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Vilela N, Gurgel BCV, Bruzos CD, Duarte WR, da Silva HDP, Pannuti CM, Duarte PM. Preloading peri-implant crestal bone loss: A retrospective study of incidence and related factors. J Periodontol 2024. [PMID: 38923568 DOI: 10.1002/jper.24-0028] [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: 01/15/2024] [Revised: 03/06/2024] [Accepted: 04/17/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND The aim of this study was to evaluate the incidence of preloading crestal bone loss (PLCBL) and to identify the patient-related and implant-related factors associated with PLCBL. METHODS This retrospective cohort examined the dental records of patients who received at least one dental implant. PLCBL was defined as a reduction ⩾0.5 mm and severe PLCBL (primary variable) as a reduction ⩾1.5 mm in mesial and/or distal bone level, measured from the day of implant placement to uncovering or abutment installation/crown delivery. The incidence of PLCBL and patient and implant variables were recorded. Bivariate analysis and binary logistic regression identified factors associated with PLCBL ⩾0.5 mm and ⩾1.5 mm. RESULTS A total of 746 dental implants placed in 361 patients from January 2011 to July 2021 was included in the analyses. Of the implants assessed, 24.4% (n = 182) exhibited PLCBL ⩾ 0.5 mm and 10.5% (n = 78) presented severe PLCBL (i.e., ⩾1.5 mm). Males (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.11-3.07), patients with diabetes (OR = 3.33, 95% CI = 1.73-6.42), and those allergic to penicillin (OR = 3.13, 95% CI = 1.57-6.22) were more likely to experience severe PLCBL (p < 0.05). Implants placed in the anterior area (OR = 2.08, 95% CI = 1.16-3.73), with bone-level platform-abutment connection (OR = 4.73, 95% CI = 1.94-11.49) and inserted supracrestally (OR = 3.77, 95% CI = 1.84-7.72), presented a greater risk of developing severe PLCBL (p < 0.05). Implants placed in a previously grafted area presented a lower likelihood of developing severe PLCBL (OR = 0.489, 95% CI = 0.28-0.84). CONCLUSION The incidence of PLCBL ⩾ 0.5 mm and ⩾1.5 mm was 24.4% and 10.5%, respectively. Male sex, diabetes, allergy to penicillin, anterior location, bone-level platform-abutment connection, and supracrestal implant placement are potential risk factors for severe PLCBL. A previously grafted area is a potential protective factor.
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Affiliation(s)
- Nathalia Vilela
- Department of Stomatology, Division of Periodontology, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Bruno C V Gurgel
- Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Carlos De Bruzos
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Wagner R Duarte
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Hélio D P da Silva
- Department of Dentistry, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Claudio M Pannuti
- Department of Stomatology, Division of Periodontology, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Poliana Mendes Duarte
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
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Konishi D, Hirata E, Takano Y, Maeda Y, Ushijima N, Yudasaka M, Yokoyama A. Near-infrared light-boosted antimicrobial activity of minocycline/hyaluronan/carbon nanohorn composite toward peri-implantitis treatments. NANOSCALE 2024. [PMID: 38913014 DOI: 10.1039/d4nr01036a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Dental implant therapy is a reliable treatment for replacing missing teeth. However, as dental implants become more widely used, peri-implantitis increasingly has become a severe complication, making successful treatment more difficult. As a result, the development of effective drug delivery systems (DDSs) and treatments for peri-implantitis are urgently needed. Carbon nanohorns (CNHs) are carbon nanomaterials that have shown promise for use in DDSs and have photothermal effects. The present study exploited the unique properties of CNHs to develop a phototherapy employing a near-infrared (NIR) photoresponsive composite of minocycline, hyaluronan, and CNH (MC/HA/CNH) for peri-implantitis treatments. MC/HA/CNH demonstrated antibacterial effects that were potentiated by NIR-light irradiation, a property that was mediated by photothermal-mediated drug release from HA/CNH. These antibacterial effects persisted even following 48 h of dialysis, a promising indication for the clinical use of this material. We propose that the treatment of peri-implantitis using NIR and MC/HA/CNH, in combination with surgical procedures, might be employed to target relatively deep affected areas in a timely and efficacious manner. We envision that this innovative approach will pave the way for future developments in implant therapy.
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Affiliation(s)
- Daisuke Konishi
- Department of Oral Functional Prosthodontics, Faculty of Dental Medicine, Graduate school of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Sapporo 060-8586, Japan.
| | - Eri Hirata
- Department of Oral Functional Prosthodontics, Faculty of Dental Medicine, Graduate school of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Sapporo 060-8586, Japan.
| | - Yuta Takano
- Research Institute for Electronic Science, Hokkaido University, Kita-20, Nishi-10, Sapporo 001-0020, Japan.
- Graduate School of Environmental Science, Hokkaido University, Kita-10, Nishi-5, Sapporo 060-0810, Japan
| | - Yukari Maeda
- Department of Oral Functional Prosthodontics, Faculty of Dental Medicine, Graduate school of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Sapporo 060-8586, Japan.
| | - Natsumi Ushijima
- Support Section for Education and Research, Faculty of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan
| | - Masako Yudasaka
- Nanomaterials Research Institute (NMRI), National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba Central 5, 1-1-1 Higashi, Tsukuba, Ibaraki 305-8565, Japan
- Meijo University, Graduate School of Science and Technology, 1-501, Shiogamaguchi, Tenpaku, Nagoya 468-8502, Japan
| | - Atsuro Yokoyama
- Department of Oral Functional Prosthodontics, Faculty of Dental Medicine, Graduate school of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Sapporo 060-8586, Japan.
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Hofer AM, Dadarlat-Pop A, Mester A, Nasui BA, Popa M, Picos A. The Impact of Peri-Implant Diseases on the General Status of Patients with Cardiovascular Diseases: A Literature Review. Life (Basel) 2024; 14:665. [PMID: 38929648 PMCID: PMC11204828 DOI: 10.3390/life14060665] [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: 04/21/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The aim of this study is to connect peri-implantitis to cardiovascular diseases, following the association found between periodontitis and cardiovascular conditions in recent years. MATERIALS AND METHODS PubMed, Scopus, Web of Science online databases were searched up to June 2023, with the exclusion criteria being research written in a language other than English. The MeSH search items were as follows: ["peri-implant health OR peri-implantitis OR peri-implant mucositis OR peri-implant disease"] AND ["cardiovascular diseases"]. Patient/population (P), intervention (I), comparison (C), outcome (O) framework questions were followed to identify the clinical evidence for the systematic review. Only clinical studies that used a control group to compare the relationship between cardiovascular diseases and peri-implantitis were selected. RESULTS A total of 118 studies were identified through electronic search of the keywords. After removing duplicates, there were 76 records to be screened. Upon exclusion of ineligible titles and abstracts, 27 studies remained for evaluation. Finally, 23 studies were excluded for not meeting the inclusion criteria, leaving 4 studies to be included in the qualitative analyses. CONCLUSIONS This study found there is a linear association between mucosal/gingival inflammation and carotid intima-media thickness test (c-IMT) values. Peri-implant mucosal inflammation could be a contributor to the vascular disease burden of an individual; further specific clinical studies should be performed in order to demonstrate this connection.
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Affiliation(s)
- Ana Maria Hofer
- Department of Community Health, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (A.M.H.); (B.A.N.); (M.P.)
| | | | - Alexandru Mester
- Department of Oral Health, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Bogdana Adriana Nasui
- Department of Community Health, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (A.M.H.); (B.A.N.); (M.P.)
| | - Monica Popa
- Department of Community Health, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (A.M.H.); (B.A.N.); (M.P.)
| | - Andrei Picos
- Department of Oral Prevention, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
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Rams TE, Sautter JD, van Winkelhoff AJ. Emergence of Antibiotic-Resistant Porphyromonas gingivalis in United States Periodontitis Patients. Antibiotics (Basel) 2023; 12:1584. [PMID: 37998786 PMCID: PMC10668829 DOI: 10.3390/antibiotics12111584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023] Open
Abstract
Antibiotic resistance patterns of the major human periodontal pathogen Porphyromonas gingivalis were assessed over a 20-year period in the United States. Subgingival P. gingivalis was cultured pre-treatment from 2193 severe periodontitis patients during three time periods: 1999-2000 (936 patients), 2009-2010 (685 patients), and 2019-2020 (572 patients). The clinical isolates were tested for in vitro resistance to 4 mg/L for clindamycin and doxycycline, 8 mg/L for amoxicillin, and 16 mg/L for metronidazole, with a post hoc combination of data for metronidazole plus amoxicillin. Clindamycin-resistant P. gingivalis was significantly more prevalent in 2009-2010 (9.1% of patients) and 2019-2020 (9.3%; 15-fold increase) as compared to 1999-2000 (0.6%). P. gingivalis resistance to amoxicillin also significantly increased from 0.1% of patients in 1999-2000 to 1.3% in 2009-2010 and 2.8% (28-fold increase) in 2019-2020. P. gingivalis resistance to metronidazole, metronidazole plus amoxicillin, and doxycycline was low (≤0.5% prevalence), and statistically unchanged, over the 20-year period. These findings are the first to reveal marked increases over 20 years in clindamycin-resistant and amoxicillin-resistant P. gingivalis in United States periodontitis patients. Increased antibiotic resistance of P. gingivalis and other periodontitis-associated bacteria threatens the efficacy of periodontal antimicrobial chemotherapy.
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Affiliation(s)
- Thomas E. Rams
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA 19140, USA;
| | - Jacqueline D. Sautter
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA 19140, USA;
| | - Arie J. van Winkelhoff
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
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Ardila CM, Jiménez-Arbeláez GA, Vivares-Builes AM. A Systematic Review of In Vitro Studies Using Microchip Platforms for Identifying Periodontopathogens from the Red Complex. Dent J (Basel) 2023; 11:245. [PMID: 37999009 PMCID: PMC10670886 DOI: 10.3390/dj11110245] [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: 08/11/2023] [Revised: 10/06/2023] [Accepted: 10/20/2023] [Indexed: 11/25/2023] Open
Abstract
Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, collectively recognized as periodontopathogens within the red complex, have been extensively studied in clinical samples collected from individuals with periodontitis. A lab-on-a-chip (LOC) is a miniature mechanism that integrates various laboratory operations onto a single microchip or a small-scale platform. This systematic review evaluates the application of LOC technology in identifying microorganisms from the red complex. This study adhered to PRISMA recommendations, and the review process encompassed several databases. In the electronic search, a total of 58 reports were found, and ultimately, 10 studies were considered relevant for inclusion. All these studies described effective, rapid, and reliable LOC systems for detecting and amplifying P. gingivalis, T. forsythia, and T. denticola. Compared to traditional methods, the LOC approach demonstrated minimal reagent requirements. Additionally, the results indicated that the amplification process took approximately 2 to 8 min, while detection could be completed in as little as 2 min and 40 s, resulting in a total experimental duration of around 11 min. Integrating miniaturization, speed, accuracy, and automation within microchip platforms makes them promising tools for detecting and amplifying microorganisms associated with the red complex in periodontal diseases.
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Affiliation(s)
- Carlos M. Ardila
- Basic Studies Department, School of Dentistry, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - Gustavo A. Jiménez-Arbeláez
- School of Dentistry, Institución Universitaria Visión de Las Américas, Medellín 050031, Colombia; (G.A.J.-A.); (A.M.V.-B.)
| | - Annie Marcela Vivares-Builes
- School of Dentistry, Institución Universitaria Visión de Las Américas, Medellín 050031, Colombia; (G.A.J.-A.); (A.M.V.-B.)
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6
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Afrasiabi S, Partoazar A, Chiniforush N. In vitro study of nanoliposomes containing curcumin and doxycycline for enhanced antimicrobial photodynamic therapy against Aggregatibacter actinomycetemcomitans. Sci Rep 2023; 13:11552. [PMID: 37464015 DOI: 10.1038/s41598-023-38812-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/15/2023] [Indexed: 07/20/2023] Open
Abstract
The excessive inappropriate use of systemic antibiotics has contributed to the emergence of antibiotic-resistant pathogens, which pose a significant risk to the success of treatment. This study has approached this problem by developing doxycycline-loaded liposome doped with curcumin (NL-Cur+Dox) for combination antibacterial therapy against Aggregatibacter actinomycetemcomitans. The characterization of formulation revealed encapsulation of both drugs in NL-Cur+Dox with an average size of 239 nm and sustained release behavior. Transmission electron microscopy analysis confirmed the vesicular-shaped nanocarriers without any aggregation or crystallization. The cytotoxic and hemolytic activities of NL-Cur+Dox were evaluated. The anti-biofilm and anti-metabolic effects of NL-Cur+Dox -mediated antimicrobial photodynamic therapy (aPDT) were examined. The data indicated that NL-Cur+Dox -mediated aPDT led to a significant reduction of biofilm (82.7%, p = 0.003) and metabolic activity (75%, p < 0.001) of A. actinomycetemcomitans compared to the control. NL-Cur+Dox had no significant cytotoxicity to human gingival fibroblast cells under selected conditions (p = 0.074). In addition, the hemolytic activity of NL-Cur+Dox were negligible (< 5%). These findings demonstrate the potential application of such potent formulations in reducing one of the main bacteria causing periodontitis where the NL-Cur+Dox could be exploited to achieve an improved phototherapeutic efficiency.
