - UNG, Dental Research Division, Department of Periodontology and Oral Implantology, São Paulo, SP, Brazil
| | - Luciene Cristina de Figueiredo
- Universidade de Guarulhos - UNG, Dental Research Division, Department of Periodontology and Oral Implantology, São Paulo, SP, Brazil
| | - Marcelo de Faveri
- Universidade de Guarulhos - UNG, Dental Research Division, Department of Periodontology and Oral Implantology, São Paulo, SP, Brazil
| | - Magda Feres
- Universidade de Guarulhos - UNG, Dental Research Division, Department of Periodontology and Oral Implantology, São Paulo, SP, Brazil
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35
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Bhavsar I, Miller CS, Ebersole JL, Dawson DR, Thompson KL, Al‐Sabbagh M. Biological response to peri‐implantitis treatment. J Periodontal Res 2019; 54:720-728. [DOI: 10.1111/jre.12681] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 06/05/2019] [Accepted: 06/09/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Ishita Bhavsar
- Department of Oral Health Practice Division of Periodontology College of Dentistry University of Kentucky Lexington Kentucky USA
| | - Craig S. Miller
- Department of Oral Health Practice Division of Oral Diagnosis Oral Medicine and Oral Radiology College of Dentistry University of Kentucky Lexington Kentucky USA
| | - Jeffrey L. Ebersole
- Center for Oral Health Research College of Dentistry University of Kentucky Lexington Kentucky USA
| | - Dolphus R. Dawson
- Department of Oral Health Practice Division of Periodontology College of Dentistry University of Kentucky Lexington Kentucky USA
| | - Katherine L. Thompson
- Department of Statistics College of Arts & Sciences University of Kentucky Lexington Kentucky USA
| | - Mohanad Al‐Sabbagh
- Department of Oral Health Practice Division of Periodontology College of Dentistry University of Kentucky Lexington Kentucky USA
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36
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Nonsurgical Treatment of Peri-implantitis Without Eliminating Granulation Tissue: A 3-Year Study. IMPLANT DENT 2019; 28:4-10. [PMID: 30363048 DOI: 10.1097/id.0000000000000832] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate a nonsurgical approach toward peri-implantitis by means of mechanical debridement and local detoxification leaving granulation tissue into the peri-implant pockets. MATERIALS AND METHODS An analysis was performed on the outcomes of 2 nonsurgical protocols: mechanical debridement plus chemical detoxification with 0.2% chlorhexidine and chlortetracycline hydrochloride (test), and mechanical debridement alone (control). Measures were collected at baseline, 3, 24, and 36 months after treatment. RESULTS Seventy-five implants with peri-implantitis were included. At a 36-month evaluation, mean pocket probing depth was 3.15 ± 0.32 mm for the test group and 5.97 ± 0.90 mm for the control group, the difference being significant. An improvement of marginal bone level was recorded for the test group, whether the control group showed a further marginal bone loss. Treatment success was 100% in the test group and 31.4% in the control group. CONCLUSION Nonsurgical implant debridement alone seemed not efficient in the treatment of peri-implantitis. Further longitudinal studies are required to evaluate the efficacy of mechanical debridement with chemical detoxification and removal of granulation tissues against mechanical debridement with chemical detoxification alone.
