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Montevecchi M, Valeriani L, Bellanova L, Stefanini M, Zucchelli G. In-vitro comparison of two different toothbrush bristles about peri-implant sulcus penetration. Int J Dent Hyg 2024; 22:465-470. [PMID: 37721091 DOI: 10.1111/idh.12751] [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: 09/10/2022] [Revised: 08/11/2023] [Accepted: 08/28/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE The aim of this preclinical study was to compare the ability of tapered and cylindrical bristles to penetrate the peri-implant sulcus. METHODS A full mandibular dental arch was reproduced in plaster cast. In site #3.6 a hollow glass cylinder was positioned simulating a 4 mm diameter implant and the gingival component was recreated by using dedicated silicone. A Bass brushing technique was performed from the vestibular side in humid environment. During it, the penetration of the bristles between the gum and the implant was recorded by mean of an optic fibre fixed inside the cylinder. The protocol included 5 toothbrushes per group and 10 tests per toothbrush, for a total of 50 assessments for each of the two groups. A scale of 5 grades for bristle penetration was defined: grade 0 (× < 2 mm), grade 1 (2 ≤ × < 3 mm), grade 2 (3 ≤ × < 4 mm), grade 3 (4 ≤ × < 5 mm) and grade 4 (5 ≤ × < 8 mm). From the video recordings the highest value of penetration was identified for each test. RESULTS The tapered bristles showed an 8 times greater penetration capacity (p = 0.001) in respect to the cylindrical bristles (multilevel analysis). The percentage of tests reaching depths ≥3 mm was 86% for tapered group and 28% for the cylindrical group. CONCLUSION This preclinical study shows a clear and superior penetration capacity of the tapered bristles in respect to traditional cylindrical ones. For tapered bristles, a potentially greater hygienic efficacy around dental implants is suggested.
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Affiliation(s)
- Marco Montevecchi
- Division of Periodontology and Implantology, Department of Biomedical and Neuromotor Sciences, School of Dentistry and Dental Hygiene, University of Bologna, Bologna, Italy
| | - Leoluca Valeriani
- Division of Periodontology and Implantology, Department of Biomedical and Neuromotor Sciences, School of Dentistry and Dental Hygiene, University of Bologna, Bologna, Italy
| | - Leonardo Bellanova
- Department of Biomedical and Neuromotor Sciences, School of Dentistry and Dental Hygiene, University of Bologna, Bologna, Italy
| | - Martina Stefanini
- Division of Periodontology and Implantology, Department of Biomedical and Neuromotor Sciences, School of Dentistry and Dental Hygiene, University of Bologna, Bologna, Italy
| | - Giovanni Zucchelli
- Division of Periodontology and Implantology, Department of Biomedical and Neuromotor Sciences, School of Dentistry and Dental Hygiene, University of Bologna, Bologna, Italy
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2
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Perussolo J, Donos N. Maintenance of peri-implant health in general dental practice. Br Dent J 2024; 236:781-789. [PMID: 38789755 PMCID: PMC11126374 DOI: 10.1038/s41415-024-7406-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024]
Abstract
The long-term maintenance or restoration of peri-implant tissues' health depends on the strategic implementation of preventive measures and interventions. These measures should be initiated before implant placement and continued throughout a patient's lifetime, as part of a tailored and comprehensive supportive peri-implant care (SPIC) programme. Central to the clinical efforts of maintaining and rehabilitating peri-implant tissues are several key factors, including the ongoing assessment and frequent monitoring of tissue health and stability, proactive oral health promotion, the control of risk factors and indicators and the provision of professional plaque biofilm removal. It is of paramount importance to underline that SPIC should not limit its scope exclusively to patients already in a state of peri-implant health; in fact, it is imperative that it should extend its protective effect to individuals who have been previously diagnosed and treated for peri-implant diseases, focusing on preventing its recurrence and progression, thereby avoiding further complications, such as implant loss.This narrative review presents an overview of the current literature on the maintenance of peri-implant tissues' health and the steps of SPIC providing insights into the critical factors to be considered when managing dental implant patients in the general dental practice.
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Affiliation(s)
- Jeniffer Perussolo
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, Turner Street, London, E1 2AD, UK
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, Turner Street, London, E1 2AD, UK.