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Affiliation(s)
- Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Partoazar
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Barbato L, Cavalcanti R, Rupe C, Scartabelli D, Serni L, Chambrone L, Cairo F. Clinical efficacy of adjunctive methods for the non-surgical treatment of peri-implantitis: a systematic review and meta-analysis. BMC Oral Health 2023; 23:375. [PMID: 37296382 PMCID: PMC10251565 DOI: 10.1186/s12903-023-03058-z] [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: 04/03/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND The aim of this systematic review (SR) was to evaluate the clinical efficacy of different adjunctive methods/therapies to the non-surgical treatment (NST) of peri-implantitis. MATERIALS AND METHODS The protocol of the review was registered in PROSPERO database (CRD42022339709) and was designed according to PRISMA statement. Electronic and hand searches were performed to identify randomized clinical trials (RCTs) comparing non-surgical treatment of peri-implantitis alone versus NST plus any adjunctive method/treatment. The primary outcome was probing pocket depth (PPD) reduction. RESULTS Sixteen RCTs were included. Only 2 out of 1189 implants were lost and follow-up ranged from 3 to 12 months. PPD reduction across the studies varied from 0.17 to 3.1 mm, while defect resolution from 5.3% to 57.1%. Systemic antimicrobials were associated to higher PPD reduction (1.56 mm; [95% CI 0.24 to 2.89]; p = 0.02) with high heterogeneity, and treatment success (OR = 3.23; [95% CI 1.17 to 8.94]; p = 0.02), compared to NST alone. No differences were found with adjunctive local antimicrobials and lasers for PPD and bleeding on probing (BoP) reduction. CONCLUSIONS Non-surgical treatment with or without adjunctive methods may reduce PPD and BoP even if complete resolution of the pocket is unpredictable. Among possible adjunctive methods, only systemic antibiotics seems to provide further benefits, but their usage should be considered with caution.
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Affiliation(s)
- Luigi Barbato
- Department of Clinical and Experimental Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence (Italy), Via Casentino, 29, Florence, Italy.
| | - Raffaele Cavalcanti
- Department of General Surgery and Surgical-Medical Specialties, University of Catania (Italy), Catania, Italy
| | - Cosimo Rupe
- Department of Clinical and Experimental Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence (Italy), Via Casentino, 29, Florence, Italy
| | - Daniele Scartabelli
- Department of Clinical and Experimental Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence (Italy), Via Casentino, 29, Florence, Italy
| | - Lapo Serni
- Department of Clinical and Experimental Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence (Italy), Via Casentino, 29, Florence, Italy
| | - Leandro Chambrone
- Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
- Unit of Basic Oral Investigation (UIBO), Universidad El Bosque, Bogotá, Colombia
- Department of Periodontics, School of Dental Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Francesco Cairo
- Department of Clinical and Experimental Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence (Italy), Via Casentino, 29, Florence, Italy
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Katalinić I, Smojver I, Morelato L, Vuletić M, Budimir A, Gabrić D. Evaluation of the Photoactivation Effect of 3% Hydrogen Peroxide in the Disinfection of Dental Implants: In Vitro Study. Biomedicines 2023; 11:biomedicines11041002. [PMID: 37189620 DOI: 10.3390/biomedicines11041002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 05/17/2023] Open
Abstract
Photoactivation of 3% hydrogen peroxide with a 445 nm diode laser represents a relatively new, insufficiently researched antimicrobial method in the treatment of peri-implantitis. The purpose of this work is to evaluate the effect of photoactivation of 3% hydrogen peroxide with a 445 nm diode laser, and to compare the obtained results with 0.2% chlorhexidine treatment and 3% hydrogen peroxide treatment without photoactivation, in vitro, on the surface of dental implants contaminated with S. aureus and C. albicans biofilms. Previously, 80 infected titanium implants with S. aureus and C. albicans cultures were divided into four groups: G1-negative control (no treatment), G2-positive control (0.2% chlorhexidine), G3 (3% hydrogen peroxide), and G4 (photoactivated 3% hydrogen peroxide). The number of viable microbes in each sample was determined by the colony forming unit (CFU) count. The results were statistically processed and analyzed, showing a statistically significant difference across all groups compared to the negative control (G1), and the absence of a statistically significant difference between groups G1-G3. The new antimicrobial treatment, according to the results, could be worthy of further analysis and research.
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Affiliation(s)
| | - Igor Smojver
- Specialty Hospital St. Catherine, 10000 Zagreb, Croatia
| | - Luka Morelato
- Department of Oral Surgery, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Marko Vuletić
- Department of Oral Surgery, School of Dental Medicine, University Hospital Centre Zagreb, University of Zagreb, 10000 Zagreb, Croatia
| | - Ana Budimir
- Department of Clinical and Molecular Microbiology, School of Medicine, University Hospital Centre Zagreb, University of Zagreb, 10000 Zagreb, Croatia
| | - Dragana Gabrić
- Department of Oral Surgery, School of Dental Medicine, University Hospital Centre Zagreb, University of Zagreb, 10000 Zagreb, Croatia
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Grusovin MG, Pispero A, Del Fabbro M, Sangiorgi M, Simion M, Stefanini M, Varoni EM. Antibiotics as Adjunctive Therapy in the Non-Surgical Treatment of Peri-Implantitis: A Systematic Review and Meta-Analysis. Antibiotics (Basel) 2022; 11:1766. [PMID: 36551424 PMCID: PMC9774402 DOI: 10.3390/antibiotics11121766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
The role of antibiotics as adjunctive therapy in the non-surgical treatment of peri-implantitis is uncertain. The aim of this systematic review of randomized controlled trials was to assess the efficacy of antibiotic therapy, local or systemic, as an adjunctive to the non-surgical therapy of peri-implantitis. Primary outcomes were: implant success rate and complications, changes in radiographic bone level, probing pocket depth (PPD), probing attachment level (PAL), bleeding on probing (BOP) and peri-implantitis resolution. Six studies were included: two using topical and four systemic antibiotics. Adjunctive local antibiotics improved PPD (mean difference (MD) = 0.6 mm; 95% CI 0.42-0.78), BOP (MD = 0.15% (95% CI 0.10, 0.19)) and the success rate (risk ratio = 9.89; 95% CI 2.39-40.84). No significant difference in bone level and success rate were found with the use of systemic antibiotics, although they appeared to improve PPD (MD = 1.15 mm; 95% CI 0.31-1.99) and PAL (MD = 1.10 mm; 95% CI 0.13-2.08). Within the limitations of this review, the adjunctive local antibiotics showed improved outcomes in terms of success rate, PPD and BOP, while adjunctive systemic antibiotics improved PPD and PAL only. Peri-implantitis resolution was about 20-30% using adjunctive local antibiotics, whilst it ranged from 2% to 65% with adjunctive systemic antibiotics. Findings are still controversial, since they are based on few studies with high heterogeneity, at the uncertain or high risk of bias and involve few patients. Non-surgical debridement and maintenance periodontal support therapy remain pivotal and the adjunctive use of antibiotics for peri-implantitis cannot be routinely recommended, even considering the increasing concern on antibiotic resistance.
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Affiliation(s)
- Maria Gabriella Grusovin
- Dipartimento Odontoiatria, Università Vita Salute “S. Raffaele”, 20132 Milan, Italy
- Libera Professionista in Gorizia (Dental Private Practice), 34170 Gorizia, Italy
| | - Alberto Pispero
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, 20122 Milan, Italy
| | - Massimo Del Fabbro
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, 20122 Milan, Italy
- IRCCS Fondazione Ca’Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Matteo Sangiorgi
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna,40123 Bologna, Italy
| | - Massimo Simion
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, 20122 Milan, Italy
| | - Martina Stefanini
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna,40123 Bologna, Italy
| | - Elena Maria Varoni
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, 20122 Milan, Italy
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Rezvan A, Sharifikolouei E, Lassnig A, Soprunyuk V, Gammer C, Spieckermann F, Schranz W, Najmi Z, Cochis A, Scalia AC, Rimondini L, Manfredi M, Eckert J, Sarac B. Antibacterial activity, cytocompatibility, and thermomechanical stability of Ti 40Zr 10Cu 36Pd 14 bulk metallic glass. Mater Today Bio 2022; 16:100378. [PMID: 36039102 PMCID: PMC9418555 DOI: 10.1016/j.mtbio.2022.100378] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/22/2022] Open
Abstract
This paper envisions Ti40Zr10Cu36Pd14 bulk metallic glass as an oral implant material and evaluates its antibacterial performance in the inhabitation of oral biofilm formation in comparison with the gold standard Ti-6Al-4V implant material. Metallic glasses are superior in terms of biocorrosion and have a reduced stress shielding effect compared with their crystalline counterparts. Dynamic mechanical and thermal expansion analyses on Ti40Zr10Cu36Pd14 show that these materials can be thermomechanically shaped into implants. Static water contact angle measurement on samples' surface shows an increased surface wettability on the Ti-6Al-4V surface after 48 h incubation in the water while the contact angle remains constant for Ti40Zr10Cu36Pd14. Further, high-resolution transmission and scanning transmission electron microscopy analysis have revealed that Ti40Zr10Cu36Pd14 interior is fully amorphous, while a 15 nm surface oxide is formed on its surface and assigned as copper oxide. Unlike titanium oxide formed on Ti-6Al-4V, copper oxide is hydrophobic, and its formation reduces surface wettability. Further surface analysis by X-ray photoelectron spectroscopy confirmed the presence of copper oxide on the surface. Metallic glasses cytocompatibility was first demonstrated towards human gingival fibroblasts, and then the antibacterial properties were verified towards the oral pathogen Aggregatibacter actinomycetemcomitans responsible for oral biofilm formation. After 24 h of direct infection, metallic glasses reported a >70% reduction of bacteria viability and the number of viable colonies was reduced by ∼8 times, as shown by the colony-forming unit count. Field emission scanning electron microscopy and fluorescent images confirmed the lower surface colonization of metallic glasses in comparison with controls. Finally, oral biofilm obtained from healthy volunteers was cultivated onto specimens' surface, and proteomics was applied to study the surface property impact on species composition within the oral plaque.
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Affiliation(s)
- Amir Rezvan
- Erich Schmid Institute of Materials Science, Austrian Academy of Sciences, A-8700, Leoben, Austria
- Department of Materials Science, Chair of Materials Physics, Montanuniversität Leoben, A-8700, Leoben, Austria
| | - Elham Sharifikolouei
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca Degli Abruzzi 24, 10129, Turin (TO), Italy
| | - Alice Lassnig
- Erich Schmid Institute of Materials Science, Austrian Academy of Sciences, A-8700, Leoben, Austria
| | - Viktor Soprunyuk
- University of Vienna, Faculty of Physics, Physics of Functional Materials, A-1090, Vienna, Austria
| | - Christoph Gammer
- Erich Schmid Institute of Materials Science, Austrian Academy of Sciences, A-8700, Leoben, Austria
| | - Florian Spieckermann
- Department of Materials Science, Chair of Materials Physics, Montanuniversität Leoben, A-8700, Leoben, Austria
| | - Wilfried Schranz
- University of Vienna, Faculty of Physics, Physics of Functional Materials, A-1090, Vienna, Austria
| | - Ziba Najmi
- Department of Health Sciences, Center for Translational Research on Autoimmune and Allergic Diseases − CAAD, Università Del Piemonte Orientale UPO, Corso Trieste 15/A, 28100, Novara (NO), Italy
| | - Andrea Cochis
- Department of Health Sciences, Center for Translational Research on Autoimmune and Allergic Diseases − CAAD, Università Del Piemonte Orientale UPO, Corso Trieste 15/A, 28100, Novara (NO), Italy
| | - Alessandro Calogero Scalia
- Department of Health Sciences, Center for Translational Research on Autoimmune and Allergic Diseases − CAAD, Università Del Piemonte Orientale UPO, Corso Trieste 15/A, 28100, Novara (NO), Italy
| | - Lia Rimondini
- Department of Health Sciences, Center for Translational Research on Autoimmune and Allergic Diseases − CAAD, Università Del Piemonte Orientale UPO, Corso Trieste 15/A, 28100, Novara (NO), Italy
| | - Marcello Manfredi
- Department of Translational Medicine, Center for Translational Research on Autoimmune and Allergic Disease – CAAD, Università Del Piemonte Orientale UPO, Corso Trieste 15/A, 28100, Novara (NO), Italy
| | - Jürgen Eckert
- Erich Schmid Institute of Materials Science, Austrian Academy of Sciences, A-8700, Leoben, Austria
- Department of Materials Science, Chair of Materials Physics, Montanuniversität Leoben, A-8700, Leoben, Austria
| | - Baran Sarac
- Erich Schmid Institute of Materials Science, Austrian Academy of Sciences, A-8700, Leoben, Austria
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11
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Akshaya S, Rowlo PK, Dukle A, Nathanael AJ. Antibacterial Coatings for Titanium Implants: Recent Trends and Future Perspectives. Antibiotics (Basel) 2022; 11:antibiotics11121719. [PMID: 36551376 PMCID: PMC9774638 DOI: 10.3390/antibiotics11121719] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/02/2022] Open
Abstract
Titanium and its alloys are widely used as implant materials for biomedical devices owing to their high mechanical strength, biocompatibility, and corrosion resistance. However, there is a significant rise in implant-associated infections (IAIs) leading to revision surgeries, which are more complicated than the original replacement surgery. To reduce the risk of infections, numerous antibacterial agents, e.g., bioactive compounds, metal ions, nanoparticles, antimicrobial peptides, polymers, etc., have been incorporated on the surface of the titanium implant. Various coating methods and surface modification techniques, e.g., micro-arc oxidation (MAO), layer-by-layer (LbL) assembly, plasma electrolytic oxidation (PEO), anodization, magnetron sputtering, and spin coating, are exploited in the race to create a biocompatible, antibacterial titanium implant surface that can simultaneously promote tissue integration around the implant. The nature and surface morphology of implant coatings play an important role in bacterial inhibition and drug delivery. Surface modification of titanium implants with nanostructured materials, such as titanium nanotubes, enhances bone regeneration. Antimicrobial peptides loaded with antibiotics help to achieve sustained drug release and reduce the risk of antibiotic resistance. Additive manufacturing of patient-specific porous titanium implants will have a clear future direction in the development of antimicrobial titanium implants. In this review, a brief overview of the different types of coatings that are used to prevent implant-associated infections and the applications of 3D printing in the development of antibacterial titanium implants is presented.