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37
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Estefanía‐Fresco R, García‐de‐la‐Fuente AM, Egaña‐Fernández‐Valderrama A, Bravo M, Aguirre‐Zorzano LA. One‐year results of a nonsurgical treatment protocol for peri‐implantitis. A retrospective case series. Clin Oral Implants Res 2019; 30:702-712. [DOI: 10.1111/clr.13456] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/16/2019] [Accepted: 05/05/2019] [Indexed: 12/28/2022]
Affiliation(s)
| | | | | | - Manuel Bravo
- School of Dentistry University of Granada Granada Spain
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38
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39
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Lang NP, Salvi GE, Sculean A. Nonsurgical therapy for teeth and implants-When and why? Periodontol 2000 2019; 79:15-21. [PMID: 30887589 DOI: 10.1111/prd.12240] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
As periodontal and peri-implant diseases represent opportunistic infections, antiinfective therapy is the method of choice. Correctly performed, the treatment outcomes will include resolution of the inflammation concomitant with shrinkage of the tissues, reflected in reduced probing depths. Depending on the patient data obtained after initial antiinfective therapy, further - mostly surgical - treatment may be rendered to reach the goals of a healthy periodontium and peri-implant tissues. Patient compliance is as important as operator skills for optimal treatment outcomes. Regenerative therapy may be applied in compliant patients and for appropriate defects. This article depicts the historical development of periodontal therapy during the 20th century and addresses the various outcome parameters to be used in daily decision making. Obviously, nonsurgical therapy has gained clinical relevance, resulting in highly satisfactory treatment outcomes in many cases. The critical probing depth above which positive attachment gain is registered varies from one treatment modality to another. It is a concept that helps facilitate decision making for additional therapeutic measures after initial therapy. Treatment of peri-implant mucositis prevents development of peri-implantitis. Hence, nonsurgical treatment of mucositis is frequently performed during the continuous monitoring of oral implants. This chapter of Periodontology 2000 presents evidence for the prevention and therapy of peri-implant diseases.
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Affiliation(s)
- Niklaus P Lang
- Department of Periodontology, University of Berne, Berne, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, University of Berne, Berne, Switzerland
| | - Anton Sculean
- Department of Periodontology, University of Berne, Berne, Switzerland
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40
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Cha J, Lee J, Kim C. Surgical Therapy of Peri-Implantitis with Local Minocycline: A 6-Month Randomized Controlled Clinical Trial. J Dent Res 2019; 98:288-295. [DOI: 10.1177/0022034518818479] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The purpose of this study was to determine the clinical, microbial, and radiographic effects of local minocycline combined with surgical treatment of peri-implantitis. Fifty patients with peri-implantitis were recruited, and surgical treatment with the local application of either minocycline or placebo ointment was performed. The application of minocycline was repeated with supragingival debridement at 1, 3, and 6 mo postoperatively. Plaque index, gingival index (GI), probing pocket depth (PPD), and bleeding/suppuration on probing were measured at baseline and 1-, 3-, and 6-mo evaluations. The change in supporting bone level (SBL) measured with cone beam computed tomography was analyzed between baseline and 6 mo. Microbial analysis was performed with real-time polymerase chain reaction. Both groups exhibited improvements in clinical and radiographic measurements after surgical treatment. There was a significant difference in the changes of mean PPD between the test and control groups (2.68 ± 1.73 and 1.55 ± 1.86 mm, respectively, P = 0.039). The changes of mean GI and SBL differed significantly between the groups (ΔGI: 0.83 ± 0.60 and 0.40 ± 0.68; ΔSBL: 0.72 ± 0.56 and 0.31 ± 0.49 mm, respectively, P = 0.026 and 0.014). Treatment success rates (defined as PPD <5 mm, absence of bleeding/suppuration on probing, and no further bone loss) were 66.7% and 36.3% in the test and control groups, respectively. The count of red complex bacteria tended to decrease in both groups until 6 mo; however, no significant intergroup difference was found. None of the patients in the test group carried Porphyromonas gingivalis or Tannerella forsythia at 6 mo. These findings indicate that the repeated local delivery of minocycline combined with surgical treatment provides significant benefits in terms of clinical parameters and radiographic bone fill, with a higher treatment success rate in the short healing period (cris.nih.go.kr KCT0002844).
