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Khetarpal S, Nathani J, Ratre MS, Solanki M. Application of Hard and Soft Tissue Regenerative Approach in Predictable Management of Peri-Implantitis: A Five-Year Follow-Up Case Report. Cureus 2024; 16:e60307. [PMID: 38882948 PMCID: PMC11176276 DOI: 10.7759/cureus.60307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/18/2024] Open
Abstract
As implant dentistry expands, the number of implants being placed increases, and so does the prevalence of associated complications, resulting in implant failure if not timely attended. The present case report aims to discuss the successful regenerative management of peri-implantitis by both hard and soft tissue augmentation with a five-year follow-up. A 60-year-old male reported a chief complaint of purulent discharge, 7 mm peri-implant probing depth, and radiographic bone loss with no pathologic mobility of the dental implant. The reflection of the full-thickness flap revealed a circumferential defect. Guided bone regeneration (GBR) was performed using a combination of autogenous and alloplastic bone grafts around the implant site. To maintain the peri-implant marginal bone level, soft tissue augmentation was done using the vestibular incision subperiosteal tunnel access (VISTA) approach, after six months. A five-year follow-up showed a significant bone fill and stable soft tissue around the implant clinically and radiographically.
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Affiliation(s)
| | - Jaya Nathani
- Periodontology, Bhabha College of Dental Sciences, Bhopal, IND
| | - Madhu S Ratre
- Periodontology, Government College of Dentistry, Indore, IND
| | - Mishthu Solanki
- Pediatric and Preventive Dentistry, Smile Makers Dental Clinic, Indore, IND
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Shiba T, Komatsu K, Takeuchi Y, Koyanagi T, Taniguchi Y, Takagi T, Maekawa S, Nagai T, Kobayashi R, Matsumura S, Katagiri S, Izumi Y, Aoki A, Iwata T. Novel Flowchart Guiding the Non-Surgical and Surgical Management of Peri-Implant Complications: A Narrative Review. Bioengineering (Basel) 2024; 11:118. [PMID: 38391604 PMCID: PMC10885994 DOI: 10.3390/bioengineering11020118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/04/2024] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
Peri-implant diseases, such as peri-implant mucositis and peri-implantitis, are induced by dysbiotic microbiota resulting in the inflammatory destruction of peri-implant tissue. Nonetheless, there has yet to be an established protocol for the treatment of these diseases in a predictable manner, although many clinicians and researchers have proposed various treatment modalities for their management. With the increase in the number of reports evaluating the efficacy of various treatment modalities and new materials, the use of multiple decontamination methods to clean infected implant surfaces is recommended; moreover, the use of hard tissue laser and/or air abrasion techniques may prove advantageous in the future. Limited evidence supports additional effects on clinical improvement in antimicrobial administration for treating peri-implantitis. Implantoplasty may be justified for decontaminating the implant surfaces in the supracrestal area. Surgical treatment is employed for advanced peri-implantitis, and appropriate surgical methods, such as resection therapy or combination therapy, should be selected based on bone defect configuration. This review presents recent clinical advances in debridement methods for contaminated implant surfaces and regenerative materials for treating peri-implant bone defects. It also proposes a new flowchart to guide the treatment decisions for peri-implant disease.
