Probing and scaling instrumentation on implant abutment surfaces: an in vitro study

An In Vivo Investigation of Non-Metallic vs. Metallic Hand Scalers on Zirconia Implant-Supported Crowns: A Year-Long Analysis of Peri-Implant Maintenance

This study examined whether the degree of abutment surface modification that may occur with regular periodontal instrumentation has a clinical impact in terms of increased plaque accumulation and increased peri-implant tissue inflammation on zirconia implant abutments. Thirteen patients who had zirconia implant crowns were recruited in this randomized clinical trial. Each patient acted as their control and had either the buccal or lingual surface of their screw-retained implant restoration scaled with a metallic scaler and the other surface with a non-metallic scaler at 3, 6, 9, and 12 months. Cytokine testing of the peri-implant crevicular fluid was completed at 0, 3, and 12 months for IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, or IFNγ. Implant crowns were removed at 12 months and evaluated under an atomic force microscope for the average roughness (Ra). The implant crowns were polished and re-inserted. The results were analyzed using the Kruskal-Wallis test, and post hoc tests were conducted with a significance level of α = 0.05. Significant differences in surface roughness (Ra) were observed between the metallic and non-metallic scalers. The median Ra values were 274.0 nm for metallic scalers and 147.1 nm for non-metallic scalers. However, there were no significant differences between the type of scaler used and the amount of clinical inflammation or cytokine production. Metallic scalers produced deeper, more aggressive surface alterations to the abutment/crown zirconia surface, but there was no statistically significant difference between the degree of surface alterations, amount of BOP, and the amplitude of cytokine inflammation produced.

Evaluating the Knowledge of General Dentist Towards the Management of Peri-Implant Diseases: A Multi-Center, Cross-Sectional Study

Background:

Recently, implants have been widely considered as an option for replacing missing teeth. There are several biological conditions that must be considered for the success of an implant. Failure to satisfy any of these factors may result in complications, such as peri-implantitis or failure of the implant.

Aim:

The aim of this study was to evaluate the general dentist's attitude towards the management of peri-implant diseases in Saudi Arabia.

Methods:

A multicenter cross-sectional electronic-based questionnaire was formulated based on the validated questionnaire from a previous study. It was targeted towards the general dental practitioners in Saudi Arabia. The study sample consisted of 721 general dental practitioners. The questionnaire consisted of 17 questions divided into five sections. Pearson's chi-square test was used for inferential statistical analysis with Holm's correction, for adjusted p-value, the alpha at 95% confidence interval was 0.05, and all values below alpha were considered statistically significant.

Results:

The majority of participants had attended an implant training course (51.2%) while the rest had not (48.7%). The majority of the participants (67.3%) thought they need special instruments for the detection of peri-implantitis but only 29.5% thought they do not need any special instruments for the intended purpose. Most participants (79.3%) said they can identify and differentiate between normal and abnormal soft tissue around an implant, while 6.5% of the respondents could not. More than half of the participants (54.8%) could differentiate between peri-implant mucositis and peri-implantitis, and 19.4% had no idea about this. Amoxicillin & metronidazole was considered as the best and most effective antibiotic by the majority of respondents (76%), while only (5%) of dentists selected ciprofloxacin.

Conclusion:

This study concludes by suggesting that most of the participants have adequate knowledge about peri-implant soft tissue assessment, mechanism of periodontitis and peri-implantitis, its initiation and progression along with its management. Most of the participants found the training courses on peri-implantitis to be efficient. It is recommended to conduct more courses and studies that would aim at understanding the pathogenesis, etiology, diagnosis, and treatment of peri-implant diseases so as to increase awareness among general dentists.