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3
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Sirinirund B, Siqueira R, Li J, Mendonça G, Zalucha J, Wang HL. Effects of crown contour on artificial biofilm removal efficacy with interdental cleaning aids: An in vitro study. Clin Oral Implants Res 2023; 34:783-792. [PMID: 37269176 DOI: 10.1111/clr.14105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 05/15/2023] [Accepted: 05/20/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To evaluate the efficacy of various interdental cleaning aids for artificial biofilm removal on different implant-supported crown designs. METHODS Mandibular models with missing first molar were fabricated and installed with single implant analogs and loaded with crowns of different designs (concave, straight, and convex). Artificial biofilm was made with occlusion spray. Thirty volunteers (periodontists, dental hygienists, and laypersons) were asked to clean the interproximal areas. The crowns were unscrewed and photographed in a standardized setting. The outcome was measured by the cleaning ratio which represents the cleaned surfaces in relation to the area of the tested surface. RESULTS A significant difference in favor of concave crown (p < .001) on the basal surface was cleaned by all tools, except the water flosser. There was evidence of an overall effect of "cleaning tool," "surface," and "crown design" (p < .0001) except for the "participant" factor. The mean cleaning ratio for each cleaning tool and overall combined surfaces were (in%): dental floss: 43.02 ± 23.93, superfloss: 42.51 ± 25.92, electric interspace brush: 36.21 ± 18.78, interdental brush: 29.10 ± 15.95, and electric water flosser: 9.72 ± 8.14. Dental floss and superfloss were significantly better (p < .05) than other tools in removing plaque. CONCLUSIONS Concave crown contour had the greatest artificial biofilm removal, followed by straight and convex crowns at the basal surface. Dental floss and superfloss were the most effective interdental cleaning devices for artificial biofilm removal. None of the tested cleaning devices were able to completely remove the artificial biofilm from the interproximal/basal surfaces.
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Affiliation(s)
- Benyapha Sirinirund
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Rafael Siqueira
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Junying Li
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Gustavo Mendonça
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Janet Zalucha
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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4
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Hamilton A, Putra A, Nakapaksin P, Kamolroongwarakul P, Gallucci GO. Implant prosthodontic design as a predisposing or precipitating factor for peri-implant disease: A review. Clin Implant Dent Relat Res 2023. [PMID: 36691784 DOI: 10.1111/cid.13183] [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: 10/24/2022] [Revised: 12/20/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023]
Abstract
Over the past decade, emerging evidence indicates a strong relationship between prosthetic design and peri-implant tissue health. The objective of this narrative review was to evaluate the evidence for the corresponding implant prosthodontic design factors on the risk to peri-implant tissue health. One of the most important factors to achieve an acceptable implant restorative design is the ideal implant position. Malpositioned implants often result in a restorative emergence profile at the implant-abutment junction that can restrict the access for patients to perform adequate oral hygiene. Inadequate cleansability and poor oral hygiene has been reported as a precipitating factors to induce the peri-implant mucositis and peri-implantitis and are influenced by restorative contours. The implant-abutment connection, restorative material selection and restoration design are also reported in the literature as having the potential to influence peri-implant sort tissue health.
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Affiliation(s)
- Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia.,Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Armand Putra
- Private Practice, Perth, Western Australia, Australia.,Department of Graduate Prosthodontic, University of Washington, Seattle, Washington, USA
| | - Pranai Nakapaksin
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Pongrapee Kamolroongwarakul
- Dental Center, Private Hospital, Bangkok, Thailand.,Department of Graduate Prosthodontic, Mahidol University, Bangkok, Thailand
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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5
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Monje A, Kan JY, Borgnakke W. Impact of local predisposing/precipitating factors and systemic drivers on peri‐implant diseases. Clin Implant Dent Relat Res 2022. [PMID: 36533411 DOI: 10.1111/cid.13155] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/01/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Strong evidence suggests the infectious nature of peri-implant diseases occurring in susceptible hosts. Epidemiological reports, though, indicate that peri-implantitis is a site-specific entity. Hence, the significance of local factors that may predispose/precipitate plaque accumulation and the impact of systemic drivers that alter the immune response are relevant in the prevention and management of peri-implant disorders. PURPOSE The purpose of the present review is to shed light on the significance of local and systemic factors on peri-implant diseases, making special emphasis on the associations with peri-implantitis. METHODS The biologic plausibility and supporting evidence aiming at providing a concluding remark were explored in the recent scientific literature for local predisposing/precipitating factors and systemic drivers related to peri-implant diseases. RESULTS Local predisposing factors such as soft tissue characteristics, implant position and prosthetic design proved being strongly associated with the occurrence of peri-implant diseases. Hard tissue characteristics, however, failed to demonstrate having a direct association with peri-implant diseases. Robust data points toward the strong link between residual sub-mucosal cement and peri-implant diseases, while limited data suggests the impact of residual sub-mucosal floss and peri-implantitis. Systemic drivers/habits such as hyperglycemia and smoking showed a strong negative impact on peri-implantitis. However, there is insufficient evidence to claim for any link between metabolic syndrome, atherosclerotic cardiovascular disease, and obesity and peri-implant diseases. CONCLUSION Local predisposing/precipitating factors and systemic drivers may increase the risk of peri-implant diseases. Therefore, comprehensive anamnesis of the patients, educational/motivational programs and exhaustive prosthetically-driven treatment planning must be fostered aiming at reducing the rate of biological complications in implant dentistry.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine University of Michigan Ann Arbor Michigan USA
