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Huang N, Li Y, Chen H, Li W, Wang C, OU Y, Likubo M, Chen J. The clinical efficacy of powder air-polishing in the non-surgical treatment of peri-implant diseases: A systematic review and meta-analysis. JAPANESE DENTAL SCIENCE REVIEW 2024; 60:163-174. [PMID: 38828461 PMCID: PMC11141045 DOI: 10.1016/j.jdsr.2024.05.003] [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: 02/26/2024] [Revised: 04/23/2024] [Accepted: 05/15/2024] [Indexed: 06/05/2024] Open
Abstract
Peri-implant diseases, characterized by inflammatory conditions affecting peri-implant tissues, encompass peri-implant mucositis and peri-implantitis. Peri-implant mucositis is an inflammatory lesion limited to the mucosa around an implant, while peri-implantitis extends from the mucosa to the supporting bone, causing a loss of osseointegration. For non-surgical treatments, we tested the null hypothesis that the presence or absence of air-polishing made no difference. The study focused on randomized controlled trials (RCTs) comparing air-polishing with mechanical or ultrasonic debridement, evaluating outcomes such as bleeding on probing (BOP), probing depth (PD), plaque index/plaque score (PI/PS), clinical attachment level (CAL), bone loss, and mucosal recession (MR). Two independent reviewers conducted data extraction and quality assessments, considering short-term (<6 months) and long-term (≥6 months) follow-up periods. After screening, ten articles were included in the meta-analysis. In nonsurgical peri-implant disease management, air-polishing moderately mitigated short-term PI/PS for peri-implant mucositis and showed a similar improvement in long-term BOP and bone loss for peri-implantitis compared to the control group. The Egger test found no evidence of publication bias except for the long-term PI/PS of peri-implant mucositis. Leave-one-out analysis confirmed the stability of the results. The findings highlight the need for future research with longer-term follow-up and high-quality, multi-center, large-sample RCTs.
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Affiliation(s)
- Nengwen Huang
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Yang Li
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Division of Perioperative Oral Health Management, Tohoku University Hospital, Sendai, Japan
- Division of Oral and Maxillofacial Radiology, Tohoku University Hospital, Sendai, Japan
- Division of Dental Informatics and Radiology, Tohoku University Graduate School of Dentistry, Sendai, Japan, Tohoku University Hospital, Sendai, Japan
| | - Huachen Chen
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Wen Li
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Chengchaozi Wang
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - YanJing OU
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Masahiro Likubo
- Division of Perioperative Oral Health Management, Tohoku University Hospital, Sendai, Japan
- Division of Oral and Maxillofacial Radiology, Tohoku University Hospital, Sendai, Japan
- Division of Dental Informatics and Radiology, Tohoku University Graduate School of Dentistry, Sendai, Japan, Tohoku University Hospital, Sendai, Japan
| | - Jiang Chen
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
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Corbella S, Radaelli K, Alberti A, Francetti L, Taschieri S. Erythritol powder airflow for the treatment of peri-implant mucositis: A randomized controlled clinical trial. Int J Dent Hyg 2024. [PMID: 38659293 DOI: 10.1111/idh.12814] [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: 04/05/2022] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES Peri-implant mucositis is a biofilm-related, reversible inflammatory disease that can evolve into peri-implantitis if not adequately treated. The aim of the present randomized controlled clinical trial was to evaluate the efficacy of air-abrasive powder as compared to chlorhexidine (CHX) for the treatment of peri-implant mucositis, in terms of clinical and patient-reported outcomes (PROMs) and occurrence of peri-implantitis 12 months after treatment. METHODS In the control group, full-mouth calculus and plaque removal was performed with ultrasound and manual devices, and a 1.0% CHX gel was applied; in the test group, supra- and subgingival biofilm removal was performed using erythritol powder with a dedicated nozzle and calculus removal was performed with ultrasonic instruments if needed. Bleeding and plaque indexes, peri-implant probing depth and tissue level were measured at 1 week, and 1, 3, 6 and 12 months after treatment, while PROMs were evaluated up to 7 days after treatment. RESULTS Among 80 included implants, 70 were analysed at 12 months follow-up (30 in the test group, 40 in the control group, and 20 subjects). Success rates (implant-level) in terms of bleeding index were significantly different between the test (96.7%) and control group (92.5%); as for PROMs, only taste sensation was significantly better in the test group. The test group was significantly correlated to the smallest changes in peri-implant probing depth between baseline and 3 months. CONCLUSIONS The study showed that both treatment strategies are effective. This suggests that the use of air-abrasive powders could be used as an alternative biofilm removal method instead of adjunctive treatments with antiseptics.
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Affiliation(s)
- Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Katherine Radaelli
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Alice Alberti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Lupi SM, De Martis D, Todaro C, Isola G, Beretta M, Rodriguez y Baena R. Conometric Connection for Implant-Supported Crowns: A Prospective Clinical Cohort Study. J Clin Med 2023; 12:7647. [PMID: 38137716 PMCID: PMC10743547 DOI: 10.3390/jcm12247647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Traditional screw or cemented connections in dental implants present limitations, prompting the exploration of alternative methods. This study assesses the clinical outcomes of single crowns and fixed partial prostheses supported by conometric connections after one year of follow-up. METHODS Twenty-two patients received 70 implants, supporting 33 rehabilitations. Biological responses and prosthodontic complications were evaluated at baseline, 6 months, and 12 months. RESULTS All implants exhibited successful osseointegration, with no losses or peri-implant inflammation. Marginal bone levels showed minimal changes, well below pathological thresholds. The difference in marginal bone loss (MBL) was -0.27 ± 0.79 mm between T0 and T1, and -0.51 ± 0.93 mm between T0 and T2. No abutment screw loosening or crown chipping occurred. However, coupling stability loss was observed in nine cases. CONCLUSIONS The conometric connection demonstrated successful integration and minimal complications after one year. This alternative shows promise, particularly in simplifying handling and improving marginal adaptation. Further research with larger sample sizes and longer follow-up is warranted for comprehensive validation.