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Affiliation(s)
- S. Akshaya
- Centre for Biomaterials, Cellular and Molecular Theranostics (CBCMT), Vellore Institute of Technology, Vellore 632014, India
- School of Advanced Sciences, Vellore Institute of Technology, Vellore 632014, India
| | - Praveen Kumar Rowlo
- Centre for Biomaterials, Cellular and Molecular Theranostics (CBCMT), Vellore Institute of Technology, Vellore 632014, India
- School of Bio Sciences & Technology, Vellore Institute of Technology, Vellore 632014, India
| | - Amey Dukle
- Centre for Biomaterials, Cellular and Molecular Theranostics (CBCMT), Vellore Institute of Technology, Vellore 632014, India
- School of Bio Sciences & Technology, Vellore Institute of Technology, Vellore 632014, India
| | - A. Joseph Nathanael
- Centre for Biomaterials, Cellular and Molecular Theranostics (CBCMT), Vellore Institute of Technology, Vellore 632014, India
- Correspondence:
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12
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Ardila CM, Vivares-Builes AM. Antibiotic Resistance in Patients with Peri-Implantitis: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315609. [PMID: 36497685 PMCID: PMC9737312 DOI: 10.3390/ijerph192315609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/17/2022] [Accepted: 11/22/2022] [Indexed: 05/31/2023]
Abstract
The implementation of adjunctive antibiotics has been recommended for the therapy of peri-implantitis (PI). In this review, antibiotic resistance patterns in PI patients were assessed. A systematic scoping review of observational studies and trials was established in conjunction with the PRISMA extension for scoping reviews. The SCOPUS, PubMed/MEDLINE, EMBASE, SCIELO, Web of Science, and LILACS databases were reviewed along with the gray literature. The primary electronic examination produced 139 investigations. Finally, four observational studies met the selection criteria. These studies evaluated 214 implants in 168 patients. Porphyromonas gingivalis and Fusobacterium nucleatum mainly presented high resistance to tetracycline, metronidazole, and erythromycin in PI patients. Similarly, Aggregatibacter actinomycetemcomitans was also highly resistant to clindamycin and doxycycline. Other microorganisms such as Tannerella forsythia, Parvimonas micra, and Prevotella intermedia/nigrescens also presented significant levels of resistance to other antibiotics including amoxicillin, azithromycin, and moxifloxacin. However, most microorganisms did not show resistance to the combination amoxicillin metronidazole. Although the management of adjunctive antimicrobials in the therapy of PI is controversial, in this review, the resistance of relevant microorganisms to antibiotics used to treat PI, and usually prescribed in dentistry, was observed. Clinicians should consider the antibiotic resistance demonstrated in the treatment of PI patients and its public health consequences.
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Affiliation(s)
- Carlos M. Ardila
- Basic Studies Department, School of Dentistry, Universidad de Antioquia UdeA, Medellín 050010, Colombia
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13
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Abstract
Frequently, periodontal health and it's associated oral biofilm has not been addressed in those patients who have systemic health issues, especially those who are not responding to medical treatment via their physician. Oral biofilm may be present in the periodontal sulcus in the absence of clinical disease of periodontal disease (bleeding on probing, gingival inflammation) and periodontal reaction is dependent on the patient's immune response to the associated bacterial and their byproducts. Increasing evidence has been emerging the past decade connecting oral biofilm with systemic conditions, either initiating them or complicating those medical conditions. The patient's health needs to be thought of as a whole-body system with connections that may originate in the oral cavity and have distant affects throughout the body. To maximize total health, a coordination in healthcare needs to be a symbiosis between the physician and dentist to eliminate the oral biofilm and aid in prevention of systemic disease or minimize those effects to improve the patient's overall health and quality of life. Various areas of systemic health have been associated with the bacteria and their byproducts in the oral biofilm. Those include cardiovascular disease, chronic kidney disease, diabetes, pulmonary disease, prostate cancer, colon cancer, pancreatic cancer, pre-term pregnancy, erectile dysfunction Alzheimer's disease and Rheumatoid arthritis. This article will discuss oral biofilm, its affects systemically and review the medical conditions associated with the oral systemic connection with an extensive review of the literature.
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Affiliation(s)
| | - Robert A. Horowitz
- Private periodontal practice Scarsdale, New York, USA
- Adjunct Clinical Assistant Professor, Department of Periodontology and Implant Dentistry, New York University College of Dentistry
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14
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Sousa V, Spratt D, Davrandi M, Mardas N, Beltrán V, Donos N. Oral Microcosm Biofilms Grown under Conditions Progressing from Peri-Implant Health, Peri-Implant Mucositis, and Peri-Implantitis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14088. [PMID: 36360970 PMCID: PMC9654334 DOI: 10.3390/ijerph192114088] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/05/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Peri-implantitis is a disease influenced by dysbiotic microbial communities that play a role in the short- and long-term outcomes of its clinical treatment. The ecological triggers that establish the progression from peri-implant mucositis to peri-implantitis remain unknown. This investigation describes the development of a novel in vitro microcosm biofilm model. Biofilms were grown over 30 days over machined titanium discs in a constant depth film fermentor (CDFF), which was inoculated (I) with pooled human saliva. Following longitudinal biofilm sampling across peri-implant health (PH), peri-implant mucositis (PM), and peri-implantitis (PI) conditions, the characterisation of the biofilms was performed. The biofilm analyses included imaging by confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM), selective and non-selective culture media of viable biofilms, and 16S rRNA gene amplification and sequencing. Bacterial qualitative shifts were observed by CLSM and SEM across conditions, which were defined by characteristic phenotypes. A total of 9 phyla, 83 genera, and 156 species were identified throughout the experiment. The phyla Proteobacteria, Bacteroidetes, Firmicutes, Fusobacteria, and Actinobacteria showed the highest prevalence in PI conditions. This novel in vitro microcosm model provides a high-throughput alternative for growing microcosm biofilms resembling an in vitro progression from PH-PM-PI conditions.
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Affiliation(s)
- Vanessa Sousa
- Periodontology and Periodontal Medicine, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Dave Spratt
- Microbial Diseases, Eastman Dental Institute, University College London, London WC1E 6BT, UK
| | - Mehmet Davrandi
- Microbial Diseases, Eastman Dental Institute, University College London, London WC1E 6BT, UK
| | - Nikos Mardas
- Centre for Oral Clinical Research, Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London E1 2AD, UK
| | - Víctor Beltrán
- Clinical Investigation and Dental Innovation Center (CIDIC), Dental School and Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco 4780000, Chile
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London E1 2AD, UK
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15
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Hasan J, Bright R, Hayles A, Palms D, Zilm P, Barker D, Vasilev K. Preventing Peri-implantitis: The Quest for a Next Generation of Titanium Dental Implants. ACS Biomater Sci Eng 2022; 8:4697-4737. [PMID: 36240391 DOI: 10.1021/acsbiomaterials.2c00540] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Titanium and its alloys are frequently the biomaterial of choice for dental implant applications. Although titanium dental implants have been utilized for decades, there are yet unresolved issues pertaining to implant failure. Dental implant failure can arise either through wear and fatigue of the implant itself or peri-implant disease and subsequent host inflammation. In the present report, we provide a comprehensive review of titanium and its alloys in the context of dental implant material, and how surface properties influence the rate of bacterial colonization and peri-implant disease. Details are provided on the various periodontal pathogens implicated in peri-implantitis, their adhesive behavior, and how this relationship is governed by the implant surface properties. Issues of osteointegration and immunomodulation are also discussed in relation to titanium dental implants. Some impediments in the commercial translation for a novel titanium-based dental implant from "bench to bedside" are discussed. Numerous in vitro studies on novel materials, processing techniques, and methodologies performed on dental implants have been highlighted. The present report review that comprehensively compares the in vitro, in vivo, and clinical studies of titanium and its alloys for dental implants.
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Affiliation(s)
- Jafar Hasan
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia
| | - Richard Bright
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
| | - Andrew Hayles
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
| | - Dennis Palms
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
| | - Peter Zilm
- Adelaide Dental School, University of Adelaide, Adelaide, 5005, South Australia, Australia
| | - Dan Barker
- ANISOP Holdings, Pty. Ltd., 101 Collins St, Melbourne VIC, 3000 Australia
| | - Krasimir Vasilev
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
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16
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Abe FC, Kodaira K, Motta CDCB, Barberato-Filho S, Silva MT, Guimarães CC, Martins CC, Lopes LC. Antimicrobial resistance of microorganisms present in periodontal diseases: A systematic review and meta-analysis. Front Microbiol 2022; 13:961986. [PMID: 36262326 PMCID: PMC9574196 DOI: 10.3389/fmicb.2022.961986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe aim of this study was to estimate the antimicrobial resistance in microorganisms present in periodontal diseases.MethodsA systematic review was conducted according to the PRISMA statement. The MEDLINE (PubMed/Ovid), EMBASE, BVS, CINAHL, and Web of Science databases were searched from January 2011 to December 2021 for observational studies which evaluated the antimicrobial resistance in periodontal diseases in permanent dentition. Studies that allowed the antimicrobial consumption until the time of sample collection, studies that used laboratory acquired strains, studies that only characterized the microbial strain present, assessment of cellular morphological changes, sequencing system validation, and time series were excluded. Six reviewers, working in pairs and independently, selected titles, abstracts, and full texts extracting data from all studies that met the eligibility criteria: characteristics of patients, diagnosis of infection, microbial species assessed, antimicrobial assessed, identification of resistance genes, and virulence factors. “The Joanna Briggs Institute” critical appraisal for case series was adapted to assess the risk of bias in the included studies.ResultsTwenty-four studies (N = 2.039 patients) were included. Prevotella and Porphyromonas species were the most cited microorganisms in the included studies, and the virulence factors were related to Staphylococcus aureus. The antimicrobial reported with the highest frequency of resistance in the included studies was ampicillin (39.5%) and ciprofloxacin showed the lowest frequency of resistance (3.4%). The most cited genes were related to macrolides. The quality of the included studies was considered critically low.ConclusionNo evidence was found regarding the profile of antimicrobial resistance in periodontal diseases, requiring further research that should focus on regional population studies to address this issue in the era of increasing antimicrobial resistance.Clinical relevanceThe knowledge about the present microorganism in periodontal diseases and their respective antimicrobial resistance profiles should guide dentists in prescribing complementary therapy for these infections.Systematic review registration[http://dx.doi.org/10.1097/MD.0000000000013158], identifier [CRD42018077810].