- Department of Periodontology Universitat Internacional de Catalunya Barcelona Spain
- Department of Periodontology, ZMK University of Bern Bern CH Switzerland
| | - Joseph Y. Kan
- Department of Implantology Loma Linda University Loma Linda California USA
| | - Wenche Borgnakke
- Department of Periodontology and Oral Medicine University of Michigan Ann Arbor Michigan USA
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6
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Khan SN, Koldsland OC, Roos-Jansåker AM, Wohlfahrt JC, Verket A, Mdala I, Magnusson A, Salvesen E, Hjortsjö C. Non-surgical treatment of mild to moderate peri-implantitis using an oscillating chitosan brush or a titanium curette-A randomized multicentre controlled clinical trial. Clin Oral Implants Res 2022; 33:1254-1264. [PMID: 36207993 PMCID: PMC10092542 DOI: 10.1111/clr.14007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 08/16/2022] [Accepted: 09/06/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This prospective, parallel-group, examiner-blinded, multicentre, randomized, controlled clinical trial aimed to assess the efficacy of an oscillating chitosan brush (OCB) versus titanium curettes (TC) on clinical parameters in the non-surgical treatment of peri-implantitis. MATERIAL AND METHODS In five dental specialist clinics, 39 patients with one implant with mild to moderate peri-implantitis, defined as 2-4 mm radiographic reduced bone level, bleeding index (BI) ≥ 2, and probing pocket depth (PPD) ≥ 4 mm were randomly allocated to test and control groups, receiving OCB or TC debridement, respectively. Treatment was performed at baseline and three months. PPD, BI, and Plaque index (PI) were measured at six sites per implant and recorded by five blinded examiners at baseline, one, three, and six month(s). Pus was recorded as present/not present. Changes in PPD and BI were compared between groups and analysed using multilevel partial ordinal and linear regression. RESULTS Thirty-eight patients completed the study. Both groups showed significant reductions in PPD and BI at six months compared with baseline (p < .05). There was no statistically significant difference in PPD and BI changes between the groups. Eradication of peri-implant disease as defined was observed in 9.5% of cases in the OCB group and 5.9% in the TC group. CONCLUSIONS Within the limitations of this six-month multicentre clinical trial, non-surgical treatment of peri-implantitis with OCB and TC showed no difference between the interventions. Eradication of disease was not predictable for any of the groups.
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Affiliation(s)
- Sadia N Khan
- Department of Prosthetics and Oral Function, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Odd Carsten Koldsland
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Ann-Marie Roos-Jansåker
- Department of Periodontology, Public Dental Health Services, Kristianstad, Sweden.,Department of Periodontology, Blekinge Hospital, Karlskrona, Sweden
| | - Johan Caspar Wohlfahrt
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Anders Verket
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Ibrahimu Mdala
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Anna Magnusson
- Department of Periodontology, Public Dental Health Services, Örebro, Sweden
| | | | - Carl Hjortsjö
- Department of Prosthetics and Oral Function, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
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7
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Stavrakis AK, Kojić S, Petrović B, Nešković I, Stojanović GM. Performance Evaluation of Dental Flosses Pre- and Post-Utilization. MATERIALS 2022; 15:ma15041522. [PMID: 35208062 PMCID: PMC8879268 DOI: 10.3390/ma15041522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 12/01/2022]
Abstract
Dental floss is an oral hygiene product used to remove food and plaque in places where toothbrushes cannot reach. Even though over the years since its introduction some research in suitable materials has been performed, thread cracking and wear can still compromise efficiency. The aim of this study was to examine the morphological properties of four different commercially available dental floss types before and after use. For that purpose, scanning electron microscopy and optical microscopy were used to assess the flosses before and after use, and tension testing was performed to determine any degradation in the floss performance after utilization. The analyzed floss samples verify the hypothesis that the properties of the floss need to be known in depth, before recommending a specific type to patients for daily use in all clinical indications.
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Affiliation(s)
- Adrian K. Stavrakis
- Faculty of Technical Sciences, University of Novi Sad, 21000 Novi Sad, Serbia; (S.K.); (G.M.S.)
- Correspondence:
| | - Sanja Kojić
- Faculty of Technical Sciences, University of Novi Sad, 21000 Novi Sad, Serbia; (S.K.); (G.M.S.)
| | - Bojan Petrović
- Department of Pediatric and Preventive Dentistry, Faculty of Medicine, Dentistry Clinic of Vojvodina, University of Novi Sad, 21000 Novi Sad, Serbia; (B.P.); (I.N.)
| | - Isidora Nešković
- Department of Pediatric and Preventive Dentistry, Faculty of Medicine, Dentistry Clinic of Vojvodina, University of Novi Sad, 21000 Novi Sad, Serbia; (B.P.); (I.N.)
| | - Goran M. Stojanović
- Faculty of Technical Sciences, University of Novi Sad, 21000 Novi Sad, Serbia; (S.K.); (G.M.S.)