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Affiliation(s)
- Saturnino Marco Lupi
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, School of Dentistry, University of Pavia, 27100 Pavia, Italy; (S.M.L.); (D.D.M.); (R.R.y.B.)
| | - Dario De Martis
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, School of Dentistry, University of Pavia, 27100 Pavia, Italy; (S.M.L.); (D.D.M.); (R.R.y.B.)
| | - Claudia Todaro
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, School of Dentistry, University of Pavia, 27100 Pavia, Italy; (S.M.L.); (D.D.M.); (R.R.y.B.)
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy;
| | - Mario Beretta
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy;
| | - Ruggero Rodriguez y Baena
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, School of Dentistry, University of Pavia, 27100 Pavia, Italy; (S.M.L.); (D.D.M.); (R.R.y.B.)
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Bi J, Khoshkam V, Hunter M, Cho C, Kar K. Effect of Air Polishing on the Treatment of Peri-Implant Diseases: A Systematic Review and Meta-Analysis. J ORAL IMPLANTOL 2023; 49:616-628. [PMID: 38258587 DOI: 10.1563/aaid-joi-d-23-00114] [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] [Indexed: 01/24/2024]
Abstract
Peri-implant diseases have become one of the notable biological complications of postrehabilitation with implant-supported restorations. Effective modalities for decontamination of biofilm deposits around implant surfaces are critical for resolution of the inflammation. Air polishing is one of the recommended clinical methods for treating peri-implant diseases. This systematic review assessed clinical evidence on efficacy of using air polishing technology for the management of peri-implant diseases, including peri-implant mucositis and peri-implantitis. Four electronic databases from January 1990 to December 2022 were searched to identify the relative human randomized clinical trials that applied air polishing for nonsurgical and surgical treatment of peri-implant mucositis and peri-implantitis. Twelve articles were selected. For treating peri-implant mucositis, air polishing showed a comparable effect to ultrasonic scaling in the reduction of bleeding on probing (BOP) and probing pocket depth (PPD). The nonsurgical approach of air polishing in treating peri-implantitis varied in the reduction of BOP, PPD, and clinical attachment level (CAL) in evaluated studies. Air polishing in the surgical treatment of peri-implantitis was comparable to mechanical cleaning, implantoplasty, and the use of Ti-brush, in regards to the significant reduction of BOP, PPD, and CAL, as well as the improvement of the bone level between baseline and follow-ups. The standardized mean difference with a 95% confidence interval of the studied parameters was estimated using the random effect model; however, statistical differences were not detected between air polishing and comparative modalities in the treatment of peri-implantitis. Within the limitations of this review, the application of air polishing did not result in more favorable outcomes in the treatment of peri-implant diseases compared to other modalities.
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Affiliation(s)
- Jiarui Bi
- Department of Endodontics and Periodontics; Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
- Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, CA, USA
| | - Vahid Khoshkam
- Department of Endodontics and Periodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
- Private practice, El Paso, TX, USA
| | - Mylea Hunter
- Department of Endodontics and Periodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
- Private practice, Fullerton, CA, USA
| | - Christopher Cho
- Department of Endodontics and Periodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Kian Kar
- Department of Endodontics and Periodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
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Dumitriu AS, Păunică S, Nicolae XA, Bodnar DC, Albu ȘD, Suciu I, Ciongaru DN, Giurgiu MC. The Effectiveness of the Association of Chlorhexidine with Mechanical Treatment of Peri-Implant Mucositis. Healthcare (Basel) 2023; 11:1918. [PMID: 37444752 DOI: 10.3390/healthcare11131918] [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: 05/22/2023] [Revised: 06/21/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: The aim of the study was to evaluate the benefit of combining chlorhexidine with the mechanical treatment of peri-implant mucositis. (2) Methods: Articles from 2016 to 2021 included in the PubMed and Scopus databases were analyzed, following the PICOS criteria and the randomized controlled study model that used chlorhexidine in various forms in the treatment of peri-mucositis. According to the established criteria, a limited number of studies were selected. These studies had as their criteria of evaluation for the effectiveness of chlorhexidine, plaque indices, bleeding indices and depth probing indices. Chlorhexidine has been used after mechanical debridement as a solution, with different concentrations of 0.06%/0.12%/0.2% alone or in a concentration of 0.03%, in combination with 0.05% cetylpyridinium chloride, as well as in the form of a gel with a concentration of 0.2%. (3) Results: The results were assessed to a placebo or other substances, and showed a significant reduction in the indices with a follow-up period ranging from 3 months to 1 year. (4) Conclusions: The association of chlorhexidine with the mechanical treatment of peri-implant mucositis has a role in reducing inflammation, although a complete remission was not obtained in all cases, and the results were not statistically significantly different from the use of other antiseptics.
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Affiliation(s)
- Anca Silvia Dumitriu
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Stana Păunică
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Ximena Anca Nicolae
- Doctoral School, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Dana Cristina Bodnar
- Department of Restorative Odontotherapy, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Ștefan Dimitrie Albu
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Ioana Suciu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Dragoș Nicolae Ciongaru
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Marina Cristina Giurgiu
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
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Paolin E, Ceccarelli G, Rodriguez Y Baena R, D'Urso L, Todaro C, Lupi SM. Long-term results of autologous periosteum-derived micro-grafts with poly(lactic-go-glycolic acid) in sinus lift augmentation surgeries: A 7-years follow-up observational study. Int J Surg Case Rep 2023; 106:108153. [PMID: 37094413 PMCID: PMC10149326 DOI: 10.1016/j.ijscr.2023.108153] [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: 02/14/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/26/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE The study aimed to present the long-term results of autologous and homologous micrografts for bone regeneration aimed at positioning dental implants after sinus lift augmentation surgeries, by combining autologous Rigenera® micrografts with poly(lactic-go-glycolic acid). CASE PRESENTATION A total of 5 patients (2 males and 3 females) from 36 to 71 years were involved in the observational study. All the patients showed a good health status system (ASA1 and 2), according to their clinical history with neither system diseases, nor under medication able to interfere with osseointegration. CLINICAL DISCUSSION The radiographic evaluations, after the implant placement and during the continuous follow-up upto 7 years, were carried out through periapical endoral x-rays. The survival and implant success rate was 100 %. Histological analyses were performed after 3 and 7 months after the surgical procedure. CONCLUSION No adverse events have been observed that can be traced back to the use of autologous micrografts with poly(lactic-go-glycolic acid), showing safety and predictable results even in long term.
