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Zhang L, Zhou C, Jiang J, Chen X, Wang Y, Xu A, He F. Clinical outcomes and risk factor analysis of dental implants inserted with lateral maxillary sinus floor augmentation: A 3- to 8-year retrospective study. J Clin Periodontol 2024; 51:652-664. [PMID: 38246602 DOI: 10.1111/jcpe.13947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 12/11/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
AIM To evaluate the 3- to 8-year outcomes of dental implants placed with lateral sinus floor augmentation (LSFA) and to identify factors affecting implant survival. MATERIALS AND METHODS This retrospective study was performed by screening all implants placed with LSFA procedures, which were conducted between January 2012 and December 2016. Subantral bone gain (SABG) and apical bone height (ABH) were assessed using panoramic radiographs. The cumulative survival rate of implants was analysed using life-table analysis and Kaplan-Meier survival curves. The influential risk factors affecting survival were assessed using univariate log-rank tests and multivariable mixture cure rate model. Implant complications were recorded. RESULTS Based on the established criteria, a total of 449 patients (760 implants) were included in this study. In the 3- to 8-year follow-up (mean ± SD, 5.81 ± 1.33 years), 15 implants in 14 patients failed, with a CRS of 96.81% on an implant basis and 95.07% on a patient basis. A history of periodontitis and poor compliance with supportive periodontal treatment was associated with a significantly higher risk of implant failure at both implant and patient levels. Significant decreases in ABH occurred during each yearly interval except for 3 years. A similar trend has been observed for SABG at 1, 2, 6 and 8 years. The total complication rate was 31.84% on implant basis, with peri-implant mucositis (21.58%) being the most frequent biologic complication and porcelain cracking (5.00%) being the most common technical complication. CONCLUSIONS Implant with LSFA is a reliable treatment option in atrophic maxilla. A history of periodontitis without regular supportive periodontal treatment was identified as a predictor for implant failure. Slight but significant shrinkage of vertically augmented bone can be observed after implant placement.
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Affiliation(s)
- Liefen Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Chuan Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Jimin Jiang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xiaoyu Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yaoqiong Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Antian Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Fuming He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
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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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Donos N, Akcali A, Padhye N, Sculean A, Calciolari E. Bone regeneration in implant dentistry: Which are the factors affecting the clinical outcome? Periodontol 2000 2023; 93:26-55. [PMID: 37615306 DOI: 10.1111/prd.12518] [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: 02/10/2023] [Revised: 07/08/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
The key factors that are needed for bone regeneration to take place include cells (osteoprogenitor and immune-inflammatory cells), a scaffold (blood clot) that facilitates the deposition of the bone matrix, signaling molecules, blood supply, and mechanical stability. However, even when these principles are met, the overall amount of regenerated bone, its stability over time and the incidence of complications may significantly vary. This manuscript provides a critical review on the main local and systemic factors that may have an impact on bone regeneration, trying to focus, whenever possible, on bone regeneration simultaneous to implant placement to treat bone dehiscence/fenestration defects or for bone contouring. In the future, it is likely that bone tissue engineering will change our approach to bone regeneration in implant dentistry by replacing the current biomaterials with osteoinductive scaffolds combined with cells and mechanical/soluble factors and by employing immunomodulatory materials that can both modulate the immune response and control other bone regeneration processes such as osteogenesis, osteoclastogenesis, or inflammation. However, there are currently important knowledge gaps on the biology of osseous formation and on the factors that can influence it that require further investigation. It is recommended that future studies should combine traditional clinical and radiographic assessments with non-invasive imaging and with patient-reported outcome measures. We also envisage that the integration of multi-omics approaches will help uncover the mechanisms responsible for the variability in regenerative outcomes observed in clinical practice.
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Affiliation(s)
- Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aliye Akcali
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Periodontology, Faculty of Dentistry, Dokuz Eylul University, Izmir, Turkey
| | - Ninad Padhye
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Medicine and Dentistry, Dental School, University of Parma, Parma, Italy
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Roccuzzo A, Imber JC, Salvi GE, Roccuzzo M. Peri-implantitis as the consequence of errors in implant therapy. Periodontol 2000 2023; 92:350-361. [PMID: 36744582 DOI: 10.1111/prd.12482] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 09/04/2022] [Accepted: 12/22/2022] [Indexed: 02/07/2023]
Abstract
Peri-implantitis is a plaque-associated pathologic condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone. It is a highly prevalent disease, as extensively estimated by large-population, cross-sectional studies. As peri-implant diseases represent opportunistic infections, it is reasonable to assume that nonideal conditions, local and/or general, may favor the progression of peri-implant inflammation. Some of these conditions could be a result of poor planning and/or inadequate execution of any step of the entire process treatment. This article describes the major possible factors in implant therapy that may lead to peri-implantitis. For some of these (ie, inappropriate patient selection, insufficient periodontal therapy, lack of diagnosis and management of peri-implant mucositis, erratic supportive peri-implant/periodontal therapy) there is a good level of evidence, whereas for others (ie, wrong implant placement, poor postoperative care, inadequate prosthetic reconstruction, lack of assessment and management of peri-implant soft-tissue deficiencies) there is little scientific evidence. More research is therefore needed to clearly identify the errors and/or complications possibly leading to peri-implantitis, particularly over the long term.
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Affiliation(s)
- Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Oral and Maxillo-Facial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni Edoardo Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mario Roccuzzo
- Specialist Periodontal Private Practice, Torino, Italy
- Division of Maxillo-facial Surgery, University of Torino, Torino, Italy
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Teixeira JFL, de Souza JAC, Magalhães FAC, de Oliveira GJPL, de Santis JB, de Souza Costa CA, de Souza PPC. Laser-Modified Ti Surface Improves Paracrine Osteogenesis by Modulating the Expression of DKK1 in Osteoblasts. J Funct Biomater 2023; 14:jfb14040224. [PMID: 37103314 PMCID: PMC10145280 DOI: 10.3390/jfb14040224] [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: 02/08/2023] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 04/28/2023] Open
Abstract
Titanium surface modifications are widely used to modulate cellular behavior by recognition of topographical cues. However, how those modifications affect the expression of mediators that will influence neighboring cells is still elusive. This study aimed to evaluate the effects of conditioned media from osteoblasts cultured on laser-modified titanium surfaces on the differentiation of bone marrow cells in a paracrine manner and to analyze the expression of Wnt pathway inhibitors. Mice calvarial osteoblasts were seeded on polished (P) and Yb:YAG laser-irradiated (L) Ti surfaces. Osteoblast culture media were collected and filtered on alternate days to stimulate mice BMCs. Resazurin assay was performed every other day for 20 days to check BMC viability and proliferation. After 7 and 14 days of BMCs maintained with osteoblasts P and L-conditioned media, alkaline phosphatase activity, Alizarin Red staining, and RT-qPCR were performed. ELISA of conditioned media was conducted to investigate the expression of Wnt inhibitors Dickkopf-1 (DKK1) and Sclerostin (SOST). BMCs showed increased mineralized nodule formation and alkaline phosphatase activity. The L-conditioned media enhanced the BMC mRNA expression of bone-related markers Bglap, Alpl, and Sp7. L-conditioned media decreased the expression of DKK1 compared with P-conditioned media. The contact of osteoblasts with Yb:YAG laser-modified Ti surfaces induces the regulation of the expression of mediators that affect the osteoblastic differentiation of neighboring cells. DKK1 is among these regulated mediators.
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Affiliation(s)
- Jorge Felipe Lima Teixeira
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara 14801-385, Brazil
| | | | | | | | - José Bernardo de Santis
- Department of Basic and Oral Biology, Bone Research Lab, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara 14801-385, Brazil
| | - Pedro Paulo Chaves de Souza
- Innovation in Biomaterials Laboratory (iBioM), School of Dentistry, Federal University of Goiás, Goiânia 74605-020, Brazil
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Fatigue Resistance of Dissected Lower First Molars Restored with Direct Fiber-Reinforced Bridges—An In Vitro Pilot Study. Polymers (Basel) 2023; 15:polym15061343. [PMID: 36987124 PMCID: PMC10053716 DOI: 10.3390/polym15061343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 03/10/2023] Open
Abstract
The aim of this research was to evaluate the mechanical impact of utilizing different fiber-reinforced composite (FRC) systems to reinforce inlay-retained bridges in dissected lower molars with different levels of periodontal support. A total of 24 lower first molars and 24 lower second premolars were included in this study. The distal canal of all molars received endodontic treatment. After root canal treatment, the teeth were dissected, and only the distal halves were kept. Standardized class II occluso-distal (OD) (premolars) and mesio-occlusal (MO) (dissected molars) cavities were prepared in all teeth, and premolar–molar units were created. The units were randomly distributed among four groups (n = six/group). With the aid of a transparent silicone index, direct inlay-retained composite bridges were fabricated. In Groups 1 and 2, both discontinuous (everX Flow) and continuous (everStick C&B) fibers were used for reinforcement, while in Groups 3 and 4, only discontinuous fibers (everX Flow) were used. The restored units were embedded in methacrylate resin, simulating either physiological periodontal conditions or furcation involvement. Subsequently, all units underwent fatigue survival testing in a cyclic loading machine until fracture, or a total of 40,000 cycles. Kaplan–Meyer survival analyses were conducted, followed by pairwise log-rank post hoc comparisons. Fracture patterns were evaluated visually and with scanning electron microscopy. In terms of survival, Group 2 performed significantly better than Groups 3 and 4 (p < 0.05), while there was no significant difference between the other groups. In the case of impaired periodontal support, a combination of both continuous and discontinuous short FRC systems increased the fatigue resistance of direct inlay-retained composite bridges compared to bridges that only contained short fibers. Such a difference was not found in the case of sound periodontal support between the two different bridges.
