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Renvert S, Giovannoli JL, Rinke S. The efficacy of reconstructive therapy in the surgical management of peri-implantitis: A 3-year follow-up of a randomized clinical trial. J Clin Periodontol 2024. [PMID: 39020503 DOI: 10.1111/jcpe.14049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 06/07/2024] [Accepted: 07/08/2024] [Indexed: 07/19/2024]
Abstract
AIM To assess whether guided bone regeneration (GBR) treatment of peri-implantitis-related bony defects could improve healing compared to open flap debridement (OFD) at 36 months. MATERIALS AND METHODS In a multi-centre, randomized clinical trial, 32 individuals received OFD (control group [CG]) and 34 GBR treatment (test group [TG]). Radiographic defect fill (RDF), probing pocket depth (PPD), bleeding on probing (BOP) suppuration (SUP), mucosal recession (MREC) and patient-reported outcomes (PROs) were evaluated at 36 months. RESULTS Fifty individuals attended a supportive peri-implant therapy program and completed the 36-month follow-up. GBR treatment resulted in an RDF of 2.13 ± 1.26 mm compared to 1.64 ± 1.54 mm following OFD (p = .18). No difference was found in PPD, BOP, SUP, REC or PROs between the groups. Successful treatment (no additional bone loss, PPD ≤ 5 mm, no BOP and no SUP) was achieved in 46.2% in TG and 20% in CG (p = .053). Treatment results obtained at 12 months were generally maintained up to 36 months. No significant changes were noticed between 12 and 36 months. CONCLUSIONS At 36 months, treatment results obtained at 1 year were sustained following both GBR and OFD in patients attending supportive peri-implant therapy. GBR resulted in more RDF and higher composite treatment success rate than OFD (ClinicalTrials.gov Identifier [NCT02375750]).
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Affiliation(s)
- Stefan Renvert
- Oral Health Sciences, Kristianstad University, Kristianstad, Sweden
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | | | - Sven Rinke
- Private Practice, Hanau, Germany
- Department of Prosthodontics, University Medical Center, Goettingen, Germany
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2
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Berglundh T, Mombelli A, Schwarz F, Derks J. Etiology, pathogenesis and treatment of peri-implantitis: A European perspective. Periodontol 2000 2024. [PMID: 38305506 DOI: 10.1111/prd.12549] [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: 10/03/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 02/03/2024]
Abstract
Peri-implantitis is a plaque-associated pathological condition occurring in tissues around dental implants. It is characterized by inflammation in the peri-implant mucosa and progressive loss of supporting bone. Over the last 30 years, peri-implantitis has become a major disease burden in dentistry. An understanding of the diagnosis, etiology and pathogenesis, epidemiology, and treatment of peri-implantitis must be a central component in undergraduate and postgraduate training programs in dentistry. In view of the strong role of European research in periodontology and implant dentistry, the focus of this review was to address peri-implantitis from a European perspective. One component of the work was to summarize new and reliable data on patients with dental implants to underpin the relevance of peri-implantitis from a population perspective. The nature of the peri-implantitis lesion was evaluated through results presented in preclinical models and evaluations of human biopsy material together with an appraisal of the microbiological characteristics. An overview of strategies and outcomes presented in clinical studies on nonsurgical and surgical treatment of peri-implantitis is discussed with a particular focus on end points of therapy and recommendations presented in the S3 level Clinical Practice Guideline for the prevention and treatment of peri-implant diseases.