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8
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Li QL, Yao MF, Cao RY, Zhao K, Wang XD. Survival Rates of Splinted and Nonsplinted Prostheses Supported by Short Dental Implants (≤8.5 mm): A Systematic Review and Meta-Analysis. J Prosthodont 2021; 31:9-21. [PMID: 34160869 DOI: 10.1111/jopr.13402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To evaluate and compare the implant survival rates, marginal bone loss, and mechanical complications of prostheses supported by splinted and nonsplinted short implants (≤8.5 mm). MATERIAL AND METHODS Electronic database (MEDLINE, CENTRAL, Web of Science, and EMBASE) and manual searches up to May 2021 were conducted to identify studies comparing splinted and nonsplinted short implants (≤8.5 mm). The primary outcome was implant survival rate. Secondary outcomes were marginal bone loss and mechanical complications. The quality of included studies and risk-of-bias were assessed according to the Newcastle-Ottawa Scale. A random-effects model was used to analyze the data. RESULTS Twelve studies fulfilled the inclusion criteria and featured 1506 short implants (596 nonsplinted and 910 splinted) with a follow-up time ranging from 1 to 16 years. Quantitative analysis found no statistically significant differences between splinted and nonsplinted short implants (≤8.5 mm) for survival rate (RR = 0.98; 95% CI 0.96, 1.01; p = 0.26)) and marginal bone loss (SMD = -0.08; 95% CI - 0.23, 0.07; p = 0.28). Veneer chipping, abutment screw breakage, screw loosening, and loss of retention were reported in the selected studies as common complications. However, no statistically significant difference was found between splinted and nonsplinted short implants (RR = 0.56; 95% CI 0.20, 1.54; p = 0.26). CONCLUSIONS Within the limitations of the present meta-analysis, it might be concluded that splinted short implants (≤8.5 mm) do not present superior performance in survival rate, marginal bone maintenance and prevention of mechanical complications compared with single-unit prostheses.
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Affiliation(s)
- Qiu-Lan Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Mian-Feng Yao
- Xiangya Hospital Central South University, Department of Stomatology, Changsha, Hunan, China
| | - Ruo-Yan Cao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Ke Zhao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Xiao-Dong Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
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9
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Cheung MC, Hopcraft MS, Darby IB. Dentists' preferences in implant maintenance and hygiene instruction. Aust Dent J 2021; 66:278-288. [PMID: 33538341 DOI: 10.1111/adj.12831] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study investigated the preferences of dentists in Australia in providing professional implant maintenance and implant-specific oral hygiene instructions (OHI). METHODS General dentists were surveyed online about their preferences in peri-implant diagnostics, maintenance provision, armamentarium used, and implant OHI techniques and frequency. RESULTS Most of the 303 respondents (96%) provided maintenance services; 87.6% reviewed implants regularly while 10.7% only performed diagnostics after detecting clinical signs/symptoms. Supragingival prosthesis cleaning was performed by 77.9% of respondents, 35.0% performed subgingival debridement, 41.9% treated peri-implant mucositis and 18.2% treated peri-implantitis. About 15% did not treat nor refer peri-implant disease, including significantly more non-implant providers and dentists without implant training. Maintenance armamentarium commonly included floss (76.3%), prophylaxis (73.9%), plastic curettes (43.3%) and stainless-steel ultrasonics (38.0%). Brushing (86.5%), flossing (73.9%) and interdental brush use (68.3%) were most commonly recommended. Implant OHI was repeated routinely by 57.4% of dentists who provided it. Dentists with greater implant training and experience were more likely to perform reviews and complex maintenance procedures. CONCLUSIONS Peri-implant diagnostics performed, treatments provided and armamentarium varied among dentists. Implant providers and those with higher levels of training had more preventative approaches to implant OHI. Possible shortcomings in disease management and OHI reinforcement were identified.
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Affiliation(s)
- M C Cheung
- Melbourne Dental School, The University of Melbourne, Melbourne, VIC, Australia
| | - M S Hopcraft
- Melbourne Dental School, The University of Melbourne, Melbourne, VIC, Australia
| | - I B Darby
- Melbourne Dental School, The University of Melbourne, Melbourne, VIC, Australia
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10
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Checchi V, Racca F, Bencivenni D, Lo Bianco L. Role of Dental Implant Homecare in Mucositis and Peri-implantitis Prevention: A Literature Overview. Open Dent J 2019. [DOI: 10.2174/1874210601913010470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Correlation between high plaque index and inflammatory lesions around dental implants has been shown and this highlights the importance of patient plaque control. Until now, knowledge of peri-implant home care practices has been based on periodontal devices.