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Affiliation(s)
- J.K. Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - J.S. Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - C.S. Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
- Department of Applied Life Science, BK21 PLUS Project, College of Dentistry, Yonsei University, Seoul, South Korea
- Department of Mechanical Engineering, College of Engineering, Yonsei University, Seoul, South Korea
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41
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Decontamination of Dental Implant Surfaces by the Er:YAG Laser Beam: A Comparative in Vitro Study of Various Protocols. Dent J (Basel) 2018; 6:dj6040066. [PMID: 30513706 PMCID: PMC6313799 DOI: 10.3390/dj6040066] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 11/16/2018] [Accepted: 11/19/2018] [Indexed: 12/18/2022] Open
Abstract
Oral rehabilitation with dental implants has revolutionized the field of dentistry and has been proven to be an effective procedure. However, the incidence of peri-implantitis has become an emerging concern. The efficacy of the decontamination of the implant surface, by means of lasers, is still controversial. Previous studies have revealed a reduction in osteoblast adhesion to carbon-contaminated implant surfaces. This in-vitro study aimed to evaluate the decontamination of failed implants by assessing the carbon proportion, after irradiation by low-energy erbium yttrium-aluminum-garnet laser (Er:YAG) (Fotona; 2940 nm, Ljubljana, Slovenia) for a single and for multiple passages, until getting a surface, free of organic matters; to find the appropriate procedure for dental-implant surface-decontamination. Ninety implants were used. Thirty sterile implants were kept as a negative control. Thirty failed implants were irradiated by the Er:YAG laser, for a single passage, and the other thirty, for multiple passages. The parameters used in our experiments were an irradiation energy of 50 mJ, frequency of 30 Hz, and an energy density of 3.76 J/cm2. A sapphire tip, with a length of 8 mm, was used with concomitant water spray irrigation, under air 6 and water spray 4. Super short pulse mode (SSP) was of 50 μs; irradiation speed being 2 mm/s. We used energy-dispersive X-ray spectroscopy (EDX) to evaluate the carbon proportion on the surfaces of the sterile implants, the contaminated, and the lased implants, with one (LX1) and with three passages (LX3). Statistical analysis was performed by ANOVA. Results showed mean difference between the three groups (contaminated, LX1, and LX3) with p < 0.0001, as between LX1 and Group A (p < 0.0001), while the difference between LX3 and the control group was not statistically significant. The decontamination of the implant surfaces with a low-energy Er:YAG laser with three passages, appeared to be an encouraging approach.
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42
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Heo S, Kim HJ, Joo JY, Lee J, Kim SJ, Choi J. Simplified nonsurgical treatment of peri-implantitis using chlorhexidine and minocycline hydrochloride. J Periodontal Implant Sci 2018; 48:326-333. [PMID: 30405940 PMCID: PMC6207798 DOI: 10.5051/jpis.2018.48.5.326] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/20/2018] [Indexed: 11/08/2022] Open
Abstract
Purpose The present study investigated the outcomes of a newly-developed, simple, and practical nonsurgical treatment modality suitable for most forms of intrabony defects around failing dental implants using intrasulcular delivery of chlorhexidine solution and minocycline hydrochloride (HCl). Methods Forty-five dental implants in 20 patients diagnosed with peri-implantitis were included. At baseline and the study endpoint, the probing pocket depth (PPD), clinical attachment level (CAL), and the presence of bleeding on probing (BOP) at 6 sites around each implant were recorded. The radiographic osseous defect morphology at the mesial or distal proximal aspect of each implant was classified as 1) narrow or wide and 2) shallow or deep. For a comparative analysis of bone changes according to the defect morphology, the distance from the implant shoulder to the most coronal bone-to-implant contact point (DIB) at the mesial and distal aspects of each implant was measured at baseline and the endpoint. Patients were scheduled to visit the clinic every 2–4 weeks for intrasulcular irrigation of chlorhexidine and delivery of minocycline HCl. Results We observed statistically significant decreases in PPD, CAL, and BOP after treatment. At the endpoint, bone levels increased in all defects, regardless of the osseous morphology of the intrabony defect. The mean DIB change in deep defects was significantly greater than that in shallow defects. Although the mean bone gain in narrow defects was greater than in wide defects, the difference was not statistically significant. Conclusions We propose that significant and sustainable improvements in both clinical and radiographic parameters can be expected when intrabony defects around dental implants are managed through a simple nonsurgical approach involving combined intrasulcular chlorhexidine irrigation and local delivery of minocycline HCl.