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Affiliation(s)
- Tord Berglundh
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andrea Mombelli
- Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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3
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Monje A, Pons R, Nart J, Miron RJ, Schwarz F, Sculean A. Selecting biomaterials in the reconstructive therapy of peri-implantitis. Periodontol 2000 2024; 94:192-212. [PMID: 37728141 DOI: 10.1111/prd.12523] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/28/2023] [Accepted: 08/21/2023] [Indexed: 09/21/2023]
Abstract
Peri-implantitis is a pathogenic inflammatory condition characterized by progressive bone loss and clinical inflammation that may compromise the stability of dental implants. Therapeutic modalities have been advocated to arrest the disorder and to establish peri-implant health. Reconstructive therapy is indicated for bone defects exhibiting contained/angular components. This therapeutic modality is based upon the application of the biological and technical principles of periodontal regeneration. Nonetheless, the comparative efficacy of reconstructive therapy and nonreconstructive modalities remains unclear. Therefore, the aim of this narrative review is to address major clinical concerns regarding the efficacy, effectiveness, and feasibility of using biomaterials in peri-implantitis therapy. In particular, the use of bone grafting materials, barrier membranes, and biologics is comprehensively explored.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Ramón Pons
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt, Germany
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
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4
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Ramanauskaite A, Becker K, Cafferata EA, Schwarz F. Clinical efficacy of guided bone regeneration in peri-implantitis defects. A network meta-analysis. Periodontol 2000 2023; 93:236-253. [PMID: 37490412 DOI: 10.1111/prd.12510] [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: 03/08/2023] [Revised: 05/17/2023] [Accepted: 06/19/2023] [Indexed: 07/27/2023]
Abstract
Guided bone regeneration (GBR) at peri-implantitis-related bone defects involves the placement of bone-filler particles in the intrabony defects and the application of a barrier membrane. The efficacy of different GBR-supported reconstructive measures as well as their potential superiority compared to non-GBR-supported treatment strategies for bone defects at peri-implantitis sites, however, remains unclear. Therefore, this analysis was designed to evaluate the long-term (≥12 months) clinical efficacy of GBR-supported reconstructive surgical therapy for peri-implantitis-related bone defects. In terms of resolving inflammation, the implementation of GBR protocols applying xenogenic bone substitutes yielded a higher reduction of bleeding on probing and probing depth value compared to the GBR protocol applying autogenous bone. Furthermore, for the changes in bleeding on probing and probing depths, GBR approaches using xenogenic bone showed superiority over the non-GBR treatments. Xenogenic bone with or without a barrier membrane was associated with improved radiographic bone levels and less soft tissue recession compared to the use of a GBR protocol implementing autogenous bone. Nonetheless, when interpreting this findings, the limited number of available studies with low to serious risk of bias and the short follow-up periods limited to 12 months should be considered.
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Affiliation(s)
- Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - Kathrin Becker
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Emilio A Cafferata
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
- Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima, Peru
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
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5
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Stiesch M, Grischke J, Schaefer P, Heitz-Mayfield LJA. Supportive care for the prevention of disease recurrence/progression following peri-implantitis treatment: A systematic review. J Clin Periodontol 2023. [PMID: 37339881 DOI: 10.1111/jcpe.13822] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVES This systematic review aimed to evaluate the efficacy of supportive care provision, frequency and protocol in patients treated for peri-implantitis, as reported in prospective and retrospective studies of at least 3-years duration. MATERIALS AND METHODS A systematic search of three electronic databases was undertaken up to 21 July 2022 and supplemented by hand-search to identify studies that included participants treated for peri-implantitis and followed for at least 3 years. Owing to high heterogeneity, a meta-analysis was not appropriate, and therefore, data and risk of bias were explored qualitatively. PRISMA guidelines for reporting were followed. RESULTS The search identified 2596 studies. Of 270 records selected during screening, 255 were excluded through independent review and 15 studies (10 prospective and 5 retrospective, with at least 20 patients) were retained for qualitative assessments. Study designs, population characteristics, supportive care protocols and reported outcomes varied markedly. Thirteen of the 15 studies had low risk of bias. Supportive peri-implant care (SPIC) following different surgical peri-implantitis treatment protocols and with recall intervals varying between 2 months and annually resulted in peri-implant tissue stability (no disease recurrence or progression) ranging from 24.4% to 100% at patient level and from 28.3% to 100% at implant level. Sevenhundred and eighty-five patients with 790 implants were included in this review. CONCLUSIONS Provision of SPIC following peri-implantitis therapy may prevent disease recurrence or progression. Insufficient evidence is available to identify (i) a specific supportive care protocol for secondary prevention of peri-implantitis, (ii) the effect of adjunctive local antiseptic agents in the secondary prevention of peri-implantitis and (iii) the impact of frequency of supportive care measures. Prospective, randomised, controlled studies designed to evaluate supportive care protocols are needed in future.