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Affiliation(s)
- Elisa Paolin
- Department of Public Health, Experimental and Forensic Medicine, Human Anatomy Unit, University of Pavia, Pavia, Italy; Human Brain Wave, Turin, Italy.
| | - Gabriele Ceccarelli
- Department of Public Health, Experimental and Forensic Medicine, Human Anatomy Unit, University of Pavia, Pavia, Italy.
| | - Ruggero Rodriguez Y Baena
- School of Dentistry, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.
| | - Luigi D'Urso
- School of Dentistry, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.
| | - Claudia Todaro
- School of Dentistry, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.
| | - Saturnino Marco Lupi
- School of Dentistry, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.
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Zakir M, Thomas D, Adams R, Farnell D, Claydon N. A Systematic Review and Meta-Analysis of the Clinical Outcomes for Adjunctive Physical, Chemical, and Biological Treatment of Dental Implants With Peri-Implantitis. J ORAL IMPLANTOL 2023; 49:168-178. [PMID: 37071563 DOI: 10.1563/aaid-joi-d-21-00204] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
The present systematic review evaluated the efficacy of adjunctive therapies in the treatment of peri-implantitis. Studies comparing the outcome of conventional surgical- or nonsurgical mechanical debridement with the addition of an adjunctive therapeutic modality were identified through an electronic and hand search of available literature. Following data extraction, meta-analyses were performed on the primary outcome measures. The effects of the adjunctive therapies on bleeding on probing (13 studies), probing pocket depth (9 studies), and radiographic bone level changes (7 studies) were analyzed to evaluate potential clinical benefit. Heterogeneity was expressed as the I2 index. Fixed and random effect models were demonstrated. The potential benefit of adjunctive therapies over control procedures was evaluated in 18 studies, representing a total of 773 implants. Quality assessment of the studies found only 3 studies to be at a low risk of bias. Meta-analysis among the different additional modalities revealed chemical therapy demonstrating significant effects in probing pocket depth reduction (0.58 mm; 0.44-0.72) and radiographic bone level gain (0.54 mm; 0.16-0.92). No significant improvements in bleeding on probing reduction were found using any adjunctive therapy. Available evidence on the benefits of adjunctive therapy to nonsurgical or surgical mechanical debridement in the treatment of peri-implantitis is limited by low numbers of standardized, controlled studies for individual therapies, heterogeneity between studies, and a variety of outcome measures. The lack of effect of any adjunctive therapy in reducing bleeding on probing questions the overall effectiveness over conventional treatment. The long-term clinical benefit potential of these therapies is not demonstrated.
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Affiliation(s)
- Mehreen Zakir
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, United Kingdom
| | - David Thomas
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, United Kingdom
| | - Robert Adams
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, United Kingdom
| | - Damian Farnell
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, United Kingdom
| | - Nicholas Claydon
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, United Kingdom
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Mastication Wear of Two Low Profile Attachment Systems for Overdenture: An In Vitro Study. BIOMED RESEARCH INTERNATIONAL 2022. [DOI: 10.1155/2022/6469890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background. Edentulism is still a major problem in the world’s population today. Implant-retained overdenture has proven to be a valid therapeutic solution in the mandible. This type of rehabilitation requires replacement of the matrices when those reach inadequate retention due to wearing processes. This study is aimed at evaluating the drop in retention of low-profile precision attachments following the application of vertical chewing forces. Two different attachment designs were compared. Methods. This in vitro study simulated an implant-retained overdenture on an edentulous mandible. Two low-profile attachments were compared. Loaded and unloaded sides were considered. Tests were performed by exerting a vertical cyclic force on the prosthesis at the level of the first molar of a hemiarch. Retention tests were performed before and after 400.000 chewing cycles, comparable to one year of use. Results. The presence of vertical load wear was identified and characterized. Retention never fell below the values indicated by the manufacturer. Furthermore, significant differences were identified between the two retention systems. Conclusions. Loss of occlusal load retention is a component that must be evaluated by the clinician during the design of implant-prosthetic rehabilitation, particularly in those cases where elevated occlusal forces or parafunctions are present.