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Affiliation(s)
- SunJin Heo
- Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Korea
| | - Hyun-Joo Kim
- Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Korea.,Department of Periodontology, Pusan National University School of Dentistry, Yangsan, Korea
| | - Ji-Young Joo
- Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Korea.,Department of Periodontology, Pusan National University School of Dentistry, Yangsan, Korea
| | - Juyoun Lee
- Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Korea.,Department of Periodontology, Pusan National University School of Dentistry, Yangsan, Korea
| | - Sung-Jo Kim
- Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Korea.,Department of Periodontology, Pusan National University School of Dentistry, Yangsan, Korea
| | - Jeomil Choi
- Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Korea.,Department of Periodontology, Pusan National University School of Dentistry, Yangsan, Korea
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Miron RJ, Zhang Y. Autologous liquid platelet rich fibrin: A novel drug delivery system. Acta Biomater 2018; 75:35-51. [PMID: 29772345 DOI: 10.1016/j.actbio.2018.05.021] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 04/24/2018] [Accepted: 05/14/2018] [Indexed: 02/07/2023]
Abstract
There is currently widespread interest within the biomaterial field to locally deliver biomolecules for bone and cartilage regeneration. Substantial work to date has focused on the potential role of these biomolecules during the healing process, and the carrier system utilized is a key factor in their effectiveness. Platelet rich fibrin (PRF) is a naturally derived fibrin scaffold that is easily obtained from peripheral blood following centrifugation. Slower centrifugation speeds have led to the commercialization of a liquid formulation (liquid-PRF) resulting in an upper plasma layer composed of liquid fibrinogen/thrombin prior to clot formation that remains in its liquid phase for approximately 15 min until injected into bodily tissues. Herein, we introduce the use of liquid PRF as an advanced local delivery system for small and large biomolecules. Potential target molecules including large (growth factors/cytokines and morphogenetic/angiogenic factors), as well as small (antibiotics, peptides, gene therapy and anti-osteoporotic) molecules are considered potential candidates for enhanced bone/cartilage tissue regeneration. Furthermore, liquid-PRF is introduced as a potential carrier system for various cell types and nano-sized particles that are capable of limiting/by-passing the immune system and minimizing potential foreign body reactions within host tissues following injection. STATEMENT OF SIGNIFICANCE There is currently widespread interest within the biomaterial field to locally deliver biomolecules for bone and cartilage regeneration. This review article focuses on the use of a liquid version of platelet rich fibrin (PRF) composed of liquid fibrinogen/thrombin as a drug delivery system. Herein, we introduce the use of liquid PRF as an advanced local delivery system for small and large biomolecules including growth factors, cytokines and morphogenetic/angiogenic factors, as well as antibiotics, peptides, gene therapy and anti-osteoporotic molecules as potential candidates for enhanced bone/cartilage tissue regeneration.
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Lee BS, Shih KS, Lai CH, Takeuchi Y, Chen YW. Surface property alterations and osteoblast attachment to contaminated titanium surfaces after different surface treatments: An in vitro study. Clin Implant Dent Relat Res 2018; 20:583-591. [PMID: 29939477 DOI: 10.1111/cid.12624] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/02/2018] [Accepted: 04/23/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Studies have reported a high prevalence of peri-implantitis. The etiology of peri-implantitis remains unclear and no available treatments result in total resolution of established peri-implantitis. PURPOSE To investigate the factors that interfere with osteoblast adhesion to contaminated titanium surfaces after different surface treatments. MATERIALS AND METHODS Grade 4 titanium discs were randomly divided into 5 groups and each group was divided into 2 subgroups, with one contaminated with Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), and the other contaminated with Porphyromonas gingivalis (P. gingivalis). Group 1 did not receive bacterial inoculation or surface debridement and served as a control. Group 2 received A. actinomycetemcomitans or P. gingivalis inoculation, separately. Group 3 received bacterial inoculation and titanium curette debridement, followed by normal saline irrigation. Group 4 received bacterial inoculation, curette debridement, normal saline irrigation, and ultrasonication. Group 5 received bacterial inoculation, curette debridement, normal saline irrigation, and placement in 0.12% chlorhexidine. After various surface treatments, the surface roughness and hydrophilicity of the titanium surface were measured, the number of adhered osteoblast cells was calculated, and the amount of residual lipopolysaccharide (LPS) was quantified. RESULTS A. actinomycetemcomitans and P. gingivalis biofilms noticeably reduced surface hydrophilicity. Groups 3-5 showed decreased hydrophilicity and fewer adhered osteoblast cells compared with the control group. Although ultrasonication was more effective in removing LPS than curette debridement and chlorhexidine, cell adhesion was not as high as with clean titanium discs. CONCLUSIONS The non-surgical treatment used in this study was not effective in removing LPS from titanium surfaces and increasing osteoblast adhesion. A more effective method to remove LPS completely is required to enhance the treatment outcome of peri-implantitis.