Objective:
The aim of this overview is to identify the presence of scientific evidence that peri-implant homecare plays a role in mucositis and peri-implantitis prevention.
Methods:
Different databases were used in order to detect publications reflecting the inclusion criteria. The search looked into peri-implant homecare studies published from 1991 to 2019 and the terms used for the identification of keywords were: Dental implants, Brush, Interproximal brushing, Interdental brushing, Power toothbrush, Cleaning, Interdental cleaning, Interspace cleaning, Flossing, Super floss, Mouth rinses, Chlorhexidine. The type of studies included in the selection for this structured review were Randomized Clinical Trials, Controlled Clinical Trials, Systematic Reviews, Reviews, Cohort Studies and Clinical cases.
Results:
Seven studies fulfilled all the inclusion criteria: 3 RCTs, one Consensus report, one cohort study, one systematic review and one review. Other 14 studies that partially met the inclusion criteria were analyzed and classified into 3 different levels of evidence: good evidence for RCTs, fair evidence for case control and cohort studies and poor evidence for expert opinion and case report.
Conclusion:
Not much research has been done regarding homecare implant maintenance. Scientific literature seems to show little evidence regarding these practices therefore most of the current knowledge comes from the periodontal literature. Manual and powered toothbrushes, dental floss and interdental brushes seem to be useful in maintaining peri-implant health. The use of antiseptic rinses or gels does not seem to have any beneficial effects.
It can be concluded that to better understand which are the most effective home care practices to prevent mucositis and peri-implantitis in implant-rehabilitated patients, new specific high evidence studies are needed.
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11
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Cortellini S, Favril C, De Nutte M, Teughels W, Quirynen M. Patient compliance as a risk factor for the outcome of implant treatment. Periodontol 2000 2019; 81:209-225. [PMID: 31407429 DOI: 10.1111/prd.12293] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Peri-implantitis can be explained using a multicausality model. Many factors are involved in the etiology of peri-implantitis, but patient compliance also plays a key role. Oral hygiene, attending recall visits, smoking behavior, and therapy comprehension are relevant factors that contribute to peri-implant health. The clinician should create the most optimal conditions for patients to facilitate adequate oral self-care and to help patients improve their oral hygiene skills. Implementation of a supportive periodontal therapy program is mandatory to control inflammation and plaque accumulation, as well as to keep the incidence of peri-implant diseases low. Patient compliance, including plaque control and dental follow-up, must be optimal. Consequently, precautions must be taken with patients treated with dental implants.
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Affiliation(s)
- Simone Cortellini
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Charlotte Favril
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Mathieu De Nutte
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Wim Teughels
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Marc Quirynen
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
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12
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Abstract
PURPOSE Patient-administered and professionally administered periimplant maintenance have been recommended to ensure long-term periimplant tissue health. In this narrative review, the effectiveness of patient and professionally administered interventions and the current level of evidence that periimplant maintenance therapy is effective in preventing the occurrence of periimplant disease were examined. MATERIALS AND METHODS A systematic literature search was performed in Ovid MEDLINE, EMBASE, Cochrane Library, and Web of Science, for evidence-based articles in support of the above topics. RESULTS Twenty-six clinical trials were included and stratified into categories based on topics. CONCLUSIONS The following conclusions were reached: (a) mechanical plaque removal is the foundation of successful periimplant therapy; (b) patient- and professionally administered plaque control has been shown to reduce periimplant inflammation, although complete resolution of inflammation is not always evident; (c) the use of adjunctive chemical agents in maintaining periimplant health still remains to be determined; and (d) regular periimplant maintenance plays a significant role in maintaining periimplant soft and hard tissue health.
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13
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French D, Naito M, Linke B. Interproximal contact loss in a retrospective cross-sectional study of 4325 implants: Distribution and incidence and the effect on bone loss and peri-implant soft tissue. J Prosthet Dent 2019; 122:108-114. [DOI: 10.1016/j.prosdent.2018.11.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 11/25/2018] [Accepted: 11/26/2018] [Indexed: 11/27/2022]
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14
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Ng E, Lim LP. An Overview of Different Interdental Cleaning Aids and Their Effectiveness. Dent J (Basel) 2019; 7:dj7020056. [PMID: 31159354 PMCID: PMC6630384 DOI: 10.3390/dj7020056] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 04/22/2019] [Accepted: 05/05/2019] [Indexed: 11/24/2022] Open
Abstract
Optimisation of plaque control is essential for the success of non-surgical and surgical periodontal therapy. This cannot be achieved with brushing alone; hence, there is a need for adjunctive interdental cleaning aids. The aim of this paper is to provide an overview of different interdental cleaning aids and review the literature for consensus on their effectiveness. A literature search of articles in English, up to December 2018, was conducted in Pubmed. High-quality flossing is difficult to achieve, and ineffective routine use of floss may not confer significant benefits over brushing alone. Interdental brushes are more effective than brushing as a monotherapy. They are at least as good if not superior to floss in reducing plaque and gingivitis. Although they are effective for patients regardless of their periodontal status (healthy or active), they are especially indicated in periodontal patients where widened embrasures are common. Added benefits include ease of use, patient acceptance, and recontouring of interdental tissues. Rubberpiks do not demonstrate inferiority to conventional interdental brushes. Wooden interdental aids appear to offer no significant advantage over brushing with respect to plaque removal; they may, however, reduce gingival bleeding. Oral irrigators are a promising tool for reducing gingival inflammation, despite minimal changes to plaque levels. For cleaning around dental implants, oral irrigators and interdental brushes are preferred over floss.