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Tan SL, Grewal GK, Mohamed Nazari NS, Mohd-Dom TN, Baharuddin NA. Efficacy of air polishing in comparison with hand instruments and/or power-driven instruments in supportive periodontal therapy and implant maintenance: a systematic review and meta-analysis. BMC Oral Health 2022; 22:85. [PMID: 35321688 PMCID: PMC8944123 DOI: 10.1186/s12903-022-02120-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 03/09/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Supportive periodontal therapy (SPT) is the key for a stable periodontal health following active treatment. Likewise, implant maintenance is crucial following implant placement. This systematic review aimed to assess clinical outcomes, patients' perception, and cost-effectiveness of repeated periodontal therapy with air polishing devices (APDs) in comparison with hand instruments and/or power-driven instruments (conventional interventions) in SPT and implant maintenance. METHODS Electronic search for randomised controlled clinical trials with minimum 6 months follow-up for SPT and implant maintenance programme was conducted for data published from 01 January 2000 to 30 April 2020 using multiple databases and hand searching. Risk of bias was assessed using the Revised Cochrane Risk-of-Bias tool (RoB 2). RESULTS A total of 823 articles were screened. 4 SPT and 2 implant maintenance studies were eligible for inclusion. For SPT, repeated APDs interventions revealed no statistically significant difference when compared to the conventional interventions (weighted mean difference [WMD] 0.11 mm, p = 0.08). Likewise, no statistical difference was noted in terms of percentage of bleeding on probing (BOP) and clinical attachment level (CAL) gain. APDs were associated with lower pain score (based on Visual Analogue Scale) and higher patient acceptance in SPT studies. For implant maintenance, APDs resulted in reduction in PPD and percentage of BOP. However, CAL gain was comparable between the two groups. In terms of patient reported outcomes, no implant maintenance studies recorded any forms of patient reported outcomes. In addition, no studies reported on economic evaluation of APDs in both SPT and implant maintenance. CONCLUSION Within the limitations of this systematic review and meta-analysis, repeated subgingival debridement using APDs in SPT resulted in similar clinical outcomes but better patients' comfort when compared to the conventional interventions. For implant maintenance, there is limited evidence to show that repeated application of APDs leads to improved clinical outcomes when compared to conventional treatments.
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Affiliation(s)
- Shiuan Lee Tan
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
| | - Galvinderjeet Kaur Grewal
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
| | - Nor Shafina Mohamed Nazari
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | - Tuti Ningseh Mohd-Dom
- Department of Family Oral Health Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Nor Adinar Baharuddin
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
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10
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孙 菲, 李 思, 危 伊, 钟 金, 王 翠, 胡 文. [Efficacy of combined application of glycine powder air-polishing in non-surgical treatment of peri-implant diseases]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022; 54:119-125. [PMID: 35165478 PMCID: PMC8860663 DOI: 10.19723/j.issn.1671-167x.2022.01.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To compare the clinical efficacy of combined application of glycine powder air-polishing and mechanical submucosal debridement in non-surgical treatment of peri-implant diseases. METHODS A randomized controlled clinical study was carried out on patients diagnosed with peri-implant diseases in the Department of Periodontology, Peking University School and Hospital of Stomatology, between May of 2020 and June of 2021.Twenty-eight patients with totally sixty-two implants were enrolled.The patients were randomly divided into the test group and control group. The patients in the test group (13 subjects/32 implants) received mechanical submucosal debridement using titanium curettes combined with application of glycine powder air-polishing, while the control group (15 subjects/30 implants) received mechanical submucosal debridement using titanium only. Clinical parameters, such as plaque index (PLI), pocket probing depth (PPD), bleeding index (BI) and the percentage of suppuration on probing on implants' level (SoP%) were measured at baseline and 8 weeks after non-surgical intervention. Changes and group differences of clinical parameters of the implants before and 8 weeks after non-surgical intervention were compared. RESULTS Mean PLI, PPD, BI of both the test group and control group significantly reduced 8 weeks after non-surgical intervention (P < 0.05). Compared with the control group, the test group achieved lower BI (2.7±0.8 vs. 2.2±0.7, P < 0.05), more reduction of BI (0.6±0.7 vs. 1.1±0.6, P < 0.01) and more reduction of SoP% (21.9% vs. 10%, P < 0.05) after non-surgical intervention. Both the control and test groups exhibited comparable PLI and PPD reductions (P>0.05). For the implants diagnosed with peri-implant mucositis, the test group revealed more signi-ficant reduction in BI and SoP% than the control group (1.0±0.7 vs. 0.4±0.7, P=0.02; 6.3% vs. 0, P=0.012). There was no significant difference existing in PLI and PD improvement between the control group and test group (P>0.05). For the implants diagnosed with peri-implantitis, there was no significant difference existing in PLI, PPD, BI and SoP% improvement values between the test and control groups (P>0.05). No complications or discomforts were reported during the study. CONCLUSION Both treatment procedures could relieve the inflammation of peri-implant soft tissue. Non-surgical mechanical submucosal debridement combined application of glycine powder air-polishing is associated with significant reduction of soft tissue bleeding and suppuration on probing especially in the implants diagnosed with peri-implant mucositis.
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Affiliation(s)
- 菲 孙
- />北京大学口腔医学院·口腔医院牙周科, 国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
| | - 思琪 李
- />北京大学口腔医学院·口腔医院牙周科, 国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
| | - 伊萍 危
- />北京大学口腔医学院·口腔医院牙周科, 国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
| | - 金晟 钟
- />北京大学口腔医学院·口腔医院牙周科, 国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
| | - 翠 王
- />北京大学口腔医学院·口腔医院牙周科, 国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
| | - 文杰 胡
- />北京大学口腔医学院·口腔医院牙周科, 国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
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Yang J, Jia P, Yue Z, Liu J, Liu Z, Tang L, Liu Q, Hou J. Microbiological and clinical evaluation of ultrasonic debridement with/without erythritol air polishing during supportive periodontal therapy in arches with full-arch fixed implant-supported prostheses: protocol for a randomised controlled trial. BMJ Open 2021; 11:e053286. [PMID: 34876432 PMCID: PMC8655551 DOI: 10.1136/bmjopen-2021-053286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Implant-supported prostheses are often successfully used in edentulous patients. However, the incidences of peri-implant mucositis and peri-implantitis increase over time. The accumulation of pathogenic bacteria adjacent to prostheses can induce peri-implant disease. Plaque removal is recommended to prevent and manage peri-implant diseases. The purpose of this study is to compare the plaque removal efficacy of ultrasonic debridement with/without erythritol air-polishing powder around implants and bridges in patients with full-arch fixed implant-supported prostheses as well as the effects of these two methods on the rates of peri-implant mucositis and peri-implantitis, and the submucosal microbiota composition over 5 years in patients undergoing supportive periodontal therapy. METHODS AND ANALYSIS We plan to enrol 10 edentulous (maxilla and/or mandible) patients seeking full-arch fixed implant-supported prostheses. The study will use a split-mouth model in which contralateral quadrants are randomly assigned to two groups. Group 1: one contralateral quadrant of full-arch fixed implant-supported prostheses will undergo ultrasonic debridement combined with erythritol air-polishing powder. Group 2: a separate contralateral quadrant of full-arch fixed implant-supported prostheses will undergo ultrasonic debridement. The 5-year trial will involve a total of 10 re-examinations per participant. The mucosal conditions around the implants will be recorded at 6-month intervals after restoration. Peri-implant submucosal plaque will be collected at each re-examination, and the bacterial flora will be analysed by 16s ribosomal RNA gene sequencing. X-ray examinations will be conducted at 12-month intervals to evaluate the marginal bone level around implants. ETHICS AND DISSEMINATION This prospective single-centre, randomised controlled trial (PKUSSIRB-202054045) has been approved by the Ethics Committee of Stomatology School and Hospital of Peking University. Data will be registered with the International Clinical Trials Registry Platform. Additionally, we will disseminate the results via publication in scientific journals. TRIAL REGISTRATION NUMBER ChiCTR-2000032431.