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Alhakeem M, Kanounisabet N, Nowzari H, Aslroosta H, Moslemi N. Risk indicators of long-term outcome of implant therapy in patients with a history of severe periodontitis or no history of periodontitis: A retrospective cohort study. Int J Dent Hyg 2023; 21:227-237. [PMID: 35090086 DOI: 10.1111/idh.12587] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of this retrospective cohort study was to assess factors associated with peri-implant disease in partially edentulous patients with a history of severe periodontitis or no history of periodontitis. METHODS Partially edentulous patients with a history of severe periodontitis/without history of periodontitis who received implant surgery within the past 6 to 8 years were recalled. Clinical and radiographic examinations were recorded. Periodontal probing depth, marginal bone loss (MBL) and peri-implantitis were considered as the primary outcome and peri-implant bleeding on probing (BOP) was considered as the secondary outcome. The following criteria were considered as the predictors, as well: history of severe periodontitis, gender, age, smoking, brushing frequency, recall interval, full-mouth plaque score, full-mouth bleeding score, splinted prosthesis, open/tight interproximal contact, width of keratinized mucosa, mucosal thickness, implants placed in the grafted bone and implant type. Univariate and multivariate regression analyses were utilized. RESULTS A total of 88 patients (186 implants) fulfilled the study. Forty-seven patients (108 implants) had a history of severe periodontitis and 41 patients (78 implants) had no history of periodontitis. There was a higher chance of peri-implantitis in patients with a history of severe periodontitis (OR = 11.13; p = 0.045), implants with lack of peri-implant KM (<2 mm) and implants placed in the grafted bone (OR = 14.94, p < 0.001; OR = 4.93, p = 0.047). The risk of peri-implant MBL ≥3 mm was higher in patients with greater FMBS (OR = 1.20; p < 0.001). The chance of peri-implant BOP was independently higher in patients who brushed their teeth at most once per day (OR = 3.20; p = 0.04), higher FMBS (OR = 1.16; p < 0.001) and irregular recall visits (OR = 15.34; p = 0.001). CONCLUSIONS Partially edentulous patients with the history of severe periodontitis, lack of peri-implant KM and implants placed in bone-grafted sites expressed higher probability of peri-implantitis. In addition, inadequate frequency of brushing (at most once daily) and irregular recall visits were associated with greater chance of peri-implant BOP.
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Affiliation(s)
- Mohammed Alhakeem
- Department of Periodontology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Kanounisabet
- Department of Periodontology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hessam Nowzari
- Diplomate of American Board of Periodontology, Beverly Hills, California, USA
| | - Hoori Aslroosta
- Department of Periodontology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Moslemi
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Correia F, Gouveia SA, Pozza DH, Felino AC, Faria-Almeida R. A Randomized Clinical Trial Comparing Implants Placed in Two Different Biomaterials Used for Maxillary Sinus Augmentation. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1220. [PMID: 36770223 PMCID: PMC9919245 DOI: 10.3390/ma16031220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/17/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
The objective of this study was to compare marginal bone loss, surgical and clinical complications, and dental implant survival rate in bilateral maxillary sinus augmented by autologous or porcine xenograft. A randomized controlled clinical trial using split-mouth design enrolled 12 consent adult patients (59.7 ± 8.7 years), who received bilateral maxillary sinus floor augmentation for oral rehabilitation with implant-supported prosthesis. Each patient received both the autologous bone from the mandible (control) or porcine xenograft (test) during the random bilateral sinus lift surgery. A total of 39 dental implants were placed in the posterior maxilla of the 12 patients after 6 months, being rehabilitated after the respective osseointegration period. Both graft materials demonstrated a high implant survival rate at 12 months: 95% for the xenograft side, only 1 implant without osseointegration, and 100% for the autologous side. Radiographic bone loss was low and similar for both groups: control group with a mean of 0.063 ± 0.126, and test group with a mean of 0.092 ± 0.163. No major surgical-related complications have occurred. Only one patient had several prosthetic complications due to fractures of prosthetic components. The maxillary sinus augmentation procedure, both with autologous bone and porcine xenograft materials, is an excellent clinical option procedure for the prosthetic rehabilitation of atrophic maxillae, with low marginal bone loss after one year follow-up, few clinical complications, and a high implant survival rate.
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Affiliation(s)
- Francisco Correia
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
| | - Sónia Alexandre Gouveia
- Intelligent Systems Associate Laboratory (LASI), Department of Electronics, Telecommunications and Informatics (DETI), Institute of Electronics and Informatics Engineering of Aveiro (IEETA), University of Aveiro, 3810-193 Aveiro, Portugal
| | - Daniel Humberto Pozza
- Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Department of Histology, Faculty of Nutrition and Food Sciences, University of Porto, 4150-177 Porto, Portugal
- Institute for Research and Innovation in Health and IBMC, University of Porto, 4200-135 Porto, Portugal
| | - António Campos Felino
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
| | - Ricardo Faria-Almeida
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
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Donos N, Calciolari E, Ghuman M, Baccini M, Sousa V, Nibali L. The efficacy of bone reconstructive therapies in the management of peri-implantitis. A systematic review and meta-analysis. J Clin Periodontol 2023. [PMID: 36635029 DOI: 10.1111/jcpe.13775] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/14/2023]
Abstract
AIM To evaluate the efficacy of bone reconstructive procedures for the reduction of probing pocket depth (PPD), bleeding on probing (BOP), and suppuration in peri-implantitis-related bone defects at ≥12-month follow-up. MATERIALS AND METHODS Three databases were searched for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that compared bone reconstructive therapies to access flap surgery (AFS) (Focused Question-FQ 1), and RCTs, CCTs, and prospective case series that assessed the efficacy of reconstructive therapies (FQ 2). Meta-analysis was performed for FQ1 when more than three studies were identified, while for FQ2 a network was drawn based on RCTs with common treatment arms. RESULTS Seven RCTs were identified for FQ1 while five RCTs and six prospective case series for FQ2. There was no significant difference in PPD change between AFS and reconstructive surgery (-0.387; p = .325) at 12 months. Furthermore, no clear differences in terms of PPD and BOP changes resulted from the different reconstructive therapies included in the network. Only a small percentage of treated cases with any modality achieved peri-implantitis resolution, as defined by different composite outcomes. CONCLUSIONS Reconstructive surgery does not offer significant improvements in peri-implant clinical parameters as compared to AFS at 12 months. It was not possible to establish a hierarchy of efficacy among the different biomaterials employed for reconstructive surgery.
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Affiliation(s)
- Nikos Donos
- Centre for Oral Clinical Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Elena Calciolari
- Centre for Oral Clinical Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Centro di Odontoiatria, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Mandeep Ghuman
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, Guy's Hospital, London, UK
| | - Michela Baccini
- Dipartimento di Statistica, Informatica, Applicazioni 'G. Parenti' (DiSIA), University of Florence, Florence, Italy
| | - Vanessa Sousa
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, Guy's Hospital, London, UK
| | - Luigi Nibali
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, Guy's Hospital, London, UK
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Cai B, Tong Z, Qian Y, Zhu W, Lu Y, Si M. Immediate loaded fixed complete dentures supported by implants in patients with a history of periodontitis: A retrospective cohort study of 2 to 7 years. J Prosthet Dent 2023; 129:125-130. [PMID: 36089545 DOI: 10.1016/j.prosdent.2022.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 01/18/2023]
Abstract
STATEMENT OF PROBLEM The outcome of implant-supported fixed complete dentures in edentulous patients with a history of periodontitis is unclear. PURPOSE The purpose of this retrospective clinical study was to assess the clinical outcomes of immediate loaded fixed complete dentures in individuals with a history of periodontitis and to analyze risk factors related to implant failure. MATERIAL AND METHODS A total of 642 implants (146 prostheses) in 119 patients were included. The follow-up period ranged from 2 to 7 years. Implant survival rates, marginal bone loss, mechanical complications, biologic complications, and patient satisfaction were evaluated. The Pearson chi-square test, independent samples t test, and multivariate generalized estimating equation were performed for statistical analysis (α=.05). RESULTS Eleven implants in 9 patients failed, leading to overall survival rates of 98.3% at the implant level and 92.4% at the patient level. The mean ±standard deviation marginal bone loss was 0.62 ±0.86 mm, and marginal bone loss did not differ significantly between axial and tilted implants (P>.05). Mechanical complications were detected in 55 (37.7%) definitive prostheses; biologic complications were detected in 318 (49.5%) implants. Smokers had a significantly lower survival rate than nonsmokers (odds ratio: 6.880, P=.013). Bruxers had a significantly higher incidence of mechanical complications than nonbruxers (P<.001). CONCLUSIONS The immediate loaded fixed complete denture supported by implants is a suitable treatment option for edentulous patients with a history of periodontitis, with high survival implant rates. Smoking is a risk factor for implant failure. Bruxism may increase the incidence of mechanical complications with implant-supported fixed complete dentures, and the overall biologic complication incidence is comparatively high.
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Affiliation(s)
- Bobo Cai
- Graduate student, Graduate Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Zhejiang, PR China
| | - Zian Tong
- Resident, Department of Oral Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Zhejiang, PR China
| | - Yinjie Qian
- Graduate student, Graduate Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Zhejiang, PR China
| | - Weijun Zhu
- Graduate student, Graduate Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Zhejiang, PR China
| | - Yifan Lu
- Graduate student, Graduate Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Zhejiang, PR China
| | - Misi Si
- Associate Professor, Department of Oral Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Zhejiang, PR China.
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11
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Sarafidou K, Lazaridi I, Gotsis S, Kirmanidou Y, Vasilaki D, Hirayama H, Michalakis K. Tooth preservation vs. extraction and implant placement in periodontally compromised patients: A systematic review and analysis of studies. J Prosthodont 2022; 31:e87-e99. [PMID: 35794083 DOI: 10.1111/jopr.13560] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/11/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this systematic review was to identify studies with a minimum of 5-years follow-up, reporting on the management of periodontally compromised teeth with either extraction and subsequent implant placement or teeth preservation with conventional periodontal treatment and application of regenerative procedures. The outcomes of these two approaches, based on clinical and radiographic data and the incidence of tooth- and implant-loss, were also investigated. MATERIAL AND METHODS A systematic search for studies reporting on clinical and radiographic outcomes of periodontal treatment or replacement of periodontally compromised teeth with implants was conducted in 3 electronic databases, followed by a hand-search in 8 journals. Only randomized controlled trials (RCTs), cohort studies, and case series with prospective design were included. RESULTS The initial search resulted in 1080 papers. After the first two screenings, 24 publications were selected for inclusion in this systematic review. The treatment protocols for the teeth preservation group contained nonsurgical and/or surgical periodontal treatment with or without regeneration procedures. The implant studies included extraction of periodontally involved teeth and implant placement with or without bone and soft tissue augmentation, followed by restoration with fixed dental prostheses (FDPs). Survival rates ranged between 81.8% and 100% in the tooth retention group, and between 94.8% and 100% in the implant group. In the extraction group, no complications were reported for 76.09% of the implants. Similarly, no complications were reported for 86.83% of the tooth retention group. The lack of standardized comparable studies prohibited conduction of a metaanalysis. CONCLUSION Both treatment approaches, treatment of periodontally compromised teeth, or tooth extraction followed by implant placement, present high survival rates. The application of bone regeneration techniques improves the long-term prognosis of periodontally involved teeth. Hence, treatment of periodontally involved teeth with subsequent application of a rigorous maintenance protocol can be a viable alternative for a number of years, before proceeding to extraction and replacement with dental implants. More well-designed randomized controlled trials are needed in order to draw definite conclusions on the subject.