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Affiliation(s)
- Meike Stiesch
- Clinic of Prosthetic Dentistry and Biomedical Materials Science, Hanover Medical School, Hanover, Germany
| | - Jasmin Grischke
- Clinic of Prosthetic Dentistry and Biomedical Materials Science, Hanover Medical School, Hanover, Germany
| | - Paula Schaefer
- Clinic of Prosthetic Dentistry and Biomedical Materials Science, Hanover Medical School, Hanover, Germany
| | - Lisa J A Heitz-Mayfield
- International Research Collaborative Oral Health and Equity, School of Anatomy and Biology, The University of Western Australia, Crawley, Western Australia, Australia
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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6
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Regidor E, Ortiz-Vigón A, Romandini M, Dionigi C, Derks J, Sanz M. The adjunctive effect of a resorbable membrane to a xenogeneic bone replacement graft in the reconstructive surgical therapy of peri-implantitis: A randomized clinical trial. J Clin Periodontol 2023; 50:765-783. [PMID: 36802084 DOI: 10.1111/jcpe.13796] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/17/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023]
Abstract
AIM To evaluate the potential adjunctive effect of a resorbable collagen membrane covering a xenogeneic bone replacement graft in the reconstructive surgical therapy of peri-implantitis. MATERIALS AND METHODS Forty-three patients (43 implants) diagnosed with peri-implantitis associated with intra-bony defects were treated with a surgical reconstructive approach that included a xenogeneic bone substitute material. Additionally, resorbable collagen membranes were placed over the grafting material at sites randomly allocated to the test group; conversely, no membranes were placed in the control group. Clinical outcomes, namely probing pocket depth (PPD), bleeding and suppuration on probing (BoP and SoP), marginal mucosal level (REC) and keratinized mucosa width (KMW), were recorded at baseline and 6 and 12 months after surgery. Radiographic marginal bone levels (MBLs) and patient-reported outcomes (PROs) were assessed at baseline and 12 months. A composite outcome (success) was evaluated at 12 months, which included the absence of BoP/SoP, PPD ≤5 mm and reduction of buccal marginal mucosal level (buccal REC) of ≤1 mm. RESULTS At 12 months, no implants were lost and treatment success was observed at 36.8% and 45.0% of implants in the test and control groups, respectively (p = .61). Similarly, there were no significant differences between groups in terms of changes of PPD, BoP/SoP, KMW, MBL or buccal REC. Post-surgical complications were observed in the test group only (e.g., soft tissue dehiscence, exposure of particulate bone graft and/or resorbable membrane). Longer surgical times (~10 min; p < .05) and higher levels of self-reported pain at 2 weeks (p < .01) were observed in the test group. CONCLUSIONS This study failed to demonstrate the presence of added clinical or radiographic benefits of the use of a resorbable membrane to cover a bone substitute material within the reconstructive surgical therapy of peri-implantitis associated with intra-bony defects.
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Affiliation(s)
- Erik Regidor
- Thinking Perio Research, Clínica Ortiz-Vigón PerioCentrum Bilbao, Bilbao, Spain
| | - Alberto Ortiz-Vigón
- Thinking Perio Research, Clínica Ortiz-Vigón PerioCentrum Bilbao, Bilbao, Spain.,Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Mario Romandini
- Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Carlotta Dionigi
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Mariano Sanz
- Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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7
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Donos N, Calciolari E, Ghuman M, Baccini M, Sousa V, Nibali L. The efficacy of bone reconstructive therapies in the management of peri-implantitis. A systematic review and meta-analysis. J Clin Periodontol 2023. [PMID: 36635029 DOI: 10.1111/jcpe.13775] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/14/2023]
Abstract
AIM To evaluate the efficacy of bone reconstructive procedures for the reduction of probing pocket depth (PPD), bleeding on probing (BOP), and suppuration in peri-implantitis-related bone defects at ≥12-month follow-up. MATERIALS AND METHODS Three databases were searched for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that compared bone reconstructive therapies to access flap surgery (AFS) (Focused Question-FQ 1), and RCTs, CCTs, and prospective case series that assessed the efficacy of reconstructive therapies (FQ 2). Meta-analysis was performed for FQ1 when more than three studies were identified, while for FQ2 a network was drawn based on RCTs with common treatment arms. RESULTS Seven RCTs were identified for FQ1 while five RCTs and six prospective case series for FQ2. There was no significant difference in PPD change between AFS and reconstructive surgery (-0.387; p = .325) at 12 months. Furthermore, no clear differences in terms of PPD and BOP changes resulted from the different reconstructive therapies included in the network. Only a small percentage of treated cases with any modality achieved peri-implantitis resolution, as defined by different composite outcomes. CONCLUSIONS Reconstructive surgery does not offer significant improvements in peri-implant clinical parameters as compared to AFS at 12 months. It was not possible to establish a hierarchy of efficacy among the different biomaterials employed for reconstructive surgery.