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Affiliation(s)
- Jingwen Yang
- Department of Prosthodontics, Peking University School of Stomatology, Beijing, China
| | - Pingyi Jia
- Department of the Fourth Clinical Division, Peking University School of Stomatology, Beijing, China
| | - Zhaoguo Yue
- Department of Periodontology, Peking University School of Stomatology, Beijing, China
| | - Jianzhang Liu
- Department of Prosthodontics, Peking University School of Stomatology, Beijing, China
| | - Zhongning Liu
- Department of Prosthodontics, Peking University School of Stomatology, Beijing, China
| | - Lin Tang
- Department of Prosthodontics, Peking University School of Stomatology, Beijing, China
| | - Qi Liu
- Department of Implant dentistry, BYBO Dental Hospital Beijing, CN, Dongcheng District, Beijing, China
| | - Jianxia Hou
- Department of Periodontology, Peking University School of Stomatology, Beijing, China
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12
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Seki K, Ikeda T, Kamimoto A, Hagiwara Y. Efficacy of glycine air-powder abrasion for treatment of peri-implantitis. J Dent Sci 2021; 17:1053-1055. [PMID: 35756798 PMCID: PMC9201631 DOI: 10.1016/j.jds.2021.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- Keisuke Seki
- Department of Implant Dentistry, Nihon University School of Dentistry Dental Hospital, Tokyo, Japan
- Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry, Tokyo, Japan
| | - Takayuki Ikeda
- Department of Implant Dentistry, Nihon University School of Dentistry Dental Hospital, Tokyo, Japan
| | - Atsushi Kamimoto
- Department of Implant Dentistry, Nihon University School of Dentistry Dental Hospital, Tokyo, Japan
- Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry, Tokyo, Japan
| | - Yoshiyuki Hagiwara
- Department of Implant Dentistry, Nihon University School of Dentistry Dental Hospital, Tokyo, Japan
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Shrivastava D, Natoli V, Srivastava KC, Alzoubi IA, Nagy AI, Hamza MO, Al-Johani K, Alam MK, Khurshid Z. Novel Approach to Dental Biofilm Management through Guided Biofilm Therapy (GBT): A Review. Microorganisms 2021; 9:microorganisms9091966. [PMID: 34576863 PMCID: PMC8468826 DOI: 10.3390/microorganisms9091966] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/18/2022] Open
Abstract
Dental biofilm plays a very crucial role in the etiopathogenesis of periodontal andperi-implant diseases. Over the past decade, tremendous research has been carried outto know the structure of biofilm and the mechanism by which it causes the destruction of supporting tissues of tooth or implant. Periodontal or peri-implant therapy usually begins with primarily removing thebiofilm and is considered as non-surgical mechanical debridement. Although scaling and root planing (SRP) is regarded as a gold standard for mechanical plaque debridement, various other means of biofilm removal have constantly been evolving. These may vary from different scaling systems such as vector systems to decontamination of pockets with LASER therapy. Nowadays, a new concept has emerged known as “guided biofilm therapy” (GBT). It is beneficial in removing the biofilm around the tooth and implant structures, resulting in better or comparable clinical outcomes than SRP. These results were substantiated with the reduction in the microbial load as well as the reduction in the inflammatory cytokines. This review will highlight the various aspects of GBT used in periodontal and peri-implant disease.
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Affiliation(s)
- Deepti Shrivastava
- Periodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
- Correspondence: ; Tel.: +966-500-782-498
| | - Valentino Natoli
- Department of Dentistry, School of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain;
- Private Dental Practice, 72015 Fasano, Italy
| | - Kumar Chandan Srivastava
- Oral Medicine Radiology, Department of Oral Maxillofacial Surgery Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Ibrahim A Alzoubi
- Periodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Ahmed Ismail Nagy
- Oral Surgery, Department of Oral Maxillofacial Surgery Diagnostic Sciences, Jouf University, Sakaka 72345, Saudi Arabia;
| | - May Othman Hamza
- Department of Prosthodontics, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Khalid Al-Johani
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Mohammad Khursheed Alam
- Orthodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
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Abd-Ul-Salam H. Peri-implantitis. INNOVATIVE PERSPECTIVES IN ORAL AND MAXILLOFACIAL SURGERY 2021:47-59. [DOI: 10.1007/978-3-030-75750-2_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Ozkan Karaca E, Tunar OL. In vitro evaluation of surface cleaning methods in two different implant defect angulations: a pilot study. BIOTECHNOL BIOTEC EQ 2021. [DOI: 10.1080/13102818.2021.1905063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Ebru Ozkan Karaca
- Faculty of Dentistry, Department of Periodontology, Yeditepe University, Istanbul, Turkey
| | - Ogul Leman Tunar
- Faculty of Dentistry, Department of Periodontology, Yeditepe University, Istanbul, Turkey
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16
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Aloy-Prósper A, Pellicer-Chover H, Peñarrocha-Oltra D, Peñarrocha-Diago M. Effect of a single initial phase of non-surgical treatment of peri-implantitis: Abrasive air polishing versus ultrasounds. A prospective randomized controlled clinical study. J Clin Exp Dent 2020; 12:e902-e908. [PMID: 33154790 PMCID: PMC7600210 DOI: 10.4317/jced.56653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 01/08/2020] [Indexed: 11/10/2022] Open
Abstract
Background Non-surgical treatment of peri-implantitis includes a correct mechanical debridement of the implant surface to reduce the inflammation and recondition the soft tissues. The aim of the study was to evaluate the results of a single phase of non-surgical therapy by comparing the effect of curettes and ultrasounds versus curettes and abrasive air polisher (Air-Flow) in the peri-implant tissue conditions, and patient satisfaction.