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Affiliation(s)
- Flávia Casale Abe
- Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, Brazil
| | - Katia Kodaira
- Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, Brazil
| | | | | | | | | | | | - Luciane Cruz Lopes
- Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, Brazil
- *Correspondence: Luciane Cruz Lopes,
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17
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The Potential Application of Natural Photosensitizers Used in Antimicrobial Photodynamic Therapy against Oral Infections. Pharmaceuticals (Basel) 2022; 15:ph15060767. [PMID: 35745686 PMCID: PMC9227410 DOI: 10.3390/ph15060767] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 02/05/2023] Open
Abstract
Oral health problems and the emergence of antimicrobial resistance among pathogenic bacterial strains have become major global challenges and are essential elements that negatively affect general well-being. Antimicrobial photodynamic therapy (APDT) is based on a light source and oxygen that activates a nontoxic photosensitizer, resulting in microbial destruction. Synthetic and natural products can be used to help the APDT against oral microorganisms. The undesirable consequences of conventional photosensitizers, including toxicity, and cost encourage researchers to explore new promising photosensitizers based on natural compounds such as curcumin, chlorella, chlorophyllin, phycocyanin, 5-aminolevulinic acid, and riboflavin. In this review, we summarize in vitro studies describing the potential use of APDT therapy conjugated with some natural products against selected microorganisms that are considered to be responsible for oral infections.
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18
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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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19
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Accioni F, Rassu G, Begines B, Rodríguez-Albelo LM, Torres Y, Alcudia A, Gavini E. Novel Utilization of Therapeutic Coatings Based on Infiltrated Encapsulated Rose Bengal Microspheres in Porous Titanium for Implant Applications. Pharmaceutics 2022; 14:pharmaceutics14061244. [PMID: 35745816 PMCID: PMC9230760 DOI: 10.3390/pharmaceutics14061244] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 02/07/2023] Open
Abstract
Despite the increasing progress achieved in the last 20 years in both the fabrication of porous dental implants and the development of new biopolymers for targeting drug therapy, there are important issues such as bone resorption, poor osseointegration, and bacterial infections that remain as critical challenges to avoid clinical failure problems. In this work, we present a novel microtechnology based on polycaprolactone microspheres that can adhere to porous titanium implant models obtained by the spacer holder technique to allow a custom biomechanical and biofunctional balance. For this purpose, a double emulsion solvent evaporation technique was successfully employed for the fabrication of the microparticles properly loaded with the antibacterial therapeutic agent, rose bengal. The resulting microspheres were infiltrated into porous titanium substrate and sintered at 60 °C for 1 h, obtaining a convenient prophylactic network. In fact, the sintered polymeric microparticles were demonstrated to be key to controlling the drug dissolution rate and favoring the early healing process as consequence of a better wettability of the porous titanium substrate to promote calcium phosphate nucleation. Thus, this joint technology proposes a suitable prophylactic tool to prevent both early-stage infection and late-stage osseointegration problems.
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Affiliation(s)
- Francesca Accioni
- Departmento de Química Orgánica y Farmacéutica, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; (F.A.); (B.B.)
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Giovanna Rassu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
- Correspondence: (G.R.); (A.A.)
| | - Belén Begines
- Departmento de Química Orgánica y Farmacéutica, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; (F.A.); (B.B.)
| | - Luisa Marleny Rodríguez-Albelo
- Departmento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Universidad de Sevilla, 41004 Sevilla, Spain; (L.M.R.-A.); (Y.T.)
| | - Yadir Torres
- Departmento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Universidad de Sevilla, 41004 Sevilla, Spain; (L.M.R.-A.); (Y.T.)
| | - Ana Alcudia
- Departmento de Química Orgánica y Farmacéutica, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; (F.A.); (B.B.)
- Correspondence: (G.R.); (A.A.)
| | - Elisabetta Gavini
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
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20
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Zhuo H, Zhang X, Li M, Zhang Q, Wang Y. Antibacterial and Anti-Inflammatory Properties of a Novel Antimicrobial Peptide Derived from LL-37. Antibiotics (Basel) 2022; 11:antibiotics11060754. [PMID: 35740160 PMCID: PMC9220503 DOI: 10.3390/antibiotics11060754] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 02/01/2023] Open
Abstract
Peri-implantitis is a pathological condition involving tissues around dental implants that are characterized by inflammation of the peri-implant mucosa and progressive loss of supporting bone. We found that the antimicrobial peptide KR-12-3 (KRIVKWIKKFLR) derived from LL-37 had antibacterial properties against Streptococcus gordonii. The purpose of this study was to evaluate its antibacterial and anti-inflammatory activities and its underlying mechanisms. We evaluated the antibacterial activities of antimicrobial peptides in planktonic and biofilm states by measuring their minimum inhibitory concentration, minimum bactericidal concentration, and biofilm susceptibility. The effects of antimicrobial peptides on the production of IL-6 and IL-8 in LPS-stimulated RAW264.7 cells were detected by enzyme-linked immunosorbent assay and other experiments, and their toxicity to MC3T3-E1 cells was also studied. While maintaining low cytotoxicity, KR-12-3 exhibited growth inhibitory effects on S. gordonii in planktonic and biofilm states. Lower concentrations of KR-12-3 treatment reduced the production of inflammatory cytokines in LPS-stimulated RAW264.8 cells. The mechanisms underlying the inhibition of biofilm formation and anti-inflammatory effects have been associated with the low expression of related genes. KR-12-3 may be used to develop an antibacterial, anti-infective, and anti-inflammatory drugs for peri-implantitis.
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21
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Polymeri A, van der Horst J, Anssari Moin D, Wismeijer D, Loos BG, Laine ML. Non-surgical peri-implantitis treatment with or without systemic antibiotics; a randomized controlled clinical trial. Clin Oral Implants Res 2022; 33:548-557. [PMID: 35238084 PMCID: PMC9314590 DOI: 10.1111/clr.13914] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 11/29/2022]
Abstract
Objectives To assess the adjunctive effect of systemic amoxicillin (AMX) and metronidazole (MTZ) in patients receiving non‐surgical treatment (NST) for peri‐implantitis (PI). Materials and methods Thirty‐seven patients were randomized into an experimental group treated with NST plus AMX + MTZ (N = 18) and a control group treated with NST alone (N = 19). Clinical parameters were evaluated at 12 weeks post‐treatment. The primary outcome was the change in peri‐implant pocket depth (PIPD) from baseline to 12 weeks, while secondary outcomes included bleeding on probing (BoP), suppuration on probing (SoP), and plaque. Data analysis was performed at patient level (one target site per patient). Results All 37 patients completed the study. Both groups showed a significant PIPD reduction after NST. The antibiotics group showed a higher mean reduction in PIPD at 12 weeks, compared with the control group (2.28 ± 1.49 mm vs. 1.47 ± 1.95 mm), however, this difference did not reach statistical significance. There was no significant effect of various potential confounders on PIPD reduction. Neither treatment resulted in significant improvements in BoP at follow‐up; 30 of 37 (81%) target sites still had BoP after treatment. Only two implants, one in each group, exhibited a successful outcome defined as PIPD < 5 mm, and absence of BoP and SoP. Conclusions Non‐surgical treatment was able to reduce PIPD at implants with PI. The adjunctive use of systemic AMX and MTZ did not show statistically significant better results compared to NST alone. NST with or without antibiotics was ineffective to completely resolve inflammation around dental implants.
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Affiliation(s)
- A Polymeri
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
| | - J van der Horst
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
| | - D Anssari Moin
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
| | - D Wismeijer
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands.,TPE, Private practice, Ellecom, the Netherlands
| | - B G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
| | - M L Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
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22
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Wyszyńska M, Rosak P, Czelakowska A, Białożyt-Bujak E, Kasperski J, Łopaciński M, Al Khatib N, Skucha-Nowak M. Pilot Study of Use of Nitric Oxide in Monitoring Multiple Dental Foci in Oral Cavity—A Case Report. Healthcare (Basel) 2022; 10:healthcare10020195. [PMID: 35206810 PMCID: PMC8872459 DOI: 10.3390/healthcare10020195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 01/25/2023] Open
Abstract
Background: The most common cause of implant loss and deteriorating restoration aesthetics is infection and chronic inflammation of the tissues around the implants. Inflammation in the oral cavity, confirmed by clinical and histopathological examination and determination of exhaled nitric oxide, is a situation which may cause the complications on the whole human body. Elimination of the patology in the oral cavity in some cases is the only resonable treatment. The aims and objectives of our work is to present a gradual treatment of advanced infalmmation and present huge reduction stamp of inflammation measured with marker nitric oxide (NO) in exhaled air. Materials and Methods: Simple treatment containing elimantion of pathology in the oral cavity was conducted. Patient that came to the dental practice suffered from the inflammation caused by lack of proper hygiene. First aid in this situation was to eliminate the inflammation which may affect negatively for general health. At first visit full hygienization was performed, at the second visit roots of abutment teeth and implants were removed under local anesthesia along with cystic changes. Results: The hygiene precedures and extraction of the unsteady inflammationprosthetic restorations significantly decreased the level of NO in exhaled air. Conclusions: During the examination of the patient coming to the dental practice great attention should be paid to the coexistence of pathologies related to the oral cavity. Omission of a dental examination and possible elimination of odontogenic foci may affect the implication of the results of general diagnostics and subsequent treatment. Measuring the level of NO on exhaled air seems to be useful diagnostic method.
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Affiliation(s)
- Magdalena Wyszyńska
- Department of Dental Materials, Division of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Poniatowskiego Street, 40-055 Katowice, Poland;
- Correspondence:
| | - Przemysław Rosak
- Specialist Dental Practice Przemysław Rosak, 13 Piłsudskiego Street, 41-300 Dąbrowa Górnicza, Poland;
| | - Aleksandra Czelakowska
- Department of Dental Prosthetics, Division of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Poniatowskiego Street, 40-055 Katowice, Poland; (A.C.); (J.K.)
| | - Ewa Białożyt-Bujak
- Department of Dental Materials, Division of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Poniatowskiego Street, 40-055 Katowice, Poland;
| | - Jacek Kasperski
- Department of Dental Prosthetics, Division of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Poniatowskiego Street, 40-055 Katowice, Poland; (A.C.); (J.K.)
| | - Maciej Łopaciński
- Department of Periodontal Diseases and Oral Mucosa Diseases, Division of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Poniatowskiego Street, 40-055 Katowice, Poland;
| | - Nour Al Khatib
- Student of 4th Year Dentistry Program, Student Scientific Society in Department/Institute of Prosthetic Dentistry and Dental Material Sciences, Division of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Poniatowskiego Street, 40-055 Katowice, Poland;
| | - Małgorzata Skucha-Nowak
- Department of Dental Propedeutics, Division of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Poniatowskiego Street, 40-055 Katowice, Poland;
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Hussain B, Haugen HJ, Aass AM, Sanz M, Antonoglou GN, Bouchard P, Bozic D, Eickholz P, Jepsen K, Jepsen S, Karaca EO, Kuru BE, Nemcovsky CE, Papapanou PN, Pilloni A, Renvert S, Roccuzzo M, Sanz-Esporrin J, Spahr A, Stavropoulos A, Verket A, Vražić D, Lyngstadaas SP. Peri-Implant Health and the Knowing-Doing Gap—A Digital Survey on Procedures and Therapies. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.726607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: Peri-implant tissue maintenance and treatment is becoming a serious challenge in implantology. With increasing numbers of implants being placed, more cases of peri-implant mucositis and peri-implantitis is seen. A digital survey on peri-implant disease management was issued to experts in periodontology and implantology to identify the tools and procedures most commonly used today to treat peri-implant diseases and successfully manage peri-implant health. The primary aim was to assess whether there is consensus in the choice of treatment to manage peri-implant diseases and to prevent their recurrence once treated. The secondary aim was to obtain insight into future protocols and /or devices, and the research and development needed.Materials and Methods: Participants in this digital survey were professionals specialising in periodontology, oral surgery, and implant dentistry. The questionnaire included both a series of closed- and open-ended questions. A total of 16 countries participated. The survey was sent by e-mail to 70 individuals, 66 received the survey and 37 of receivers responded, two of the participants were excluded due to insufficient filling of the survey. In the end 35 respondents completed the survey.Results: Respondents agree that the efficacy of mechanical and chemical decontamination of implant surfaces needs to be improved and better documented. It is a common opinion that the current remedies, mostly adapted from periodontal practises, do not provide effective and reliable clinical outcomes when treating peri-implant ailments. There is a general agreement amongst experts that regularly scheduled (3–6-month intervals) maintenance treatments are essential for maintaining peri-implant health in patients experiencing implant complications. Respondents are also concerned about unnecessary use of systemic antibiotics for managing peri-implant health.Conclusion: Regardless of agreements in parts, there was no observed consensus on the most effective treatment options for treating peri-implantitis. The experts all agree it is an urgent need for well-designed, long-term follow-up randomised and controlled clinical trials comparing interventions to provide an evidence-based strategy for peri-implant health management.