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Affiliation(s)
- Ethan Ng
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, 11 Lower Kent Ridge Road, Singapore 119083, Singapore.
- Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore.
| | - Lum Peng Lim
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, 11 Lower Kent Ridge Road, Singapore 119083, Singapore.
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15
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Tuna T, Kuhlmann L, Bishti S, Sirazitdinova E, Deserno T, Wolfart S. Removal of simulated biofilm at different implant crown designs with interproximal oral hygiene aids: An
in vitro
study. Clin Oral Implants Res 2019; 30:627-636. [DOI: 10.1111/clr.13448] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 03/02/2019] [Accepted: 04/02/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Taskin Tuna
- Department of Prosthodontics and Biomaterials RWTH University Aachen Germany
| | - Lena Kuhlmann
- Department of Prosthodontics and Biomaterials RWTH University Aachen Germany
| | - Shaza Bishti
- Department of Prosthodontics and Biomaterials RWTH University Aachen Germany
| | - Ekaterina Sirazitdinova
- Department of Medical Informatics, Division of Image and Data Management RWTH University Aachen Germany
| | - Thomas Deserno
- Department of Medical Informatics, Division of Image and Data Management RWTH University Aachen Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials RWTH University Aachen Germany
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16
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Bidra AS, Persenaire MJ, Natarajan E. Management of peripheral giant cell granuloma around complete-arch fixed implant-supported prosthesis: A case series. J Prosthet Dent 2019; 122:181-188. [PMID: 31027952 DOI: 10.1016/j.prosdent.2019.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 11/15/2022]
Abstract
Abnormal peri-implant tissue response in the form of benign reactive lesions, such as peripheral giant cell granuloma and pyogenic granuloma, is a less frequent biologic complication associated with dental implant therapy. However, these lesions can cause gingival pain, swelling, and discomfort, as well as peri-implant bone loss and possible implant failure. Few reports in the dental literature have described these lesions around complete-arch fixed implant-supported prostheses. The purpose of this clinical report was to describe 3 distinct scenarios in patients with complete-arch fixed implant-supported prostheses presenting with benign reactive lesions that were histologically diagnosed as peripheral giant cell granulomas. Each of these 3 patients had acrylic resin as one of the materials in their prosthesis. The distinctive management of each of these 3 patients encompassed surgical, prosthodontic, and pharmacologic means.
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Affiliation(s)
- Avinash S Bidra
- Program Director and Maxillofacial Prosthodontist, Post-Graduate Prosthodontics, University of Connecticut Health Center, Farmington, Conn; Private practice, Meriden, Conn.
| | | | - Easwar Natarajan
- Associate Professor, Section of Oral Pathology, University of Connecticut Health Center, Farmington, Conn
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17
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DiBenedetto D. Study questions. J Am Dent Assoc 2019; 150:241. [DOI: 10.1016/j.adaj.2019.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Understanding Peri-Implantitis as a Plaque-Associated and Site-Specific Entity: On the Local Predisposing Factors. J Clin Med 2019; 8:jcm8020279. [PMID: 30823574 PMCID: PMC6406659 DOI: 10.3390/jcm8020279] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 12/22/2022] Open
Abstract
The prevalence of implant biological complications has grown enormously over the last decade, in concordance with the impact of biofilm and its byproducts upon disease development. Deleterious habits and systemic conditions have been regarded as risk factors for peri-implantitis. However, little is known about the influence of local confounders upon the onset and progression of the disease. The present narrative review therefore describes the emerging local predisposing factors that place dental implants/patients at risk of developing peri-implantitis. A review is also made of the triggering factors capable of inducing peri-implantitis and of the accelerating factors capable of interfering with the progression of the disease.