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Affiliation(s)
- Katia Sarafidou
- Department of Prosthodontics, Aristotle University of Thessaloniki, Faculty of Health Sciences, School of Dentistry, Thessaloniki, Greece
| | - Ioanna Lazaridi
- Division of Regenerative Dentistry and Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Sotirios Gotsis
- Graduate and Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Yvoni Kirmanidou
- Private Practice limited to Prosthodontics, Thessaloniki, Greece
| | - Dimitra Vasilaki
- Private Practice limited to Prosthodontics, Thessaloniki, Greece
| | - Hiroshi Hirayama
- Department of Restorative Sciences and Biomaterials, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA
| | - Konstantinos Michalakis
- Department of Restorative Sciences and Biomaterials, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
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A Retrospective Analysis of Biological Complications of Dental Implants. Int J Dent 2022; 2022:1545748. [PMID: 35990253 PMCID: PMC9391181 DOI: 10.1155/2022/1545748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/25/2022] [Accepted: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
Methods A retrospective analysis of patients aged ≥18 years and having dental implants placed at Dubai Health Authority in 2010. Relevant information related to systemic-, patient-, implant-, site-, surgical- and prosthesis-related factors were collected. The strength of association between the prevalence of peri-implant mucositis and peri-implantitis and each variable was measured by chi-square analysis. A binary logistic regression analysis was performed to identify possible risk factors. Results A total of 162 patients with 301 implant-supported restorations were included in the study. The age of the patients ranged between 19 and 72 with a mean age of 46.4 ± 11.7 years. The prevalence of peri-implant mucositis at the patient and implant levels were 44.4% and 38.2%, respectively. For peri-implantitis, the prevalence at the patient level was 5.6%, while the prevalence at the implant level was 4.0%. The binary logistic regression identified three risk factors (smoking habits, histories of treated periodontitis and lack of peri-implant maintenance) for peri-implantitis. Conclusion Within the limitations of this study, smoking habits, history of treated periodontitis and lack of peri-implant maintenance were significant risk factors for peri-implantitis. Early detection of these factors would ensure appropriate planning and care of patients at high risk of developing peri-implant diseases.
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13
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Ye ZY, Ye H, Yu XX, Wang Y, Wu LJ, Ding X. Timing selection for loosened tooth fixation based on degree of alveolar bone resorption: a finite element analysis. BMC Oral Health 2022; 22:328. [PMID: 35941612 PMCID: PMC9358908 DOI: 10.1186/s12903-022-02375-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 08/03/2022] [Indexed: 11/24/2022] Open
Abstract
Objective This study aimed to evaluate timing of fixation to retard bone absorption using finite element analysis(FEA). Methods Volunteer CT images were used to construct four models of mandibles with varying degrees of alveolar bone resorption. By simulating occlusal force loading, biomechanical analysis was made on the periodontal membrane, tooth root and surrounding bone (both cancellous and cortical) of mandibular dentition. Results The von Mises stress value of the periodontal structures was positively related with the degree of alveolar bone resorption, and the von Mises stress at the interface between the periodontal membrane and tooth root was increased significantly in moderate to severe periodontitis models. The von Mises stress at the interface between the periodontal cortical bone and cancellous bone was increased significantly in the severe periodontitis model. And the von Mises stress value with oblique loading showed significantly higher than vertical loading. Conclusion Teeth with moderate to severe periodontitis, loosened tooth fixation can be used to retard bone absorption.
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Affiliation(s)
- Zhang-Yan Ye
- Department of Stomatology, Pingyang Hospital Affiliated to Wenzhou Medical University, Wenzhou, 325400, Zhejiang, People's Republic of China
| | - Hao Ye
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, 325015, Zhejiang, People's Republic of China
| | - Xi-Xi Yu
- Wenzhou Medical University, Wenzhou, 325015, Zhejiang, People's Republic of China
| | - Yong Wang
- Wenzhou Medical University, Wenzhou, 325015, Zhejiang, People's Republic of China
| | - Li-Jun Wu
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, 325015, Zhejiang, People's Republic of China
| | - Xi Ding
- Wenzhou Medical University, Wenzhou, 325015, Zhejiang, People's Republic of China. .,Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015, Zhejiang, People's Republic of China.
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14
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Sui H, Tang Z, Zhang X, Wei D, Meng H, Han J. A prospective, multicentre study of 6-mm short implants in posterior alveolar bone supporting splinted crowns: A 5-year follow-up study. J Clin Periodontol 2022; 49:537-546. [PMID: 35246872 DOI: 10.1111/jcpe.13610] [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: 06/26/2021] [Revised: 01/30/2022] [Accepted: 02/10/2022] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the clinical and radiographic outcomes of 6-mm short implants, placed in the posterior jaws and supporting splinted crowns, at 5 years after early loading. MATERIALS AND METHODS Forty-five patients with 95 implants (diameter: 4 mm; length: 6 mm) were enrolled at three centres. Two to three implants were placed in either the maxillary or the mandibular posterior region in each patient and restored with screw-retained splinted crowns at 6 weeks later. Clinical and radiographic outcomes were evaluated at implant placement, at loading, and at 6, 12, 24, 36, and 60 months after loading. Biological and mechanical complications were recorded. Marginal changes in bone level in relation to clinical parameters were evaluated using a generalized linear mixed model. RESULTS During the 5 years of follow-up, the mean change in the marginal bone level (MBL) was 0.04 ± 0.14 mm. Four implants in four patients were lost before loading, one implant in one patient was lost at the 5-year follow-up, and two patients were lost to follow-up. The survival and success rates were 88.4% (38/43) at the patient level. The incidence rates of peri-implant mucositis and peri-implantitis were 29.4% and 7.0%, respectively. The rate of technical complications was 14.0%. CONCLUSIONS Over a 5-year period, 6-mm short implants supporting early loaded splinted crowns in maxillary or mandibular posterior regions showed stable MBLs and acceptable technical and biological complication rates.
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Affiliation(s)
- Huiping Sui
- Department of Periodontology, Peking University School of Stomatology, Beijing, China
| | - Zhihui Tang
- Department of Oral and Maxillofacial Surgery, The Second Clinic of Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiao Zhang
- Department of Oral and Maxillofacial Surgery, The First Dental Center, Peking University School of Stomatology, Beijing, China
| | - Diyuan Wei
- Department of Periodontology, Peking University School of Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, Peking University School of Stomatology, Beijing, China
| | - Jie Han
- Department of Periodontology, Peking University School of Stomatology, Beijing, China
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15
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Zhou N, Huang H, Liu H, Li Q, Yang G, Zhang Y, Ding M, Dong H, Mou Y. Microbiota analysis of peri-implant mucositis in patients with periodontitis history. Clin Oral Investig 2022; 26:6223-6233. [PMID: 35672515 PMCID: PMC9525361 DOI: 10.1007/s00784-022-04571-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/30/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To investigate the bacterial diversity in peri-implant plaques and the effect of periodontitis history on the occurrence of peri-implant mucositis. MATERIALS AND METHODS Three groups of subgingival plaques were collected from peri-implant sulci in the first molar area. The three groups included healthy implants in patients without periodontitis (NH implant), healthy implants in patients with periodontitis history (PH implant), and peri-implant mucositis implants in patients with periodontitis history (PM implant). Subgingival plaques in periodontal pockets of contralateral natural first molars were also collected. Bacterial DNA was extracted and the V4 region of the 16S rDNA sequence was amplified and sequenced on an Illumina HiSeq platform. The operational taxonomic units obtained from amplicon sequencing were used to analyze the prevalence and identity of bacteria based on public databases and advanced techniques. RESULTS Analysis of similarities indicated a significant difference in bacterial structures between the NH implant and PM implant groups. Additionally, a significantly higher relative abundance of the genera Actinomyces and Streptococcus was found in the samples of the NH implant group. The genera Fusobacterium and Prevotella could be considered as potential biomarkers for peri-implant mucositis. Moreover, more gram-negative anaerobic bacteria (Porphyromonas and Prevotella) were detected in the samples from patients with periodontitis history. CONCLUSIONS The increased accumulation of Fusobacterium and Prevotella is associated with a higher risk of peri-implant mucositis. In addition, patients with periodontal history may be more likely to develop peri-implant mucositis. CLINICAL RELEVANCE The increase in periodontal pathogens and the decrease in health-associated bacteria in patients with periodontitis history may be more likely to develop peri-implant mucositis. These results provide a bacteriological basis for the prevention and treatment of peri-implant mucositis in patients with periodontitis history.
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Affiliation(s)
- Na Zhou
- Department of Jiangbei, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Haohao Huang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Hui Liu
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qiang Li
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Guangwen Yang
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yu Zhang
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Meng Ding
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Heng Dong
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.
| | - Yongbin Mou
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.
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16
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Dereka X, Akcalı A, Trullenque-Eriksson A, Donos N. Systematic review on the association between genetic polymorphisms and dental implant-related biological complications. Clin Oral Implants Res 2021; 33:131-141. [PMID: 34820916 DOI: 10.1111/clr.13882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 09/18/2021] [Accepted: 11/02/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of this systematic review was to evaluate the association between specific genetic polymorphisms and dental implant-related biological complications in patients having a follow-up period of at least 12-months post-loading. MATERIAL AND METHODS A sensitive search strategy was developed to identify implant-related genetic-association studies. This was performed by searching five databases. A three-stage screening (titles, abstract, full text) was carried out in duplicate and independently by two reviewers. Assessment was carried out according to the suggested scale for quality assessment of periodontal genetic-association studies and adapted to genetic analyses of implant-related studies leading to an overall final score 0-20 based on the summation of positive answers. RESULTS The initial search resulted in 1838 articles. Sixty-seven full-text articles were assessed for eligibility and four studies met the defined inclusion criteria. IL-6 G174C, TNF-α -308, IL-1A-889 and IL-1B+3954 and CD14-159 C/T polymorphisms were evaluated. The quality assessment scores ranged from 6 to 11 positive answers from out of a maximum score of 20. The great heterogeneity among the studies did not allow a meta-analysis. CONCLUSIONS The published evidence on genetic predisposition and implant biologic complications is limited. The small number of identified studies evaluating the association between genetic polymorphisms and peri-implant disease presented methodological and reporting inadequacies. Thus, the potential link between genetic polymorphisms and biological complications should be further investigated and clarified through well-designed clinical studies on adequately powered and appropriately included study populations.