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Affiliation(s)
- Takahiko Shiba
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Keiji Komatsu
- Department of Lifetime Oral Health Care Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Yasuo Takeuchi
- Department of Lifetime Oral Health Care Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Tatsuro Koyanagi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Yoichi Taniguchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Toru Takagi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Shogo Maekawa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Takahiko Nagai
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Ryota Kobayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Shunsuke Matsumura
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
- Oral Care Periodontics Center, Southern TOHOKU Research Institute for Neuroscience, Southern TOHOKU General Hospital, Koriyama 963-8052, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
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Hong I, Koo KT, Oh SY, Park HW, Sanz-Martín I, Cha JK. Comprehensive treatment protocol for peri-implantitis: an up-to date narrative review of the literature. J Periodontal Implant Sci 2024; 54:54.e2. [PMID: 38290998 DOI: 10.5051/jpis.2303360168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/19/2023] [Accepted: 11/02/2023] [Indexed: 02/01/2024] Open
Abstract
This narrative review describes up-to-date treatment options for peri-implantitis and proposes a treatment protocol and flowchart based on the current scientific evidence. Peri-implantitis treatment should be based on the phased treatment protocol for periodontitis, which is a continuous flow of decisions for extraction, nonsurgical and surgical treatments with step-by-step re-evaluation. The protocol's goals are to fulfill the success criteria for peri-implantitis treatment (probing depth of ≤5 mm, and absence of bleeding on probing, suppuration, and progressive bone loss) and to halt disease progression. Fixtures with peri-implantitis can initially be classified as failed or failing. A failed implant needs to be removed. In contrast, nonsurgical and surgical treatments can be applied to a failing implant. Nonsurgical treatment should be the initial treatment for failing implants; however, sole nonsurgical treatment was regarded as inefficient for peri-implantitis. Recent studies have found that the adjunctive use of antibiotics to nonsurgical debridement increased the success of nonsurgical treatment for peri-implantitis. Surgical treatments can be classified into resective, access, and reconstructive surgeries. The technique should be selected according to the patient's bone defect configuration, which relate to regenerative potential. Various combinations of decontamination methods (e.g., mechanical, chemical, and pharmacological approaches) are required to achieve absolute surface decontamination. Clinicians should select an appropriate surface decontamination strategy according to the purpose of surgery. After signs of disease disappear and its progression is halted through active peri-implantitis treatment, it is necessary to enroll patients into maintenance programs. Compliance of patients with the maintenance program reduces the recurrence of peri-implantitis and sustains clinical success after treatment. Maintenance visits should include professional plaque control and hygiene care reinforcement for patients, and their interval should be set according to individual peri-implantitis risk. Clinicians should remind that peri-implantitis treatment is not a single procedure, but rather a continuing cycle of treatment and re-evaluation.
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Affiliation(s)
- Inpyo Hong
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sang-Yoon Oh
- Private practice, Mapo Acro Dental Clinic, Seoul, Korea
| | | | - Ignacio Sanz-Martín
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Private Practice, Lausanne, Switzerland
- Postgraduate Program in Periodontology, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.
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Lu H, Yan X, Zhu B, Zhang L, Feng X, Piao M, Huang B, Wang X, Zhang H, Wang Q, Meng H. The occurrence of peri-implant mucositis associated with the shift of submucosal microbiome in patients with a history of periodontitis during the first two years. J Clin Periodontol 2020; 48:441-454. [PMID: 33617025 DOI: 10.1111/jcpe.13410] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 10/04/2020] [Accepted: 11/22/2020] [Indexed: 12/16/2022]
Abstract
AIM To investigate the dynamic changes of peri-implant microbiome in patients with a history of periodontitis and to construct a microbial prediction model. MATERIALS AND METHODS The prospective study was performed at one month (T1), one year (T2) and two years (T3) after restoration. Clinical examinations [probing depth (PD), bleeding on probing (BOP), suppuration (SUP)], radiographic examinations and sample collection were conducted at three timepoints. Peri-implant sulcular fluid (PISF) was collected and analysed by 16S rRNA gene sequencing. Generalized linear mixed model (GLMM) was used to identify differences. RESULTS Totally, 168 subjects were assessed for eligibility. Twenty-two patients were recruited in the longitudinal study. Eventually, 67 PISF samples from 24 implants of 12 patients were collected and analysed. Peri-implant microbiome showed increasing diversity and complexity over time. Disease-associated genera Porphyromonas, Tannerella, Treponema and Prevotella dramatically increased from T1 to T3. The prediction model for clinical suppuration at T1 showed a high accuracy of 90%. CONCLUSION The dysbiosis of peri-implant microbiome increased with time during the two-year observation in patients with a history of periodontitis. Genera of Porphyromonas, Tannerella, Treponema and Prevotella were biomarkers of peri-implant mucositis. Microbiota at the early stage could predict subsequent microbial dysbiosis and clinical suppuration.