Material and Methods A double-blind randomized and controlled prospective clinical study was conducted on patients in peri-implant maintenance phase diagnosed of peri-implantitis treated in the Oral Surgery Unit of the Stomatology Department of the Faculty of Medicine and Dentistry of the University of Valencia, between September of 2017 and May of 2018. They were divided into 2 groups: Group 1: curettes and ultrasounds, and Group 2: curettes and Air-Flow. The clinical and radiological baseline parameters were evaluated after 3-weeks of treatment, as well as patient satisfaction.
Results The sample included 34 patients. Group 1 (17 patients, 38 implants) and Group 2 (17 patients, 32 implants). All the variables improved statistically significantly after treatment in both groups, with the exception of recessions and keratinized mucosa and bone loss that did not vary. When comparing both groups, the type of treatment did not influence the majority of the variables, with the exception of the plaque index (p=0.011) and modified bleeding index from the palatine (p=0.048), which reduced statistically significant in the group 2, as well as the patient satisfaction which was higher in the group 2 (p<0.001).
Conclusions An initial phase of non-surgical treatment achieves an improvement of the peri-implant clinical parameters, thought the method of debridement used seems not to influence. Key words:Peri-implantitis, peri-implant disease, non-surgical treatment, air-abrasive device, mechanical debridement.
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Affiliation(s)
- Amparo Aloy-Prósper
- Assistant Professor of Oral Surgery, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Hilario Pellicer-Chover
- Collaborating Professor of the Master in Oral Surgery and Implant Dentistry, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - David Peñarrocha-Oltra
- Doctor Assistant of Oral Surgery, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Miguel Peñarrocha-Diago
- Chairman of Oral Surgery, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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Abstract
The advent of new technologies in the field of medicine and dentistry is creating improvements that lead clinicians to have materials and procedures able to improve patients’ quality of life. The aim of this article is to evaluate occlusion load and its consequences on fixed implant-supported prosthesis. New materials have granted clinicians the possibility achieve great aesthetic results in dental prosthesis, and new procedures allow them to standardize and give precise and repeatable results, especially for the functional and long-term stability aspects of products. Some principles should be carefully evaluated and applied to every dental prosthesis; the evaluation of the forces and fitting of meso-structures to dental implants, an aspect that is often not well considered by clinicians, is the main focus of this article.
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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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Abstract
Abstract
Purpose of the Review
Peri-implant diseases are inflammatory reactions to bacterial infections affecting osseointegrated dental implants. In recent years, scientific interest on this topic has increased, as demonstrated by the appearance of a large number of protocols for treating peri-implant mucositis (PIM) and peri-implantitis (PI). The aim of the present narrative review is to provide an overview of the recent (e.g., 2014–present) published protocols for the non-surgical treatment of peri-implant diseases.
Recent Findings
Several adjunctive measures for mechanical debridement have been proposed and investigated to achieve implant surface decontamination and resolution of mucosal inflammation. However, none of the adjunctive measures has been shown to significantly improve peri-implant conditions compared with non-surgical mechanical debridement alone.
Summary
Non-surgical approaches for the treatment of peri-implant diseases have been proved to be reliable in reducing clinical signs of peri-implant inflammation (e.g., BoP), although with limited capability to achieve complete disease resolution. Due to the limited benefits from the use of currently proposed adjunctive methods (e.g., chlorhexidine, lasers, photodynamic therapy, systemic probiotics) their application is not recommended until further investigations prove their clinical utility.
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Abstract
This article summarizes the microbiological findings at dental implants, drawing distinctions between the peri-implant microbiome and the periodontal microbiome, and summarizes what is known regarding biofilm as a risk factor for specific stages of implant treatment. Targeted microbial analysis is reviewed as well as the latest results from open-ended sequencing of the peri-implant flora. At this time there remains a lack of consensus for a specific microbial profile that is associated with peri-implantitis, suggesting that there may be other factors which influence the microbiome such as titanium surface dissolution. Therapeutic interventions to address the biofilm are presented at the preoperative, perioperative, and postoperative stages. Evidence supports that perioperative chlorhexidine reduces biofilm-related implant complications and failure. Regular maintenance for dental implants is also shown to reduce peri-implant mucositis and implant failure. Maintenance procedures should aim to disrupt the biofilm without damaging the titanium dioxide surface layer in an effort to prevent further oxidation. Evidence supports the use of glycine powder air polishing as a valuable adjunct to conventional therapies for use at implant maintenance visits. For the treatment of peri-implantitis, nonsurgical therapy has not been shown to be effective, and while surgical intervention is not always predictable, it has been shown to be superior to nonsurgical treatment for decontamination of the implant surface that is not covered by bone.