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19
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Wohlfahrt JC, Aass AM, Koldsland OC. Treatment of peri‐implant mucositis with a chitosan brush—A pilot randomized clinical trial. Int J Dent Hyg 2019; 17:170-176. [DOI: 10.1111/idh.12381] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 07/02/2018] [Accepted: 12/19/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Johan Caspar Wohlfahrt
- Department of Periodontology, Institute of Clinical Dentistry University of Oslo Oslo Norway
| | - Anne M. Aass
- Department of Periodontology, Institute of Clinical Dentistry University of Oslo Oslo Norway
| | - Odd C. Koldsland
- Department of Periodontology, Institute of Clinical Dentistry University of Oslo Oslo Norway
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20
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Ravidà A, Saleh MHA, Muriel MC, Maska B, Wang HL. Biological and Technical Complications of Splinted or Nonsplinted Dental Implants: A Decision Tree for Selection. IMPLANT DENT 2018; 27:89-94. [PMID: 29283896 DOI: 10.1097/id.0000000000000721] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To present an in-depth review on splinting versus nonsplinting the restorations of adjacent dental implants, in addition to discussing biological and technical complications associated with either choice; and to provide the clinician with a decision tree that serves in everyday judgments when it comes to addressing this issue. MATERIALS AND METHODS A comprehensive literature review was performed for articles comparing success of splinted versus nonsplinted dental implants. RESULTS There is no evidence to suggest that implementing either prosthetic design results in higher implant survival. Both designs tend to have their own set of complications, but there is compelling evidence to suggest that splinted restorations generally have less technical complications. CONCLUSION Either splinting or nonsplinting are valid options for restoring adjacent implants, but each tend to face different biological and technical complications. Knowing which patients are more likely to face particular complications is strategic to provide patients with successful restorations.
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Affiliation(s)
- Andrea Ravidà
- Post-Doctoral Student, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Muhammad H A Saleh
- Post-Doctoral Student, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | | | - Bartosz Maska
- Graduate Resident, Deparment of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Hom-Lay Wang
- Professor and Director of Graduate Periodontics, Deparment of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
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21
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Monje A, Caballé-Serrano J, Nart J, Peñarrocha D, Wang HL, Rakic M. Diagnostic accuracy of clinical parameters to monitor peri-implant conditions: A matched case-control study. J Periodontol 2018; 89:407-417. [DOI: 10.1002/jper.17-0454] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/19/2017] [Accepted: 10/20/2017] [Indexed: 01/28/2023]
Affiliation(s)
- Alberto Monje
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor MI
- Department of Oral Surgery and Stomatology; ZMK School of Dentistry; Bern CH
- Department of Periodontology; Universitat Internacional de Catalunya; Barcelona Spain
| | - Jordi Caballé-Serrano
- Department of Oral and Maxillofacial Surgery; Universitat Internacional de Catalunya; Barcelona Spain
| | - Jose Nart
- Department of Periodontology; Universitat Internacional de Catalunya; Barcelona Spain
| | - David Peñarrocha
- Department of Oral Surgery; Universitat de Valencia; Valencia Spain
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor MI
| | - Mia Rakic
- INSERM UMR-1229 RMeS; Faculty of Dental Surgery; University of Nantes; Nantes France
- Institute for Biological Research “Sinisa Stankovic”; University of Belgrade; Belgrade Serbia
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22
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Goh EXJ, Lim LP. Implant maintenance for the prevention of biological complications: Are you ready for the next challenge? JOURNAL OF INVESTIGATIVE AND CLINICAL DENTISTRY 2017; 8. [PMID: 27987273 DOI: 10.1111/jicd.12251] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 10/07/2016] [Indexed: 11/29/2022]
Abstract
With increasing knowledge of wound biology and material sciences, the provision of dental implants as a treatment modality has become increasingly predictable and more commonly used to replace missing teeth. However, without appropriate follow up, peri-implant diseases could develop and affect the long-term success of implants. Currently, there is not enough focus on the prevention of peri-implant diseases, as compared to the definition of the disease, its prevalence, and treatment. In the present study, we aim to summarize various factors influencing the successful maintenance of dental implants and highlight current gaps in knowledge. Factors influencing the successful maintenance of dental implants can be divided into three categories: implant-, dentist-, and patient-related factors. Patients with dental implants are often more dentally aware, and this offers an advantage. Compared to gingiva, peri-implant mucosa responds at a different pace to the bacterial challenge. Dental practitioners should be aware of how treatment protocols affect long-term success, and be vigilant in detecting peri-implant diseases at an early stage. Compared to periodontal maintenance, less longitudinal studies on implant maintenance are available, and therefore, there is a tendency to rely heavily on information extrapolated from the periodontal literature. More studies on the significance of implant maintenance care are required.
