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Konishi D, Hirata E, Takano Y, Maeda Y, Ushijima N, Yudasaka M, Yokoyama A. Near-infrared light-boosted antimicrobial activity of minocycline/hyaluronan/carbon nanohorn composite toward peri-implantitis treatments. NANOSCALE 2024. [PMID: 38913014 DOI: 10.1039/d4nr01036a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Dental implant therapy is a reliable treatment for replacing missing teeth. However, as dental implants become more widely used, peri-implantitis increasingly has become a severe complication, making successful treatment more difficult. As a result, the development of effective drug delivery systems (DDSs) and treatments for peri-implantitis are urgently needed. Carbon nanohorns (CNHs) are carbon nanomaterials that have shown promise for use in DDSs and have photothermal effects. The present study exploited the unique properties of CNHs to develop a phototherapy employing a near-infrared (NIR) photoresponsive composite of minocycline, hyaluronan, and CNH (MC/HA/CNH) for peri-implantitis treatments. MC/HA/CNH demonstrated antibacterial effects that were potentiated by NIR-light irradiation, a property that was mediated by photothermal-mediated drug release from HA/CNH. These antibacterial effects persisted even following 48 h of dialysis, a promising indication for the clinical use of this material. We propose that the treatment of peri-implantitis using NIR and MC/HA/CNH, in combination with surgical procedures, might be employed to target relatively deep affected areas in a timely and efficacious manner. We envision that this innovative approach will pave the way for future developments in implant therapy.
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Affiliation(s)
- Daisuke Konishi
- Department of Oral Functional Prosthodontics, Faculty of Dental Medicine, Graduate school of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Sapporo 060-8586, Japan.
| | - Eri Hirata
- Department of Oral Functional Prosthodontics, Faculty of Dental Medicine, Graduate school of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Sapporo 060-8586, Japan.
| | - Yuta Takano
- Research Institute for Electronic Science, Hokkaido University, Kita-20, Nishi-10, Sapporo 001-0020, Japan.
- Graduate School of Environmental Science, Hokkaido University, Kita-10, Nishi-5, Sapporo 060-0810, Japan
| | - Yukari Maeda
- Department of Oral Functional Prosthodontics, Faculty of Dental Medicine, Graduate school of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Sapporo 060-8586, Japan.
| | - Natsumi Ushijima
- Support Section for Education and Research, Faculty of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan
| | - Masako Yudasaka
- Nanomaterials Research Institute (NMRI), National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba Central 5, 1-1-1 Higashi, Tsukuba, Ibaraki 305-8565, Japan
- Meijo University, Graduate School of Science and Technology, 1-501, Shiogamaguchi, Tenpaku, Nagoya 468-8502, Japan
| | - Atsuro Yokoyama
- Department of Oral Functional Prosthodontics, Faculty of Dental Medicine, Graduate school of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Sapporo 060-8586, Japan.
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Carvalhaes JM, Ponzoni D, Tonini KR, de Carvalho PSP. Clinical study on the association between keratinized mucosa and peri-implant health when external hexagon implants are installed in the posterior region of the maxilla and mandible: a cohort study. Int J Oral Maxillofac Surg 2024; 53:231-238. [PMID: 37468344 DOI: 10.1016/j.ijom.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 06/25/2023] [Accepted: 06/28/2023] [Indexed: 07/21/2023]
Abstract
This study evaluated the association between keratinized mucosa (KM) and peri-implant health of external hexagon implants in the posterior region in 84 patients with 242 implants. Modified plaque index (MPI), modified sulcular bleeding index (MSBI), probing depth (PD), keratinized mucosa (KM) width, and peri-implant bone loss were evaluated. The implants were divided according to the KM: (1) absence of KM, (2) KM width >0 and <2 mm, and (3) KM width ≥2 mm. Of the 242 implants evaluated, 63 (26.0%) had no KM band, 56 (23.1%) had KM width <2 mm, and 123 (50.8%) had KM width ≥2 mm. One hundred and sixty-seven (69.0%) were used in multiple unit restorations and 75 (31.0%) in single tooth restorations; 66.9% were placed in the mandible and 33.1% in the maxilla. For single tooth and multiple unit implant restorations, MPI (P=0.069 and P=0.387, respectively), MSBI (P=0.695 and P=0.947, respectively), PD (P=0.270 and P=0.258, respectively), and mesial bone loss (P=0.121 and P=0.239, respectively) were not affected by the KM width. On the distal surface, bone loss was influenced by the absence of KM when single tooth implant restorations were used (P=0.032). No association was found between KM width and the peri-implant tissue health.
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Affiliation(s)
- J M Carvalhaes
- Brazilian Association of Dentistry, Maceió, Alagoas, Brazil
| | - D Ponzoni
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil.
| | - K R Tonini
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - P S P de Carvalho
- Bauru School of Dentistry, University of São Paulo - USP, Bauru, São Paulo, Brazil
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Bianconi S, Romanos G, Testori T, Del Fabbro M. Management of Advanced Peri-Implantitis by Guided Bone Regeneration in Combination with Trabecular Metal Fixtures, Two Months after Removal of the Failed Implants: Two-Year Results of a Single-Cohort Clinical Study. J Clin Med 2024; 13:713. [PMID: 38337407 PMCID: PMC10856143 DOI: 10.3390/jcm13030713] [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: 12/27/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Background: Implant replacement is among the treatment options for severe peri-implantitis. The aim of this single-cohort study was to evaluate the feasibility of replacing compromised implants affected by advanced peri-implantitis with new implants with a porous trabecular metal (TM) structure. Materials and Methods: Patients with one or more implants in the posterior region showing a defect depth >50% of implant length, measured from the residual crest, were consecutively included. Two months after implant removal, patients received a TM implant combined with a xenograft and a resorbable membrane. The implant stability quotient (ISQ) was measured at placement and re-assessed five months later (at uncovering), then after 6, 12, and 24 months of function. Marginal bone loss was radiographically evaluated. Results: Twenty consecutive cases were included. One patient dropped out due to COVID-19 infection, and nineteen cases were evaluated up to 24 months. At placement, the mean ISQ was 53.08 ± 13.65 (standard deviation), which increased significantly to 69.74 ± 9.01 after five months of healing (p < 0.001) and to 78.00 ± 7.29 after six months of loading (p < 0.001). Thereafter, the ISQ remained stable for up to 24 months (80.55 ± 4.73). All implants successfully osseointegrated and were restored as planned. After two years, the average marginal bone level change was -0.41 ± 0.38 mm (95% confidence interval -0.60, -0.21), which was limited yet significantly different from the baseline (p < 0.05). Conclusions: The treatment of advanced peri-implant defects using TM implants inserted two months after explantation in combination with guided bone regeneration may achieve successful outcomes up to two years follow-up, even in the presence of low primary stability.
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Affiliation(s)
- Stefano Bianconi
- Department of Oral Surgery and Dentistry, General Hospital, 39100 Bolzano, Italy;
| | - Georgios Romanos
- Department of Periodontics and Endodontics, Stony Brook University, Stony Brook, NY 11794, USA;
| | - Tiziano Testori
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy;
- Department of Implantology and Oral Rehabilitation, Dental Clinic, IRCCS Ospedale Galeazzi-Sant’Ambrogio, 20157 Milan, Italy
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA 01451, USA
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy;
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Herce-López J, Pingarrón MDC, Tofé-Povedano Á, García-Arana L, Espino-Segura-Illa M, Sieira-Gil R, Rodado-Alonso C, Sánchez-Torres A, Figueiredo R. Customized Subperiosteal Implants for the Rehabilitation of Atrophic Jaws: A Consensus Report and Literature Review. Biomimetics (Basel) 2024; 9:61. [PMID: 38275459 PMCID: PMC10812919 DOI: 10.3390/biomimetics9010061] [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: 12/31/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
(1) Background: The aim was to perform a literature review on customized subperiosteal implants (CSIs) and provide clinical guidelines based on the results of an expert consensus meeting held in 2023. (2) Methods: A literature search was performed in Pubmed (MEDLINE) in July 2023, including case series and cohort studies with a minimum follow-up of 6 months that analyzed totally or partially edentulous patients treated with CSIs. Previously, an expert consensus meeting had been held in May 2023 to establish the most relevant clinical guidelines. (3) Results: Six papers (four case series and two retrospective cohort studies) were finally included in the review. Biological and mechanical complication rates ranged from 5.7% to 43.8% and from 6.3% to 20%, respectively. Thorough digital planning to ensure the passive fit of the CSI is mandatory to avoid implant failure. (4) Conclusions: CSIs are a promising treatment option for rehabilitating edentulous patients with atrophic jaws; they seem to have an excellent short-term survival rate, a low incidence of major complications, and less morbidity in comparison with complex bone grafting procedures. As the available data on the use of CSIs are very scarce, it is not possible to establish clinical recommendations based on scientific evidence.
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Affiliation(s)
- Javier Herce-López
- Oral and Maxillofacial Surgeon, Virgen Macarena University Hospital, 41009 Seville, Spain;
| | | | - Álvaro Tofé-Povedano
- Oral and Maxillofacial Surgeon, Puerta del Mar University Hospital, 11009 Cádiz, Spain;
| | - Laura García-Arana
- Oral and Maxillofacial Surgeon, San Francisco de Asís University Hospital, 28002 Madrid, Spain;
| | | | - Ramón Sieira-Gil
- Oral and Maxillofacial Consultant, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, Spain;
| | | | - Alba Sánchez-Torres
- Professors of Oral Surgery, Faculty of Medicine and Health Sciences, Researchers at the IDIBELL Institute, University of Barcelona (Spain), 08907 Barcelona, Spain;
| | - Rui Figueiredo
- Professors of Oral Surgery, Faculty of Medicine and Health Sciences, Researchers at the IDIBELL Institute, University of Barcelona (Spain), 08907 Barcelona, Spain;
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Chou YH, Chen YJ, Pan CP, Yen WH, Liu PF, Feng IJ, Lin YC, Hu KF. Prevalence of peri-implantitis after alveolar ridge preservation at periodontitis and nonperiodontitis extraction sites: A retrospective cohort study. Clin Implant Dent Relat Res 2023; 25:1000-1007. [PMID: 37424382 DOI: 10.1111/cid.13243] [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: 04/19/2023] [Revised: 06/05/2023] [Accepted: 06/18/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION Periodontitis is the main indication for dental extraction and often leads to peri-implantitis (PI). Alveolar ridge preservation (ARP) is an effective means of preserving ridge dimensions after extraction. However, whether PI prevalence is lower after ARP for extraction after periodontitis remains unclear. This study investigated PI after ARP in patients with periodontitis. MATERIALS AND METHODS This study explored the 138 dental implants of 113 patients. The reasons for extraction were categorized as periodontitis or nonperiodontitis. All implants were placed at sites treated using ARP. PI was diagnosed on the basis of radiographic bone loss of ≥3 mm, as determined through comparison of standardized bitewing radiographs obtained immediately after insertion with those obtained after at least 6 months. Chi-square and two-sample t testing and generalized estimating equations (GEE) logistic regression model were employed to identify risk factors for PI. Statistical significance was indicated by p < 0.05. RESULTS The overall PI prevalence was 24.6% (n = 34). The GEE univariate logistic regression demonstrated that implant sites and implant types were significantly associated with PI (premolar vs. molar: crude odds ratios [OR] = 5.27, 95% confidence intervals [CI] = 2.15-12.87, p = 0.0003; bone level vs. tissue level: crude OR = 5.08, 95% CI = 2.10-12.24; p = 0.003, respectively). After adjustment for confounding factors, the risks of PI were significantly associated with implant sites (premolar vs. molar: adjusted OR [AOR] = 4.62, 95% CI = 1.74-12.24; p = 0.002) and implant types (bone level vs. tissue level: AOR = 6.46, 95% CI = 1.67-25.02; p = 0.007). The reason for dental extraction-that is, periodontitis or nonperiodontitis-was not significantly associated with PI. CONCLUSION ARP reduces the incidence of periodontitis-related PI at extraction sites. To address the limitations of our study, consistent and prospective randomized controlled trials are warranted.