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Affiliation(s)
- Xanthippi Dereka
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.,Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Aliye Akcalı
- Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK.,Department of Periodontology, Faculty of Dentistry, Dokuz Eylul University, Izmir, Turkey
| | - Anna Trullenque-Eriksson
- Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK.,Centre for Oral Immunobiology & Regenerative Medicine, Institute of Dentistry, Bart's & The London School of Dentistry & Medicine, Queen Mary University of London (QMUL), London, UK
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17
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Montero E, Molina A, Palombo D, Morón B, Pradíes G, Sanz-Sánchez I. Efficacy and risks of tooth-supported prostheses in the treatment of partially edentulous patients with stage IV periodontitis. A systematic review and meta-analysis. J Clin Periodontol 2021; 49 Suppl 24:182-207. [PMID: 34786742 DOI: 10.1111/jcpe.13482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/26/2021] [Accepted: 03/31/2021] [Indexed: 01/08/2023]
Abstract
AIM The aim was to evaluate the efficacy and effectiveness of tooth-supported fixed prostheses in partially edentulous patients with stage IV periodontitis. MATERIAL AND METHODS Randomized and controlled clinical trials (RCTs and CCTs) and prospective/retrospective cohort studies or case series were searched in three databases. Survival rate of abutment teeth was considered the primary outcome. Meta-analyses were performed whenever possible. RESULTS Twenty-four publications were included. No RCTs or CCTs compared the efficacy of tooth-supported fixed prostheses between patients with severe periodontitis or non-periodontitis patients. Most of the data retrieved were derived from case series. The incidence of abutment-tooth loss after a follow-up period from 2 to 35.4 years was low (n = 17 studies; weighted mean incidence (WMI) = 4.8%; confidence interval (CI) [3.2, 6.5]). The corresponding figure for prostheses failure was WMI = 6.9% (n = 18; 95% CI [4.1, 9.7]). Technical complications seemed to be more frequent than biological complications (caries, endodontic failure, root fracture, etc.). Periodontal outcomes tended to remain stable over time. CONCLUSION Tooth-supported fixed prostheses seemed to be a valid treatment approach to restore masticatory function in patients with stage IV periodontitis once periodontal therapy has been accomplished. However, the comparative efficacy of this treatment among periodontitis and non-periodontitis patients is unclear due to the absence of clinical trials.
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Affiliation(s)
| | - Ana Molina
- Universidad Complutense de Madrid, Madrid, Spain
| | | | - Belén Morón
- Universidad Complutense de Madrid, Madrid, Spain
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18
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Donos N, André Mezzomo L, Mardas N, Goldoni M, Calciolari E. Efficacy of tooth-supported compared to implant-supported full-arch removable prostheses in patients with terminal dentition. A systematic review. J Clin Periodontol 2021; 49 Suppl 24:224-247. [PMID: 34775624 DOI: 10.1111/jcpe.13477] [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] [Received: 01/24/2021] [Revised: 03/15/2021] [Accepted: 04/19/2021] [Indexed: 01/21/2023]
Abstract
AIMS To compare tooth- (TSRP) and implant-supported (ISRP) removable prostheses in terms of abutment and prosthesis survival (PICO 1) and estimated cumulative survival of teeth/implants and prostheses (PICO 2) at ≥12-month post-prosthesis delivery in patients with stage IV periodontitis. MATERIALS AND METHODS Five databases were searched to identify RCTs, CCTs, single arms, prospective cohort studies, case series and retrospective studies. Duplicate screening was performed, and ranges for abutment and prosthesis survival were calculated. RESULTS Twenty-six studies were included in the qualitative assessment. Only one study with critical risk of bias comparing the two treatment modalities reported similar survival rates at 2 years. Overall, prospective studies on ISRPs indicated an implant survival rate ranging from 96.4% to 100% and a prosthesis survival rate of 100% with a follow-up from 12 to 54 months. Prospective studies on TSRPs indicated a tooth survival ranging from 85.71% to 100% at 1- to 10-years follow-up. CONCLUSIONS The available evidence is of poor quality, and it does not allow to make robust conclusions on the efficacy of these rehabilitations in stage IV periodontitis patients. Particularly for TSRPs, careful patient selection is crucial and a certain number of biological and prosthetic complications should be expected.
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Affiliation(s)
- Nikolaos Donos
- Centre for Oral Clinical Research and Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Luis André Mezzomo
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Nikolaos Mardas
- Centre for Oral Clinical Research and Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Matteo Goldoni
- Medical Statistics, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Elena Calciolari
- Centre for Oral Clinical Research and Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Dental School, Department of Medicine and Surgery, University of Parma, Parma, Italy
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19
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De Ry SP, Roccuzzo A, Lang NP, Heitz-Mayfield LJ, Ramseier CA, Sculean A, Salvi GE. Evaluation of the implant disease risk assessment (IDRA) tool: A retrospective study in patients with treated periodontitis and implant-supported fixed dental prostheses (FDPs). Clin Oral Implants Res 2021; 32:1299-1307. [PMID: 34388276 PMCID: PMC9290928 DOI: 10.1111/clr.13828] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/26/2021] [Accepted: 07/08/2021] [Indexed: 01/06/2023]
Abstract
Aim To evaluate the Implant Disease Risk Assessment (IDRA) tool for the prediction of peri‐implantitis in treated periodontitis patients with implant‐supported fixed dental prostheses (FDPs) after at least 5 years of function. Material and methods From the patient pool of implant patients enrolled in a regular supportive periodontal therapy programme (SPT) for at least 5 years, 239 patients were screened. Eighty patients met the inclusion criteria and underwent evaluation through the criteria of the IDRA tool. Areas under the curve (AUCs) for receiver operating characteristic (ROC) curves including 95% confidence intervals were estimated. Results Seventy‐nine patients (43 males and 36 females, 8 smokers), aged on average 59.0 years (range: 40–79 years) at baseline (i.e. FDP delivery) were analysed. The calculated IDRA‐risk was in 34 patients (42.5%) a moderate risk, while 45 patients (56.3%) were considered at high IDRA‐risk. One patient categorized at low IDRA‐risk was excluded from the analysis. The AUC was 0.613 (95% CI: 0.464–0.762) if the IDRA‐risk was associated with prevalence of peri‐implantitis at the most recent follow‐up. Peri‐implantitis was diagnosed in 4 patients (12%) at moderate and in 12 patients (27%) at high IDRA‐risk, respectively. The calculated odds ratio for developing peri‐implantitis in patients with high IDRA‐risk compared with patients with moderate IDRA‐risk was 2.727 with no statistically significant difference between the two groups (95% CI: 0.793–9.376). Conclusion Within the limitations of the present retrospective study, the IDRA algorithm might represent a promising tool to assess patients at moderate or high risk of developing peri‐implantitis.
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Affiliation(s)
- Siro P De Ry
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Niklaus P Lang
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Lisa J Heitz-Mayfield
- International Research Collaborative, Faculty of Science, The University of Western Australia, Perth, West Perth, Australia
| | - Christoph A Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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20
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Vagia P, Papalou I, Burgy A, Tenenbaum H, Huck O, Davideau JL. Association between periodontitis treatment outcomes and peri-implantitis: A long-term retrospective cohort study. Clin Oral Implants Res 2021; 32:721-731. [PMID: 33714224 DOI: 10.1111/clr.13741] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 01/21/2021] [Accepted: 03/01/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Retrospectively evaluate the association of periodontal treatment outcomes and the prevalence of peri-implant diseases around tissue-level implants. MATERIALS AND METHODS Eighty-six patients with 260 tissue-level implants attending supporting periodontal and implant therapy for more than 3 years were evaluated. Clinical and radiographic periodontal and implant data were recorded at initial examination (T0), before implant placement (T1) and at final re-examination (T2). Two definitions of peri-implantitis severity, PIBE and PIKA, were used corresponding to the presence of periodontal pocket ≥5 mm or ≥6 mm with bleeding on probing or suppuration and radiographic signs of a bone level ≥2 mm, or ≥3 mm during implant follow-up, respectively. Analyses were performed at patient level. RESULTS The mean implant follow-up per patient was 9.4 years and 38.0% of patients had implant for at least 10 years. Two implants were lost due to peri-implantitis. The prevalence of patients with PIKA and PIBE was 15.1% and 12.8%, respectively. Residual periodontal pockets, clinical attachment loss and bone loss/age at T2 were more pronounced in patients with PIKA and PIBE. Cox regression analysis adjusted with the number of implants per patient showed that residual pockets at T1 were independently associated with PIKA and PIBE. Initial diagnosis of severe periodontitis was associated with PIBE incidence. CONCLUSIONS The present study showed that periodontal conditions before implant placement are a risk indicator for peri-implantitis incidence. During implant follow-up, the severity of periodontal status appeared to be a reliable indicator of patient susceptibility to peri-implantitis.
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Affiliation(s)
- Panagiota Vagia
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Ioanna Papalou
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Alexandre Burgy
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Henri Tenenbaum
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Olivier Huck
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Jean-Luc Davideau
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
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21
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Evaluation of Implant Survival by Analysing Dental Panoramic Radiographs: 10-Year Retrospective Study. BALKAN JOURNAL OF DENTAL MEDICINE 2021. [DOI: 10.2478/bjdm-2020-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Summary
Background/Aim: Panoramic radiographs have been used widely for pre-implant evaluation and the preparation of treatment protocols. Panoramic radiography is often the first choice method for the implant placements because it gives information on the overall shape of the jaws, the position of the maxillary sinus floor and the nasal cavity floor, and vertical position of the mandibular canal and the mental foramen in relation to dental implants. The specific aim of the present study was to evaluate 10-year survival rate of dental implants by analysis of dental panoramic radiographs.
Material and Methods: This retrospective study was conducted on 507 panoramic radiographs of 156 implant patients. Initial oral health status, proceedings of Restorative/Endodontic treatments before implant placement, missing number of teeth and edentulism types, finalization of implant related prosthetic treatments during controls, implant quality scorings at baseline/ controls and implant fails were analyzed.
Results: The study results reveal statistically significant difference between the performed R/E treatment rates, according to the need for R/E treatments (p= 0.008). During the initial radiograph 96.1% of the implants were successful and 3.9% had satisfactory survival. At last control 86% of the implants were successful, 10.3% had satisfactory survival, 1% had impairment in survival and 2.8% were unsuccessful. The change in the last control compared to the initial radiograph is statistically significant (p= 0.000) regarding satisfactory survival.
Conclusions: Long-term implant survival is not significantly affected by gender, age, type of edentulism, the presence of periodontal disease, R/E treatment needs, implant location, prosthesis type, and the presence of multiple implants.