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Affiliation(s)
- Bor-Shiunn Lee
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University and Department of Operative Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuang-Shao Shih
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Chern-Hsiung Lai
- College of Life Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yasuo Takeuchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yi-Wen Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University and Department of Periodontology, National Taiwan University Hospital, Taipei, Taiwan
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Gershenfeld L, Kalos A, Whittle T, Yeung S. Randomized clinical trial of the effects of azithromycin use in the treatment of peri-implantitis. Aust Dent J 2018; 63:374-381. [PMID: 29679488 DOI: 10.1111/adj.12614] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND The aim of this clinical trial was to establish a proof of concept that the adjunctive use of systemic azithromycin (AZM) in conjunction with mechanical debridement has an increased benefit in reducing soft tissue inflammation in the treatment of peri-implantitis. METHODS In a randomized, double-blind, clinical trial, the treatment group (nine patients) received AZM as well as mechanical debridement in a single course of treatment, whereas the control group (eight patients) received a placebo and mechanical debridement. The primary outcome variables studied were bleeding on probing, suppuration, pocket probing depth and gingival recession. The secondary variables studied were gingival index, plaque index, microbiological and interleukin-1β status. The observation period was 6 months. RESULTS Over the 6 months' observation period, the treatment patients showed a consistently greater reduction of gingival inflammation and an improvement in soft tissue healing than the control patients. CONCLUSIONS The adjunctive use of a single course of systemic azithromycin can assist in the control of peri-implant mucositis in the treatment of peri-implantitis.
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Affiliation(s)
- L Gershenfeld
- Faculty of Dentistry, University of Sydney, Sydney, New South Wales, Australia
| | - A Kalos
- Faculty of Dentistry, University of Sydney, Sydney, New South Wales, Australia
| | - T Whittle
- Jaw Function Research Unit, Westmead Centre for Oral Health, University of Sydney, Sydney, New South Wales, Australia
| | - S Yeung
- Department of Oral Restorative Sciences (Periodontics), Westmead Centre for Oral Health, University of Sydney, Sydney, New South Wales, Australia
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Galofré M, Palao D, Vicario M, Nart J, Violant D. Clinical and microbiological evaluation of the effect of Lactobacillus reuteri
in the treatment of mucositis and peri-implantitis: A triple-blind randomized clinical trial. J Periodontal Res 2018; 53:378-390. [DOI: 10.1111/jre.12523] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2017] [Indexed: 12/15/2022]
Affiliation(s)
- M. Galofré
- Department of Periodontology; Universitat Internacional de Catalunya; Barcelona Spain
| | - D. Palao
- Department of Periodontology; Universitat Internacional de Catalunya; Barcelona Spain
| | - M. Vicario
- Department of Periodontology; Universitat Internacional de Catalunya; Barcelona Spain
| | - J. Nart
- Department of Periodontology; Universitat Internacional de Catalunya; Barcelona Spain
| | - D. Violant
- Department of Periodontology; Universitat Internacional de Catalunya; Barcelona Spain
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Zhang S, Wang M, Jiang T, Zhou Y, Wang Y. Roles of a new drug-delivery healing abutment in the prevention and treatment of peri-implant infections: a preliminary study. RSC Adv 2018; 8:38836-38843. [PMID: 35558280 PMCID: PMC9090660 DOI: 10.1039/c8ra07676f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 11/05/2018] [Indexed: 11/21/2022] Open
Abstract
In this study we modified the common healing abutment into a specifically designed drug-delivery abutment (DDA), which is a hollow columnar system with drug-distribution holes in peripheral wall. The objective of this study was to investigate the possibility of the prevention and treatment of peri-implant diseases with this drug-delivery system. Minocycline hydrochloride was added to DDAs with different hole diameters, and then subjected to bacteria-inhibition tests in vitro with three oral bacterial strains, namely, Streptococcus mutans, Streptococcus sanguinis, and Porphyromonas gingivalis. The implants were placed into the mandible of beagle dogs. DDAs with or without minocycline and normal healing abutments were installed. One week after surgery, the plaques on all the abutments were analyzed by plaque stain. Following this, both abutments and adjacent teeth received oral hygiene to maintain