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Affiliation(s)
- Hongye Lu
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xia Yan
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Bin Zhu
- Department of Periodontology, Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Li Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xianghui Feng
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Muzi Piao
- Department of Periodontology, Second Dental Center, Peking University School and Hospital of Stomatology, Beijing, China
| | - Baoxin Huang
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Xiane Wang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Haidong Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Qi Wang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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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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Neely AL, Thompson TN, Gupta V, Kinaia B. Successful Management of Peri-Implantitis Using a Titanium Brush and a Doxycycline-Saline Slurry for Surface Detoxification With Guided Bone Regeneration: A 5-Year Follow-Up. Clin Adv Periodontics 2019; 10:118-122. [PMID: 31845465 DOI: 10.1002/cap.10085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 08/16/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The inflammation associated with peri-implantitis lesions can be difficult to manage and regeneration of lost bone is unpredictable. Unfortunately, opinions vary on the best method(s) for elimination of inflammation and restoration of residual osseous defects. This report describes the successful surgical management of a peri-implantitis lesion with reduction of inflammation and maintenance of nearly completely regenerated horizontal and vertical bone over 5 years. CASE PRESENTATION A 55-year-old healthy, non-smoking, African-American female presented in 2013 with inflammation and >25% bone loss at implant site #18. Probing depths ranged from 6 to 13 mm with bleeding on probing (BOP). She was diagnosed with peri-implantitis. She reported a history of routine scaling every 6 months since implant and crown placement 3 years earlier (2010). Initial periodontal treatment consisted of non-surgical scaling and implant debridement. Deep pockets and BOP persisted at re-evaluation. Surgical treatment consisted of full thickness flap, soft tissue curettage with titanium curets, and detoxification of the implant surface with a doxycycline and sterile saline slurry using a titanium brush. Mineralized freeze-dried bone allograft and demineralized freeze-dried bone allograft in a 50:50 ratio was placed and covered with a resorbable collagen membrane. All postoperative visits were uneventful. Maximum probing depths around the treated implant at the 5+-year follow-up (2019) were 4 mm with no BOP and nearly complete bone fill. CONCLUSIONS This case illustrates that it is possible to successfully eliminate clinical inflammation associated with peri-implantitis, regenerate bone, and maintain health for >5 years.
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Affiliation(s)
- Anthony L Neely
- Graduate Periodontics Division, University of Detroit Mercy Dental, Detroit, MI.,Private practice, Southfield, MI
| | - Tamika N Thompson
- Graduate Periodontics Division, University of Detroit Mercy Dental, Detroit, MI
| | - Vidushi Gupta
- Graduate Periodontics Division, University of Detroit Mercy Dental, Detroit, MI
| | - Bassam Kinaia
- Graduate Periodontics Division, University of Detroit Mercy Dental, Detroit, MI.,Private practice, Sterling Heights, MI
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Froum SH, Cantor-Balan R, Kerbage C, Froum SJ. Thermal Testing of Titanium Implants and the Surrounding Ex-Vivo Tissue Irradiated With 9.3um CO2 Laser. IMPLANT DENT 2019; 28:463-471. [PMID: 31348019 DOI: 10.1097/id.0000000000000923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To measure the temperature rise and surface damage of titanium dental implants and the surrounding tissue in a pig jaw during 9.3-μm carbon dioxide (CO2) laser irradiation at various durations of time. MATERIALS AND METHODS Thermal analysis tests were performed on 12 implants with the same surface. Twelve implants mounted alone or in pig jaws were laser-irradiated with a 9.3-μm CO2 laser using 3 different power settings. The temperature of the implant body and the proximal tissues was measured with a J-Type Thermocouple after being laser-irradiated with 3 different power setting for 30, 60 seconds, and 2 minutes. Scanning electron microscope (SEM) and digital microscope images were also taken of the all the implants before and after laser irradiation to detect the presence or absence of surface damage. RESULTS Temperature analysis showed that in all cases the implant and the proximal tissue temperatures remained around the start temperatures of the implant and tissues with fluctuations of ±3°C but never reached the upper threshold of 44°C, the temperature at which thermal injury to bone has been reported. Digital and SEM images that were taken of the implants showed an absence of surface damage at the cutting speed of 20% (0.7 W); however, cutting speeds of 30% to 100% (1.0-4.2 W) did yield surface damage. CONCLUSIONS Laser irradiation of titanium implant surfaces using a 9.3-μm carbon dioxide laser with an average power of 0.7 W showed no increase in thermal temperature of the implant body and tissue temperatures as well as no evidence of implant surface damage.