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Affiliation(s)
- Nikos Donos
- Centre for Oral Clinical Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Elena Calciolari
- Centre for Oral Clinical Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Centro di Odontoiatria, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Mandeep Ghuman
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, Guy's Hospital, London, UK
| | - Michela Baccini
- Dipartimento di Statistica, Informatica, Applicazioni 'G. Parenti' (DiSIA), University of Florence, Florence, Italy
| | - Vanessa Sousa
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, Guy's Hospital, London, UK
| | - Luigi Nibali
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, Guy's Hospital, London, UK
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8
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Montero E, Roccuzzo A, Molina A, Monje A, Herrera D, Roccuzzo M. Minimal invasiveness in the reconstructive treatment of peri-implantitis defects. Periodontol 2000 2022; 91:199-216. [PMID: 35899987 DOI: 10.1111/prd.12460] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/30/2022] [Accepted: 06/05/2022] [Indexed: 11/30/2022]
Abstract
Peri-implantitis is a plaque-associated pathologic condition occurring in tissues around dental implants, clinically characterized by increased peri-implant probing pocket depth and progressive loss of supporting bone. Consequently, to arrest further disease progression and to increase the chance to obtain re-osseointegration, surgical reconstructive procedures have been adopted. In particular, following a paradigm gathered from periodontal therapy, recent protocols have underlined the importance of a minimally invasive approach to optimize the outcomes of therapy while minimizing the risks of postoperative complications. The present review summarizes the level of evidence on the surgical reconstructive protocols focusing on the new approaches aiming to minimize surgical trauma and patients' postoperative discomfort, underlining the pros and cons of each treatment modality.
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Affiliation(s)
- Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Ana Molina
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Mario Roccuzzo
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Division of Maxillofacial Surgery, University of Torino, Torino, Italy
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9
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Øen M, Leknes KN, Lund B, Bunæs DF. The efficacy of systemic antibiotics as an adjunct to surgical treatment of peri-implantitis: a systematic review. BMC Oral Health 2021; 21:666. [PMID: 34961495 PMCID: PMC8711198 DOI: 10.1186/s12903-021-02020-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/08/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Microbial biofilm accumulation is the main cause of peri-implantitis. The majority of surgical peri-implantitis treatment protocols suggests adjunctive use of systemic antibiotics to target specific putative bacteria. The aim of this systematic review was to critically evaluate the adjunctive use of systemically administered antibiotics in surgical treatment of peri-implantitis by reviewing previously published systematic reviews and primary studies. METHODS A systematic literature search was conducted in four electronic databases (MEDLINE, The Cochrane Library, EMBASE, and Web of Science) for randomised controlled trials, cohort studies, case-control studies, and systematic reviews reporting surgical treatment of peri-implantitis with and without adjunctive systemically administered antibiotic therapy. The included systematic reviews and primary studies were qualitatively assessed using AMSTAR and GRADE, respectively. No restrictions were set for date of publication, journal, or language. RESULTS The literature search identified 681 papers. Only seven systematic reviews and two primary studies met the inclusion criteria. Four out of seven included systematic reviews concluded that no evidence exists for use of systemic antibiotics to improve the clinical outcomes in surgical treatment of peri-implantitis. One review did not estimate the level of evidence, one did not clearly state any beneficial effect, whereas one reported a limited adjunctive effect. Further, the two included primary studies did not show a long-term significant benefit of adjunctive use of systemically administrated antibiotics. However, one study reported a short-term adjunctive effect in patients with modified surface implants. Due to heterogeneity in study design, low number of included primary studies, and grade of bias, no meta-analysis was performed. CONCLUSION The use of systemically administered antibiotics as an adjunct to surgical interventions of peri-implantitis cannot be justified as a part of a standard treatment protocol. A pervasive problem is the lack of uniform diagnosis criteria for peri-implantitis, deficient information about patient characteristics, absence of high quality long-term randomised controlled trials, and authors' declaration on conflict of interest.