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Affiliation(s)
- Yu-Hsiang Chou
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yan-Jun Chen
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Cheng-Pin Pan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Hsi Yen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Feng Liu
- Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - I-Jung Feng
- Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Ying-Chu Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kai-Fang Hu
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Lin IP, Chang CC, Tu CC, Lai CL, Su FY. Efficacy of free gingival grafting to augment keratinized mucosa around dental implants in posterior regions after restorative procedures: A retrospective clinical study. J Prosthet Dent 2023; 130:715-722. [PMID: 35000695 DOI: 10.1016/j.prosdent.2021.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 01/22/2023]
Abstract
STATEMENT OF PROBLEM Data on the shrinkage of free gingival grafts (FGGs) vary. Most studies have analyzed grafts in nonmolar sites because of measurement limitations and have addressed the changes in grafts and keratinized mucosa width (KMW) only in the early healing phase. PURPOSE The purpose of this retrospective clinical study was to assess the dimensional changes of an FGG in the posterior regions and their influencing factors, with the aim of obtaining sufficient and stable KMW after restoration. MATERIAL AND METHODS A total of 77 implants in 40 participants who had undergone an FGG surgery were recruited. Graft sizes during surgery and the surface areas of keratinized mucosa at the follow-up visit after restorations were compared by digital analysis and verified by clinical measurements and photographs. The association between shrinkage and the graft sizes, implant location, and sex and age of the participants was evaluated. The influence of the shrinkage of FGG on the KMW after restoration was analyzed by multivariable linear regression with generalized estimating equation (GEE) models. RESULTS The mean ±standard deviation shrinkage of FGG around implants in the posterior regions was 24.76 ±14.77%, and the mean ±standard deviation KMW was 4.16 ±1.77 mm at the follow-up visit. Larger grafts had a statistically higher shrinkage ratio (P<.001). No statistically significant difference was found regarding the effect of implant location, sex, and age on the shrinkage of FGG and final KMW (P>.05). The mean ±standard deviation follow-up period after restoration was 12.45 ±7.73 months CONCLUSIONS: Free gingival grafting was found to be a predictable treatment approach for augmentation of KMW around implants in the posterior region after the fabrication of prostheses as long as grafts of sufficient size were placed. Stable outcomes were shown in the study participants in the follow-up period of up to 3 years.
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Affiliation(s)
- I-Ping Lin
- Clinical Instructor/Director, Division of Periodontology, Department of Dentistry, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan, ROC; Lecturer, Graduate Institute of Clinical Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei City, Taiwan, ROC
| | - Chung-Chieh Chang
- Clinical Instructor, Division of Periodontology, Department of Dentistry, Chang Gung Memorial Hospital Linkou Main Branch and Chang Gung University, Taoyuan City, Taiwan, ROC.
| | - Chia-Chun Tu
- Graduate student, Graduate Institute of Clinical Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei City, Taiwan, ROC
| | - Chao-Lun Lai
- Director, Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei City, Taiwan, ROC
| | - Fang-Ying Su
- Statistical Technician, Department of Medical Research, National Taiwan University Hsin-Chu Branch, Hsinchu, Taiwan, ROC
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Aljalloud AA, Dayoub S, Tolibah YA. Prevalence and risk factors of peri-implant diseases at patient-level: A cross-sectional study in Syria. Clin Exp Dent Res 2023; 9:783-790. [PMID: 37767767 PMCID: PMC10582216 DOI: 10.1002/cre2.792] [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: 07/05/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVES This research aims to assess the prevalence of peri-implant diseases and to analyze variables of the probable risk at the patient level associated with the occurrence of peri-implant diseases in Syrian patients. MATERIALS AND METHODS A cross-sectional study has been carried out on 142 patients with 380 dental implants placed between 2015 and 2021. Patients were invited by phone to return to Damascus University's Periodontology Department for clinical and radiological examination. A descriptive statistical analysis was implemented for the prevalence of peri-implant diseases at the level of the patients. Also, the peri-implant diseases' factors of risk were determined by the multivariate analytical model. RESULTS The prevalence rate of peri-implant mucositis and peri-implantitis in patients was 58.5% and 25.4%, respectively. Peri-implant disease is associated with multivariate risk indices, gender female (peri-implant mucositis [OR = 0.269; 95% CI: 0.131-0.552] and peri-implantitis [OR = 0.561; 95% CI: 0.561-0.216]), diabetes (peri-implant mucositis [OR = 3.4; 95% CI: 1.73-12.73]), periodontitis (peri-implant mucositis [OR = 2.409; 95% CI: 1.760-2.613], peri-implantitis [OR = 10.445; 95% CI: 4.097-26.629]). CONCLUSIONS Peri-implant diseases are common in the Syrian community. Several patient-level variables (gender female, diabetes, and periodontitis) are associated with peri-implant disease.
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Affiliation(s)
| | - Suleiman Dayoub
- Department of PeriodontologyFaculty of Dentistry, Damascus UniversityDamascusSyria
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Mayer Y, Khoury J, Horwitz J, Ginesin O, Canullo L, Gabay E, Giladi HZ. A novel nonsurgical therapy for peri-implantitis using focused pulsed electromagnetic field: A pilot randomized double-blind controlled clinical trial. Bioelectromagnetics 2023; 44:144-155. [PMID: 37655846 DOI: 10.1002/bem.22481] [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: 03/03/2023] [Revised: 05/06/2023] [Accepted: 07/18/2023] [Indexed: 09/02/2023]
Abstract
Pulsed electromagnetic field (PEMF) therapy modulates the immune response and is successfully used in orthopedics to treat osteoarthritis and improve bone regeneration. This may suggest that this treatment may consequently reduce peri-implant soft tissue inflammation and marginal bone loss. To compare clinical, radiographic, and immunological results following nonsurgical treatment for peri-implantitis with or without PEMF therapy. Patients with peri-implantitis were included: pocket probing depth (PPD) between 6 and 8 mm with bleeding on probing (BOP); crestal bone loss between 3 and 5 mm. A novel healing abutment that contained active (test) or inactive (control) PEMF was connected. PEMF was administered via the abutment at exposure ratio of 1/500-1/5000, intensity: 0.05-0.5 mT, frequency: 10-50 kHz for 30 days. Nonsurgical mechanical implant surface debridement was performed. Patients were examined at baseline, 1 and 3 months. Clinical assessment included: plaque index, BOP, PPD, recession, and bone crest level which was radiography measured. Samples of peri-implant crevicular fluid were taken to analyze interleukin-1β (IL-1β). Twenty-three patients (34 implants; 19 control, 15 test) were included. At the follow-up, mean crestal bone loss was lower in the test group at 1 and 3 months (2.48 mm vs. 3.73 mm, p < 0.05 and 2.39 vs. 3.37, p < 0.01). IL-1β levels were also lower in the test group at 2 weeks (72.86 pg/mL vs. 111.7, p < 0.05). Within all the limitation of this preliminary study, the test group improved clinical parameters after a short-term period compared to the control group.
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Affiliation(s)
- Yaniv Mayer
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Juan Khoury
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
| | - Jacob Horwitz
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ofir Ginesin
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Luigi Canullo
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, Genova, Italy
| | - Eran Gabay
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Hadar Z Giladi
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Lafuente-Ibáñez-de-Mendoza I, Marichalar-Mendia X, García-De-La-Fuente AM, Quindós-Andrés G, Eraso-Barrio E, Martínez-Conde-Llamosas R, Fernández-Jiménez A, Aguirre-Urizar JM. Presence and implication of Candida spp. in patients with peri-implantitis enrolled in a supportive peri-implant therapy program of the Basque Country (Spain). A case-control study. Clin Implant Dent Relat Res 2023; 25:938-947. [PMID: 37259674 DOI: 10.1111/cid.13226] [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: 03/13/2023] [Revised: 04/17/2023] [Accepted: 05/12/2023] [Indexed: 06/02/2023]
Abstract
INTRODUCTION The peri-implant sulcus is a good niche for infectious colonization such as Candida spp. In this study, the level of Candida spp. fungal colonization is analyzed in patients with peri-implantitis under supportive peri-implant therapy, as well as its correlation with the main clinicopathological data. METHODS A case-control study was carried out on 161 patients treated with dental implants, 80 with PI and 81 without PI, which corresponded to 91 women and 70 men, whose mean age was 60.90 years. A specific protocol was completed for the clinical and implant data. Microbiological samples were taken by oral rinse and with paper tips from the peri-implant sulcus. For the quantitative and qualitative analysis Candida Chromogenic Agar/CONDA plates were incubated for 72 h at 36 + 1°C. Fungal growth was considered active when having more than 50 CFU. Specific Candida spp. cultures were later confirmed by API ID 32C and PCR. RESULTS Fungal growth was achieved in 28% of oral rinse and 6.75% of peri-implant fluid samples. No significant differences were recognized between study groups. Most of the cultures (>65%) showed more than 50 CFU. The most frequent species were Candida albicans and Candida parapsilosis. There was no association between different PI risk factors and fungal data. The presence of Candida spp. in the oral cavity of patients with dental implants was related to total edentulism and the use of implant-fixed complete prosthesis implant-retained removable prosthesis. CONCLUSIONS These results suggest that there is no link between PI and presence of Candida in patients with dental implants undergoing regular supportive periodontal therapy.
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Affiliation(s)
| | - Xabier Marichalar-Mendia
- Department of Nursery I, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Ana María García-De-La-Fuente
- Department of Stomatology II, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Guillermo Quindós-Andrés
- Department of Immunology, Microbiology, Parasitology, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Elena Eraso-Barrio
- Department of Immunology, Microbiology, Parasitology, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Leioa, Spain
| | | | - Aitziber Fernández-Jiménez
- Department of Stomatology II, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - José Manuel Aguirre-Urizar
- Department of Stomatology II, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Leioa, Spain
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Laleman I, Lambert F. Implant connection and abutment selection as a predisposing and/or precipitating factor for peri-implant diseases: A review. Clin Implant Dent Relat Res 2023; 25:723-733. [PMID: 36825512 DOI: 10.1111/cid.13185] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/17/2023] [Indexed: 02/25/2023]
Abstract
Peri-implant mucosal integration is becoming a critical aspect for long term implant health and can be triggered the selection of implant components. The aim of this review is therefore to investigate the evidence concerning implant connection and abutment characteristics (abutment materials, design, handling) as predisposing or precipitating factor for peri-implant mucositis and peri-implantitis. Although the evidence that these features can directly predispose/precipitate peri-implant diseases is limited, there are -few- studies showing a potential role of the implant connection, trans-mucosal configuration, and handling in the development of early bone loss and/or peri-implantitis. With bone level implants, conical internal connections (with inherent platform switching) might be preferred over internal flat-flat and external connections to decrease the risk of early bone loss and potentially the risk of peri-implant disease. Moreover, there is a trend suggesting moving the prosthetic interface coronally (to the juxta-mucosal level) as soon as possible to reduce the number of disconnections and to limit the risk of cements remnants. This can be achieved by choosing a tissue-level implant or to place a trans-mucosal abutment (one abutment-one time approach) to optimize the peri-implant soft tissue seal. In absence of evidence for the biocompatibility regarding several restorative materials, biocompatible materials such as titanium or zirconia should be preferred in the trans-mucosal portion. Finally, higher implants (≥2mm) with an emergence angle below 30° seem more favourable. It should however be noted that some of this information is solely based on indirect information (such as early bone loss) and more research is needed before making firm recommendations about abutment choice. [Correction added on 13 March 2023, after first online publication: 'longer implants (≥2mm)' was changed to 'higher implants (≥2mm)' in this version.].