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Affiliation(s)
- Diane M Daubert
- Department of Periodontics, University of Washington, Seattle, Washington, USA
| | - Bradley F Weinstein
- Department of Periodontics, University of Washington, Seattle, Washington, USA
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Abstract
PURPOSE Patient-administered and professionally administered periimplant maintenance have been recommended to ensure long-term periimplant tissue health. In this narrative review, the effectiveness of patient and professionally administered interventions and the current level of evidence that periimplant maintenance therapy is effective in preventing the occurrence of periimplant disease were examined. MATERIALS AND METHODS A systematic literature search was performed in Ovid MEDLINE, EMBASE, Cochrane Library, and Web of Science, for evidence-based articles in support of the above topics. RESULTS Twenty-six clinical trials were included and stratified into categories based on topics. CONCLUSIONS The following conclusions were reached: (a) mechanical plaque removal is the foundation of successful periimplant therapy; (b) patient- and professionally administered plaque control has been shown to reduce periimplant inflammation, although complete resolution of inflammation is not always evident; (c) the use of adjunctive chemical agents in maintaining periimplant health still remains to be determined; and (d) regular periimplant maintenance plays a significant role in maintaining periimplant soft and hard tissue health.
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Lupi SM, Redoglia L, Rodriguez Y Baena A, Garbelli G, Rodriguez Y Baena R. Detection of peri-implant inflammation by the use of a matrix metalloproteinase-8 chair-side test. MINERVA STOMATOLOGICA 2019; 68:168-176. [PMID: 31357850 DOI: 10.23736/s0026-4970.19.04149-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Active matrix metalloproteinase-8 (MMP-8) enzymes are associated with inflammation and the degradation of implant-supporting tissues. A high concentration of these enzymes in the peri-implant sulcular fluid (PISF) has been associated with a pathological condition. The aim of the present study was to evaluate the ability of a chair-side MMP-8 test to individuate pathological peri-implant site. The working hypothesis is that positive response to MMP-8 test corresponds to pathological values of periodontal indexes. A secondary working hypothesis is that PISF sampling method influences the test accuracy. METHODS Fifty implants from 50 patients were evaluated during scheduled follow-up appointments in a clinical setting using the MMP-8 chair-side test and periodontal indices (probing depth, bleeding on probing, plaque index and peri-implant inflammation index). Two methods of PISF sampling were tested. RESULTS The MMP-8 test demonstrated significant diagnostic capacity and good sensitivity and accuracy regarding indices of bleeding on probing, plaque index, and peri-implant inflammation index but fair agreement. CONCLUSIONS Further studies should be performed to better define the interpretation of the MMP-8 chair-test results and their correlation to peri-implant indexes.
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Affiliation(s)
- Saturnino M Lupi
- School of Dentistry, Department of Clinico-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy -
| | - Lucia Redoglia
- School of Dentistry, Department of Clinico-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Arianna Rodriguez Y Baena
- Unit of Oral Surgery, Dental School, Department of Dentistry, San Raffaele Hospital IRCSS, Vita Salute University, Milan, Italy
| | - Giorgia Garbelli
- School of Dentistry, Department of Clinico-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Ruggero Rodriguez Y Baena
- School of Dentistry, Department of Clinico-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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Alasqah MN. Antimicrobial efficacy of photodynamic therapy on dental implant surfaces: A systematic review of in vitro studies. Photodiagnosis Photodyn Ther 2019; 25:349-353. [DOI: 10.1016/j.pdpdt.2019.01.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/09/2019] [Accepted: 01/11/2019] [Indexed: 12/21/2022]
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Covalently-Linked Hyaluronan versus Acid Etched Titanium Dental Implants: A Crossover RCT in Humans. Int J Mol Sci 2019; 20:ijms20030763. [PMID: 30754668 PMCID: PMC6387289 DOI: 10.3390/ijms20030763] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 01/24/2019] [Accepted: 02/06/2019] [Indexed: 12/11/2022] Open
Abstract
Biochemical modification of titanium surfaces (BMTiS) entails immobilization of biomolecules to implant surfaces in order to induce specific host responses. This crossover randomized clinical trial assesses clinical success and marginal bone resorption of dental implants bearing a surface molecular layer of covalently-linked hyaluronan in comparison with control implants up to 36 months after loading. Patients requiring bilateral implant rehabilitation received hyaluronan covered implants in one side of the mouth and traditional implants in the other side. Two months after the first surgery, a second surgery was undergone to uncover the screw and to place a healing abutment. After two weeks, the operator proceeded with prosthetic procedures. Implants were evaluated by periapical radiographs and the crestal bone level was recorded at mesial and distal sites—at baseline and up to 36 months. One hundred and six implants were positioned, 52 HY-coated, and 48 controls were followed up. No differences were observed in terms of insertion and stability, wound healing, implant success, and crestal bone resorption at any time considered. All interventions had an optimal healing, and no adverse events were recorded. This trial shows, for the first time, a successful use in humans of biochemical-modified implants in routine clinical practice and in healthy patients and tissues with satisfactory outcomes.
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Maxillary Sinus Lift Using Autologous Periosteal Micrografts: A New Regenerative Approach and a Case Report of a 3-Year Follow-Up. Case Rep Dent 2018; 2018:3023096. [PMID: 30140472 PMCID: PMC6081519 DOI: 10.1155/2018/3023096] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 06/14/2018] [Indexed: 12/30/2022] Open
Abstract
This case report discusses about an innovative bone regeneration method that involves the use of autologous periosteal micrografts, which were used for a maxillary sinus floor lift in a 52-year-old female patient. This method allows for harvesting of a graft that is to be seeded on a PLGA scaffold and involves collection of a very little amount of palatal periosteal tissue in the same surgical site after elevation of a flap and disaggregation of it by using a Rigenera® filter. Histological samples collected at the time of implant installation demonstrate a good degree of bone regeneration. The clinical and radiographic outcomes at the 3-year follow-up visit showed an adequate stability of hard and soft tissues around the implants. This report demonstrates the possibility to obtain a sufficient quality and quantity of bone with a progenitor cell-based micrograft and in turn make the site appropriate for an implant-supported rehabilitation procedure, with stable results over a period of two years.
