Comparison of Osteoimmunological and Microbiological Parameters of Extra Short and Longer Implants Loaded in the Posterior Mandible: A Split Mouth Randomized Clinical Study

OBJECTIVES

This study aimed to evaluate the levels of TNF-α, PGE2, RANKL, RANK, OPG, the markers of periimplant bone loss in peri-implant crevicular fluid obtained around standard and extra short implants. Moreover, the levels of putative oral pathogens were investigated in the submucosal biofilm samples.

MATERIAL AND METHODS

The implants were divided into two groups according to their lengths: standard (≥8 mm) and extra short (4 mm). A total of 60 implants were researched in 30 patients. The probing depth (PD), clinical attachment level (CAL), presence of bleeding on probing (BOP), 3-year survival rate (CSR), and bone loss (BL) were measured.

RESULTS

No statistically significant difference was found in the values of PD, CAL, BOP, CSR, and BL between the groups (P> 0.05). Total amounts of PGE2, TNF-α, RANKL, RANK, OPG, and RANKL/OPG were not statistically significantly different between the groups (P> 0.05). The abundance of F. nucleatum, T. forsythia, P. intermedia, P. gingivalis, S. oralis and T. denticola was compared between the groups and the results were not statistically significant (P> 0.05).

CONCLUSION

The results of this study suggested that PGE2, TNF-α, RANKL, RANK, OPG, and RANKL/OPG in PICF, as well as microbiological parameters in submucosal biofilms, were similar between standard (≥8 mm) and extra short (4 mm) implants. Therefore, the implant length does not seem to influence the bone loss, levels of osteoimmunological and microbiological markers in the peri-implant tissues and survival rates.

Evaluation of different materials used for sealing of implant abutment access channel and the peri-implant sulcus microbiota: A 6-month, randomized controlled trial

OBJECTIVE

Peri-implantitis has been attributed to a myriad of factors, including microleakage at the abutment-implant interface. Implant abutment access channel sealing materials (IACSM) are readily used in implant dentistry, with little evidence on their effect on microleakage. This study aims to evaluate the effect of IACSM on the microbial composition in the implant access channel and the peri-implant sulcus.

METHODS

A total of n = 8 patients (64 implants) were included in this single-blinded, randomized controlled trial, whereas four different materials (cotton, polytetrafluoroethylene [PTFE], synthetic foam, or polyvinyl siloxane [PVS]) were randomly placed as an IACSM. Following 6 months, microbial analysis was completed on the IACSM and samples from the peri-implant sulci via PCR and high-throughput sequencing. Bacterial samples on the IACSM and in the peri-implant sulci were classified according to Socransky's microbial complexes.

RESULTS

There was a preponderance of early colonizing bacteria within the IACSM, while the peri-implant sulci were dominated by Orange complex bacteria. The proportion of Red and Orange complex members on the IACSM was significantly less than in the peri-implant sulci. The proportion of Green, Yellow, and Blue complex members found on the IACSM was significantly greater than in the peri-implant sulci. Atopobium, a diverse species not included in the microbial complexes, was frequently detected in the peri-implant sulcus samples.

CONCLUSIONS

No detectable effects of IACSM on the microbial community in the peri-implant sulcus or on the IACSM were identified. Variation of bacterial species was most dependent on the individual patient. No significant differences were found in the periodontal parameters between the different treatment groups.

Oral microbiome and peri-implant diseases: where are we now?

Peri-implant infective diseases (PIIDs) in oral implantology are commonly known as peri-implant mucositis (PIM) and periimplantitis (PI). While PIM is restricted to the peri-implant mucosa and is reversible, PI also affects implant-supporting bone and, therefore, is very difficult to eradicate. PIIDs in clinical outcome may resemble gingivitis and periodontitis, as they share similar risk factors. However, recent study in the field of proteomics and other molecular studies indicate that PIIDs exhibit significant differences when compared to periodontal diseases. This review aims to elucidate the current knowledge of PIIDs, their etiopathology and diversified microbiology as well as the role of molecular studies, which may be a key to personalized diagnostic and treatment protocols of peri-implant infections in the near future.