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Affiliation(s)
- Isabelle Laleman
- Department of Periodontology and oro-dental Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
- Dental Biomaterials Research Unit (d-BRU), Faculty of Medicine, University of Liège, Liège, Belgium
| | - France Lambert
- Department of Periodontology and oro-dental Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
- Dental Biomaterials Research Unit (d-BRU), Faculty of Medicine, University of Liège, Liège, Belgium
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11
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Tardelli JDC, Bagnato VS, Reis ACD. Bacterial Adhesion Strength on Titanium Surfaces Quantified by Atomic Force Microscopy: A Systematic Review. Antibiotics (Basel) 2023; 12:994. [PMID: 37370313 DOI: 10.3390/antibiotics12060994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/04/2022] [Accepted: 12/05/2022] [Indexed: 06/29/2023] Open
Abstract
Few studies have been able to elucidate the correlation of factors determining the strength of interaction between bacterial cells and substrate at the molecular level. The aim was to answer the following question: What biophysical factors should be considered when analyzing the bacterial adhesion strength on titanium surfaces and its alloys for implants quantified by atomic force microscopy? This review followed PRISMA. The search strategy was applied in four databases. The selection process was carried out in two stages. The risk of bias was analyzed. One thousand four hundred sixty-three articles were found. After removing the duplicates, 1126 were screened by title and abstract, of which 57 were selected for full reading and 5 were included; 3 had a low risk of bias and 2 moderated risks of bias. (1) The current literature shows the preference of bacteria to adhere to surfaces of the same hydrophilicity. However, this fact was contradicted by this systematic review, which demonstrated that hydrophobic bacteria developed hydrogen bonds and adhered to hydrophilic surfaces; (2) the application of surface treatments that induce the reduction of areas favorable for bacterial adhesion interfere more in the formation of biofilm than surface roughness; and (3) bacterial colonization should be evaluated in time-dependent studies as they develop adaptation mechanisms, related to time, which are obscure in this review.
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Affiliation(s)
- Juliana Dias Corpa Tardelli
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto 14040-904, Brazil
| | - Vanderlei Salvador Bagnato
- Department of Physics and Materials Science, São Carlos Institute of Physics, University of São Paulo (USP), São Carlos 13566-970, Brazil
| | - Andréa Cândido Dos Reis
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto 14040-904, Brazil
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12
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Rusu D, Rădulescu V, Stratul SI, Luchian I, Calniceanu H, Vela O, Boia S, Kardaras G, Chinnici S, Soanca A. Clinical and Radiological Characterization of the Long-Term Association between Unaffected/Minimally Affected Implants and History of Severe Periodontitis: A Retrospective Study. Diagnostics (Basel) 2023; 13:1880. [PMID: 37296732 PMCID: PMC10253056 DOI: 10.3390/diagnostics13111880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/05/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVES The objectives of this research were to compare, retrospectively, the clinical and radiographic modifications of periodontal parameters and peri-implant conditions and to analyze the relationship between the changes in periodontal parameters and peri-implant conditions over a mean follow-up period of 7.6 years in a treated population with progressive/uncontrolled periodontitis and at least one unaffected/minimally affected implant. MATERIALS AND METHODS Nineteen partially edentulous patients having 77 implants inserted, with a mean age of 54.84 ± 7.60 years, were matched for age, gender, compliance, smoking status, general health, and implant characteristics. Periodontal parameters were evaluated in the remaining teeth. Means per teeth and implants were used when making comparisons. RESULTS Statistically significant differences were observed between baseline and final examination in teeth for tPPD, tCAL and MBL. Furthermore, at 7.6 years, statistically significant differences existed between implants and teeth with regard to iCAL and tCAL (p = 0.03). Multiple regression analyses were performed and revealed a significant association regarding iPPD and CBL with smoking and periodontal diagnosis. In addition, FMBS was significantly associated with CBL. Unaffected/minimally affected implants were found more frequently in the posterior mandible, with longer lengths (>10 mm) and small diameters (<4 mm), including in screwed multi-unit bridges. CONCLUSIONS The study results appear to reflect minimally affected mean crestal bone-level loss around implants in comparison to the marginal bone-level loss around teeth when exposed to uncontrolled severe periodontal disease over a mean period of observation of 7.6 years, while the unaffected/minimally affected implants seemed to benefit from a combination of clinical factors, including posterior mandibular position, smaller diameters, and screwed multi-unit restorations.
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Affiliation(s)
- Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.R.); (H.C.); (O.V.); (S.C.)
| | - Viorelia Rădulescu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.R.); (H.C.); (O.V.); (S.C.)
| | - Stefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.R.); (H.C.); (O.V.); (S.C.)
| | - Ionut Luchian
- Department of Periodontology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Horia Calniceanu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.R.); (H.C.); (O.V.); (S.C.)
| | - Octavia Vela
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.R.); (H.C.); (O.V.); (S.C.)
| | - Simina Boia
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.R.); (H.C.); (O.V.); (S.C.)
| | - Giorgios Kardaras
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.R.); (H.C.); (O.V.); (S.C.)
| | - Salvatore Chinnici
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.R.); (H.C.); (O.V.); (S.C.)
| | - Andrada Soanca
- Department of Periodontology, Faculty of Dental Medicine, Applicative Periodontal Regeneration Research Unit, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj Napoca, Romania
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Lazăr L, Dakó T, Mureșan IÉ, Suciu M, Maftei GA, Tatarciuc M, Lazăr AP. Is Laser Therapy an Adjuvant in the Treatment of Peri-Implant Mucositis? A Randomized Clinical Trial. Diagnostics (Basel) 2023; 13:diagnostics13061192. [PMID: 36980500 PMCID: PMC10047770 DOI: 10.3390/diagnostics13061192] [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: 02/26/2023] [Revised: 03/14/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023] Open
Abstract
(1) Background: Early diagnosis and treatment of peri-implant mucositis may reduce inflammatory markers and halt the progression of the condition to peri-implantitis. Adjunctive laser treatment may have therapeutic benefits that are not yet well known. The aim of this study was to determine the advantages and limitations of laser therapy as an adjuvant in the treatment of peri-implant mucositis. (2) Methods: A total of 42 patients with at least 2 implants situated in different hemiarches were included in this study and divided into two groups: G1 (received laser therapy) and G2 (no laser therapy). Periodontal health status indices were recorded at the initial moment (T0), and all patients underwent non-surgical debridement therapy accompanied by oral hygiene training. In patients from group G1, one implant site received adjuvant laser therapy (subgroup IL), and the other one did not receive active laser light (IC). The plaque index (PI), probing pocket depth (PPD), and bleeding on probing (BOP) values recorded after 3 months (T1) and 6 months (T2) were analyzed and compared with those at T0. (3) Results: PI values considerably reduced at moment T1 and T2 for both G1 and G2 (p = 0.0031). PPD was also reduced, but the difference between the groups and the three recording moments was not statistically significant. Statistically significant differences were found when comparing the BOP values between G1 IL and G1 IC for T0/T1 (p = 0.0182) and T1/T2 (p < 0.0001), but there was no significant difference between G2 and G1 IL or G1 IC. (4) Conclusions: Laser therapy as an adjunct to conventional treatment of peri-implant mucositis leads to a statistically significant reduction in bleeding on probing at 3-month and 6-month re-evaluations. Moreover, it leads to an evident reduction in probing depth but with no statistical significance. These results should be interpreted with caution, and more in-depth research should be performed to create a complete laser therapy protocol for peri-implant mucositis.
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Affiliation(s)
- Luminița Lazăr
- Department of Periodontology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
| | - Timea Dakó
- Department of Odontology and Oral Pathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
| | | | - Mircea Suciu
- Department of Oral Rehabilitation and Occlusology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
| | - George-Alexandru Maftei
- Department of Dento-Alveolar Surgery and Oral Pathology, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Monica Tatarciuc
- Department of Oral Implantology, Removable Dentures and Technology, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Ana-Petra Lazăr
- Department of Oral Rehabilitation and Occlusology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
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14
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Sadowsky SJ. Peri-implantitis after 40 years: Evidence, mechanisms, and implications: A mapping review. J Prosthet Dent 2023:S0022-3913(23)00114-2. [PMID: 36935269 DOI: 10.1016/j.prosdent.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 03/19/2023]
Abstract
STATEMENT OF PROBLEM The high prevalence of peri-implantitis (PI) continues to plague patients and the disease is resistant to present treatment regimens. An analysis of the available research is lacking. PURPOSE Given the abundance and diversity of research on the topic of PI, the purpose of this mapping review was to synthesize the literature on the prevention of PI, the histopathology of the disease, the state of present therapeutics, and any emerging treatments. MATERIAL AND METHODS An extensive literature search was undertaken by using the electronic databases of PubMed, Web of Science, and Science Direct. The keyword strings were peri-implantitis, dental implant, risk assessment, histopathology, prosthesis design, and treatment. The filters applied were time interval from 2000 to 2002; language, English. RESULTS A total of 3635 articles were taken from PubMed, 3686 articles from Web of Science, and 2450 articles from Science Direct. After applying the inclusion and exclusion criteria to the titles and abstracts of selected investigations, 214 studies were retrieved. CONCLUSIONS The evidence reflects a concerning incidence of PI, without a predictable treatment protocol. An in-depth patient risk assessment considering risk modification, emphasis on surgical and restorative expertise, and strict recall and maintenance is essential to minimize PI.
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Affiliation(s)
- Steven J Sadowsky
- Professor, Preventive and Restorative Department, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, Calif.
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15
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Mahardawi B, Jiaranuchart S, Damrongsirirat N, Arunjaroensuk S, Mattheos N, Somboonsavatdee A, Pimkhaokham A. The lack of keratinized mucosa as a risk factor for peri-implantitis: a systematic review and meta-analysis. Sci Rep 2023; 13:3778. [PMID: 36882495 PMCID: PMC9992510 DOI: 10.1038/s41598-023-30890-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
This study aimed to investigate the effect of the lack of keratinized mucosa on the risk of peri-implantitis, while also accounting for possible confounding factors. A literature search was conducted in PubMed and Scopus, including human studies that assessed the presence and width of keratinized mucosa in relation to the occurrence of peri-implantitis. Twenty-two articles were included, and 16 cross-sectional studies we meta-analyzed. The prevalence of peri-implantitis was 6.68-62.3% on patient-level and 4.5-58.1% on implant-level. The overall analysis indicated that the lack of keratinized mucosa was associated with a higher prevalence of peri-implantitis (OR = 2.78, 95% CI 2.07-3.74, p < 0.00001). Similar results were shown when subgroup analyses were performed, including studies with a similar case definition of peri-implantitis (Marginal Bone Loss, MBL ≥ 2 mm) (OR = 1.96, 95% CI 1.41-2.73, p < 0.0001), fixed prostheses only (OR = 2.82, 95% CI 1.85-4.28, p < 0.00001), patients under regular implant maintenance (OR = 2.08, 95% CI 1.41-3.08, p = 0.0002), and studies adjusting for other variables (OR = 3.68, 95% CI 2.32-5.82, p = 0.007). Thus, the lack of keratinized mucosa is a risk factor that increases the prevalence of peri-implantitis and should be accounted for when placing dental implants.
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Affiliation(s)
- Basel Mahardawi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Sirimanas Jiaranuchart
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Napat Damrongsirirat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Sirida Arunjaroensuk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anupap Somboonsavatdee
- Department of Statistics, Chulalongkorn Business School, Chulalongkorn University, Bangkok, Thailand
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand.