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Affiliation(s)
- Edwin X J Goh
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore
| | - Lum Peng Lim
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore
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23
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Wohlfahrt JC, Evensen BJ, Zeza B, Jansson H, Pilloni A, Roos-Jansåker AM, Di Tanna GL, Aass AM, Klepp M, Koldsland OC. A novel non-surgical method for mild peri-implantitis- a multicenter consecutive case series. Int J Implant Dent 2017; 3:38. [PMID: 28776288 PMCID: PMC5543013 DOI: 10.1186/s40729-017-0098-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 07/13/2017] [Indexed: 12/17/2022] Open
Abstract
AIM The aim of the present study was to evaluate the effect on peri-implant mucosal inflammation from the use of a novel instrument made of chitosan in the non-surgical treatment of mild peri-implantitis across several clinical centers. MATERIALS AND METHODS In this 6-month multicenter prospective consecutive case series performed in six different periodontal specialist clinics, 63 implants in 63 patients were finally included. The subjects had mild peri-implantitis defined as radiographic bone loss of 1-2 mm, pocket probing depth (PPD) ≥4 mm and a positive bleeding on probing (mBoP) score. The patients were clinically examined at baseline and after 2, 4, 12 and 24 weeks, and radiographs were taken at baseline and at 3 and 6 months. Treatment of the implants with the chitosan brush seated in an oscillating dental drill piece was performed at baseline and at 3 months. Reductions in the clinical parameters (PPD and mBoP) were compared between baseline and the later examination time points. RESULTS Significant reductions in both PPD and mBoP were observed at all time points compared with the baseline clinical measurements (p < 0.001). The mean PPD and mBoP at baseline were 5.15 mm (4.97; 5.32) and 1.86 (1.78; 1.93), respectively, whereas the mean PPD and mBoP at 6 months were 4.0 mm (3.91; 4.19) and 0.64 (0.54; 0.75), respectively. Stable reductions in PPD and mBoP were evident up to 6 months after the initial treatment and 3 months after the second treatment. All 63 implants were reported to have stable radiographic levels of osseous support. CONCLUSIONS This case series demonstrated that an oscillating chitosan brush is safe to use and seems to have merits in the non-surgical treatment of dental implants with mild peri-implantitis. To measure the effectiveness of the method, a multicenter randomized clinical trial needs to be undertaken.
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Affiliation(s)
- J C Wohlfahrt
- Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Pb. 1109 Blindern, 0317, Oslo, Norway.
| | | | - B Zeza
- Department of Dental and Maxillofacial Sciences, Section of Periodontology, Sapienza, University of Rome, Rome, Italy
| | - H Jansson
- Center for Oral Health, Department of Natural Science and Biomedicine, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - A Pilloni
- Department of Dental and Maxillofacial Sciences, Section of Periodontology, Sapienza, University of Rome, Rome, Italy
| | - A M Roos-Jansåker
- Department of Periodontology, Public Dental Health Service, Kristianstad, Sweden.,Department of Periodontology, Public Specialist Dental Clinic, Karlskrona, Sweden
| | - G L Di Tanna
- Center for Primary Care and Public Health, Queen Mary University of London, London, UK
| | - A M Aass
- Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Pb. 1109 Blindern, 0317, Oslo, Norway
| | - M Klepp
- Private Practice, Stavanger, Norway
| | - O C Koldsland
- Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Pb. 1109 Blindern, 0317, Oslo, Norway
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24
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Ken Y, Tachikawa N, Kasugai S. Differences in knowledge related to dental implants between patients with and without a treatment history of dental implants. Clin Oral Implants Res 2016; 28:1062-1066. [PMID: 27402338 DOI: 10.1111/clr.12918] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2016] [Indexed: 12/28/2022]
Affiliation(s)
- Yukawa Ken
- Dental Implant Clinic; Tokyo Medical and Dental University; Tokyo Japan
| | - Noriko Tachikawa
- Dental Implant Clinic; Tokyo Medical and Dental University; Tokyo Japan
| | - Shohei Kasugai
- Oral Implantology and Regenerative Dental Medicine; Tokyo Medical and Dental University; Tokyo Japan
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25
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Dalago HR, Schuldt Filho G, Rodrigues MAP, Renvert S, Bianchini MA. Risk indicators for Peri-implantitis. A cross-sectional study with 916 implants. Clin Oral Implants Res 2016; 28:144-150. [DOI: 10.1111/clr.12772] [Citation(s) in RCA: 137] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Haline Renata Dalago
- Implant Dentistry; Federal University of Santa Catarina (UFSC); Florianópolis Brazil
| | - Guenther Schuldt Filho
- Implant Dentistry; Federal University of Santa Catarina (UFSC); Florianópolis Brazil
- Universität Bern; Bern Switzerland
| | | | - Stefan Renvert
- Department of Health Sciences; Kristianstad University; Kristianstad Sweden
- Blekinge Institute of Technology; Karlskrona Sweden
- School of Dental Sciences; Trinity College; Dublin Ireland
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