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Guarnieri R, Di Nardo D, Di Giorgio G, Miccoli G, Testarelli L. Evaluation of peri-implant tissues condition after 10-15 years of loading in treated chronic periodontitis patients attending a private practice setting: A retrospective study. Clin Oral Implants Res 2021; 32:422-436. [PMID: 33452830 DOI: 10.1111/clr.13712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 09/22/2020] [Accepted: 01/07/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To retrospectively evaluate the conditions of the peri-implant tissues in treated patients with chronic periodontitis (CP) and in patients without chronic periodontitis (noCP). MATERIALS AND METHODS A chart review was used to evaluate 267 implants, 134 placed in 42 CP treated patients and 133 placed in 46 noCP patients. The primary outcome was to evaluate the condition of the peri-implant tissues (health, peri-mucositis, and peri-implantitis). The secondary outcome was to evaluate the possible association of some variables, such as, Plaque Index (PI), Bleeding Index (BI), probing pocket depth (PD), bleeding on probing (BoP), bone level (BL), loading time, type of implant placement and loading protocol, type of prosthesis, type of bone, implant manufacturer, and implant diameter and length, with the implant health condition. RESULTS The analysis of patient files revealed that after 10-15 years of loading (mean loading time 13.4 ± 2.07 years), six noCP patients (13%) experienced implant loss with a total of nine implants (6.7%) lost. The remaining 124 implants were classified: 54 (43.5%) as healthy, 45 (36.3%) with peri-implant mucositis, and 25 (20.2%) with peri-implantitis. Twelve CP subjects (28.5%) experienced implant loss with a total of 19 implants (14.1%) lost. The remaining 115 implants were classified: 34 (29.5%) as healthy, 40 (34.7%) with peri-implant mucositis and 41 (35.6%) with peri-implantitis. Compared with noCP subjects, only treated CP subjects with recurrent periodontal disease (RPD) showed differences statistically significant (p < .05). CONCLUSIONS After 10-15 years of loading, in CP patients treated in a private practice setting, most implants (70.1%) were classified with some type of peri-implant inflammation. In patients with RPD, a higher tendency for implant loss and peri-implant biologic complications was found.
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Affiliation(s)
- Renzo Guarnieri
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Dario Di Nardo
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Gianni Di Giorgio
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Gabriele Miccoli
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Luca Testarelli
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
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Abd-Ul-Salam H. Peri-implantitis. INNOVATIVE PERSPECTIVES IN ORAL AND MAXILLOFACIAL SURGERY 2021:47-59. [DOI: 10.1007/978-3-030-75750-2_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Liu W, Du B, Tan S, Wang Q, Li Y, Zhou L. Vertical Guided Bone Regeneration in the Rabbit Calvarium Using Porous Nanohydroxyapatite Block Grafts Coated with rhVEGF 165 and Cortical Perforation. Int J Nanomedicine 2020; 15:10059-10073. [PMID: 33335394 PMCID: PMC7737884 DOI: 10.2147/ijn.s268182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/13/2020] [Indexed: 12/19/2022] Open
Abstract
Introduction Vertical bone augmentation without osseous walls to support the stability of clots and bone grafts remains a challenge in dental implantology. The objectives of this study were to confirm that cortical perforation of the recipient bed is necessary and to evaluate whether nanohydroxyapatite (nHA) block grafts coated with recombinant human vascular endothelial growth factor165 (rhVEGF165) and cortical perforation can improve vertical bone regeneration. Materials and Methods We prepared nHA blocks coated with or without rhVEGF165 on the rabbit calvarium through cortical perforation, and designated the animals as the nonperforated group (N-nHA), rhVEGF165 group (NV-nHA), perforated group (P-nHA) and rhVEGF165 on perforated group (PV-nHA). Micro-computed tomography (micro-CT) and fluorescence microscopy were selected to evaluate parameters of vertical bone regeneration at 4 and 6 weeks. Results The ratio of the newly formed bone volume to the titanium dome volume (BV/TV) and the bone mineral density (BMD) were significantly higher in the PV-nHA group than in the N-nHA group at 4 and 6 weeks, as determined using micro-CT. The fluorescence analysis showed slightly greater increases in new bone regeneration (NB%) and vertical height (VH%) gains in the P-nHA group than in the N-nHA group. Greater increases in NB% and VH% were observed in groups treated with rhVEGF165 and perforation than in the blank groups, with significant differences detected at 4 and 6 weeks (N-nHA compared with PV-nHA, p<0.05). A greater VH% that was observed at the midline of the block in the PV-nHA group than in the other three groups at both time points (0.75±0.53% at 4 weeks and 0.83±0.42% at 6 weeks). Conclusion According to the present study, cortical perforation is necessary and nHA blocks coated with rhVEGF165 and decoration could work synergistically to improve vertical bone regeneration by directly affecting primary osteoblasts and promoting angiogenesis and osteoinduction.
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Affiliation(s)
- Weizhen Liu
- Department of Periodontics, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Bing Du
- Center of Stomatology, The Second People's Hospital of Foshan, Foshan, Guangdong, People's Republic of China
| | - Siyi Tan
- Center of Stomatology, Panyu Central Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Qin Wang
- Department of Oral Maxillofacial Surgery, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Yi Li
- Department of Periodontics, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Lei Zhou
- Center of Oral Implantology, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
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Saad S, Beauchamp J. A spate of bad breath: report from the International Conference on Oral Malodour 2019. J Breath Res 2020; 14:040201. [DOI: 10.1088/1752-7163/ab8d8a] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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26
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Cortellini P, Stalpers G, Mollo A, Tonetti MS. Periodontal regeneration versus extraction and dental implant or prosthetic replacement of teeth severely compromised by attachment loss to the apex: A randomized controlled clinical trial reporting 10-year outcomes, survival analysis and mean cumulative cost of recurrence. J Clin Periodontol 2020; 47:768-776. [PMID: 32249446 PMCID: PMC7384072 DOI: 10.1111/jcpe.13289] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/07/2020] [Accepted: 03/25/2020] [Indexed: 12/19/2022]
Abstract
Background Periodontal regeneration can change tooth prognosis and represents an alternative to extraction in teeth compromised by severe intra‐bony defects. The aim of this study was to compare periodontal regeneration (PR) with tooth extraction and replacement (TER) in a population with attachment loss to or beyond the apex of the root in terms of professional, patient‐reported and economic outcomes. Methods This was a 10‐year randomized controlled clinical trial. 50 stage III or stage IV periodontitis subjects with a severely compromised tooth with attachment loss to or beyond the apex were randomized to PR or TER with either an implant‐ or a tooth‐supported fixed partial denture. Subjects were kept on a strict periodontal supportive care regimen every 3 months and examined yearly. Survival and recurrence analysis were performed. Results 88% and 100% survival rates were observed in the PR and TER groups. Complication‐free survival was not significantly different: 6.7–9.1 years for PR and 7.3–9.1 years for TER (p = .788). In PR, the observed 10‐year attachment gain was 7.3 ± 2.3 mm and the residual probing depths were 3.4 ± 0.8 mm. Recurrence analysis showed that the 95% confidence interval of the costs was significantly lower for PR compared with TER throughout the whole 10‐year period. Patient‐reported outcomes and oral health‐related quality‐of‐life measurements improved in both groups. Conclusions Periodontal regeneration can change the prognosis of hopeless teeth and is a less costly alternative to tooth extraction and replacement. The complexity of the treatment limits widespread application to the most complex cases but provides powerful proof of principle for the benefits of PR in deep intra‐bony defect.
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Affiliation(s)
- Pierpaolo Cortellini
- Accademia Toscana di Ricerca Odontostomatologia (ATRO), Florence, Italy.,European Research Group on Periodontology (ERGOPERIO), Genova, Italy
| | | | | | - Maurizio S Tonetti
- European Research Group on Periodontology (ERGOPERIO), Genova, Italy.,Division of Periodontology and Implant Dentistry, Faculty of Dentistry, University of Hong Kong, Hong Kong, SAR China
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Sonnenschein SK, Kohnen R, Ciardo A, Ziegler P, Seide S, Kim TS. Changes of clinical parameters at implants: A retrospective comparison of implants versus natural teeth over 5 years of supportive periodontal therapy. Clin Oral Implants Res 2020; 31:646-654. [PMID: 32233083 DOI: 10.1111/clr.13601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 03/02/2020] [Accepted: 03/12/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To compare clinical parameters of implants versus natural teeth over a period of 5 years during supportive periodontal therapy (SPT). MATERIAL AND METHODS A total of 421 SPT patients were screened for implants (I) and corresponding control teeth (C). Data (patient level [P ]: sex, age, smoking status, systemic diseases, adherence, oral hygiene indices, mean probing depth [PD]P , bleeding on probing [BOP]P , periodontal risk profile; implant/control tooth level [I/C ]: PDI/C , BOPI/C ; site level at implants [SITE ]: position, dental arch, aspect, BOPSITE ) were assessed at the first SPT session where the implant was probed (T1) and 5 years later (T2). The influence of patient and implant/control-related factors on PDI/C /BOPI/C was tested (linear mixed model) as well as the influence of site-specific factors on the PDSITE change (multilevel regression). RESULTS A total of 70 patients (151 implants) were included. Mean PDI was 2.75 ± 0.85 mm (T1) and 2.87 ± 0.79 mm (T2). Mean PDC was 2.42 ± 0.66 mm (T1) and 2.49 ± 0.71 mm (T2). BOPI increased from 8.62 ± 15.01% (T1) to 24.06 ± 26.79% (T2) and BOPC from 9.97 ± 17.78% (T1) to 15.52 ± 22.69% (T2). The differences between implants and controls were significant for BOP (p = .0032). At T2, BOPI/C was associated with periodontal risk (p = .0351). The site-specific analysis revealed an association of BOPSITE at T1 with the progression of PDSITE (p = .0058). CONCLUSIONS Probing depths of implants and controls seem to change similarly during SPT but retention of inflammation-free conditions at implants appears to be more difficult compared to natural teeth. Patients with a high-risk profile appear to have an increased susceptibility for BOP around implants, and BOP at implants seems to be a predictor for further PD increase.
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Affiliation(s)
- Sarah K Sonnenschein
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Rebecca Kohnen
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Antonio Ciardo
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Philipp Ziegler
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Svenja Seide
- Institute of Medical Biometry and Informatics, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
| | - Ti-Sun Kim
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
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Vianna TT, Taiete T, Casarin RCV, Giorgi MCC, Aguiar FHB, Silvério KG, Nociti Júnior FH, Sallum EA, Casati MZ. Evaluation of peri-implant marginal tissues around tissue-level and bone-level implants in patients with a history of chronic periodontitis. J Clin Periodontol 2019; 45:1255-1265. [PMID: 30107048 DOI: 10.1111/jcpe.12999] [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] [Received: 04/08/2017] [Revised: 07/03/2018] [Accepted: 08/07/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To evaluate clinical and radiographic characteristics in peri-implant marginal tissues in patients with a history of chronic periodontitis, rehabilitated using tissue-level or bone-level implants. MATERIAL AND METHODS Using a split-mouth design, 20 patients with a history of chronic periodontitis were selected and received two different implants, tissue-level group (n = 20) and the bone-level group (n = 20). Peri-implant probing depth, relative peri-implant mucosal margin position, relative peri-implant clinical attachment level, peri-implant plaque index and peri-implant bleeding on probing were evaluated at prosthesis installation, 1, 3, 6, 12 and 24 months after implant loading. Radiographic marginal bone level was evaluated at implant insertion, prosthesis installation, 6 and 24 months after implant loading. RESULTS The mean difference of peri-implant marginal bone resorption from implant installation to 24 months in function was 0.75 ± 1.12 mm for the tissue-level group and 0.70 ± 0.72 mm for the bone-level group. No statistically significant difference was found between groups at all assessment periods for clinical and radiographic peri-implant evaluation. CONCLUSION Under a rigid supportive therapy, both approaches performed likewise regarding clinical and radiographic parameters for rehabilitation of patients with a history of chronic periodontitis.