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16
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Vilarrasa J, Soldini MC, Pons R, Valles C, Blasi G, Monje A, Nart J. Outcome indicators of non-surgical therapy of peri-implantitis: a prospective case series analysis. Clin Oral Investig 2023:10.1007/s00784-023-04918-2. [PMID: 36786958 DOI: 10.1007/s00784-023-04918-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/05/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES This study aims to identify patient and implant indicators influencing the non-surgical therapeutic outcomes of peri-implantitis at 6 months of follow-up. METHODS This case series involved patients with at least one implant diagnosed with peri-implantitis according to the 2017 World Workshop criteria. Non-surgical therapy consisted of mechanical debridement of the peri-implant pockets combined with metronidazole 500 mg 3 times a day for 7 days. At baseline and at 6 months, clinical and radiographic variables were collected to calculate treatment success (probing pocket depth reduction to 5 mm without bleeding on probing or < 5 mm irrespective of bleeding on probing at all implant sites, and lack of bone loss progression). The primary outcome was treatment success (%) at 6 months. The influence of the patient and implant/prosthetic variables upon disease resolution was assessed through simple and multiple logistic regression analyses at patient and implant level, using generalized estimation equations models. RESULTS A total of 74 patients and 107 implants were analyzed at 6 months. Disease resolution was established in 25.7% of the patients and 24.1% of the implants. Patients with stage IV and grade C periodontitis, inadequate oral hygiene at baseline, and wide diameter (≥ 4.5 mm) presented significantly greater treatment failure, whereas smokers and former smokers demonstrated a tendency toward failure. At 6 months, there was a significant decrease in probing pocket depth and bleeding on probing of 1.08 ± 1.06 mm and 14%, respectively. Radiographically, a significant gain in marginal bone level of 0.43 ± 0.56 mm was observed. CONCLUSION Disease resolution after non-surgical treatment of peri-implantitis is negatively influenced by the loss of support of the adjacent periodontium, poor baseline oral hygiene, and wide diameter implants (≥ 4.5 mm). CLINICAL RELEVANCE This study helps to discriminate the clinical situations in which non-surgical treatment is less likely to achieve treatment success at short term.
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Affiliation(s)
- Javi Vilarrasa
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Maria Costanza Soldini
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Ramón Pons
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain.
| | - Cristina Valles
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Gonzalo Blasi
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain.,Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, MI, USA.,Department of Periodontology, University of Bern, Bern, Switzerland
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
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17
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Diaz P, Gonzalo E, Villagra LJG, Miegimolle B, Suarez MJ. What is the prevalence of peri-implantitis? A systematic review and meta-analysis. BMC Oral Health 2022; 22:449. [PMID: 36261829 PMCID: PMC9583568 DOI: 10.1186/s12903-022-02493-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 10/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Peri-implantitis is a usual finding but estimates of its prevalence fluctuate very much. This may be due to the wide variety of disease definitions. This systematic review aims to estimate the overall prevalence of peri-implantitis and the effect of different study designs, function times and use of probing depth on prevalence rate. Methods Following electronic and manual searches of the literature published from January 2005 to December 2021, data were extracted from the studies fitting the study criteria. Fifty-seven articles were included in this study. Results Prevalence of peri-implantitis was 19.53% (95% CI 12.87–26.19) at the patient-level, and 12.53% (95% CI 11.67–13.39) at the implant-level and it remains highly variable even following restriction to the clinical case definition. The use of probing depth like diagnostic criteria affected the prevalence data. Conclusion The results indicate that it remains essential the identification of the diagnostic markers for more accurate disease classification.
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Affiliation(s)
- Pedro Diaz
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid (UCM), Pza Ramón y Cajal S/N, 28040, Madrid, Spain
| | - Esther Gonzalo
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid (UCM), Pza Ramón y Cajal S/N, 28040, Madrid, Spain.
| | - Luis J Gil Villagra
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid (UCM), Pza Ramón y Cajal S/N, 28040, Madrid, Spain
| | - Barbara Miegimolle
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid (UCM), Pza Ramón y Cajal S/N, 28040, Madrid, Spain
| | - Maria J Suarez
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, University Complutense of Madrid (UCM), Pza Ramón y Cajal S/N, 28040, Madrid, Spain
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Zhao R, Zhao W, Huang J, Fang M, Dong Y, Chen J, Ji Z, Tian M. Prevalence and Risk Factors of Peri-Implant Disease: A Retrospective Case-Control Study in Western China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12667. [PMID: 36231969 PMCID: PMC9566187 DOI: 10.3390/ijerph191912667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/24/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The present study aimed to investigate the prevalence of peri-implant disease and identify potential disease risk factors in western China. METHODS The present retrospective study was conducted in 131 consecutive patients receiving 248 dental implants treated with implant-supported prostheses with a mean follow-up of 2.52 years. Several patient-related, implant-related, and oral hygiene maintenance factors were analyzed. RESULTS Peri-implant disease developed in 68 (51.91%) patients and 110 (44.35%) implants. The prevalence of peri-implant mucositis and peri-implantitis were 45.80% and 7.63%, respectively, at the subject level, and 36.69% and 7.66%, respectively, at the implant level. Multivariate analysis exhibited that male [odds ratio (OR) = 1.91; 95% confidence interval (CI): 1.02-3.57; p = 0.04], implant length < 10mm (OR = 7.87; 95% CI:1.62-38.46; p = 0.01), poor proximal contact of the prosthesis (OR = 1.90; 95% CI: 1.06-3.42; p = 0.03), tooth brushing once a day (OR = 3.11; 95% CI: 1.26-7.68; p = 0.04) and moderate periodontitis (OR = 13.00; 95% CI: 4.38-38.60; p < 0.01) were independent risk factors for peri-implant disease.
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Affiliation(s)
- Rui Zhao
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Wen Zhao
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Jin Huang
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Ming Fang
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Yan Dong
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Jihua Chen
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Zhaohua Ji
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an 710032, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Air Force Medical University, Xi’an 710032, China
| | - Min Tian
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
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Tapered, Sand-Blasted, Large-Grit, and Acid-Etched Surfaced Internal Dental Implant in the Diverse Pathologic Jaw. J Craniofac Surg 2022; 33:2161-2168. [DOI: 10.1097/scs.0000000000008743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 03/30/2022] [Indexed: 11/25/2022] Open
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20
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Roccuzzo A, Klossner S, Stähli A, Imber JC, Eick S, Sculean A, Salvi GE. Non-surgical mechanical therapy of peri-implantitis with or without repeated adjunctive diode laser application. A 6-month double-blinded randomized clinical trial. Clin Oral Implants Res 2022; 33:900-912. [PMID: 35775311 PMCID: PMC9546299 DOI: 10.1111/clr.13969] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/14/2022] [Accepted: 06/24/2022] [Indexed: 11/27/2022]
Abstract
Objectives The objective of this study is to investigate the outcomes following non‐surgical therapy of peri‐implantitis (PI) with or without adjunctive diode laser application. Materials and methods A double‐blinded randomized controlled clinical trial was carried out in 25 subjects with 25 implants diagnosed with PI. Following curettage of granulation tissue, test implants (T) were treated with adjunctive application of a diode laser for 90 s (settings: 810 nm, 2.5 W, 50 Hz, 10 ms), while at control implants (C) non‐activated adjunctive diode laser was applied. The entire treatment procedure was performed at days 0 (i.e., baseline), 7 and 14. The primary outcome measure was change in mean pocket probing depth (PPD). Clinical and microbiological outcomes, as well as host‐derived inflammatory markers were evaluated at baseline, 3 and 6 months, while radiographic outcomes were assessed at baseline and at the 6‐month follow‐up. Results No statistically significant differences with respect to baseline patient characteristic were observed. After 6 months, both test and control implants yielded statistically significant PPD changes compared with baseline (T: 1.28 and C: 1.47 mm) but without statistically significant difference between groups (p = .381). No statistically significant changes in peri‐implant marginal bone levels were detected (p = .936). No statistically significant differences between test and control implants were observed with respect to microbiological and host‐derived parameters (p > .05). At the 6‐month follow‐up, treatment success was observed in 41.7% (n = 5) of test and 46.2% (n = 6) of control patients, respectively (p = .821). Conclusion Repeated adjunctive application of diode laser in the non‐surgical management of PI failed to provide significant benefits compared with mechanical instrumentation alone.
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Affiliation(s)
- Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sabrina Klossner
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sigrun Eick
- 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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21
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Ramanauskaite A, Schwarz F, Sader R. Influence of width of keratinized tissue on the prevalence of peri-implant diseases: A systematic review and meta-analysis. Clin Oral Implants Res 2022; 33 Suppl 23:8-31. [PMID: 35763022 DOI: 10.1111/clr.13766] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/25/2021] [Accepted: 05/03/2021] [Indexed: 12/16/2022]
Abstract
AIM To evaluate the influence of the width of keratinized tissue (KT) on the prevalence of peri-implant diseases, and soft- and hard-tissue stability. MATERIALS AND METHODS Clinical studies reporting on the prevalence of peri-implant diseases (primary outcome), plaque index (PI), modified plaque index (mPI), bleeding index (mBI), bleeding on probing (BOP), probing pocket depths (PD), mucosal recession (MR), and marginal bone loss (MBL) and/or patient-reported outcomes (PROMs; secondary outcomes) were searched. The weighted mean differences (WMD) were estimated for the assessed clinical and radiographic parameters by employing a random-effect model that considered different KT widths (i.e., <2 and ≥2 mm). RESULTS Twenty-two articles describing 21 studies (15 cross-sectional, five longitudinal comparative studies, and one case series with pre-post design) with an overall high to low risk of bias were included. Peri-implant mucositis and peri-implantitis affected 20.8% to 42% and at 10.5% to 44% of the implants with reduced or absent KT (i.e., <2 mm or 0 mm). The corresponding values at the implant sites with KT width of ≥2 mm or >0 mm were 20.5% to 53% and 5.1% to 8%, respectively. Significant differences between implants with KT < 2 mm and those with KT ≥ 2 mm were revealed for WMD for BOP, mPI, PI, MBL, and MR all favoring implants with KT ≥ 2 mm. CONCLUSION Reduced KT width is associated with an increased prevalence of peri-implantitis, plaque accumulation, soft-tissue inflammation, mucosal recession, marginal bone loss, and greater patient discomfort.
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Affiliation(s)
- Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurtam am Main, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurtam am Main, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurtam am Main, Germany
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22
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Astolfi V, Ríos-Carrasco B, Gil-Mur FJ, Ríos-Santos JV, Bullón B, Herrero-Climent M, Bullón P. Incidence of Peri-Implantitis and Relationship with Different Conditions: A Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074147. [PMID: 35409826 PMCID: PMC8998347 DOI: 10.3390/ijerph19074147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/14/2022] [Accepted: 03/29/2022] [Indexed: 01/09/2023]
Abstract
Articles on the prevalence of peri-implant diseases showed that 90% of peri-implant tissues had some form of inflammatory response and a prevalence of peri-implantitis from 28% to 51% according to various publications. Objective: To provide an overview of how risk factors can be related with peri-implantitis. Methods: A retrospective longitudinal study including 555 implants placed in 132 patients was evaluated based on the presence of peri-implantitis following the criteria of Renvert et al. 2018. Results: In total, 21 patients (15.9%) suffered peri-implantitis (PPG) and 111 patients (84.1%) did not suffer peri-implantitis (NPG). The results reveal that smokers have a high incidence of peri-implantitis (72.7%) compared to non-smokers (27.3%) (p < 0.0005). Another variable with significant results (p < 0.01) was periodontitis: 50% PPG and 23.9% NPG suffered advanced periodontitis. Systemic diseases such as arterial hypertension, diabetes mellitus, osteoporosis, and cardiovascular diseases do not show a statistically significant influence on the incidence of peri-implantitis. Patients who did not attend their maintenance therapy appointment had an incidence of peri-implantitis of 61.4%, compared to 27.3% in those who attend (p < 0.0001). From the results obtained, we can conclude that relevant factors affect peri-implantitis, such as tobacco habits, moderate and severe periodontitis, and attendance in maintenance therapy.
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Affiliation(s)
- Víctor Astolfi
- Department of Periodontology, School of Dentistry, Universidad de Seville, C/Avicena S/N, 41009 Seville, Spain; (V.A.); (J.V.R.-S.); (B.B.); (P.B.)
| | - Blanca Ríos-Carrasco
- Department of Periodontology, School of Dentistry, Universidad de Seville, C/Avicena S/N, 41009 Seville, Spain; (V.A.); (J.V.R.-S.); (B.B.); (P.B.)