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Affiliation(s)
- Malene Øen
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Knut N Leknes
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway.
| | - Bodil Lund
- Division of Oral Diagnostics and Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet and Medical Unit for Reconstructive Plastic- and Craniofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Dagmar F Bunæs
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
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10
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Ramanauskaite A, Fretwurst T, Schwarz F. Efficacy of alternative or adjunctive measures to conventional non-surgical and surgical treatment of peri-implant mucositis and peri-implantitis: a systematic review and meta-analysis. Int J Implant Dent 2021; 7:112. [PMID: 34779939 PMCID: PMC8593130 DOI: 10.1186/s40729-021-00388-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/06/2021] [Indexed: 12/26/2022] Open
Abstract
Purpose To evaluate the efficacy of alternative or adjunctive measures to conventional non-surgical or surgical treatment of peri-implant mucositis and peri-implantitis. Material and methods Prospective randomized and nonrandomized controlled studies comparing alternative or adjunctive measures, and reporting on changes in bleeding scores (i.e., bleed0ing index (BI) or bleeding on probing (BOP)), probing depth (PD) values or suppuration (SUPP) were searched. Results Peri-implant mucositis: adjunctive use of local antiseptics lead to greater PD reduction (weighted mean difference (WMD) = − 0.23 mm; p = 0.03, respectively), whereas changes in BOP were comparable (WMD = − 5.30%; p = 0.29). Non-surgical treatment of peri-implantitis: alternative measures for biofilm removal and systemic antibiotics yielded higher BOP reduction (WMD = − 28.09%; p = 0.01 and WMD = − 17.35%; p = 0.01, respectively). Surgical non-reconstructive peri-implantitis treatment: WMD in PD amounted to − 1.11 mm favoring adjunctive implantoplasty (p = 0.02). Adjunctive reconstructive measures lead to significantly higher radiographic bone defect fill/reduction (WMD = 56.46%; p = 0.01 and WMD = − 1.47 mm; p = 0.01), PD (− 0.51 mm; p = 0.01) and lower soft-tissue recession (WMD = − 0.63 mm; p = 0.01), while changes in BOP were not significant (WMD = − 11.11%; p = 0.11). Conclusions Alternative and adjunctive measures provided no beneficial effect in resolving peri-implant mucositis, while alternative measures were superior in reducing BOP values following non-surgical treatment of peri-implantitis. Adjunctive reconstructive measures were beneficial regarding radiographic bone-defect fill/reduction, PD reduction and lower soft-tissue recession, although they did not improve the resolution of mucosal inflammation. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-021-00388-x.
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Affiliation(s)
- Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University Frankfurt, Carolinum, 60596, Frankfurt am Main, Germany
| | - Tobias Fretwurst
- Department of Oral- and Maxillofacial Surgery, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Frankfurt, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany.