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24
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González Regueiro I, Martínez Rodriguez N, Barona Dorado C, Sanz-Sánchez I, Montero E, Ata-Ali J, Duarte F, Martínez-González JM. Surgical approach combining implantoplasty and reconstructive therapy with locally delivered antibiotic in the treatment of peri-implantitis: A prospective clinical case series. Clin Implant Dent Relat Res 2021; 23:864-873. [PMID: 34651432 DOI: 10.1111/cid.13049] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Nonsurgical treatment, resective surgery, reconstructive surgery, or combined approaches have been proposed for the treatment of peri-implantitis, with variable results. PURPOSE To evaluate the 1-year clinical and radiographic outcomes following combined resective and reconstructive surgical treatment with topical piperacillin/tazobactam antibiotic in the management of peri-implantitis. MATERIAL AND METHODS Forty-three patients diagnosed with peri-implantitis were included. Surgical treatment consisted of implantoplasty of the supra-crestal component of the defect, the application of a topical antibiotic solution over the implant surface, and subsequent reconstruction of the intra-osseous component of the peri-implant defect. The primary outcome was disease resolution, defined as the absence of bleeding on probing (BoP) and/or suppuration on probing (SoP), a peri-implant pocket probing depth (PPD) ≤5 mm, and no bone loss >0.5 mm 1 year after surgery. Secondary outcomes included changes in BoP, PPD, SoP, and peri-implant marginal bone levels. One implant per patient was included in the analysis. RESULTS The treatment success rate of the 43 dental implants included in the study was 86% at 1 year after surgery. Mean PPD and BoP decreased from 6.41 ± 2.11 mm and 100% at baseline to 3.19 ± 0.99 mm (p < 0.001) and 14% (p < 0.001) at 1 year, respectively. SoP was significantly reduced from 48.8% at baseline to 0% 1 year after surgery (p < 0.001). Radiographically, a mean defect fill of 2.64 ± 1.59 mm was recorded (p < 0.001). CONCLUSIONS The combination of a resective and reconstructive surgical approach together with locally delivered antibiotic achieved a high disease resolution rate after 1 year of follow-up and constitutes a viable option for the management of peri-implantitis.
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Affiliation(s)
| | | | | | - Ignacio Sanz-Sánchez
- Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - Eduardo Montero
- Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - Javier Ata-Ali
- Faculty of Health Sciences, Department of Dentistry, Universidad Europea de Valencia, Valencia, Spain.,Public Dental Health Service, Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, Valencia, Spain.,Department of Surgery and Medical-Surgical Specialities, Area of Orthodontics, University Medical and Dental School, University of Oviedo (Spain), Instituto Asturiano de Odontologia, Oviedo, Spain
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25
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Ghilini F, Fagali N, Pissinis DE, Benítez G, Schilardi PL. Multifunctional Titanium Surfaces for Orthopedic Implants: Antimicrobial Activity and Enhanced Osseointegration. ACS APPLIED BIO MATERIALS 2021; 4:6451-6461. [PMID: 35006865 DOI: 10.1021/acsabm.1c00613] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The use of implants in orthopedics and dental practice is a widespread surgical procedure to treat diverse diseases. However, peri-implantitis due to infections and/or poor osseointegration can lead to metallic implant failure. The aim of this study was to develop a multifunctional coating on titanium (Ti) surfaces, to simultaneously deal with both issues, by combining antibacterial silver nanoparticles (AgNPs) and regenerative properties of lactoferrin (Lf). A simple and cost-effective methodology that allows the direct multifunctionalization of Ti surfaces was developed. The modified surfaces were characterized by atomic force microscopy (AFM), X-ray photoelectron spectroscopy, and contact angle measurements. Additionally, in vitro preosteoblast cell adhesion, cell viability, and differentiation were evaluated. The antibacterial capability of the surfaces was tested against Staphylococcus aureus as a prosthesis infection model strain. Our results showed that Lf adsorbed on both Ti surfaces and Ti surfaces with adsorbed AgNPs. Simultaneously, the presence of Lf and AgNPs notably improved preosteoblast adhesion, proliferation, and differentiation, whereas it reduced the bacterial colonization by 97.7%. Our findings indicate that this simple method may have potential applications in medical devices to both improve osseointegration and reduce bacterial infection risk, enhancing successful implantation and patients' quality of life.
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Affiliation(s)
- Fiorela Ghilini
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Facultad de Ciencias Exactas, UNLP - CONICET, CC16 Suc 4, 1900 La Plata, Buenos Aires, Argentina
| | - Natalia Fagali
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Facultad de Ciencias Exactas, UNLP - CONICET, CC16 Suc 4, 1900 La Plata, Buenos Aires, Argentina
| | - Diego E Pissinis
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Facultad de Ciencias Exactas, UNLP - CONICET, CC16 Suc 4, 1900 La Plata, Buenos Aires, Argentina
| | - Guillermo Benítez
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Facultad de Ciencias Exactas, UNLP - CONICET, CC16 Suc 4, 1900 La Plata, Buenos Aires, Argentina
| | - Patricia L Schilardi
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Facultad de Ciencias Exactas, UNLP - CONICET, CC16 Suc 4, 1900 La Plata, Buenos Aires, Argentina
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26
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De Waal YCM, Vangsted TE, Van Winkelhoff AJ. Systemic antibiotic therapy as an adjunct to non-surgical peri-implantitis treatment: A single-blind RCT. J Clin Periodontol 2021; 48:996-1006. [PMID: 33939193 PMCID: PMC8251966 DOI: 10.1111/jcpe.13464] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/10/2021] [Accepted: 03/19/2021] [Indexed: 11/27/2022]
Abstract
Aim The aim of this single‐blind RCT was to evaluate the adjunctive clinical and microbiological effect of systemic amoxicillin (AMX) plus metronidazole (MTZ) to non‐surgical treatment of peri‐implantitis. Material and methods Patients (N = 62) with peri‐implantitis were randomly assigned to receive full‐mouth mechanical debridement and decontamination and use of chlorhexidine (control group) or combined with antibiotic therapy of AMX/MTZ (test group). Primary outcome was change in bleeding score from baseline (T0) to 3‐month follow‐up (T3). Secondary parameters were plaque, suppuration, PPD, CAL, bone level, microbiology, adverse events and need for additional surgery. Data were analysed with linear multiple regression analysis. Results 57 patients with 122 implants completed 3‐month follow‐up. Both groups showed major clinical improvements at T3 in both peri‐implant and periodontal parameters. However, no significant differences were observed between both groups for any of the primary or secondary parameters. Conclusions Systemic antibiotic therapy of AMX/MTZ does not improve clinical and microbiological outcomes of non‐surgical peri‐implantitis treatment and should not be routinely recommended. Although complete disease resolution may be difficult to achieve, meticulously performed full‐mouth non‐surgical treatment, achieving a high level of daily oral hygiene and healthy periodontal tissues, can significantly improve the starting position of the subsequent (surgical) peri‐implantitis treatment phase.
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Affiliation(s)
- Yvonne C M De Waal
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tine E Vangsted
- Parodontologische Kliniek Den Haag, The Hague, The Netherlands
| | - Arie Jan Van Winkelhoff
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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27
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Tamayo JA, Riascos M, Vargas CA, Baena LM. Additive manufacturing of Ti6Al4V alloy via electron beam melting for the development of implants for the biomedical industry. Heliyon 2021; 7:e06892. [PMID: 34027149 PMCID: PMC8120950 DOI: 10.1016/j.heliyon.2021.e06892] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/27/2021] [Accepted: 04/21/2021] [Indexed: 11/18/2022] Open
Abstract
Additive Manufacturing (AM) or rapid prototyping technologies are presented as one of the best options to produce customized prostheses and implants with high-level requirements in terms of complex geometries, mechanical properties, and short production times. The AM method that has been more investigated to obtain metallic implants for medical and biomedical use is Electron Beam Melting (EBM), which is based on the powder bed fusion technique. One of the most common metals employed to manufacture medical implants is titanium. Although discovered in 1790, titanium and its alloys only started to be used as engineering materials for biomedical prostheses after the 1950s. In the biomedical field, these materials have been mainly employed to facilitate bone adhesion and fixation, as well as for joint replacement surgeries, thanks to their good chemical, mechanical, and biocompatibility properties. Therefore, this study aims to collect relevant and up-to-date information from an exhaustive literature review on EBM and its applications in the medical and biomedical fields. This AM method has become increasingly popular in the manufacturing sector due to its great versatility and geometry control.
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Affiliation(s)
- José A. Tamayo
- Grupo Calidad, Metrología y Producción, Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Mateo Riascos
- Grupo Calidad, Metrología y Producción, Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Carlos A. Vargas
- Grupo Materiales Avanzados y Energía (Matyer), Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Libia M. Baena
- Grupo de Química Básica, Aplicada y Ambiente (Alquimia), Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
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28
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Grischke J, Szafrański SP, Muthukumarasamy U, Haeussler S, Stiesch M. Removable denture is a risk indicator for peri-implantitis and facilitates expansion of specific periodontopathogens: a cross-sectional study. BMC Oral Health 2021; 21:173. [PMID: 33794847 PMCID: PMC8017824 DOI: 10.1186/s12903-021-01529-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 03/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background The prevalence of peri-implantitis ranges between 7 and 38.4% depending on risk indicators such as smoking, diabetes mellitus, lack of periodontal maintenance program, and history or presence of periodontitis. Currently, the possible effect of the type of superstructure on peri-implant health is unclear. This cross-sectional study aims to investigate the influence of the superstructure on the prevalence of peri-implant mucositis, peri-implantitis and peri-implant dysbiosis. Methods During a 32-month recruitment period dental implants were assessed to diagnose healthy peri-implant tissues, mucositis or peri-implantitis. The study included 1097 implants in 196 patients. Out of all peri-implantitis cases 20 randomly chosen submucosal biofilms from implants with fixed denture (FD) originating from 13 patients and 11 biofilms from implants with removable dentures (RD) originating from 3 patients were studied for microbiome analysis. Composition of transcriptionally active biofilms was revealed by RNAseq. Metatranscriptomic profiles were created for thirty-one peri-implant biofilms suffering from peri-implantitis and microbiome changes associated with superstructure types were identified. Results 16.41% of the implants were diagnosed with peri-implantitis, 25.00% of implants with RD and 12.68% of implants with FD, respectively. Multivariate analysis showed a significant positive association on patient (p = < 0.001) and implant level (p = 0.03) between the prevalence of peri-implantitis and RD. Eight bacterial species were associated either with FD or RD by linear discriminant analysis effect size method. However, significant intergroup confounders (e.g. smoking) were present. Conclusions Within the limitations of the present work, RDs appear to be a risk indicator for peri-implantitis and seem to facilitate expansion of specific periodontopathogens. Potential ecological and pathological consequences of shift in microbiome from RDs towards higher activity of Fusobacterium nucleatum subspecies animalis and Prevotella intermedia require further investigation.
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Affiliation(s)
- Jasmin Grischke
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Szymon P Szafrański
- Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Hannover, Germany.,Cluster of Excellence RESIST (EXC 2155), Hannover, Germany
| | - Uthayakumar Muthukumarasamy
- Institute for Molecular Bacteriology, TWINCORE GmbH, Centre for Clinical and Experimental Research, A Joint Venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
| | - Susanne Haeussler
- Cluster of Excellence RESIST (EXC 2155), Hannover, Germany.,Institute for Molecular Bacteriology, TWINCORE GmbH, Centre for Clinical and Experimental Research, A Joint Venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
| | - Meike Stiesch
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Cluster of Excellence RESIST (EXC 2155), Hannover, Germany
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Antibacterial and antibiofilm properties of graphene and its derivatives. Colloids Surf B Biointerfaces 2021; 200:111588. [PMID: 33529928 DOI: 10.1016/j.colsurfb.2021.111588] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 12/22/2022]
Abstract
Infections resulting from bacteria and biofilms have become a huge problem threatening human health. In recent years, the antibacterial and antibiofilm effects of graphene and its derivatives have been extensively studied. However, there continues to be some controversy over whether graphene and its derivatives can resist infection and biofilms. Moreover, the antibacterial mechanism and cytotoxicity of graphene and its derivatives are unclear. In the present review, antibacterial and antibiofilm abilities of graphene and its derivatives in solution, on the surface are reviewed, and their toxicity and possible mechanisms are also reviewed. Furthermore, we propose possible future development directions for graphene and its derivatives in antibacterial and antibiofilm applications.