- Correspondence:
| | - Francisco Javier Gil-Mur
- Technological Health Research Center, Biomaterials of the Faculties of Medicine and Dentistry, International University of Cataluña, 08017 Barcelona, Spain;
| | - José Vicente Ríos-Santos
- Department of Periodontology, School of Dentistry, Universidad de Seville, C/Avicena S/N, 41009 Seville, Spain; (V.A.); (J.V.R.-S.); (B.B.); (P.B.)
| | - Beatriz Bullón
- Department of Periodontology, School of Dentistry, Universidad de Seville, C/Avicena S/N, 41009 Seville, Spain; (V.A.); (J.V.R.-S.); (B.B.); (P.B.)
| | | | - Pedro Bullón
- Department of Periodontology, School of Dentistry, Universidad de Seville, C/Avicena S/N, 41009 Seville, Spain; (V.A.); (J.V.R.-S.); (B.B.); (P.B.)
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23
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Namadmalian Esfahani N, Mohseni Salehimonfared S, Khorsand A, Shamshiri AR. Dimensional changes of keratinized mucosa after accordion versus conventional free gingival graft around dental implants: A randomized two-arm parallel clinical trial. Clin Oral Implants Res 2022; 33:472-481. [PMID: 35191105 DOI: 10.1111/clr.13907] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/17/2022] [Accepted: 02/15/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Free gingival graft (FGG) is the most effective way to increase the apico-coronal width of the keratinized mucosa. In case of limited donor tissue, the accordion technique can be used. This study compared FGG for dimensional and clinical changes using accordion and conventional methods. MATERIALS AND METHODS Ninety-four implants with keratinized tissue deficiency (< 2mm) were randomly assigned to treatment with accordion (49 implants) and conventional (45 implants) FGG. Endpoints including apico-coronal keratinized tissue width, vertical shrinkage, vestibular depth, probing depth, bleeding on probing, and plaque index were measured. The graft harvesting and recipient bed preparation method were similar in the two groups, and the only difference was the graft length. FGG was harvested with a length 40% shorter than the mesiodistal length of the recipient area in the accordion method and as much as the recipient area in the conventional method. RESULTS vertical graft shrinkage 1, 3 and 6 months following conventional graft placement was 12.04±14.99, 17.12±20.40, 23.29±24.63 percent, respectively. In the accordion graft group, the shrinkage was significantly greater with 30.10±16.12, 36.99±15.51, 43.75±18.78 percent at 1, 3 and 6 months, respectively (p-Value<0.001). Other factors did not show a clinically significant difference between the two groups. CONCLUSIONS Comparison of vertical shrinkage changes shows that the shrinkage rate in the accordion group is significantly higher than the conventional group.
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Affiliation(s)
| | | | - Afshin Khorsand
- Periodontics Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Shamshiri
- Research Center for Caries Prevention, Dentistry Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Liu Y, Zhang WS, Tang ZH, Ye DD, Su S, Zhang SM, Qiu J. Anti-inflammatory effects of the immobilization of SEMA4D on titanium surfaces in an endothelial cell/macrophage indirect coculture model. Biomed Mater 2021; 17. [PMID: 34731839 DOI: 10.1088/1748-605x/ac3620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 11/03/2021] [Indexed: 11/12/2022]
Abstract
In this study, we established a procedure to prepare a Semaphorin4D (SEMA4D)-immobilized titanium surface and explored its effects on macrophage behaviors in an endothelial cell/macrophage indirect coculture model. The SEMA4D-bovine serum albumin complex was immobilized onto a preprocessed poly L-lysine titanium surface through NaOH hydrothermal treatment and self-assembly technology. All titanium specimens were examined for surface microstructure, surface element composition, and surface wettability by field emission scanning electron microscopy, x-ray photoelectron spectroscopy (XPS), and water contact angle measurement, respectively. Subsequently, we constructed an endothelial cell/macrophage indirect coculture model and evaluated the activation of NF-κB signaling pathway and the expression of proinflammatory cytokines (TNFα, IL-6, and IL-1β) in macrophages. In XPS analysis, the SEMA4D-immobilized titanium surface appeared as a loose porous structure covered with uniform film, which exhibited better hydrophilicity than the control smooth titanium surface. In the indirect coculture model, SEMA4D attenuated the activation of NF-κB signaling pathway of lipopolysaccharide-stimulated THP-1 macrophages, thereby downregulating the expression of proinflammatory cytokines in macrophages. In conclusion, SEMA4D could be immobilized on titanium surfaces through NaOH hydrothermal treatment and self-assembly technology. Meanwhile, SEMA4D immobilization altered the characteristics of the titanium surfaces, which negatively regulated macrophage behaviors in the endothelial cell/macrophage indirect coculture model.
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Affiliation(s)
- Yao Liu
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, People's Republic of China
| | - Wen-Si Zhang
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, People's Republic of China
| | - Ze-Hua Tang
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, People's Republic of China
| | - Di-di Ye
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, People's Republic of China
| | - Shan Su
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, People's Republic of China
| | - Song-Mei Zhang
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, United States of America
| | - Jing Qiu
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, People's Republic of China.,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, People's Republic of China
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25
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Ramanauskaite A, Becker K, Wolfart S, Lukman F, Schwarz F. Efficacy of rehabilitation with different approaches of implant-supported full-arch prosthetic designs: A systematic review. J Clin Periodontol 2021; 49 Suppl 24:272-290. [PMID: 34761399 DOI: 10.1111/jcpe.13540] [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: 06/23/2021] [Revised: 07/14/2021] [Accepted: 07/20/2021] [Indexed: 12/13/2022]
Abstract
AIM To evaluate the efficacy of different types of rehabilitation with fixed or removable full-arch implant-supported prosthesis designs in terms of implant loss and success in patients with at least one edentulous jaw, with tooth loss mainly due to periodontitis. MATERIALS AND METHODS Clinical studies with at least 12 months reporting on implant loss and implant success were searched. Meta-analysis was conducted to estimate cumulative implant loss considering different prostheses designs. RESULTS A total of 11 studies with unclear to low risk of bias were included in the analysis. Estimated cumulative implant loss for fixed prostheses within 1 year and 5 years was 0.64% (95% confidence interval [CI]: 0.31%-1.31%) and 1.85% (95% CI: 0.85%-3.95%), respectively. The corresponding values for removable prostheses amounted to 0.71% (95% CI: 0.22%-2.28%) and 4.45% (95% CI: 2.48%-7.85%). Peri-implantitis affected 10%-50% of the patients restored with implant-supported fixed prostheses. CONCLUSIONS Based on the limited low-quality data, the present analysis points to a low and similar cumulative implant loss within 1 year for patients with tooth loss mainly due to stage IV periodontitis restored with either removable or fixed implant-supported full-arch prosthesis. At 5 years of functioning, there was a tendency for better outcomes using fixed designs.
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Affiliation(s)
- Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt, Germany
| | - Kathrin Becker
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Center for Implantology, University Hospital Aachen, RWTH Aachen, Aachen, Germany
| | - Fanya Lukman
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt, Germany
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26
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Aslroosta H, Akbari S, Naddafpour N, Adnaninia ST, Khorsand A, Namadmalian Esfahani N. Effect of microthread design on the preservation of marginal bone around immediately placed implants: a 5-years prospective cohort study. BMC Oral Health 2021; 21:541. [PMID: 34670544 PMCID: PMC8529818 DOI: 10.1186/s12903-021-01881-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/04/2021] [Indexed: 11/24/2022] Open
Abstract
Background This study aimed to evaluate the effect of the microthread design at the implant neck on the preservation of marginal bone around immediately-placed implants in a 5-year follow up. Methods Thirty patients received 41 immediately placed implants which were randomly assigned to treatment groups with microthreaded implants (test group, n = 22) or threaded implants (control group, n = 19). Clinical and radiographic analyses were carried out after 1 and5 years. Plaque index, bleeding on probing, suppuration, probing depth and marginal bone loss were subject to evaluations. The results were analyzed with the T-test, Fisher’s exact test and Mann–Whitney U test. Results No implants failed; thirty-five implants (in 27 patients); 21 microthreaded and 14 threaded implants; completed the 5 year follow up. The mean values of the marginal bone loss in microthreaded and threaded groups were 1.12 ± 0.95 mm and 0.87 ± 0.78 mm, respectively during an observation period of 70.9 ± 10.4 months; the differences in marginal bone loss and other pre-implant parameters were not significant between groups (P > 0.05). Conclusion Both implant designs showed acceptable results in terms of the clinical parameters and marginal bone level. Within the limitation of this study, the results did not demonstrate any superiority of the microthread design compared to threaded one in marginal bone preservation around immediately placed implants over 5 years of loading.
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Affiliation(s)
- Hoori Aslroosta
- Periodontics Department, Dental Faculty, Tehran University of Medical Sciences, Tehran, Iran
| | - Solmaz Akbari
- Periodontics Department, Dental Implant Research Center, Dentistry Research Institute, Dental Faculty, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nima Naddafpour
- Periodontics Department, Dental Faculty, Islamic Azad University, Tehran, Iran
| | | | - Afshin Khorsand
- Periodontics Department, Dental Faculty, Tehran University of Medical Sciences, Tehran, Iran
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27
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Mattheos N, Janda M, Acharya A, Pekarski S, Larsson C. Impact of design elements of the implant supracrestal complex (ISC) on the risk of peri-implant mucositis and peri-implantitis: A critical review. Clin Oral Implants Res 2021; 32 Suppl 21:181-202. [PMID: 34642979 DOI: 10.1111/clr.13823] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 07/11/2021] [Accepted: 07/20/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The aim of this review was to investigate the evidence correlating the emergence profile (EP) and emergence angle (EA), peri-implant tissue height, implant neck design, abutment and/or prosthesis material, retention and connection types with risk of peri-implant mucositis and peri-implantitis. METHODS Seven focus questions were identified, and seven electronic search queries were conducted in PubMed. Human studies reporting on bleeding on probing, probing depth or case definitions of peri-implant mucositis and peri-implantitis were included. RESULTS Emerging evidence with bone-level implants suggests a link between EA combined with convex EP and peri-implantitis. Depth of the peri-implant sulcus of ≥3 mm is shown to be reducing the effectiveness of treatment of established peri-implant mucositis. Modification of the prosthesis contour is shown to be an effective supplement of the anti-infective treatment of peri-implant mucositis. Limited evidence points to no difference with regard to the risk for peri-implant mucositis between tissue- and bone-level implants, as well as the material of the abutment or the prosthesis. Limited evidence suggests the use or not of prosthetic abutments in external connections and does not change the risk for peri-implantitis. Literature with regard to prosthesis retention type and risk for peri-implantitis is inconclusive. CONCLUSIONS Limited evidence indicates the involvement of EA, EP, sulcus depth and restricted accessibility to oral hygiene in the manifestation and/or management of peri-implant mucositis/peri-implantitis. Conclusions are limited by the lack of consensus definitions and validated outcomes measures, as well as diverse methodological approaches. Purpose-designed studies are required to clarify current observations.
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Affiliation(s)
- Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Martin Janda
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Aneesha Acharya
- Department of Periodontics, Dr. D. Y. Patil Dental College and Hospital, Pune, India
| | - Stephanie Pekarski
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Christel Larsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Aiquel LL, Pitta J, Antonoglou GN, Mischak I, Sailer I, Payer M. Does the timing of implant placement and loading influence biological outcomes of implant-supported multiple-unit fixed dental prosthesis-A systematic review with meta-analyses. Clin Oral Implants Res 2021; 32 Suppl 21:5-27. [PMID: 34642990 PMCID: PMC9292924 DOI: 10.1111/clr.13860] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/23/2021] [Accepted: 06/10/2021] [Indexed: 12/04/2022]
Abstract
OBJECTIVE To investigate the impact of timing of implant placement and loading on implant survival and biological outcomes of multiple-unit implant-supported fixed dental prosthesis (FDPs). MATERIAL AND METHODS A literature search was performed by three independent reviewers for studies reporting on ≥10 patients with FPDs supported by ≥two implants over ≥3 years of follow-up. Data were analyzed on implant survival and biological complications as primary outcomes and biological events, including changes in peri-implant marginal bone level (MBL), probing depth, soft-tissue level, and health condition as secondary outcomes. RESULTS 7002 titles were identified, 360 full-texts were screened, and 14 studies were included. These comprised 6 randomized controlled studies (RCTs), 5 cohort studies, and 3 case series with identifiable implant placement and loading protocols in five of 09 possible combinations. All groups but one (IPIL) showed implant survival rates >90%. A meta-analysis based on 3 RCTs found no differences in survival rate between DPIL and DPDL (p = .227). CONCLUSIONS High survival rates for all studied implant placement and loading combinations were shown for FPDs over ≥3 years of follow-up. When a delayed implant placement protocol is applied, immediate or delayed loading demonstrated similar survival rates. The heterogeneity of the data did not allow to draw any further conclusions on the occurrence of biological complications related to timing of implant placement/loading.