a healing environment. Eleven weeks later, the ligature-induced experimental peri-implantitis model was set up for eight weeks. Periapical radiographs and clinical measurements were performed during the process. We found that inhibition zones were observed surrounding all the tested drug-delivery abutments in all three bacterial strains. One week after implant installation, oral plaque formed on the DDAs with minocycline was significantly less than that on normal abutments and DDAs without drugs. DDA with the minocycline group showed a relatively slower rate of deterioration of the mucosal inflammation and probing depth in the experimental peri-implant lesions. We suggest that this drug-delivery abutment could effectively deliver medications into peri-implant tissues to minimize plaque formation and relieve peri-implant inflammation in the experimental peri-implantitis model. We modified a normal abutment into a drug delivery abutment and discussed its possible application in the prevention and treatment of peri-implant infections.![]()
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Affiliation(s)
- Shuang Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST)
- Key Laboratory of Oral Biomedicine Ministry of Education
- School and Hospital of Stomatology
- Wuhan University
- Wuhan 430079
| | - Min Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST)
- Key Laboratory of Oral Biomedicine Ministry of Education
- School and Hospital of Stomatology
- Wuhan University
- Wuhan 430079
| | - Tao Jiang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST)
- Key Laboratory of Oral Biomedicine Ministry of Education
- School and Hospital of Stomatology
- Wuhan University
- Wuhan 430079
| | - Yi Zhou
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST)
- Key Laboratory of Oral Biomedicine Ministry of Education
- School and Hospital of Stomatology
- Wuhan University
- Wuhan 430079
| | - Yining Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST)
- Key Laboratory of Oral Biomedicine Ministry of Education
- School and Hospital of Stomatology
- Wuhan University
- Wuhan 430079
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Vancomycin and tobramycin impregnated mineralized allograft for the surgical regenerative treatment of peri-implantitis: a 1-year follow-up case series. Clin Oral Investig 2017; 22:2199-2207. [PMID: 29275491 DOI: 10.1007/s00784-017-2310-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 12/12/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To assess the clinical and radiographic outcomes of the regenerative treatment of peri-implantitis using a vancomycin and tobramycin impregnated allograft (VTA) after a 12-month period. MATERIAL AND METHODS Thirteen consecutive patients who required a regenerative treatment of peri-implantitis were recruited. For the 17 implant sites, a flap was raised, and after mechanical and chemical implant decontamination, a vancomycin and tobramycin impregnated allograft was placed in the defect and then covered with a collagen membrane. Soft tissues were sutured allowing a non-submerged healing. Clinical and radiographic variables were evaluated at baseline and at 12 months after treatment. RESULTS No signs of continuous bone loss were observed and no implant was lost, yielding a 100% survival rate. All patient's clinical examination at 12 months revealed peri-implant health showing absence of suppuration and a statistically significant reduction in terms of bleeding on probing scores (70.6%, P = 0.001). Initial probing pocket depth (7.88 ± 1.22 mm) was significantly reduced at 12 months healing, a mean reduction of 4.23 ± 1.47 mm (P = 0.001) was achieved. The mean radiological infrabony defect at baseline reached 4.33 ± 1.62 mm, and was significantly reduced up to 0.56 ± 0.88 mm, which represents an 86.99 ± 18.2% bone fill from the original infrabony defect. CONCLUSIONS Within the limits of the study, the application of VTA with a collagen membrane yielded positive outcomes in terms of radiographic bone fill, pocket depth reduction, and attachment gain after a 12-month period. Thus, VTA plus a collagen membrane seem to be suitable for the regenerative treatment of peri-implantitis. CLINICAL RELEVANCE The use of locally delivered antibiotic together with the bone graft may reduce the undesirable effects related to the systemic administration and the risk of resistances. In the light of the results obtained, these grafting materials might offer new treatment strategies in the surgical regenerative treatment of peri-implantitis.
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McCracken G, Asuni A, Ritchie M, Vernazza C, Heasman P. Failing to meet the goals of periodontal recall programs. What next? Periodontol 2000 2017; 75:330-352. [DOI: 10.1111/prd.12159] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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