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Affiliation(s)
- Scott H Froum
- Assistant Professor, Department of Periodontics, Stony Brook Dental School, Stony Brook, NY
| | | | - Charles Kerbage
- Vice President of Research and Development, Convergent Dental, Needham, MA
| | - Stuart J Froum
- Clinical Adjunct Professor and Director of Clinical Research, Ashman Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY
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A risk-based decision making tree for managing fractured abutment and prosthetic screws: A systematic review. J Prosthet Dent 2018; 119:552-559. [DOI: 10.1016/j.prosdent.2017.05.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/20/2017] [Accepted: 05/22/2017] [Indexed: 11/24/2022]
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Abstract
INTRODUCTION Periimplant diseases have slowly become a common complication in implant patients. Here, we present a prognosis system to aid clinicians and researchers in the evaluation and treatment of periimplant diseases. This prognosis system divides periimplant disease into favorable, questionable, unfavorable, and hopeless cases based on the level of bone loss, pocket depth, mobility, bleeding on probing, and suppuration. MATERIALS AND METHODS To test the accuracy of our prognostic scale, the authors designed and conducted a database search to compile articles allowing for testing of the proposed prognostic scale. DISCUSSION The literature search returned 101 articles, of which two reported all relevant values for the prognostic system and were used to evaluate its reliability and accuracy. The prognostic system correctly predicted the likely outcome of periimplant disease up to 1 year posttreatment for all examined implants. CONCLUSIONS The proposed prognostic system can be used as a tool for clinicians as they develop a treatment plan for all stages of periimplant disease.
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Ramanauskaite A, Juodzbalys G. Diagnostic Principles of Peri-Implantitis: a Systematic Review and Guidelines for Peri-Implantitis Diagnosis Proposal. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2016; 7:e8. [PMID: 27833733 PMCID: PMC5100648 DOI: 10.5037/jomr.2016.7308] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 08/22/2016] [Indexed: 12/12/2022]
Abstract
Objectives To review and summarize the literature concerning peri-implantitis diagnostic parameters and to propose guidelines for peri-implantitis diagnosis. Material and Methods An electronic literature search was conducted of the MEDLINE (Ovid) and EMBASE databases for articles published between 2011 and 2016. Sequential screening at the title/abstract and full-text levels was performed. Systematic reviews/guidelines of consensus conferences proposing classification or suggesting diagnostic parameters for peri-implantitis in the English language were included. The review was recorded on PROSPERO system with the code CRD42016033287. Results The search resulted in 10 articles that met the inclusion criteria. Four were papers from consensus conferences, two recommended diagnostic guidelines, three proposed classification of peri-implantitis, and one suggested an index for implant success. The following parameters were suggested to be used for peri-implantitis diagnosis: pain, mobility, bleeding on probing, probing depth, suppuration/exudate, and radiographic bone loss. In all of the papers, different definitions of peri-implantitis or implant success, as well as different thresholds for the above mentioned clinical and radiographical parameters, were used. Current evidence rationale for the diagnosis of peri-implantitis and classification based on consecutive evaluation of soft-tissue conditions and the amount of bone loss were suggested. Conclusions Currently there is no single uniform definition of peri-implantitis or the parameters that should be used. Rationale for diagnosis and prognosis of peri-implantitis as well as classification of the disease is proposed.