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Affiliation(s)
- Louise Leite Aiquel
- Department of Oral Surgery and OrthodonticsUniversity Clinic of Dental Medicine and Oral HealthMedical University of GrazGrazAustria
| | - João Pitta
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
| | - Georgios N. Antonoglou
- Department of Oral Surgery and OrthodonticsUniversity Clinic of Dental Medicine and Oral HealthMedical University of GrazGrazAustria
| | - Irene Mischak
- Department of Oral Surgery and OrthodonticsUniversity Clinic of Dental Medicine and Oral HealthMedical University of GrazGrazAustria
| | - Irena Sailer
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
| | - Michael Payer
- Department of Oral Surgery and OrthodonticsUniversity Clinic of Dental Medicine and Oral HealthMedical University of GrazGrazAustria
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29
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Alhamad M, Barão VAR, Sukotjo C, Cooper LF, Mathew MT. Ti-Ions and/or Particles in Saliva Potentially Aggravate Dental Implant Corrosion. MATERIALS 2021; 14:ma14195733. [PMID: 34640130 PMCID: PMC8510105 DOI: 10.3390/ma14195733] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/17/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
The corrosive titanium products in peri-implant tissues are a potential risk factor for peri-implantitis. There is very limited information available on the effect of the corrosion and wear products on the dental implant corrosion. Therefore, we determined the influence of Ti-ions and Ti-particles on Ti corrosion. Eighteen commercially pure-Ti-grade-2 discs were polished to mirror-shine. Samples were divided into six groups (n = 3) as a function of electrolytes; (A) Artificial saliva (AS), (B) AS with Ti-ions (the electrolyte from group A, after corrosion), (C) AS with Ti-particles 10 ppm (D) AS with Ti-particles 20 ppm, (E) AS with Ti-ions 10 ppm, and (F) AS with Ti-ions 20 ppm. Using Tafel’s method, corrosion potential (Ecorr) and current density (Icorr) were estimated from potentiodynamic curves. Electrochemical Impedance Spectroscopy (EIS) data were used to construct Nyquist and Bode plots, and an equivalent electrical circuit was used to assess the corrosion kinetics. The corroded surfaces were examined through a 3D-white-light microscope and scanning electronic microscopy. The data demonstrated that the concentration of Ti-ions and corrosion rate (Icorr) are strongly correlated (r = 0.997, p = 0.046). This study indicated that high Ti-ion concentration potentially aggravates corrosion. Under such a severe corrosion environment, there is a potential risk of increased implant associated adverse tissue reactions.
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Affiliation(s)
- Mostafa Alhamad
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, USA;
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Valentim A. R. Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo 13414-903, Brazil;
| | - Cortino Sukotjo
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, USA;
- Department of Prosthodontics, School of Dental Medicine, Bahçeşehir University, Istanbul 34353, Turkey
- Correspondence: (C.S.); (M.T.M.)
| | - Lyndon F. Cooper
- Department of Oral Biology, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, USA;
| | - Mathew T. Mathew
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, USA;
- Correspondence: (C.S.); (M.T.M.)
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Curtis DA, Lin GH, Rajendran Y, Gessese T, Suryadevara J, Kapila YL. Treatment planning considerations in the older adult with periodontal disease. Periodontol 2000 2021; 87:157-165. [PMID: 34463978 DOI: 10.1111/prd.12383] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Periodontal health in the elderly is influenced by numerous factors, including systemic conditions, patient compliance, age-associated changes, and restorative procedures. The numerous comorbidities seen in the elderly necessitate individualized approaches for treatment planning. In this paper, we review how age, comorbidities, oral hygiene, and restorative dental procedures collectively influence the treatment and management of the periodontium in the elderly. The elderly population is predicted to double in 30 years, which will have an economic impact the dental profession needs to plan for. Preventative and noninvasive treatment, supportive periodontal therapy, and patient-specific maintenance plans are imperative to maintaining oral health in the older population. Multiple coexisting changes, including xerostomia, altered wound healing, altered bone physiology, altered microbiome, and diminished plaque control, can add complexity to periodontal management. Considerations of the patient's general health, the selected periodontal treatment plan, and the selected completed restorative procedures need to be considered. The influence of caries, fixed prosthodontics, partial dentures, shortened dental arch, and implant therapy can have unintended impacts on periodontal health in the elderly. Adverse periodontal outcomes in the elderly can be minimized by carefully assessing the patient's medical history, impact of medications, functional needs, properly finishing and contouring restorations to avoid plaque accumulation, and designing restorations to allow access for hygiene. Partial dentures can be a source of plaque accumulation leading to periodontal disease, caries, and recession around abutment teeth. A shortened dental arch should be considered as a functional and cost-effective alternative to partial dentures. With dental implants, the patient's tissue phenotype, keratinized tissue quantity, risk of peri-implantitis, and patient access for maintaining adequate oral hygiene are all important to consider. Implant risk-assessment tools show promise by providing a systematic approach for early diagnosis to avoid future complications.
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Affiliation(s)
- Donald A Curtis
- Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Guo-Hao Lin
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Yogalakshmi Rajendran
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Tsegazeab Gessese
- Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Jyotirmaie Suryadevara
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA.,Navy Dental Corps, Naval Medical Leader and Professional Development Command, Bethesda, Maryland, USA
| | - Yvonne L Kapila
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA
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Kao RT, Lin GH, Kapila Y, Sadowsky S, Curtis DA. A commentary on strategic extraction. J Periodontol 2021; 93:11-19. [PMID: 34435680 DOI: 10.1002/jper.20-0855] [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: 02/16/2021] [Revised: 07/23/2021] [Accepted: 08/10/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Advancements in strategies to maintain compromised teeth combined with a greater understanding of risks associated with dental implants invite a reassessment of the benefits of strategic extraction of a tooth with a questionable prognosis or of limited strategic value. METHODS Evidence of the management of compromised teeth and decision making for strategic extraction was reviewed. Additionally, the risks for peri-implantitis were evaluated from the perspective of patient centric, biologic, and biomechanical complications. RESULTS Recent clinical innovations support a more predictable maintenance of compromised dentition, and the clinical literature provides evidence of the risks associated with dental implants. CONCLUSIONS Because of the improvements in dental management of compromised dentition, strategic extraction should be deferred, whenever possible, to avoid complications associated with peri-implantitis.
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Affiliation(s)
- Richard T Kao
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, California.,Private Practice, San Jose, California
| | - Guo-Hao Lin
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, California
| | - Yvonne Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, California
| | - Steven Sadowsky
- Department of Preventive and Restorative Dentistry, School of Dentistry, University of the Pacific, San Francisco, California
| | - Donald A Curtis
- Department of Restorative Dentistry, School of Dentistry, University of California, San Francisco, California
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Wada M, Mameno T, Otsuki M, Kani M, Tsujioka Y, Ikebe K. Prevalence and risk indicators for peri-implant diseases: A literature review. JAPANESE DENTAL SCIENCE REVIEW 2021; 57:78-84. [PMID: 34158874 PMCID: PMC8203834 DOI: 10.1016/j.jdsr.2021.05.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 03/18/2021] [Accepted: 05/23/2021] [Indexed: 02/08/2023] Open
Abstract
Peri-implant diseases are known as undesirable conditions that can occur after implant therapy. Although several risk indicators are becoming clear, the causes of peri-implant diseases have not been completely investigated. The purpose of this review was to summarize the prevalence and risk indicators for peri-implant diseases by referring to current papers from various angles. Many studies have reported the varied prevalence of peri-implant mucositis (23.9%-88.0% at the patient level and 9.7%-81.0% at the implant level) and peri-implantitis (8.9%-45% at the patient level and 4.8%-23.0% at the implant level). Additionally, several studies concluded that poor oral hygiene and lack of regular maintenance were strongly correlated with the development of both peri-implant mucositis and peri-implantitis. Diabetes and a history of periodontitis were revealed as risk indicators for peri-implantitis. However, there was no definitive conclusion about the correlations between peri-implant diseases and other factors such as smoking, the shape of the implant superstructure, and the condition of the keratinized mucosa. Further studies useful for evidence-based decision-making are needed for predictable implant therapy in the long term.
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Affiliation(s)
- Masahiro Wada
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Tomoaki Mameno
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Motohiro Otsuki
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan.,Private Dental Office, Japan
| | - Misako Kani
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Yoshitaka Tsujioka
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Kazunori Ikebe
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
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Predictive modeling for peri-implantitis by using machine learning techniques. Sci Rep 2021; 11:11090. [PMID: 34045590 PMCID: PMC8160334 DOI: 10.1038/s41598-021-90642-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/11/2021] [Indexed: 12/15/2022] Open
Abstract
The purpose of this retrospective cohort study was to create a model for predicting the onset of peri-implantitis by using machine learning methods and to clarify interactions between risk indicators. This study evaluated 254 implants, 127 with and 127 without peri-implantitis, from among 1408 implants with at least 4 years in function. Demographic data and parameters known to be risk factors for the development of peri-implantitis were analyzed with three models: logistic regression, support vector machines, and random forests (RF). As the results, RF had the highest performance in predicting the onset of peri-implantitis (AUC: 0.71, accuracy: 0.70, precision: 0.72, recall: 0.66, and f1-score: 0.69). The factor that had the most influence on prediction was implant functional time, followed by oral hygiene. In addition, PCR of more than 50% to 60%, smoking more than 3 cigarettes/day, KMW less than 2 mm, and the presence of less than two occlusal supports tended to be associated with an increased risk of peri-implantitis. Moreover, these risk indicators were not independent and had complex effects on each other. The results of this study suggest that peri-implantitis onset was predicted in 70% of cases, by RF which allows consideration of nonlinear relational data with complex interactions.
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Gündoğar H, Uzunkaya M, Öğüt S, Sarı F. Effect of peri-implant disease on oral health-related quality of life in geriatric patients. Gerodontology 2021; 38:414-421. [PMID: 33977569 DOI: 10.1111/ger.12556] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 02/23/2021] [Accepted: 04/18/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effect of peri-implant disease on the quality of life in geriatric patients using implant-supported overdentures. BACKGROUND Peri-implant disease and bone loss are two main complications of dental implant treatment that can impact the quality of life in the geriatric population. MATERIALS AND METHODS This cross-sectional study included 109 geriatric individuals treated in the prosthodontics and periodontology departments. On clinical examination, periodontal pocket depth, gingival index (GI) and plaque index (PIn) were measured to determine peri-implant status. Marginal bone loss was measured by radiological examination, using ImageJ software. Moreover, the Oral Healthy Impact Profile-14 (OHIP-14) questionnaire was used to evaluate participants' perceived oral health-related quality of life. RESULTS Peri-implantitis (PI) and peri-implant mucositis (PM) prevalence were 30% and 24%, respectively. Only 44% of patients had healthy implants. Although total OHIP-14 scores were higher in the PI group than in the healthy and PM groups, this difference was not statistically significant (P = .148). Total OHIP-14 score was significantly correlated with PIn and GI. CONCLUSIONS Within the limitations of this study, it can be said that on quality of life in patients using implant-supported overdenture related to clinical parameters such as PIn and GI. Results also indicated that geriatric patients should take action to improve their oral health. Further longitudinal studies are needed to support our results and should include control groups that use conventional removable dentures.