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Affiliation(s)
- Tiago T Vianna
- Division of Periodontics, Piracicaba Dental School/State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Tiago Taiete
- Division of Periodontics, Piracicaba Dental School/State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Renato C V Casarin
- Division of Periodontics, Piracicaba Dental School/State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Maria C C Giorgi
- Division of Restorative Dentistry, Amazonas State University, Manaus, Amazonas, Brazil
| | - Flávio Henrique B Aguiar
- Division of Restorative Dentistry, Piracicaba Dental School/State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Karina G Silvério
- Division of Periodontics, Piracicaba Dental School/State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Francisco H Nociti Júnior
- Division of Periodontics, Piracicaba Dental School/State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Enilson A Sallum
- Division of Periodontics, Piracicaba Dental School/State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Márcio Z Casati
- Division of Periodontics, Piracicaba Dental School/State University of Campinas, Piracicaba, São Paulo, Brazil
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Park JW. Positive regulation of Porphyromonas gingivalis lipopolysaccharide-stimulated osteoblast functions by strontium modification of an SLA titanium implant surface. J Biomater Appl 2019; 34:802-811. [PMID: 31558092 DOI: 10.1177/0885328219878836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Jin-Woo Park
- School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
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30
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Papapetros D, Karagiannis V, Konstantinidis A, Apatzidou DA. Interim tissue changes following connective tissue grafting and two-stage implant placement. A randomized clinical trial. J Clin Periodontol 2019; 46:958-968. [PMID: 31206749 DOI: 10.1111/jcpe.13159] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 05/10/2019] [Accepted: 06/09/2019] [Indexed: 12/14/2022]
Abstract
AIM To determine tissue changes at implants placed either conventionally or in combination with a connective tissue graft (CTG). MATERIALS AND METHODS Forty-eight partially edentulous subjects were randomized into two treatment Groups, and 46 completed the study. Group-A (NA = 23) received crestal implant placement. In Group-B (NB = 23), a CTG harvested from the palate was stabilized over the implant neck. At the time of implant placement (T0), Groups were categorized as having thin mucosa ≤ 2.5 mm at the surgical site (NS ubgroup- AI = 12, NS ubgroup- BI = 11) or thick mucosa > 2.5 mm (NS ubgroup- AII = 11, NS ubgroup- BII = 12). Mucosa thickness, width of keratinized tissue (WKT), crestal bone levels and relative bone thickness were determined at T0 and at the two-stage surgery (T1). RESULTS At T1, on the alveolar crest, mucosa thickness significantly decreased in the thick mucosa Subgroups (-AII/-BII, both p = 0.001), but increased at thin mucosa grafted sites (p = 0.049). No significant changes were noted in the WKT for either group. Thin mucosa grafted Subgroups (-AI/-BI) demonstrated significant decreases in crestal bone levels (both p ≤ 0.008). Crestal relative bone thickness decreased in all Subgroups (p ≤ 0.027 for significant changes). CONCLUSIONS Connective tissue grafting resulted in smaller reductions of mucosa thickness on the alveolar crest and appeared to have the greater effects at sites with initially thin mucosa.
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Affiliation(s)
- Dimitrios Papapetros
- Lab of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassilis Karagiannis
- School of Mathematics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Antonis Konstantinidis
- Lab of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Danae A Apatzidou
- Lab of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Abstract
There are few absolute contraindications to dental implant placement. Relative contraindications include cognitive decline, American Society of Anesthesiology patient status IV or higher categories, or medical conditions that may jeopardize the life or lifespan of the patient. Precautions for placing dental implants should be viewed with respect to the evidence-based exposures that can contribute to risk of failure, including but not limited to local, behavioral, and medical factors. Risk for dental implant failure increases in association with (1) past history of periodontal disease, (2) bruxism, (3) smoking, and (4) radiation therapy.
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Affiliation(s)
- Amritpal S Kullar
- Division of Oral Diagnosis, Oral Medicine, Oral Radiology, MN324 College of Dentistry, University of Kentucky, 800 Rose Street, Lexington, KY 40356-0297, USA
| | - Craig S Miller
- Division of Oral Diagnosis, Oral Medicine, Oral Radiology, MN324 College of Dentistry, University of Kentucky, 800 Rose Street, Lexington, KY 40356-0297, USA.
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Atieh MA, Pang JK, Lian K, Wong S, Tawse-Smith A, Ma S, Duncan WJ. Predicting peri-implant disease: Chi-square automatic interaction detection (CHAID) decision tree analysis of risk indicators. J Periodontol 2019; 90:834-846. [PMID: 30730061 DOI: 10.1002/jper.17-0501] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 02/04/2019] [Accepted: 02/05/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Further validation of the risk indicators / predictors for peri-implant diseases is required to allow clinicians and patients to make informed decisions and optimize dental implant treatment outcomes. The aim of this study was to build prediction models, using Chi-square automatic interaction detection (CHAID) analysis, to determine which systemic-, patient-, implant-, site-, surgical- and prostheses-related risk indicators had more impact on the onset of peri-implant diseases. METHODS A retrospective analysis of 200 patients who received implant-supported prostheses between 1998 and 2011 was conducted to evaluate the prevalences and risk indicators for peri-implant mucositis and peri-implantitis. The data were further analyzed using CHAID to produce two predictive models. RESULTS The prevalence of peri-implant mucositis was 20.2% and 10.2% for patients and implants, respectively, while the prevalence of peri-implantitis was 10.1% at the patient level and 5.4% at the implant level. CHAID decision tree analysis identified three predictors (history of treated periodontitis, absence of regular supportive peri-implant maintenance, and use of bone graft) for peri-implant mucositis and three predictors (smoking, absence of regular supportive peri-implant maintenance, and placement of ≥2 implants) for peri-implantitis. CONCLUSIONS Within the limitations of this study, CHAID decision tree analysis identified the most plausible risk indicators and provided two predictive models for use in a particular university setting that would allow early detection and ensure appropriate care and maintenance of patients at high risk of peri-implant diseases.
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Affiliation(s)
- Momen A Atieh
- Oral Implantology Research Group, Sir John Walsh Research Institute, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Ju Keat Pang
- Oral Implantology Research Group, Sir John Walsh Research Institute, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Kylie Lian
- Oral Implantology Research Group, Sir John Walsh Research Institute, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Stephanie Wong
- Oral Implantology Research Group, Sir John Walsh Research Institute, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Andrew Tawse-Smith
- Oral Implantology Research Group, Sir John Walsh Research Institute, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Sunyoung Ma
- Oral Implantology Research Group, Sir John Walsh Research Institute, Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Warwick J Duncan
- Oral Implantology Research Group, Sir John Walsh Research Institute, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Francetti L, Cavalli N, Taschieri S, Corbella S. Ten years follow‐up retrospective study on implant survival rates and prevalence of peri‐implantitis in implant‐supported full‐arch rehabilitations. Clin Oral Implants Res 2019; 30:252-260. [DOI: 10.1111/clr.13411] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/16/2019] [Accepted: 01/16/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
| | - Nicolò Cavalli
- Department of Biomedical, Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
| | - Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
| | - Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
- Department of Oral Surgery, Institute of Dentistry I. M. Sechenov First Moscow state medical University Moscow Russia
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Mazel A, Belkacemi S, Tavitian P, Stéphan G, Tardivo D, Catherine JH, Aboudharam G. Peri-implantitis risk factors: A prospective evaluation. ACTA ACUST UNITED AC 2019; 10:e12398. [DOI: 10.1111/jicd.12398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 11/19/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Anthony Mazel
- UFR Odontologie; Aix-Marseille Université; Marseille France
| | - Souad Belkacemi
- Aix-Marseille Université UM63; Institut de Recherche pour le Développement IRD 198; Assistance Publique - Hôpitaux de Marseille (AP-HM), Microbes, Evolution, Phylogeny and Infection (MEΦI); Institut Hospitalo-Universitaire (IHU) - Méditerranée Infection; Marseille France
| | | | | | | | | | - Gérard Aboudharam
- UFR Odontologie; Aix-Marseille Université; Marseille France
- Aix-Marseille Université UM63; Institut de Recherche pour le Développement IRD 198; Assistance Publique - Hôpitaux de Marseille (AP-HM), Microbes, Evolution, Phylogeny and Infection (MEΦI); Institut Hospitalo-Universitaire (IHU) - Méditerranée Infection; Marseille France
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Kröger A, Hülsmann C, Fickl S, Spinell T, Hüttig F, Kaufmann F, Heimbach A, Hoffmann P, Enkling N, Renvert S, Schwarz F, Demmer RT, Papapanou PN, Jepsen S, Kebschull M. The severity of human peri‐implantitis lesions correlates with the level of submucosal microbial dysbiosis. J Clin Periodontol 2018; 45:1498-1509. [DOI: 10.1111/jcpe.13023] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 10/01/2018] [Accepted: 10/15/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Annika Kröger
- Department of Periodontology, Operative and Preventive DentistryUniversity of Bonn Bonn Germany
- Department of Oral SurgerySchool of DentistryUniversity of Birmingham Birmingham UK
| | - Claudia Hülsmann
- Department of Periodontology, Operative and Preventive DentistryUniversity of Bonn Bonn Germany
| | - Stefan Fickl
- Department of PeriodontologyUniversity of Würzburg Würzburg Germany
| | - Thomas Spinell
- Department of Operative Dentistry and PeriodontologyLMU Munich Munich Germany
- Private Practice Bolzano Italy
| | - Fabian Hüttig
- Department of ProsthodonticsUniversity of Tübingen Tübingen Germany
| | | | - André Heimbach
- Department of Human GeneticsUniversity of Bonn Bonn Germany
| | - Per Hoffmann
- Department of Human GeneticsUniversity of Bonn Bonn Germany
- Department of BiomedicineUniversity of Basel Basel Switzerland
| | | | - Stefan Renvert
- Department of Health SciencesKristianstad University Kristianstad Sweden
| | - Frank Schwarz
- Department of Oral Surgery and ImplantologyCarolinumGoethe University Frankfurt Germany
- Department of Oral SurgeryUniversitätsklinikum Düsseldorf Düsseldorf Germany
| | - Ryan T. Demmer
- Division of Epidemiology and Community HealthSchool of Public HealthUniversity of Minnesota Minneapolis Minnesota
| | - Panos N. Papapanou
- Division of PeriodonticsSection of Oral, Diagnostic and Rehabilitation SciencesColumbia University College of Dental Medicine New York New York
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive DentistryUniversity of Bonn Bonn Germany
| | - Moritz Kebschull
- Department of Periodontology, Operative and Preventive DentistryUniversity of Bonn Bonn Germany
- Division of PeriodonticsSection of Oral, Diagnostic and Rehabilitation SciencesColumbia University College of Dental Medicine New York New York
- The School of DentistryUniversity of Birmingham Birmingham UK
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Jones A. Accuracy of mucosa supported guided dental implant surgery. Clin Case Rep 2018; 6:2131-2139. [PMID: 30455906 PMCID: PMC6230664 DOI: 10.1002/ccr3.1809] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/19/2018] [Accepted: 08/21/2018] [Indexed: 12/18/2022] Open
Abstract
Implant deviation at platform and apex was comparable to that seen in similar studies, showing that Mucosa Supported Guided Dental Implant Surgery can be a safe implant placement technique. Implant diameter and length, bone density and density deviations showed moderate strong correlation with apical deviation.