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Affiliation(s)
- Ausra Ramanauskaite
- Clinic of Dental and Oral Pathology, Lithuanian University of Health Sciences, Kaunas Lithuania
| | - Gintaras Juodzbalys
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania
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Effectiveness of disinfection therapies and promotion of osteoblast growth on osseotite and nanotite implant surfaces. IMPLANT DENT 2016; 23:426-33. [PMID: 24776940 DOI: 10.1097/id.0000000000000067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of 4 procedures to disinfect implant surfaces intentionally inoculated with bacteria and afterward to evaluate osteoblast viability to the disinfected implant surfaces. MATERIALS AND METHODS Eighty-eight commercially pure Osseotite and Nanotite titanium implant discs were inoculated with Porphyromonas gingivalis. The implant surfaces were disinfected with EDTA, tetracycline, citric acid, or neodymium-doped yttrium aluminum garnet (Nd:YAG) laser. The implant discs were then placed in cultures of osteoblast cells. RESULTS Osseotite implant discs were easier to disinfect compared with the Nanotite implant discs. Citric acid and tetracycline were the most effective solutions for the disinfection of P. gingivalis from the Osseotite implant discs. CONCLUSION The Nanotite implant discs were the most difficult to disinfect, likely because of their chemical and physical properties. Citric acid and tetracycline were most effective for disinfecting the Osseotite implant discs, and further clinical research is needed to verify these effects in vivo. The Nd:YAG laser was the weakest disinfection method, and it is not recommended for disinfecting implant surfaces until its effectiveness is improved.
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Chan HL, Lin GH, Suarez F, MacEachern M, Wang HL. Surgical Management of Peri-Implantitis: A Systematic Review and Meta-Analysis of Treatment Outcomes. J Periodontol 2014; 85:1027-41. [DOI: 10.1902/jop.2013.130563] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Schmidt EC, Papadimitriou DEV, Caton JG. Surgical Management of Peri-Implantitis: A Clinical Case Report. Clin Adv Periodontics 2014. [DOI: 10.1902/cap.2012.120060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Froum SJ. Regenerative Treatment for a Peri-Implantitis-Affected Implant: A Case Report. Clin Adv Periodontics 2013. [DOI: 10.1902/cap.2012.120036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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A 5-year retrospective study on postsurgical periimplant infection during initial bone healing period: clinical characteristics, management, and prognosis. IMPLANT DENT 2013; 22:20-5. [PMID: 23303269 DOI: 10.1097/id.0b013e31827c8d93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this 5-year evaluation was to assess the clinical characteristics, management, and prognosis of postsurgical periimplant infection during the initial bone healing period. METHODS Nine hundred twenty-five implants (514 patients) placed without bone augmentation procedures were assessed. Ten implants (1.08%) in 7 patients (1.36%) were diagnosed as postsurgical periimplant infection. Different management methods were adopted respectively. RESULTS All reported implant infections were diagnosed after 2 weeks from implant surgery. Among the infected cases, 7 implants (70%) in 4 patients (57%) were successfully treated and loaded. Three implants (30%) in 3 patients (43%) failed to achieve osseointegration. CONCLUSIONS It is suggested that surgeons should observe the patient closely to detect possible infection during at least 1 month from surgery. Most postsurgical periimplant infections could recover and achieve osseointegration after timely and effective management.
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Decision Tree for the Management of Periimplant Diseases. IMPLANT DENT 2012. [DOI: 10.1097/id.0b013e31825a32cb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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