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Affiliation(s)
- Hasan Gündoğar
- Department of Peridontology, Gaziantep University, Gaziantep, Turkey.,Department of Medical Biochemistry, Gaziantep University, Gaziantep, Turkey
| | - Meral Uzunkaya
- Department of Peridontology, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Sevgi Öğüt
- Ministry of Healthy, Şahinbey Oral Health Hospital, Gaziantep, Turkey
| | - Fatih Sarı
- Department of Prosthodontics, Gaziantep University, Gaziantep, Turkey
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Peri-Implantitis: A Clinical Update on Prevalence and Surgical Treatment Outcomes. J Clin Med 2021; 10:jcm10051107. [PMID: 33800894 PMCID: PMC7962026 DOI: 10.3390/jcm10051107] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 02/06/2023] Open
Abstract
Dental implants may be considered a reliable routine procedure in clinical practice for the replacement of missing teeth. Results from long-term studies indicate that implant-supported dental prostheses constitute a predictable treatment method for the management of fully and partially edentulous patients. Implants and their restorations, however, are not free from biological complications. In fact, peri-implantitis, defined as progressive bone loss associated to clinical inflammation, is not a rare finding nowadays. This constitutes a concern for clinicians and patients given the negative impact on the quality of life and the sequelae originated by peri-implantitis lesions. The purpose of this narrative review is to report on the prevalence of peri-implantitis and to overview the indications, contraindications, complexity, predictability and effectiveness of the different surgical therapeutic modalities to manage this disorder.
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Vilarrasa J, Peña M, Gumbau L, Monje A, Nart J. Exploring the relationship among dental caries, nutritional habits, and peri-implantitis. J Periodontol 2021; 92:1306-1316. [PMID: 33599333 DOI: 10.1002/jper.20-0879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND A study was made of the prevalence, co-occurrence and association among caries, nutritional habits, and peri-implant disease, with an analysis of the influence of other patient and implant factors upon peri-implant disease. METHODS The included subjects underwent a clinical examination and were asked to complete a questionnaire. Demographic data and potential lifestyle/behavioral variables were collected. Clinical and radiographic assessment allowed calculation of the decayed, missing and filled teeth (DMFT) index and peri-implant diagnosis. Uni- and multivariate multinomial logistic regression analyses were applied to identify predictors of peri-implant disease. RESULTS A total of 169 patients with 311 implants were studied. At patient level, 92.2% of the subjects presented at least one carious lesion, whereas 22.5% and 56.2% were diagnosed with peri-implantitis and mucositis, respectively. Those patients with more than two caries had a higher risk of mucositis (OR = 3.33). Statistically significant associations for peri-implantitis included full mouth periodontal indexes, sugar-rich diets, keratinized mucosa width, number of missing teeth and interproximal untreated caries or fillings adjacent to implants. CONCLUSION High caries risk profiles and mucositis/peri-implantitis tended to accumulate within subjects. A sugar-enriched diet and untreated caries or fillings adjacent to implant sites may be further considered as risk indicators of peri-implantitis.
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Affiliation(s)
- Javi Vilarrasa
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Marta Peña
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Laura Gumbau
- Faculty of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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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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Osteoclast-mediated biocorrosion of pure titanium in an inflammatory microenvironment. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 119:111610. [PMID: 33321654 DOI: 10.1016/j.msec.2020.111610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 09/28/2020] [Accepted: 10/05/2020] [Indexed: 01/15/2023]
Abstract
Titanium (Ti) and alloys thereof are commonly utilized in biomedical settings owing to their desirable mechanical properties and good biocompatibility. However, when exposed to biological systems for extended periods of time, Ti still undergoes corrosion. In the present study, we therefore explore the impact of osteoclasts (OC) on the surface characteristics and corrosion of commercially pure Titanium (cpTi) in the context of lipopolysaccharide (LPS)-induced inflammation. We utilized tartrate resistant acidic phosphatase (TRAP) and fluorescence staining to assess OC properties, while scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), optical profilometer, electrochemical impedance spectroscopy (EIS), potentiodynamic polarization tests, and inductively coupled plasma atomic emission spectrometry (ICP-AES) were used to evaluate metal microstructure, surface composition and roughness, electrochemical corrosion properties, and metal ion release. SEM findings demonstrated that the surface of cpTi exhibited micro-pitting as well as the presence of viable OCs. Correspondingly, cpTi that had been exposed to OCs exhibited reduced levels of Ti, oxygen, and oxides within the corroded regions relative to smooth Ti as measured via EDS and XPS. OC exposure was also associated with significant changes in cpTi surface roughness, a significant decrease in corrosion resistance, and a significant increase in the release of Ti ions into the surrounding medium. In summary, these findings indicate that OC culture on the surface of cpTi can directly corrode titanium and lead to the release of Ti ions.
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Parvini P, Obreja K, Becker K, Galarraga ME, Schwarz F, Ramanauskaite A. The prevalence of peri-implant disease following immediate implant placement and loading: a cross-sectional analysis after 2 to 10 years. Int J Implant Dent 2020; 6:63. [PMID: 33073302 PMCID: PMC7569077 DOI: 10.1186/s40729-020-00259-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022] Open
Abstract
Background To evaluate the prevalence of peri-implant disease after immediate implant placement and loading. Material and methods This cross-sectional analysis included a total of 47 patients with 64 implants exhibiting a mean loading time of 2 to 10 years (4.23 ± 1.7 years). The surgical and prosthetic procedures were standardized in all patients. Peri-implant health and disease was assessed based on the established case definitions. Results The prevalence of peri-implant health, peri-implant mucositis, and peri-implantitis amounted to 38.3%, 57.5%, and 4.2% of the patients, respectively. Mucosal recession of 1 mm was present at 4 (6%) implants. No suppuration, pain, or implant failures were reported. Ordinal logistic regression revealed that reduced keratinized mucosa height was significantly associated with the diagnosis of peri-implant mucositis and peri-implantitis (OR = 0.514, P = 0.0125). Conclusion Immediate implant placement and loading was associated with high success rates at 2 to 10 years.
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Affiliation(s)
- Puria Parvini
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt am Main, Germany
| | - Karina Obreja
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt am Main, Germany
| | - Kathrin Becker
- Department of Orthodontics, Westdeutsche Kieferklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
| | | | - Frank Schwarz
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt am Main, Germany
| | - Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt am Main, Germany
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40
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Abstract
Peri-implant diseases are prevalent with a weighted mean prevalence rate of 43% across Europe and 22% across South and North America. Although the main etiologic agent is bacterial biofilm, a myriad of factors influence the initiation and progression of the disease. Unfortunately, the treatment of peri-implant diseases is at best favorable in the short term with a high rate of persistent inflammation and recurrence. Therefore, it is sensible to consider and control all potential factors that may predispose an implant to peri-implant tissue inflammation in an attempt to avoid the disease. This paper reviews recent evidence on factors that may predispose implants to peri-implantitis and measures that can be taken to prevent it.
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Affiliation(s)
- Jia-Hui Fu
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, USA
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41
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Khan A, Sharma D. Management of Peri-Implant Diseases: A Survey of Australian Periodontists. Dent J (Basel) 2020; 8:dj8030100. [PMID: 32882900 PMCID: PMC7558189 DOI: 10.3390/dj8030100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/14/2020] [Accepted: 08/14/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND/AIM This survey-based study aims to explore the clinical management protocols of followed by Australian periodontists in relation to peri-implant diseases. MATERIALS AND METHODS A five-part online questionnaire was developed and administered through email. Descriptive statistics were used for analysis, with the univariate associations between a categorical outcome and the variables evaluated using Pearson's Chi-squared test. RESULTS The survey yielded 99 responses, resulting in a response rate of 41.8%. Most participants were male and aged 35-44 years. More than a quarter of practitioners had been placing implants for 6-10 years and almost two-fifths of practitioners placed 1-10 implants per month. The estimated prevalence of peri-implant mucositis and peri-implantitis in the general Australian population was 47% and 21%, respectively. Practitioners reported using systemic antibiotics to manage peri-implant mucositis (7%) and (72%) peri-implantitis lesions, with a combination of amoxicillin and metronidazole. Most common treatment modalities were oral hygiene instructions, nonsurgical debridement and antimicrobial gel/rinse. Surgical debridement and systemic antibiotics were also often used for peri-implantitis treatment. Practitioners preferred a 3-month clinical follow-up and 6-month radiographic evaluation. Furthermore, three-quarters of practitioners rated their management as moderately effective, although upwards of nine-tenths expressed the need for further training and awareness. CONCLUSION This study confirms a significant use of empirical treatment modalities due to lack of standard therapeutic protocol. However, some approaches followed by the specialists may provide a basis to formulate a therapeutic protocol for peri-implant disease management.
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Affiliation(s)
- Ahsen Khan
- College of Medicine and Dentistry, James Cook University, 14-88 McGregor Road, Smithfield 4878, QLD, Australia;
| | - Dileep Sharma
- Department of Periodontics, James Cook University, 14-88 McGregor Road, Smithfield 4878, QLD, Australia
- The Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, 14-88 McGregor Road, Smithfield 4878, QLD, Australia
- Correspondence:
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Roccuzzo M, Fierravanti L, Pittoni D, Dalmasso P, Roccuzzo A. Implant survival after surgical treatment of peri‐implantitis lesions by means of deproteinized bovine bone mineral with 10% collagen: 10‐year results from a prospective study. Clin Oral Implants Res 2020; 31:768-776. [DOI: 10.1111/clr.13628] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/15/2020] [Accepted: 04/10/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Mario Roccuzzo
- Private practice Torino Italy
- Division of Maxillo‐facial SurgeryUniversity of Torino Torino Italy
- Department of Periodontics and Oral MedicineUniversity of Michigan MI USA
| | | | | | - Paola Dalmasso
- Department of Public Health and PediatricsUniversity of Torino Torino Italy
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental MedicineUniversity of Bern Bern Switzerland
- Department of Oral and Maxillofacial SurgeryCopenhagen University Hospital (Rigshospitalet) Copenhagen Denmark
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43
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Kabir L, Stiesch M, Grischke J. The effect of keratinized mucosa on the severity of peri-implant mucositis differs between periodontally healthy subjects and the general population: a cross-sectional study. Clin Oral Investig 2020; 25:1183-1193. [PMID: 32607828 PMCID: PMC7878216 DOI: 10.1007/s00784-020-03422-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/18/2020] [Indexed: 12/25/2022]
Abstract
Objective The study aims to investigate the effect of reduced keratinized mucosa (KM) and other risk indicators on the severity of peri-implant mucositis in (i) the general population, (ii) in periodontally healthy patients, and (iii) in periodontally healthy patients without a history of periodontitis. Materials and methods Anamnesis and the following clinical parameters were taken: mucosal-index, bleeding on probing, local plaque index, oral hygiene-index, and width of KM. Mucositis severity score was determined for each implant. Multi-level and subgroup analysis was performed on the patient and implant level. Results Six hundred twelve implants in 130 patients were analyzed. Subgroup analysis showed significant associations between KM < 2 mm and the severity score in (ii) periodontally healthy patients (p = 0.014) and in (iii) patients without history of periodontitis (p = 0.017). Secondary outcome showed higher severity scores for patients with insufficient oral hygiene or without residual teeth (p ≤ 0.001), in maxillary implants (p = 0.04), and for the number of implants per patient (p ≤ 0.001). Conclusion Within the limits of the study, one may conclude that a reduced width of KM is a risk indicator for the severity of peri-implant mucositis in periodontally healthy patients and patients without a history of periodontitis. Clinical relevance The results indicate a band of ≥ 2 mm KM to reduce the severity of peri-implant mucositis in periodontally healthy patients.
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Affiliation(s)
- Laila Kabir
- Department of Prosthetic Dentistry and Biomedical Materials Research, Hannover Medical School, Hannover, Germany
| | - Meike Stiesch
- Department of Prosthetic Dentistry and Biomedical Materials Research, Hannover Medical School, Hannover, Germany
| | - Jasmin Grischke
- Department of Prosthetic Dentistry and Biomedical Materials Research, Hannover Medical School, Hannover, Germany.