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37
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Zhang H, Li W, Zhang L, Yan X, Shi D, Meng H. A nomogram prediction of peri-implantitis in treated severe periodontitis patients: A 1-5-year prospective cohort study. Clin Implant Dent Relat Res 2018; 20:962-968. [PMID: 30370993 DOI: 10.1111/cid.12686] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 09/10/2018] [Accepted: 09/20/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND No nomogram of peri-implantitis was reported before which is valuable for risk-estimating, clinical decision-making, and better-patients-communicating. PURPOSE To identify the risk indicators and develop a nomogram prediction model of peri-implantitis in treated severe periodontitis patients. MATERIALS AND METHODS A prospective study was conducted on 100 patients with 214 implants. Periodontal and peri-implant parameters were evaluated at implant surgery procedure (T1), and at follow-up (T2). Risk factors were analyzed by logistic regression analyses with generalized estimating equations. Nomogram was developed and the discriminatory ability of the model was analyzed. RESULTS The incidence of peri-implantitis at patient-level and implant level were 16% and 11.2% respectively, with no implant lost. The variables associated with peri-implantitis were the PDT1 ≥ 6 mm (%) > 10%, the implant position, length, and diameter after adjusting for covariates. A nomogram prediction model of peri-implantitis were developed with factors of PD T1 ≥ 6 mm (%) > 10% and implant placed in posterior. The area under the ROC curves of stepwise model was 0.794. CONCLUSIONS The residual pockets and implants position were identified as predictors for the peri-implantitis. The nomogram can be used to estimate the risk of peri-implantitis in treated severe periodontitis patients.
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Affiliation(s)
- Haidong Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wenjing Li
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Li Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xia Yan
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Dong Shi
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
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38
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Xie Y, Meng H, Han J, Xu L, Zhang L, Li W. A retrospective cohort study of peri-implant condition in Chinese patients with different periodontal condition and maintenance frequency. Clin Oral Implants Res 2018; 29:1135-1142. [DOI: 10.1111/clr.13377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 08/30/2018] [Accepted: 08/31/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Yesi Xie
- Department of Periodontology; Peking University School of Stomatology; Beijing China
- Center of Stomatology; China-Japan Friendship Hospital; Beijing China
| | - Huanxin Meng
- Department of Periodontology; Peking University School of Stomatology; Beijing China
| | - Jie Han
- Department of Periodontology; Peking University School of Stomatology; Beijing China
| | - Li Xu
- Department of Periodontology; Peking University School of Stomatology; Beijing China
| | - Li Zhang
- Department of Periodontology; Peking University School of Stomatology; Beijing China
| | - Wenjing Li
- Department of Periodontology; Peking University School of Stomatology; Beijing China
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Salvi GE, Monje A, Tomasi C. Long‐term biological complications of dental implants placed either in pristine or in augmented sites: A systematic review and meta‐analysis. Clin Oral Implants Res 2018; 29 Suppl 16:294-310. [DOI: 10.1111/clr.13123] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Giovanni E. Salvi
- Department of PeriodontologySchool of Dental MedicineUniversity of Bern Bern Switzerland
| | - Alberto Monje
- Department of Oral Surgery and StomatologySchool of Dental MedicineUniversity of Bern Bern Switzerland
| | - Cristiano Tomasi
- Department of PeriodontologyInstitute of OdontologyThe Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden
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40
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Ting M, Craig J, Balkin BE, Suzuki JB. Peri-implantitis: A Comprehensive Overview of Systematic Reviews. J ORAL IMPLANTOL 2018; 44:225-247. [DOI: 10.1563/aaid-joi-d-16-00122] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of this systematic review was to perform a comprehensive overview of systematic reviews and meta-analyses pertaining to peri-implantitis in humans, including the prevalence and incidence, the diagnostic findings, microbial findings, effects of systemic diseases, and treatment of peri-implantitis. Electronic databases were searched for systematic reviews and meta-analyses of peri-implantitis. In view of the limitations of the included systematic reviews, the outcome of this overview suggested that (1) occurrence of peri-implantitis was higher in patients with periodontitis, in patients who smoke, and after 5 years of implant function; (2) the microbial profile of peri-implantitis was different from periodontitis; (3) risk for peri-implantitis was higher in patients with uncontrolled diabetes and cardiovascular disease; (4) there was no strong evidence to suggest the most effective treatment intervention for peri-implantitis, although most peri-implantitis treatments can produce successful outcomes; and (5) postimplant maintenance may be crucial in patients with a high risk of peri-implantitis.
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Affiliation(s)
- Miriam Ting
- Kornberg School of Dentistry, Temple University, Philadelphia, Penn
| | - James Craig
- Department of Periodontology and Oral Implantology, Kornberg School of Dentistry, Temple University, Philadelphia, Penn
| | - Burton E. Balkin
- Department of Periodontology and Oral Implantology, Kornberg School of Dentistry, Temple University, Philadelphia, Penn
| | - Jon B. Suzuki
- Department of Periodontology and Oral Implantology, Kornberg School of Dentistry, Temple University, Philadelphia, Penn
- Department of Microbiology and Immunology, School of Medicine, Temple University, Philadelphia, Penn
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41
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Should implants be considered for patients with periodontal disease? Br Dent J 2018; 221:705-711. [PMID: 27932832 DOI: 10.1038/sj.bdj.2016.905] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2016] [Indexed: 01/21/2023]
Abstract
Dental implants are seen as a good option for replacing missing teeth. The success and survival rates for implants are very high. Concerns are developing about the problem of peri-implantitis. The reports of its prevalence vary but it is noted that the presence of periodontal disease is a risk factor. The issue of peri-implantitis was raised in the House of Lords in 2014. Complaints relating to implants is on the rise with the General Dental Council. Placement of implants in patients with periodontal disease is not a treatment that should be done without a full periodontal assessment and stabilisation of periodontal disease first. This review considers the risk of placing implants in patients with aggressive and chronic periodontitis.
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42
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Mangano F, Raspanti M, Maghaireh H, Mangano C. Scanning Electron Microscope (SEM) Evaluation of the Interface between a Nanostructured Calcium-Incorporated Dental Implant Surface and the Human Bone. MATERIALS 2017; 10:ma10121438. [PMID: 29258208 PMCID: PMC5744373 DOI: 10.3390/ma10121438] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 12/26/2022]
Abstract
Purpose. The aim of this scanning electron microscope (SEM) study was to investigate the interface between the bone and a novel nanostructured calcium-incorporated dental implant surface in humans. Methods. A dental implant (Anyridge®, Megagen Implant Co., Gyeongbuk, South Korea) with a nanostructured calcium-incorporated surface (Xpeed®, Megagen Implant Co., Gyeongbuk, South Korea), which had been placed a month earlier in a fully healed site of the posterior maxilla (#14) of a 48-year-old female patient, and which had been subjected to immediate functional loading, was removed after a traumatic injury. Despite the violent trauma that caused mobilization of the fixture, its surface appeared to be covered by a firmly attached, intact tissue; therefore, it was subjected to SEM examination. The implant surface of an unused nanostructured calcium-incorporated implant was also observed under SEM, as control. Results. The surface of the unused implant showed a highly-structured texture, carved by irregular, multi-scale hollows reminiscent of a fractal structure. It appeared perfectly clean and devoid of any contamination. The human specimen showed trabecular bone firmly anchored to the implant surface, bridging the screw threads and filling the spaces among them. Conclusions. Within the limits of this human histological report, the sample analyzed showed that the nanostructured calcium-incorporated surface was covered by new bone, one month after placement in the posterior maxilla, under an immediate functional loading protocol.
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Affiliation(s)
- Francesco Mangano
- Department of Medicine and Surgery, University of Insubria, Varese 21100, Italy.
| | - Mario Raspanti
- Department of Medicine and Surgery, University of Insubria, Varese 21100, Italy.
| | | | - Carlo Mangano
- Department of Dental Sciences, University Vita Salute S. Raffaele, Milan 20132, Italy.
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43
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Derks H, Westheide D, Pfefferle T, Eickholz P, Dannewitz B. Retention of molars after root-resective therapy: a retrospective evaluation of up to 30 years. Clin Oral Investig 2017; 22:1327-1335. [DOI: 10.1007/s00784-017-2220-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/26/2017] [Indexed: 12/26/2022]
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44
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Lafaurie GI, Sabogal MA, Castillo DM, Rincón MV, Gómez LA, Lesmes YA, Chambrone L. Microbiome and Microbial Biofilm Profiles of Peri-Implantitis: A Systematic Review. J Periodontol 2017; 88:1066-1089. [PMID: 28625077 DOI: 10.1902/jop.2017.170123] [Citation(s) in RCA: 160] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND This systematic review assesses microbiologic profiles of peri-implantitis, periodontitis, and healthy implants based on studies that evaluated microbial biofilms and entire microbiomes to establish their similarities and differences. METHODS The Medical Literature Analysis and Retrieval System Online via PubMed, Excerpta Medica Database, and Cochrane Central Register of Controlled Trials, were searched without language restrictions through July 30, 2016. Observational studies that evaluated microbial profiles or entire microbiomes of peri-implantitis compared with healthy implants or periodontitis were considered eligible for inclusion. A descriptive summary was created to determine quantity of data and interstudy variations. RESULTS Of 126 potentially eligible articles, 26 were included in this study. Twenty-one of these articles evaluated the microbiologic profile of peri-implantitis versus healthy implants or periodontitis using conventional microbiologic techniques. Five articles evaluated the entire microbiome using genomic sequencing. Teeth with periodontitis, healthy implants, or implants with peri-implantitis were colonized by periodontal microorganisms. Porphyromonas gingivalis and especially Prevotella intermedius/nigrescens were often identified at peri-implantitis sites. Peri-implantitis sites were also colonized by uncultivable asaccharolytic anaerobic Gram-positive rods and anaerobic Gram-negative rods, which were not frequently identified in teeth with periodontitis or healthy implants. Opportunistic microorganisms were not found very frequently in peri-implantitis sites. CONCLUSIONS Peri-implantitis represents a heterogeneous mixed infection that includes periodontopathic microorganisms, uncultivable asaccharolytic anaerobic Gram-positive rods and other uncultivable Gram-negative rods, and, rarely, opportunistic microorganisms such as enteric rods and Staphylococcus aureus. Sequencing methods that evaluate the entire microbiome improve identification of microorganisms associated with peri-implantitis.