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30
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Zhou X, Wu D, Liang D, Zhang W, Shi Q, Cao Y. Evaluation of modified cold‐atmospheric pressure plasma (MCAP) for the treatment of peri‐implantitis in beagles. Oral Dis 2020; 28:495-502. [PMID: 33320400 DOI: 10.1111/odi.13757] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Xincai Zhou
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
| | - Donglei Wu
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
| | - Defeng Liang
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
| | - Wenhao Zhang
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
| | - Qi Shi
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
- Department of Stomatology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Yingguang Cao
- Department of Stomatology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
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Effects of Various Polishing Techniques on the Surface Characteristics of the Ti-6Al-4V Alloy and on Bacterial Adhesion. COATINGS 2020. [DOI: 10.3390/coatings10111057] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ti-6Al-4V, although widely used in dental materials, causes peri-implant inflammation due to the long-term accumulation of bacteria around the implant, resulting in bone loss and eventual failure of the implant. This study aims to overcome the problem of dental implant infection by analyzing the influence of Ti-6Al-4V surface characteristics on the quantity of accumulated bacteria. Ti-6Al-4V specimens, each with different surface roughness are produced by mechanical, chemical, and electrolytic polishing. The surface roughness, surface contact angle, surface oxygen content, and surface structure were measured via atomic force microscopy (AFM), laser scanning confocal microscopy (LSCM), drop shape analysis (using sessile drop), X-ray photoelectron spectroscopy (XPS), and X-ray diffraction (XRD). The micro and macro surface roughness are 10.33–120.05 nm and 0.68–2.34 μm, respectively. The surface X direction and Y direction contact angle are 21.38°–96.44° and 18.37°–92.72°, respectively. The surface oxygen content is 47.36–59.89 at.%. The number of colonies and the optical density (OD) are 7.87 × 106–17.73 × 106 CFU/mL and 0.189–0.245, respectively. The bacterial inhibition were the most effective under the electrolytic polishing of Ti-6Al-4V. The electrolytic polishing of Ti-6Al-4V exhibited the best surface characteristics: the surface roughness of 10 nm, surface contact angle of 92°, and surface oxygen content of 54 at.%, respectively. This provides the best surface treatment of Ti-6Al-4V in dental implants.
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Antibiotic Resistance of Human Periodontal Pathogen Parvimonas micra Over 10 Years. Antibiotics (Basel) 2020; 9:antibiotics9100709. [PMID: 33080856 PMCID: PMC7602954 DOI: 10.3390/antibiotics9100709] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 12/12/2022] Open
Abstract
Changes were evaluated over 10 years in the in vitro resistance of human periodontopathic strains of Parvimonas micra to four antibiotics. Subgingival biofilms culture positive for P. micra from 300 United States adults with severe periodontitis in 2006, and from a similar group of 300 patients in 2016, were plated onto anaerobically incubated enriched Brucella blood agar alone, or supplemented with either doxycycline (4 mg/L), clindamycin (4 mg/L), amoxicillin (8 mg/L), or metronidazole (16 mg/L). P. micra growth on antibiotic-supplemented media indicated in vitro resistance to the evaluated antibiotic concentration. P. micra resistance was significantly more frequent among patients in 2016, as compared to 2006, for doxycycline (11.3% vs. 0.3% patients; 37.7-fold increase), and clindamycin (47.3% vs. 2.0% patients; 23.7-fold increase) (both p < 0.001), whereas resistance to amoxicillin (2.3% vs. 1.0% patients) and metronidazole (0% vs. 0.3% patients) remained low and statistically unchanged between the two patient groups (p-values > 0.05). No P. micra isolates in 2006 or 2016 were jointly resistant in vitro to both amoxicillin and metronidazole. The alarming increases in subgingival P. micra resistance to doxycycline and clindamycin raise serious questions about the empiric use of these antibiotics, either locally or systemically, in the treatment of United States periodontitis patients harboring subgingival P. micra.
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Strategies to Reduce Biofilm Formation in PEEK Materials Applied to Implant Dentistry-A Comprehensive Review. Antibiotics (Basel) 2020; 9:antibiotics9090609. [PMID: 32948018 PMCID: PMC7559429 DOI: 10.3390/antibiotics9090609] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/08/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022] Open
Abstract
Polyether-ether-ketone (PEEK) has emerged in Implant Dentistry with a series of short-time applications and as a promising material to substitute definitive dental implants. Several strategies have been investigated to diminish biofilm formation on the PEEK surface aiming to decrease the possibility of related infections. Therefore, a comprehensive review was carried out in order to compare PEEK with materials widely used nowadays in Implant Dentistry, such as titanium and zirconia, placing emphasis on studies investigating its ability to grant or prevent biofilm formation. Most studies failed to reveal significant antimicrobial activity in pure PEEK, while several studies described new strategies to reduce biofilm formation and bacterial colonization on this material. Those include the PEEK sulfonation process, incorporation of therapeutic and bioactive agents in PEEK matrix or on PEEK surface, PEEK coatings and incorporation of reinforcement agents, in order to produce nanocomposites or blends. The two most analyzed surface properties were contact angle and roughness, while the most studied bacteria were Escherichia coli and Staphylococcus aureus. Despite PEEK's susceptibility to biofilm formation, a great number of strategies discussed in this study were able to improve its antibiofilm and antimicrobial properties.
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Kallas P, Kang H, Valen H, Haugen HJ, Andersson M, Hulander M. Effect of silica nano-spheres on adhesion of oral bacteria and human fibroblasts. Biomater Investig Dent 2020; 7:134-145. [PMID: 33063045 PMCID: PMC7534277 DOI: 10.1080/26415275.2020.1816175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/19/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE This study investigated the effect of surface nano-patterning on adhesion of an oral early commensal colonizer, Streptococcus mitis and the opportunistic pathogen Staphylococcus aureus and human fibroblasts (HDFa) in a laminar flow cell. METHODS Nanostructured surfaces were made by functionalizing glass substrates with 40 nm SiO2 nanoparticles. Gradients in nanoparticle surface coverage were fabricated to study the effect of nanoparticle spacing within a single experiment. Bacterial adhesion was investigated after 5 min of contact time by subjecting surfaces to a flow in a laminar flow cell. In addition, to examine the particles effect on human cells, the establishment of focal adhesion and spreading of primary human dermal fibroblasts (HDFa) were investigated after 4 and 24 h. RESULTS Adhesion of both S. aureus and S. mitis decreased on surfaces functionalized with nanoparticles and coincided with higher nanoparticle surface coverage on the surface. Both strains were tested on three separate surfaces. The regression analysis showed that S. mitis was influenced more by surface modification than S. aureus. The establishment of focal adhesions in HDFa cells was delayed on the nanostructured part of the surfaces after both 4 and 24 h of culturing. SIGNIFICANCE In the current manuscript, we have used a flow cell to investigate the effect of nanotopographies on S. aureus and S. mitis adhesion. The present findings are of relevance for design of future implant and prostheses surfaces in order to reduce adhesion of bacteria.
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Affiliation(s)
- Pawel Kallas
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Hua Kang
- Department of Chemistry and Chemical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Håkon Valen
- Nordic Institute of Dental Materials, Oslo, Norway
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Martin Andersson
- Department of Chemistry and Chemical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Mats Hulander
- Department of Chemistry and Chemical Engineering, Chalmers University of Technology, Gothenburg, Sweden
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Ribeiro-Vidal H, Sánchez MC, Alonso-Español A, Figuero E, Ciudad MJ, Collado L, Herrera D, Sanz M. Antimicrobial Activity of EPA and DHA against Oral Pathogenic Bacteria Using an In Vitro Multi-Species Subgingival Biofilm Model. Nutrients 2020; 12:nu12092812. [PMID: 32937742 PMCID: PMC7551721 DOI: 10.3390/nu12092812] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 11/16/2022] Open
Abstract
In search for natural products with antimicrobial properties for use in the prevention and treatment of periodontitis, the purpose of this investigation was to evaluate the antimicrobial activity of two omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), using an in vitro multi-species subgingival biofilm model including Streptococcus oralis, Actinomyces naeslundii, Veillonella parvula, Fusobacterium nucleatum, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans. The antimicrobial activities of EPA and DHA extracts (100 µM) and the respective controls were assessed on 72 h biofilms by their submersion onto discs for 60 s. Antimicrobial activity was evaluated by quantitative polymerase chain reaction (qPCR), confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). ANOVA with Bonferroni correction was used to evaluate the antimicrobial activity of each of the fatty acids. Both DHA and EPA significantly reduced (p < 0.001 in all cases) the bacterial strains used in this biofilm model. The results with CLSM were consistent with those reported with qPCR. Structural damage was evidenced by SEM in some of the observed bacteria. It was concluded that both DHA and EPA have significant antimicrobial activity against the six bacterial species included in this biofilm model.
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Affiliation(s)
- Honorato Ribeiro-Vidal
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, 28040 Madrid, Spain; (H.R.-V.); (M.C.S.); (A.A.-E.); (E.F.); (D.H.)
| | - María Carmen Sánchez
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, 28040 Madrid, Spain; (H.R.-V.); (M.C.S.); (A.A.-E.); (E.F.); (D.H.)
- Medicine Department, Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain; (M.J.C.); (L.C.)
| | - Andrea Alonso-Español
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, 28040 Madrid, Spain; (H.R.-V.); (M.C.S.); (A.A.-E.); (E.F.); (D.H.)
| | - Elena Figuero
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, 28040 Madrid, Spain; (H.R.-V.); (M.C.S.); (A.A.-E.); (E.F.); (D.H.)
| | - Maria José Ciudad
- Medicine Department, Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain; (M.J.C.); (L.C.)
| | - Luís Collado
- Medicine Department, Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain; (M.J.C.); (L.C.)
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, 28040 Madrid, Spain; (H.R.-V.); (M.C.S.); (A.A.-E.); (E.F.); (D.H.)
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, 28040 Madrid, Spain; (H.R.-V.); (M.C.S.); (A.A.-E.); (E.F.); (D.H.)
- Correspondence: ; Tel.: +34-913-942-021
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Khan A, Sharma D. Management of Peri-Implant Diseases: A Survey of Australian Periodontists. Dent J (Basel) 2020; 8:dj8030100. [PMID: 32882900 PMCID: PMC7558189 DOI: 10.3390/dj8030100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/14/2020] [Accepted: 08/14/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND/AIM This survey-based study aims to explore the clinical management protocols of followed by Australian periodontists in relation to peri-implant diseases. MATERIALS AND METHODS A five-part online questionnaire was developed and administered through email. Descriptive statistics were used for analysis, with the univariate associations between a categorical outcome and the variables evaluated using Pearson's Chi-squared test. RESULTS The survey yielded 99 responses, resulting in a response rate of 41.8%. Most participants were male and aged 35-44 years. More than a quarter of practitioners had been placing implants for 6-10 years and almost two-fifths of practitioners placed 1-10 implants per month. The estimated prevalence of peri-implant mucositis and peri-implantitis in the general Australian population was 47% and 21%, respectively. Practitioners reported using systemic antibiotics to manage peri-implant mucositis (7%) and (72%) peri-implantitis lesions, with a combination of amoxicillin and metronidazole. Most common treatment modalities were oral hygiene instructions, nonsurgical debridement and antimicrobial gel/rinse. Surgical debridement and systemic antibiotics were also often used for peri-implantitis treatment. Practitioners preferred a 3-month clinical follow-up and 6-month radiographic evaluation. Furthermore, three-quarters of practitioners rated their management as moderately effective, although upwards of nine-tenths expressed the need for further training and awareness. CONCLUSION This study confirms a significant use of empirical treatment modalities due to lack of standard therapeutic protocol. However, some approaches followed by the specialists may provide a basis to formulate a therapeutic protocol for peri-implant disease management.
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Affiliation(s)
- Ahsen Khan
- College of Medicine and Dentistry, James Cook University, 14-88 McGregor Road, Smithfield 4878, QLD, Australia;
| | - Dileep Sharma
- Department of Periodontics, James Cook University, 14-88 McGregor Road, Smithfield 4878, QLD, Australia
- The Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, 14-88 McGregor Road, Smithfield 4878, QLD, Australia
- Correspondence:
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Wang J, Zhan L, Zhang X, Wu R, Liao L, Wei J. Silver Nanoparticles Coated Poly(L-Lactide) Electrospun Membrane for Implant Associated Infections Prevention. Front Pharmacol 2020; 11:431. [PMID: 32322206 PMCID: PMC7158749 DOI: 10.3389/fphar.2020.00431] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 03/20/2020] [Indexed: 01/25/2023] Open
Abstract
Bacterial infection has been a critic problem for implant infections. Poly(L-lactide) (PLLA) membrane has great potential for Guided bone regeneration (GBR), however, PLLA lack antibacterial property and thus may face bacterial infections. In this work, a mussel inspired method was used to treat PLLA membrane with dopamine and formed polydopamine (PDA) coated PLLA (PLLA@PDA), and then silver Nanoparticles (AgNPs) was immobilized on the surface of PLLA via the reduction effect of PDA. The XPS results showed that the silver element contents may be tuned from 1.6% to 15.4%. The AgNPs coated PLLA (PLLA@Ag) showed good antibacterial property (98.3% bactericidal efficiency may be obtained) and good biocompatibility, implying that the PLLA@Ag membrane have potential application as antibacterial GBR membrane, which may enhance the application of PLLA.