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Rinke S, Nordlohne M, Leha A, Renvert S, Schmalz G, Ziebolz D. Risk indicators for mucositis and peri-implantitis: results from a practice-based cross-sectional study. J Periodontal Implant Sci 2020; 50:183-196. [PMID: 32617183 PMCID: PMC7321710 DOI: 10.5051/jpis.2020.50.3.183] [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: 09/18/2019] [Revised: 03/02/2020] [Accepted: 04/01/2020] [Indexed: 11/08/2022] Open
Abstract
Purpose This practice-based cross-sectional study aimed to investigate whether common risk indicators for peri-implant diseases were associated with peri-implant mucositis and peri-implantitis in patients undergoing supportive implant therapy (SIT) at least 5 years after implant restoration. Methods Patients exclusively restored with a single implant type were included. Probing pocket depth (PPD), bleeding on probing (BOP), suppuration, and radiographic bone loss (RBL) were assessed around implants. The case definitions were as follows: peri-implant mucositis: PPD ≥4 mm, BOP, no RBL; and peri-implantitis: PPD ≥5 mm, BOP, RBL ≥3.5 mm. Possible risk indicators were compared between patients with and without mucositis and peri-implantitis using the Fisher exact test and the Wilcoxon rank-sum test, as well as a multiple logistic regression model for variables showing significance (P<0.05). Results Eighty-four patients with 169 implants (observational period: 5.8±0.86 years) were included. A patient-based prevalence of 52% for peri-implant mucositis and 18% for peri-implantitis was detected. The presence of 3 or more implants (odds ratio [OR], 4.43; 95 confidence interval [CI], 1.36-15.05; P=0.0136) was significantly associated with an increased risk for mucositis. Smoking was significantly associated with an increased risk for peri-implantitis (OR, 5.89; 95% CI, 1.27-24.58; P=0.0231), while the presence of keratinized mucosa around implants was associated with a lower risk for peri-implantitis (OR, 0.05; 95% CI, 0.01-0.25; P<0.001). Conclusions The number of implants should be considered in strategies to prevent mucositis. Furthermore, smoking and the absence of keratinized mucosa were the strongest risk indicators for peri-implantitis in patients undergoing SIT in the present study.
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Affiliation(s)
- Sven Rinke
- Department of Prosthodontics, University Medical Center Goettingen, Goettingen, Germany
| | - Marc Nordlohne
- Private Practice, Weilburg, Germany.,Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Andreas Leha
- Department of Medical Statistics, Georg-August-University, Goettingen, Germany
| | - Stefan Renvert
- School of Health and Society, Kristianstad University, Kristianstad, Sweden
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
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45
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Taheri M, Akbari S, Shamshiri AR, Shayesteh YS. Marginal bone loss around bone-level and tissue-level implants: A systematic review and meta-analysis. Ann Anat 2020; 231:151525. [PMID: 32380195 DOI: 10.1016/j.aanat.2020.151525] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 03/19/2020] [Accepted: 04/07/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To review the scientific evidence regarding the marginal bone loss around the tissue-level and bone-level implants. METHODS MEDLINE-PubMed and EMBASE databases were searched for the relevant English articles (up to February 2019) assessing the marginal bone loss (MBL) as the primary outcome. To be selected, studies were supposed to directly mention "tissue-level" and "bone-level" implants or implants with and without a smooth neck. Relevant data were extracted and meta-analysis was performed to evaluate the effect of implant neck design. RESULTS A total of 19 studies (10 clinical, and 9 RCT studies) were included for qualitative analysis. There was a vast heterogeneity between studies in terms of implant designs and study protocol. Out of 19 articles included, 11 studies reached to a statistically significant difference in MBL between the groups; however, the differences were not found to be clinically relevant. Bone-level implants with platform-switched abutments in most of the cases showed better marginal bone stability compared to tissue-level implants or bone-level implants with matching abutments. Seven RCTs with 12 months follow-up data were selected for meta-analysis (I2=93%; heterogeneous), and the results showed less MBL around bone-level implants compared to tissue-level group (WMD=-0.21mm; 95% CI -0.42, 0.00; P=0.06). CONCLUSION The available data regarding comparison of MBL around bone-level and tissue-level implants are heterogeneous. Bone-level implants with platform switching may better preserve crestal bone.
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Affiliation(s)
- Mina Taheri
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Solmaz Akbari
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ahmad Reza Shamshiri
- Research Center for Caries Prevention, Dentistry Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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46
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Yan X, Lu H, Zhang L, Zhu B, Piao M, Huang B, Zhang H, Meng H. A three-year study on periodontal microorganisms of short locking-taper implants and adjacent teeth in patients with history of periodontitis. J Dent 2020; 95:103299. [DOI: 10.1016/j.jdent.2020.103299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/06/2020] [Accepted: 02/14/2020] [Indexed: 10/25/2022] Open
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47
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Renvert S, Persson GR, Pirih FQ, Camargo PM. Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations. J Periodontol 2019; 89 Suppl 1:S304-S312. [PMID: 29926953 DOI: 10.1002/jper.17-0588] [Citation(s) in RCA: 176] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/04/2018] [Accepted: 02/01/2018] [Indexed: 11/08/2022]
Abstract
The objective of this review is to identify case definitions and clinical criteria of peri-implant healthy tissues, peri-implant mucositis, and peri-implantitis. The case definitions were constructed based on a review of the evidence applicable for diagnostic considerations. In summary, the diagnostic definition of peri-implant health is based on the following criteria: 1) absence of peri-implant signs of soft tissue inflammation (redness, swelling, profuse bleeding on probing), and 2) the absence of further additional bone loss following initial healing. The diagnostic definition of peri-implant mucositis is based on following criteria: 1) presence of peri-implant signs of inflammation (redness, swelling, line or drop of bleeding within 30 seconds following probing), combined with 2) no additional bone loss following initial healing. The clinical definition of peri-implantitis is based on following criteria: 1) presence of peri-implant signs of inflammation, 2) radiographic evidence of bone loss following initial healing, and 3) increasing probing depth as compared to probing depth values collected after placement of the prosthetic reconstruction. In the absence of previous radiographs, radiographic bone level ≥3 mm in combination with BOP and probing depths ≥6 mm is indicative of peri-implantitis.
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Affiliation(s)
- Stefan Renvert
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - G Rutger Persson
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,Departments of Periodontics and Oral Medicine, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Flavia Q Pirih
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Paulo M Camargo
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
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48
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Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Periodontol 2019; 89 Suppl 1:S267-S290. [PMID: 29926957 DOI: 10.1002/jper.16-0350] [Citation(s) in RCA: 390] [Impact Index Per Article: 78.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/14/2017] [Accepted: 09/24/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVES This narrative review provides an evidence-based overview on peri-implantitis for the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. METHODS A literature review was conducted addressing the following topics: 1) definition of peri-implantitis; 2) conversion from peri-implant mucositis to peri-implantitis, 3) onset and pattern of disease progression, 4) characteristics of peri-implantitis, 5) risk factors/indicators for peri-implantitis, and 6) progressive crestal bone loss in the absence of soft tissue inflammation. CONCLUSIONS 1)Peri-implantitis is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant connective tissue and progressive loss of supporting bone. 2)The histopathologic and clinical conditions leading to the conversion from peri-implant mucositis to peri-implantitis are not completely understood. 3)The onset of peri-implantitis may occur early during follow-up and the disease progresses in a non-linear and accelerating pattern. 4a)Peri-implantitis sites exhibit clinical signs of inflammation and increased probing depths compared to baseline measurements. 4b)At the histologic level, compared to periodontitis sites, peri-implantitis sites often have larger inflammatory lesions. 4c)Surgical entry at peri-implantitis sites often reveals a circumferential pattern of bone loss. 5a)There is strong evidence that there is an increased risk of developing peri-implantitis in patients who have a history of chronic periodontitis, poor plaque control skills, and no regular maintenance care after implant therapy. Data identifying "smoking" and "diabetes" as potential risk factors/indicators for peri-implantitis are inconclusive. 5b)There is some limited evidence linking peri-implantitis to other factors such as: post-restorative presence of submucosal cement, lack of peri-implant keratinized mucosa and positioning of implants that make it difficult to perform oral hygiene and maintenance. 6)Evidence suggests that progressive crestal bone loss around implants in the absence of clinical signs of soft tissue inflammation is a rare event.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Alberto Monje
- Department of Oral Surgery and Stomatology, ZMK School of Dentistry, University of Bern, Bern, Switzerland.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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Mameno T, Wada M, Otsuki M, Okuno I, Ozeki K, Tahara A, Ikebe K. Risk indicators for marginal bone resorption around implants in function for at least 4 years: A retrospective longitudinal study. J Periodontol 2019; 91:37-45. [PMID: 31373383 DOI: 10.1002/jper.18-0756] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 05/30/2019] [Accepted: 05/30/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Marginal bone stability is considered one of the most important issues in implant dentistry. It is essential to understand how various factors influence bone resorption around implants. The purpose of this retrospective longitudinal study was to identify potential risk indicators associated with marginal bone resorption around implants in function for at least 4 years. METHODS Several systemic-related, intraoral-related, implant-related factors were collected. Marginal bone level change (MBLC) was determined by comparing intraoral radiographs taken at baseline (1 year after prosthesis delivery), and at follow-up (over 3 years from baseline). A hierarchical regression analysis using liner mixed-effects models was performed to examine correlations between MBLC and various factors. RESULTS Overall, 514 patients with 1535 implants were analyzed. The mean age of the participants was 62.9 years. Mean annual MBLC was 0.048 mm, and mean functional time was 5.96 years. The result showed that the following explanatory variables had significant effects on MBLC: functional time, plaque control record > 20%, Eichner index C1-3, maxilla, cement-retained superstructure, and keratinized mucosa width < 2 mm. We did not find statistically significant associations between bone resorption and some variables known as risk factors, such as diabetes, smoking, and history of periodontitis. CONCLUSIONS Within the limits of this study, longer functional time, poor oral hygiene, loss of occlusal support, location in the maxilla, cement-retained superstructure, and less keratinized mucosa should be considered as risk indicators for bone resorption around implants.
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Affiliation(s)
- Tomoaki Mameno
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Masahiro Wada
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Motohiro Otsuki
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Ikuhisa Okuno
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Kenji Ozeki
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Akihiko Tahara
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
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50
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Renvert S, Persson GR, Pirih FQ, Camargo PM. Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations. J Clin Periodontol 2019; 45 Suppl 20:S278-S285. [PMID: 29926496 DOI: 10.1111/jcpe.12956] [Citation(s) in RCA: 176] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/04/2018] [Accepted: 02/01/2018] [Indexed: 12/26/2022]
Abstract
The objective of this review is to identify case definitions and clinical criteria of peri-implant healthy tissues, peri-implant mucositis, and peri-implantitis. The case definitions were constructed based on a review of the evidence applicable for diagnostic considerations. In summary, the diagnostic definition of peri-implant health is based on the following criteria: 1) absence of peri-implant signs of soft tissue inflammation (redness, swelling, profuse bleeding on probing), and 2) the absence of further additional bone loss following initial healing. The diagnostic definition of peri-implant mucositis is based on following criteria: 1) presence of peri-implant signs of inflammation (redness, swelling, line or drop of bleeding within 30 seconds following probing), combined with 2) no additional bone loss following initial healing. The clinical definition of peri-implantitis is based on following criteria: 1) presence of peri-implant signs of inflammation, 2) radiographic evidence of bone loss following initial healing, and 3) increasing probing depth as compared to probing depth values collected after placement of the prosthetic reconstruction. In the absence of previous radiographs, radiographic bone level ≥3 mm in combination with BOP and probing depths ≥6 mm is indicative of peri-implantitis.
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Affiliation(s)
- Stefan Renvert
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - G Rutger Persson
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,Departments of Periodontics and Oral Medicine, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Flavia Q Pirih
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Paulo M Camargo
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
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