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Affiliation(s)
- Gloria Inés Lafaurie
- Unit of Basic Oral Investigation, School of Dentistry, El Bosque University, Bogotá, Colombia
| | - María Alejandra Sabogal
- Unit of Basic Oral Investigation, School of Dentistry, El Bosque University, Bogotá, Colombia
| | - Diana Marcela Castillo
- Unit of Basic Oral Investigation, School of Dentistry, El Bosque University, Bogotá, Colombia
| | | | - Luz Amparo Gómez
- Division of Periodontics, School of Dentistry, El Bosque University
| | | | - Leandro Chambrone
- Unit of Basic Oral Investigation, School of Dentistry, El Bosque University, Bogotá, Colombia
- MSc Dentistry Program, School of Dentistry, Ibirapuera University, São Paulo, Brazil
- Department of Periodontics, College of Dentistry, The University of Iowa, Iowa City, IA
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45
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Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2017; 118:281-346. [DOI: 10.1016/j.prosdent.2017.04.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 04/27/2017] [Accepted: 04/27/2017] [Indexed: 01/19/2023]
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46
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Rzeznik M, Triba MN, Levy P, Jungo S, Botosoa E, Duchemann B, Le Moyec L, Bernaudin JF, Savarin P, Guez D. Identification of a discriminative metabolomic fingerprint of potential clinical relevance in saliva of patients with periodontitis using 1H nuclear magnetic resonance (NMR) spectroscopy. PLoS One 2017; 12:e0182767. [PMID: 28837579 PMCID: PMC5570357 DOI: 10.1371/journal.pone.0182767] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 07/24/2017] [Indexed: 12/31/2022] Open
Abstract
Periodontitis is characterized by the loss of the supporting tissues of the teeth in an inflammatory-infectious context. The diagnosis relies on clinical and X-ray examination. Unfortunately, clinical signs of tissue destruction occur late in the disease progression. Therefore, it is mandatory to identify reliable biomarkers to facilitate a better and earlier management of this disease. To this end, saliva represents a promising fluid for identification of biomarkers as metabolomic fingerprints. The present study used high-resolution 1H-nuclear magnetic resonance (NMR) spectroscopy coupled with multivariate statistical analysis to identify the metabolic signature of active periodontitis. The metabolome of stimulated saliva of 26 patients with generalized periodontitis (18 chronic and 8 aggressive) was compared to that of 25 healthy controls. Principal Components Analysis (PCA), performed with clinical variables, indicated that the patient population was homogeneous, demonstrating a strong correlation between the clinical and the radiological variables used to assess the loss of periodontal tissues and criteria of active disease. Orthogonal Projection to Latent Structure (OPLS) analysis showed that patients with periodontitis can be discriminated from controls on the basis of metabolite concentrations in saliva with satisfactory explained variance (R2X = 0.81 and R2Y = 0.61) and predictability (Q2Y = 0.49, CV-AUROC = 0.94). Interestingly, this discrimination was irrespective of the type of generalized periodontitis, i.e. chronic or aggressive. Among the main discriminating metabolites were short chain fatty acids as butyrate, observed in higher concentrations, and lactate, γ-amino-butyrate, methanol, and threonine observed in lower concentrations in periodontitis. The association of lactate, GABA, and butyrate to generate an aggregated variable reached the best positive predictive value for diagnosis of periodontitis. In conclusion, this pilot study showed that 1H-NMR spectroscopy analysis of saliva could differentiate patients with periodontitis from controls. Therefore, this simple, robust, non-invasive method, may offer a significant help for early diagnosis and follow-up of periodontitis.
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Affiliation(s)
- Matthias Rzeznik
- Paris 13 University, Sorbonne Paris Cité, CSPBAT, UMR 7244, CNRS, Bobigny, France.,APHP, Department of Periodontology, Bretonneau Hospital, Paris-Descartes University, Paris, France
| | - Mohamed Nawfal Triba
- Paris 13 University, Sorbonne Paris Cité, CSPBAT, UMR 7244, CNRS, Bobigny, France
| | - Pierre Levy
- APHP, Department of Public Health, Tenon Hospital, Paris, France.,UMR-S1136 (EPAR team), INSERM UPMC, Sorbonne Universités, Paris, France
| | - Sébastien Jungo
- APHP, Department of Periodontology, Bretonneau Hospital, Paris-Descartes University, Paris, France
| | - Eliot Botosoa
- Paris 13 University, Sorbonne Paris Cité, CSPBAT, UMR 7244, CNRS, Bobigny, France
| | - Boris Duchemann
- Paris 13 University, Sorbonne Paris Cité, CSPBAT, UMR 7244, CNRS, Bobigny, France.,APHP, Department of Pneumology, Avicenne Hospital, Bobigny, France
| | | | - Jean-François Bernaudin
- APHP, Department of Pneumology, Avicenne Hospital, Bobigny, France.,UPMC Paris 6, Sorbonne Universités, Paris, France.,Paris 13 University, Sorbonne Paris Cité, EA2363, Bobigny, France
| | - Philippe Savarin
- Paris 13 University, Sorbonne Paris Cité, CSPBAT, UMR 7244, CNRS, Bobigny, France
| | - Dominique Guez
- APHP, Department of Periodontology, Bretonneau Hospital, Paris-Descartes University, Paris, France
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47
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Moreno Rodríguez JA, Caffesse RG. A New Papilla Preservation Technique for Periodontal Regeneration of Severely Compromised Teeth. Clin Adv Periodontics 2017. [DOI: 10.1902/cap.2017.170033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Raúl G. Caffesse
- Visiting Professor, Postgraduate Periodontics, Complutense University of Madrid, Spain
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48
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Effect of periodontitis history on implant success: a long-term evaluation during supportive periodontal therapy in a university setting. Clin Oral Investig 2017; 22:235-244. [DOI: 10.1007/s00784-017-2104-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 03/13/2017] [Indexed: 12/14/2022]
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49
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Theodoridis C, Grigoriadis A, Menexes G, Vouros I. Outcomes of implant therapy in patients with a history of aggressive periodontitis. A systematic review and meta-analysis. Clin Oral Investig 2016; 21:485-503. [PMID: 28013438 DOI: 10.1007/s00784-016-2026-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 12/05/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the outcomes of implant therapy in partially dentate patients treated for aggressive periodontitis (GAgP) in comparison to periodontally healthy (HP) and patients treated for chronic periodontitis (CP) utilizing radiographic and clinical parameters. MATERIAL AND METHODS An electronic search of databases, supplemented by hand searching, was conducted to identify relevant clinical studies. Sequential screenings at the title, abstract and full-text levels were performed independently and in duplicate. A random effects meta-analysis was conducted and bias corrected bootstrap 95 % confidence intervals were estimated for group comparisons. RESULTS The search strategy revealed a total of 899 results. After title screening, abstract scanning, and full-text reading, seven articles fulfilled the inclusion criteria. The 3-year survival rate for CP and HP patients was 100 % while in GAgP subjects, the respective value was 97.98 %; this difference being statistically significant. The 3-year mean marginal bone loss (MBL) was 1.07 mm for the GAgP group, 0.47 mm for the CP group, and 0.69 mm for the HP group. A significant difference between the GAgP and CP groups was identified (p < 0.05). The weighted mean differences of MBL concerning the above groups were also calculated and examined for statistical significance in both 1 and 3 years. CONCLUSIONS The 3-year survival rate and peri-implant marginal bone loss was found statistically significantly lower in GAgP subjects (SR 97.98 % vs 100 %) in comparison to HP and CP individuals. CLINICAL RELEVANCE The outcome of implant therapy in terms of survival rate and marginal bone loss is considered very important for the clinician in decision making when placing implants in patients with a history of aggressive periodontitis.
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Affiliation(s)
- Charis Theodoridis
- Department of Dentoalveolar Surgery, Implant Surgery and Radiology, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Grigoriadis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Georgios Menexes
- School of Agriculture, Laboratory of Agronomy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Vouros
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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50
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Telleman G, Raghoebar GM, Vissink A, Meijer HJA. Impact of platform switching on inter-proximal bone levels around 8.5 mm implants in the posterior region; 5-year results from a randomized clinical trial. J Clin Periodontol 2016; 44:326-336. [PMID: 27883203 DOI: 10.1111/jcpe.12654] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2016] [Indexed: 01/28/2023]
Abstract
AIM To assess the medium-term results of 8.5 mm implants supplied with a conventional platform-matched implant-abutment connection or a platform-switched design. MATERIALS AND METHODS Eighty patients with one or more missing teeth in the maxillary or mandibular posterior zone were randomly assigned for treatment with implants with a conventional (control group) or platform-switched (test group) implant-abutment connection. Follow-up visits were conducted 1 month, 1 year and 5 years after functional loading. Inter-proximal bone loss, assessed with standardized peri-apical radiographs, clinical parameters, survival of implants and satisfaction of patients were the outcome parameters studied. RESULTS After 5 years of loading, five of the 80 patients were lost to follow-up. The inter-proximal bone loss in the test group (0.38 ± 0.61 mm) was comparable to the bone loss in the control group (0.41 ± 0.47 mm; p = 0.201). Remarkably, bone loss has not progressed compared to the 1-year results. Implant survival, clinical parameters and satisfaction of the patients were favourable and comparable for the test and control group. CONCLUSION The 5-years results showed that inter-proximal bone resorption was minor and comparable around platform-matched and platform-switched implants, and implant survival, peri-implant health and patients' satisfaction were favourable.
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Affiliation(s)
- Gerdien Telleman
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.,Department of Fixed and Removable Prosthodontics, Centre for Dentistry and Oral Hygiene, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
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