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Affiliation(s)
- Jiaolong Wang
- School of Stomatology, Nanchang University, Nanchang, China.,The Key Laboratory of Oral Biomedicine, Nanchang, China
| | - Lilin Zhan
- School of Stomatology, Nanchang University, Nanchang, China.,The Key Laboratory of Oral Biomedicine, Nanchang, China
| | - Xianhua Zhang
- School of Stomatology, Nanchang University, Nanchang, China.,The Key Laboratory of Oral Biomedicine, Nanchang, China
| | - Runfa Wu
- School of Stomatology, Nanchang University, Nanchang, China.,The Key Laboratory of Oral Biomedicine, Nanchang, China
| | - Lan Liao
- School of Stomatology, Nanchang University, Nanchang, China.,The Key Laboratory of Oral Biomedicine, Nanchang, China
| | - Junchao Wei
- School of Stomatology, Nanchang University, Nanchang, China.,The Key Laboratory of Oral Biomedicine, Nanchang, China.,College of Chemistry, Nanchang University, Nanchang, China
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Mayer Y, Ginesin O, Horwitz J. A nonsurgical treatment of peri-implantitis using mechanic, antiseptic and anti-inflammatory treatment: 1 year follow-up. Clin Exp Dent Res 2020; 6:478-485. [PMID: 32185910 PMCID: PMC7453777 DOI: 10.1002/cre2.286] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/01/2020] [Accepted: 03/03/2020] [Indexed: 12/12/2022] Open
Abstract
Aims The study's aim was to assess the clinical outcome 6 and 12 months after a nonsurgical treatment of peri‐implantitis per se or in conjunction with a combination of local antiseptic and anti‐inflammatory treatment. Materials and methods Included were 69 patients with periodontitis, with 106 implants, diagnosed with peri‐implantitis. Peri‐implantitis was defined as radiographic bone loss ≥3 mm, probing depth (PD) ≥ 6 mm, with bleeding on probing. Group M peri‐implantitis was treated with ultrasonic debridement and soft tissue curettage. Group P had additional implant surface treatment with rotatory hand piece composed of chitosan bristle, soft tissue curettage combined with application of 0.95% hypochlorite and 1 mg minocycline HCl. Results After 6 months, both groups demonstrated significant reduction of mean plaque index, PD, and clinical attachment level (0.71 ± 0.57, 0.81 ± 0.55; 4.77 ± 0.73 mm, 4.42 ± 0.5 mm; 5.03 ± 0.86 mm, 5.13 ± 0.73 mm; respectively) and bleeding on probing. After 6 and 12 months, group P showed significantly better PD results compared to group M. The bleeding was significantly less in group P after 12 months (15.3% ± 6.2, 25.1% ± 8.2, respectively). Conclusions Adjunctive treatment with local antiseptic and anti‐inflammatories during mechanical phase was positively associated with inflammation reduction and connective tissue reattachment.
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Affiliation(s)
- Yaniv Mayer
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.,Periocenter Ltd., Haifa, Israel
| | - Ofir Ginesin
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.,Periocenter Ltd., Haifa, Israel
| | - Jacob Horwitz
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
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New Evidences of Antibacterial Effects of Cranberry Against Periodontal Pathogens. Foods 2020; 9:foods9020246. [PMID: 32102416 PMCID: PMC7074180 DOI: 10.3390/foods9020246] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/18/2020] [Accepted: 02/20/2020] [Indexed: 01/01/2023] Open
Abstract
The worrying rise in antibiotic resistances emphasizes the need to seek new approaches for treating and preventing periodontal diseases. The purpose of this study was to evaluate the antibacterial and anti-biofilm activity of cranberry in a validated in vitro biofilm model. After chemical characterization of a selected phenolic-rich cranberry extract, its values for minimum inhibitory concentration and minimum bactericidal concentration were calculated for the six bacteria forming the biofilm (Streptococcus oralis, Actinomyces naeslundii, Veillonella parvula, Fusobacterium nucleatum, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans). Antibacterial activity of the cranberry extract in the formed biofilm was evaluated by assessing the reduction in bacteria viability, using quantitative polymerase chain reaction (qPCR) combined with propidium monoazide (PMA), and by confocal laser scanning microscopy (CLSM), and anti-biofilm activity by studying the inhibition of the incorporation of different bacteria species in biofilms formed in the presence of the cranberry extract, using qPCR and CLSM. In planktonic state, bacteria viability was significantly reduced by cranberry (p < 0.05). When growing in biofilms, a significant effect was observed against initial and early colonizers (S. oralis (p ≤ 0.017), A. naeslundii (p = 0.006) and V. parvula (p = 0.010)) after 30 or 60 s of exposure, while no significant effects were detected against periodontal pathogens (F. nucleatum, P. gingivalis or A. actinomycetemcomitans (p > 0.05)). Conversely, cranberry significantly (p < 0.001 in all cases) interfered with the incorporation of five of the six bacteria species during the development of 6 h-biofilms, including P. gingivalis, A. actinomycetemcomitans, and F. nucleatum. It was concluded that cranberry had a moderate antibacterial effect against periodontal pathogens in biofilms, but relevant anti-biofilm properties, by affecting bacteria adhesion in the first 6 h of development of biofilms.
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Rams TE, Sautter JD, van Winkelhoff AJ. Comparative In Vitro Resistance of Human Periodontal Bacterial Pathogens to Tinidazole and Four Other Antibiotics. Antibiotics (Basel) 2020; 9:antibiotics9020068. [PMID: 32046045 PMCID: PMC7168304 DOI: 10.3390/antibiotics9020068] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 12/13/2022] Open
Abstract
The in vitro resistance of selected red/orange complex periodontal pathogens to tinidazole was compared with four other antibiotics. Subgingival biofilm samples from 88 adults with severe periodontitis were anaerobically incubated on enriched Brucella blood agar with and without supplementation with tinidazole (16 mg/L), metronidazole (16 mg/L), amoxicillin (8 mg/L), doxycycline (4 mg/L), or clindamycin (4 mg/L). Growth of Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia/nigrescens, Parvimonas micra, Fusobacterium nucleatum, Streptococcus constellatus, or Campylobacter rectus on antibiotic-supplemented plates indicated their in vitro antibiotic resistance. Tinidazole inhibited all test species, except P. intermedia/nigrescens, P. micra, and S. constellatus in 3.8%, 10.2%, and 88.9% of species-positive patients, respectively. Significantly fewer patients yielded tinidazole-resistant test species, and had significantly lower subgingival proportions of tinidazole-resistant organisms, than patients with amoxicillin, doxycycline, or clindamycin-resistant species, but not those with metronidazole-resistant strains. Joint in vitro species resistance to tinidazole and amoxicillin, or metronidazole and amoxicillin, was rare. Tinidazole performed in vitro similar to metronidazole, and markedly better than amoxicillin, doxycycline, or clindamycin, against fresh clinical isolates of red/orange complex periodontal pathogens. As a result of its similar antimicrobial spectrum, and more convenient once-a-day oral dosing, tinidazole should be considered in place of metronidazole for systemic periodontitis drug therapy.
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Affiliation(s)
- Thomas E. Rams
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA 19140, USA
- Department of Microbiology and Immunology, Temple University School of Medicine, Philadelphia, PA 19140, USA
- Correspondence:
| | - Jacqueline D. Sautter
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA 19140, USA
| | - Arie J. van Winkelhoff
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
- Department of Periodontology, University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, 9713 GZ Groningen, The Netherlands
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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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Nie J, Zhang Q, Zheng H, Xu LX, Wang XY, Chen F. Pyrosequencing of the subgingival microbiome in peri-implantitis after non-surgical mechanical debridement therapy. J Periodontal Res 2019; 55:238-246. [PMID: 31677272 DOI: 10.1111/jre.12708] [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] [Received: 03/05/2019] [Revised: 09/28/2019] [Accepted: 10/09/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Peri-implantitis remains a challenge for dental implant therapy, and the prognosis of non-surgical therapy for peri-implantitis is unsatisfactory. In order to reveal the impact of non-surgical mechanical debridement therapy on microbial communities, we investigated the subgingival microbial communities of healthy implants and implants with peri-implantitis, both before and after the therapy. MATERIAL AND METHODS Subgingival plaques were collected from patients with healthy dental implants (HC; n = 10) and from patients with peri-implantitis (n = 13) before and after non-surgical mechanical debridement therapy. The treatment was conducted using curettes for submucosal debridement followed by irrigation with 0.2% (w/v) chlorhexidine, with re-examination 1 month later. 16S rRNA pyrosequencing was used to analyze the subgingival microbiome, and co-occurrence networks were adopted to explore the interactions between pathogens in the microbial communities. RESULTS A total of 506 955 high-quality reads were generated, and 2222 operational taxonomic units were finally detected using a 97% similarity cutoff, with a mean of 249 ± 69 per sample. The peri-implantitis sites harbored similar microbial communities before and after the treatment, as demonstrated by the microbial diversity, relative abundance, and prevalence of bacteria. Most importantly, the microbial community structures were stable before and after non-surgical therapy based on the microbial diversity and bacterial composition, as well as the interactions between key pathogens, including Enterobacteriaceae, Selenomonas sputigena, Parvimonas, Eubacterium infirmum, Campylobacter gracilis, Tannerella forsythia, and Fusobacterium, which were measured using a co-occurrence network analysis. Periodontal pathogens were also detected in subgingival plaque after the treatment. Distinct microbial communities were found between the healthy and peri-implantitis sites. CONCLUSION Our results demonstrate that non-surgical mechanical debridement therapy did not significantly affect the subgingival microbial communities in peri-implantitis, and the stable microbial networks created via interactions among pathogens may be responsible for the poor prognosis of peri-implantitis treatment.
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Affiliation(s)
- Jie Nie
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Qian Zhang
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
| | - Hui Zheng
- Department of Orthodontics, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Li-Xin Xu
- The Third Dental Center, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiao-Yan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Feng Chen
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
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Evaluation of Drug Susceptibility of Microorganisms in Odontogenic Inflammations and Dental Surgery Procedures Performed on an Outpatient Basis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:2010453. [PMID: 31687380 PMCID: PMC6800958 DOI: 10.1155/2019/2010453] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 08/06/2019] [Accepted: 09/11/2019] [Indexed: 01/05/2023]
Abstract
Bacterial infections are the most common cause of purulent soft tissue inflammations in the head and neck area. These bacteria are also responsible for the majority of inflammatory complications after third molar removal. The key to success of antibacterial treatment in both cases is the use of an appropriate antibacterial agent. The aim of the study was to evaluate the susceptibility profile of bacteria isolated from material collected from patients with intraoral odontogenic abscesses. The test material consisted of swabs taken from the odontogenic abscesses, after their incision and drainage. Another swab was collected from the lesion area, 10 days after the initial visit. Results were compared with an identical study conducted on a control group of healthy patients, who had undergone third molar removal. Bacteria identified in this study consisted of aerobic and anaerobic strains, both Gram-positive and Gram-negative. According to the EUCAST guidelines, none of the tested antibiotics was recommended for all identified bacteria. The percentage of bacterial strains sensitive to amoxicillin and clavulanic acid was 78.13% and 81.48% in the study and control groups, respectively, whereas, the percentage of those sensitive to clindamycin was 96.43% and 80.00%, respectively. For Gram-negative aerobic bacteria, gentamicin and ciprofloxacin were among medications affecting all cultured species. 100.00% of strains were found to be susceptible to these antibiotics. Statistically significant relationship between the presence of Gram-negative aerobic strains and the occurrence of complications was found. In the case of the most frequently occurring bacteria in the study, amoxicillin with clavulanic acid and clindamycin were shown to be very effective. In cases of severe purulent odontogenic inflammations, it is recommended to use a combination of antibiotics. Amoxicillin with ciprofloxacin and clindamycin with cefuroxime seem to be the proper choices based on the results of this study.
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Ingendoh‐Tsakmakidis A, Mikolai C, Winkel A, Szafrański SP, Falk CS, Rossi A, Walles H, Stiesch M. Commensal and pathogenic biofilms differently modulate peri-implant oral mucosa in an organotypic model. Cell Microbiol 2019; 21:e13078. [PMID: 31270923 PMCID: PMC6771885 DOI: 10.1111/cmi.13078] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/14/2019] [Accepted: 06/28/2019] [Indexed: 02/06/2023]
Abstract
The impact of oral commensal and pathogenic bacteria on peri-implant mucosa is not well understood, despite the high prevalence of peri-implant infections. Hence, we investigated responses of the peri-implant mucosa to Streptococcus oralis or Aggregatibacter actinomycetemcomitans biofilms using a novel in vitro peri-implant mucosa-biofilm model. Our 3D model combined three components, organotypic oral mucosa, implant material, and oral biofilm, with structural assembly close to native situation. S. oralis induced a protective stress response in the peri-implant mucosa through upregulation of heat shock protein (HSP70) genes. Attenuated inflammatory response was indicated by reduced cytokine levels of interleukin-6 (IL-6), interleukin-8 (CXCL8), and monocyte chemoattractant protein-1 (CCL2). The inflammatory balance was preserved through increased levels of tumor necrosis factor-alpha (TNF-α). A. actinomycetemcomitans induced downregulation of genes important for cell survival and host inflammatory response. The reduced cytokine levels of chemokine ligand 1 (CXCL1), CXCL8, and CCL2 also indicated a diminished inflammatory response. The induced immune balance by S. oralis may support oral health, whereas the reduced inflammatory response to A. actinomycetemcomitans may provide colonisation advantage and facilitate later tissue invasion. The comprehensive characterisation of peri-implant mucosa-biofilm interactions using our 3D model can provide new knowledge to improve strategies for prevention and therapy of peri-implant disease.