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Lupi SM, Rodriguez Y Baena A, Cervino G, Todaro C, Rizzo S. Long-Term Effects of Acute Myeloid Leukemia Treatment on the Oral System in a Pediatric Patient. Open Dent J 2018; 12:230-237. [PMID: 29760815 PMCID: PMC5897961 DOI: 10.2174/1874210601812010230] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 02/20/2018] [Accepted: 02/28/2018] [Indexed: 12/26/2022] Open
Abstract
Introduction: Acute Myeloid Leukemia (AML) in pediatric patients is a serious disease, although, for the subgroup of patients who receive proper treatment, a long-term survival rate above 50% is typical. The cycles of chemo- and radiotherapy used to treat AML can impair dental development. Case Report: Herein, we describe the oral condition of a 25-year-old male patient treated for AML with chemo- and radiotherapy from 5 to 7 years of age; his AML has remained in remission for the past 18 years. He had lost only one permanent tooth, but the remaining teeth demonstrated serious deformations and radicular hypoplasia. Two teeth required immediate extraction and subsequent replacement by implant-supported crowns. We found that the decayed, missing, filled teeth (DMFT) index was not representative of the real oral condition. Here, we report the full case and provide a brief review of the literature. Conclusion: Antitumor treatment of pediatric leukemia can induce total impairment of dental development and function. These adverse effects may become clinically evident many years after the resolution of cancer, and can be significantly detrimental to the patient’s quality of life.
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Affiliation(s)
- Saturnino Marco Lupi
- Department of Clinical, Surgical, Pediatric and Diagnostic Sciences, School of Dentistry, University of Pavia, P.le Golgi 2, 27100 Pavia , Italy
| | - Arianna Rodriguez Y Baena
- Department of Clinical, Surgical, Pediatric and Diagnostic Sciences, School of Dentistry, University of Pavia, P.le Golgi 2, 27100 Pavia , Italy
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, Policlinico G. Martino, Via Consolare Valeria, 98100 Messina, Italy
| | - Claudia Todaro
- Department of Clinical, Surgical, Pediatric and Diagnostic Sciences, School of Dentistry, University of Pavia, P.le Golgi 2, 27100 Pavia , Italy
| | - Silvana Rizzo
- Department of Clinical, Surgical, Pediatric and Diagnostic Sciences, School of Dentistry, University of Pavia, P.le Golgi 2, 27100 Pavia , Italy
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Goh EXJ, Lim LP. Implant maintenance for the prevention of biological complications: Are you ready for the next challenge? JOURNAL OF INVESTIGATIVE AND CLINICAL DENTISTRY 2017; 8. [PMID: 27987273 DOI: 10.1111/jicd.12251] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 10/07/2016] [Indexed: 11/29/2022]
Abstract
With increasing knowledge of wound biology and material sciences, the provision of dental implants as a treatment modality has become increasingly predictable and more commonly used to replace missing teeth. However, without appropriate follow up, peri-implant diseases could develop and affect the long-term success of implants. Currently, there is not enough focus on the prevention of peri-implant diseases, as compared to the definition of the disease, its prevalence, and treatment. In the present study, we aim to summarize various factors influencing the successful maintenance of dental implants and highlight current gaps in knowledge. Factors influencing the successful maintenance of dental implants can be divided into three categories: implant-, dentist-, and patient-related factors. Patients with dental implants are often more dentally aware, and this offers an advantage. Compared to gingiva, peri-implant mucosa responds at a different pace to the bacterial challenge. Dental practitioners should be aware of how treatment protocols affect long-term success, and be vigilant in detecting peri-implant diseases at an early stage. Compared to periodontal maintenance, less longitudinal studies on implant maintenance are available, and therefore, there is a tendency to rely heavily on information extrapolated from the periodontal literature. More studies on the significance of implant maintenance care are required.
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Affiliation(s)
- Edwin X J Goh
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore
| | - Lum Peng Lim
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore
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Lupi SM, Cislaghi M, Rizzo S, Rodriguez Y Baena R. Rehabilitation with implant-retained removable dentures and its effects on perioral aesthetics: a prospective cohort study. Clin Cosmet Investig Dent 2016; 8:105-110. [PMID: 27757052 PMCID: PMC5053264 DOI: 10.2147/ccide.s115384] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The onset of perioral wrinkles often prompts patients to request treatment. This aesthetic deterioration linked to aging may be associated with tooth and alveolar bone loss in fully edentulous patients. Purpose To evaluate perioral wrinkles before and after maxillary and mandibular rehabilitation with implant-retained dentures in fully edentulous patients. Methods In this prospective cohort, single-center, blinded study, patients requiring maxillary and mandibular rehabilitation with implant-retained dentures were enrolled. The patients were photographed in the same position before and after oral rehabilitation. Wrinkles were evaluated in the photographs by blinded observers using validated rating scales. The following parameters were analyzed: upper and lower radial lip lines, marionette lines, upper and lower lip fullness, nasolabial folds, corner of the mouth lines, and the labiomental crease. Statistical analysis was performed using the Wilcoxon signed ranks test for paired data, with P<0.05 considered significant. Results Upper and lower implant-retained dentures were applied in 31 patients (15 males; mean ± standard deviation age 62.13±8.69 years, range 47–77 years). The oral rehabilitation procedures significantly improved (P<0.05) the upper and lower radial lip lines, marionette lines, upper and lower lip fullness, the nasolabial folds, and the corner of the mouth lines. Conclusion Maxillary and mandibular rehabilitation with implant-retained dentures in fully edentulous patients improves perioral aesthetics. Patients requiring oral rehabilitation and desiring perioral aesthetic improvement could benefit from treatment with this type of prosthesis.
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Affiliation(s)
- Saturnino Marco Lupi
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Matteo Cislaghi
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Silvana Rizzo
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Ruggero Rodriguez Y Baena
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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