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Affiliation(s)
| | - Carina Mikolai
- Department of Prosthetic Dentistry and Biomedical Materials ScienceHannover Medical SchoolHannoverGermany
| | - Andreas Winkel
- Department of Prosthetic Dentistry and Biomedical Materials ScienceHannover Medical SchoolHannoverGermany
| | - Szymon P. Szafrański
- Department of Prosthetic Dentistry and Biomedical Materials ScienceHannover Medical SchoolHannoverGermany
| | - Christine S. Falk
- Institute of Transplant ImmunologyHannover Medical SchoolHannoverGermany
| | - Angela Rossi
- Translational Center for Regenerative TherapiesFraunhofer Institute of Silicate Research ISCWürzburgGermany
| | - Heike Walles
- Translational Center for Regenerative TherapiesFraunhofer Institute of Silicate Research ISCWürzburgGermany
- Chair of Tissue Engineering and Regenerative MedicineUniversity Hospital of WürzburgWürzburgGermany
| | - Meike Stiesch
- Department of Prosthetic Dentistry and Biomedical Materials ScienceHannover Medical SchoolHannoverGermany
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Ramón-Morales CA, Ramón-Morales OM, Ardila CM. Gram-negative enteric rods/Pseudomonas colonization in mucositis and peri-implantitis of implants restored with cemented and screwed reconstructions: A cross-sectional study. Clin Implant Dent Relat Res 2019; 21:946-952. [PMID: 31313462 DOI: 10.1111/cid.12820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 05/12/2019] [Accepted: 06/29/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE To evaluate the association between Gram-negative enteric rods and Pseudomonas with mucositis and peri-implantitis, in implants restored with cemented and screw-retained reconstructions. MATERIALS AND METHODS Individuals treated with implants, diagnosed with peri-implant mucositis and or peri-implantitis, participated in this study. Microbiota from the implant and the gingival sulcus of two neighboring teeth were also studied. The microorganisms were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. RESULTS A total of 52 and 51 implants cemented and screwed restored were evaluated in 31 patients. The presence of Gram-negative enteric rods/Pseudomonas (P = .01) was significantly higher in the cemented restored implants. When the unit of analysis was the implant, the presence of Gram-negative enteric rods/Pseudomonas was associated with cemented restored implants after adjustment for possible confounders (odds ratio [OR] = 3.7; 95% CI, 1.4-10; P = .01); besides, peri-implantitis was statistically significant in the multivariate model (P = .008). Considering the patient as a unit of analysis, peri-implantitis was associated with cemented restored implants (OR = 9.4; 95% CI, 2-46; P = .006); this statistically significant association remained after adjusting for potential confounders (OR = 6.8; 95% CI, 1.3-37; P = .02). CONCLUSION The presence of Gram-negative enteric rods/Pseudomonas was associated with cemented restored implants; besides, peri-implantitis was associated with cemented restored implants.
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Affiliation(s)
| | | | - Carlos M Ardila
- Biomedical Stomatology Research Group, Universidad de Antioquia UdeA, Medellín, Colombia
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Sánchez MC, Ribeiro-Vidal H, Esteban-Fernández A, Bartolomé B, Figuero E, Moreno-Arribas MV, Sanz M, Herrera D. Antimicrobial activity of red wine and oenological extracts against periodontal pathogens in a validated oral biofilm model. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:145. [PMID: 31226983 PMCID: PMC6588849 DOI: 10.1186/s12906-019-2533-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 05/29/2019] [Indexed: 02/06/2023]
Abstract
Background Previous research findings support an antimicrobial effect of polyphenols against a variety of pathogens, but there is no evidence of this effect against periodontal pathogens in complex biofilms. The purpose of this study was to evaluate the antimicrobial activity of red wine and oenological extracts, rich in polyphenols, against the periodontal pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum and total bacteria growing in an in vitro oral biofilm static model. Methods A previously validated biofilm model, including Streptococcus oralis, Actinomyces naeslundii, Veillonella parvula, F. nucleatum, P. gingivalis and A. actinomycetemcomitans was developed on sterile hydroxyapatite discs. Red wine (and dealcoholized wine), and two polyphenols-rich extracts (from wine and grape seeds) were applied to 72 h biofilms by dipping the discs during 1 and 5 min in the wine solutions and during 30 s and 1 min in the oenological extracts. Resulting biofilms were analyzed by confocal laser scanning microscopy and viable bacteria (colony forming units/mL) were measured by quantitative polymerase chain reaction combined with propidium monoazide. A generalized linear model was constructed to determine the effect of the tested products on the viable bacterial counts of A. actinomycetemcomitans, P. gingivalis and F. nucleatum, as well on the total number of viable bacteria. Results The results showed that red wine and dealcoholized red wine caused reduction in viability of total bacteria within the biofilm, with statistically significant reductions in the number of viable P. gingivalis after 1 min (p = 0.008) and in A. actinomycetemcomitans after 5 min of exposure (p = 0.011) with red wine. No evidence of relevant antibacterial effect was observed with the oenological extracts, with statistically significant reductions of F. nucleatum after 30 s of exposure to both oenological extracts (p = 0.001). Conclusions Although moderate, the antimicrobial impact observed in the total bacterial counts and counts of A. actinomycetemcomitans, P. gingivalis and F. nucleatum, encourage further investigations on the potential use of these natural products in the prevention and treatment of periodontal diseases.
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Nart J, Pons R, Valles C, Esmatges A, Sanz-Martín I, Monje A. Non-surgical therapeutic outcomes of peri-implantitis: 12-month results. Clin Oral Investig 2019; 24:675-682. [PMID: 31123873 DOI: 10.1007/s00784-019-02943-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 05/02/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To assess the clinical and radiographic outcomes of implants treated by means of non-surgical debridement with systemic antibiotic therapy. MATERIALS AND METHODS A prospective case series study evaluating the 12-month clinical and radiographic outcomes of peri-implantitis lesions treated with ultrasonic scaler debridement, a glycine air abrasive, and metronidazole followed by supportive maintenance. Clinical and radiographic variables and success criteria were defined a priori. RESULTS Overall, 21 patients were included. One implant failed during the study period (implant survival rate 95.24%). Substantial changes occurred at 12 months in all the clinical and radiographic variables, reaching strong statistical significance in the majority of them. According to the success criteria applied, 40.90% of the peri-implantitis were arrested and resolved, while 59.1% presented with at least one probed site with bleeding on probing (BoP). Moreover, 95.45% exhibited peri-implant pocket depth (PPD) < 5 mm at the end of the study. None of the implants presented with progressive bone loss. CONCLUSION Non-surgical therapy of peri-implantitis is effective to arrest progressive bone loss, reduce PPD and suppuration, and achieve radiographic bone fill in the majority of cases. Nevertheless, it failed to be completely efficacious in the achievement of successful therapeutic outcomes as BoP remained frequently present. CLINICAL RELEVANCE Non-surgical therapy achieved significant clinical and radiological improvements.
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Affiliation(s)
- José Nart
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, 08195, Sant Cugat del Vallès, Barcelona, Spain.
| | - Ramón Pons
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, 08195, Sant Cugat del Vallès, Barcelona, Spain
| | - Cristina Valles
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, 08195, Sant Cugat del Vallès, Barcelona, Spain
| | | | - Ignacio Sanz-Martín
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, 08195, Sant Cugat del Vallès, Barcelona, Spain
| | - Alberto Monje
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, 08195, Sant Cugat del Vallès, Barcelona, Spain
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Alécio ABW, Ferreira CF, Babu J, Shokuhfar T, Jo S, Magini R, Garcia-Godoy F. Doxycycline Release of Dental Implants With Nanotube Surface, Coated With Poly Lactic-Co-Glycolic Acid for Extended pH-controlled Drug Delivery. J ORAL IMPLANTOL 2019; 45:267-273. [PMID: 31008689 DOI: 10.1563/aaid-joi-d-18-00069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
When dental implants become infected, the progression of the disease is rapid. Commercially available dental implant surfaces can be easily contaminated, resulting in rapid progression of peri-mucositis and peri-implantitis. The aim of this study was to evaluate, in vitro, the pattern of doxycycline release from by dental implants with titanium nanotube surface (DINS) at different pHs to examine novel drug loading and chemical coating techniques. Nine DINS were loaded with doxycycline and subsequently coated with polylactic-co-glycolic acid (PLGA). High-performance liquid chromatography (HPLC) was used to measure the amounts of released doxycycline in a 30-day period. Cytotoxicity of the DINS was evaluated by an assay using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT). The results showed that the experimental DINS coated with doxycycline and PLGA showed a mean drug release during the experimental period for the groups: pH 7.4 (8.39 μg/mL), pH 6.4 (8.63 μg/mL). The pH 5.4 (15.18 μl/mL) doxycycline release from DINS was faster at pH 5.4 than those at pHs 6.4 and 7.4 (P = .0031 and .0034, respectively). This new surface treatment of dental implants with titanium nanotubes and subsequent drug loading demonstrated biocompatibility and sustained doxycycline release over a 30-day period. Additional studies are needed in order to adopt a stable drug release at neutral pH environment while warranting a constant drug release in an acidic pH environment.
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Affiliation(s)
| | - Cimara Fortes Ferreira
- Department of Prosthodontics, University of Tennessee Health Sciences College of Dentistry, Memphis, Tenn
| | - Jegdish Babu
- Department of Biosciences Research, University of Tennessee Health Sciences College of Dentistry, Memphis, Tenn
| | - Tolou Shokuhfar
- Department of Bioengineering, University of Illinois, Chicago, Ill
| | - Seongbong Jo
- Department of Pharmaceutics and Drug Delivery, University of Mississippi, Oxford, Miss
| | - Ricardo Magini
- Department of Periodontology, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Franklin Garcia-Godoy
- Department of Biosciences Research, University of Tennessee Health Sciences College of Dentistry, Memphis, Tenn
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Cai Z, Li Y, Wang Y, Chen S, Jiang S, Ge H, Lei L, Huang X. Antimicrobial effects of photodynamic therapy with antiseptics on Staphylococcus aureus biofilm on titanium surface. Photodiagnosis Photodyn Ther 2019; 25:382-388. [DOI: 10.1016/j.pdpdt.2019.01.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/29/2018] [Accepted: 01/18/2019] [Indexed: 02/07/2023]
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Agarwalla SV, Ellepola K, Costa MCFD, Fechine GJM, Morin JLP, Castro Neto AH, Seneviratne CJ, Rosa V. Hydrophobicity of graphene as a driving force for inhibiting biofilm formation of pathogenic bacteria and fungi. Dent Mater 2019; 35:403-413. [PMID: 30679015 DOI: 10.1016/j.dental.2018.09.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 09/18/2018] [Accepted: 09/26/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To evaluate the surface and wettability characteristics and the microbial biofilm interaction of graphene coating on titanium. METHODS Graphene was deposited on titanium (Control) via a liquid-free technique. The transfer was performed once (TiGS), repeated two (TiGD) and five times (TiGV) and characterized by AFM (n=10), Raman spectroscopy (n=10), contact angle and SFE (n=5). Biofilm formation (n=3) to Streptococcus mutans, Enterococcus faecalis, Pseudomonas aeruginosa and Candida albicans was evaluated after 24h by CV assay, CFU, XTT and confocal microscopy. Statistics were performed by one-way Anova, Tukey's tests and Pearson's correlation analysis at a pre-set significance level of 5 %. RESULTS Raman mappings revealed coverage yield of 82 % for TiGS and ≥99 % for TiGD and TiGV. Both TiGD and TiGV presented FWHM>44cm-1 and ID/IG ratio<0.12, indicating multiple graphene layers and occlusion of defects. The contact angle was significantly higher for TiGD and TiGV (110° and 117°) comparing to the Control (70°). The SFE was lower for TiGD (13.8mN/m) and TiGV (12.1mN/m) comparing to Control (38.3mN/m). TiGD was selected for biofilm assays and exhibited significant reduction in biofilm formation for all microorganisms compared to Control. There were statistical correlations between the high contact angle and low SFE of TiGD and decreased biofilm formation. SIGNIFICANCE TiGD presented high quality and coverage and decreased biofilm formation for all species. The increased hydrophobicity of graphene films was correlated with the decreased biofilm formation for various species.
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Affiliation(s)
| | - Kassapa Ellepola
- Faculty of Dentistry, National University of Singapore, Singapore
| | | | | | - Julien Luc Paul Morin
- Centre for Advanced 2D Materials and Graphene Research Centre, National University of Singapore, Singapore
| | - A H Castro Neto
- Centre for Advanced 2D Materials and Graphene Research Centre, National University of Singapore, Singapore
| | | | - Vinicius Rosa
- Faculty of Dentistry, National University of Singapore, Singapore; Centre for Advanced 2D Materials and Graphene Research Centre, National University of Singapore, Singapore.
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