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11
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Polymeri A, Anssari-Moin D, van der Horst J, Wismeijer D, Laine ML, Loos BG. Surgical treatment of peri-implantitis defects with two different xenograft granules: A randomized clinical pilot study. Clin Oral Implants Res 2020; 31:1047-1060. [PMID: 32803798 PMCID: PMC7693249 DOI: 10.1111/clr.13651] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 06/03/2020] [Accepted: 08/10/2020] [Indexed: 12/24/2022]
Abstract
Objectives To investigate whether xenograft EB (EndoBon) is non‐inferior to xenograft BO (Bio‐Oss) when used in reconstructive surgery of peri‐implant osseous defects. Materials and methods Dental patients with one implant each demonstrating peri‐implantitis were randomized to receive surgical debridement and defect fill with either BO or EB. Changes in bone level (BL) and intrabony defect depth (IDD) evaluated radiographically were the primary outcomes. The secondary outcomes included changes in probing pocket depth (PPD), bleeding on probing (BoP), and suppuration on probing (SoP). All outcomes were recorded before treatment and at 6 and 12 months post‐treatment. Results Twenty‐four patients (n = 11 BO, n = 13 EB) completed the study. Both groups demonstrated significant within‐group improvements in all clinical and radiographic parameters at 6 and 12 months (p ≤ .001). At 12 months, both groups presented with IDD reductions of 2.5–3.0 mm on average. The inter‐group differences were not statistically significant at all time points and for all the examined parameters (p > .05). While the radiographic defect fill in both groups exceeded > 1 mm and can be considered treatment success, successful treatment outcomes as defined by Consensus Reporting (no further bone loss, PPD ≤ 5 mm, no BOP, and no SoP) were identified in 2/11 (18%) BO and 0/13 (0%) EB individuals (Fisher's exact test, p = .199). Conclusions Within the limitations of this pilot study, the application of xenograft EB showed to be non‐inferior to xenograft BO when used in reconstructive surgery of peri‐implant osseous defects.
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Affiliation(s)
- Angeliki Polymeri
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - David Anssari-Moin
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Joyce van der Horst
- Department Oral Implantology and Prosthodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Daniel Wismeijer
- Department Oral Implantology and Prosthodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Marja L Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
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12
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Monje A, Pons R, Roccuzzo A, Salvi GE, Nart J. Reconstructive therapy for the management of peri‐implantitis via submerged guided bone regeneration: A prospective case series. Clin Implant Dent Relat Res 2020; 22:342-350. [DOI: 10.1111/cid.12913] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/27/2020] [Accepted: 04/08/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Alberto Monje
- Department of Periodontology Universitat Internacional de Catalunya Barcelona Spain
| | - Ramón Pons
- Department of Periodontology Universitat Internacional de Catalunya Barcelona Spain
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine University of Bern Bern Switzerland
- Department of Oral and Maxillofacial Surgery Copenhagen University Hospital (Rigshospitalet) Copenhagen Denmark
| | - Giovanni E. Salvi
- Department of Periodontology, School of Dental Medicine University of Bern Bern Switzerland
| | - José Nart
- Department of Periodontology Universitat Internacional de Catalunya Barcelona Spain
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Wang WC, Lagoudis M, Yeh CW, Paranhos KS. Management of peri-implantitis - A contemporary synopsis. ACTA ACUST UNITED AC 2019; 38:8-16. [PMID: 29229078 DOI: 10.1016/j.sdj.2017.10.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 05/07/2017] [Accepted: 10/06/2017] [Indexed: 11/25/2022]
Abstract
Prevalence of peri-implant complication is expected to be on the rise with the increased number of implants being placed. Depending on the degree of osseous involvement, the clinician needs to decide if the treatment goal is to arrest the disease progression, regeneration or explantation and replacement. Host's medical status, defect configuration, aesthetic outcome, ability to access for plaque control post-treatment, and the patient's wishes are key factors to consider. The purpose of this review is to provide a contemporary synopsis on the management of peri-implantitis with emphasis on explantation. Guidance on the identification of factors/situations where salvaging an implant may be less favourable is discussed and the various techniques to remove a fractured, or peri-implantitis-affected non-mobile implant are described.
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Affiliation(s)
- Wendy Cw Wang
- Department of Periodontology and Implant Dentistry, New York University, United States.
| | - Miltiadis Lagoudis
- Department of Periodontology and Implant Dentistry, New York University, United States
| | - Che-Wei Yeh
- Department of Periodontology and Implant Dentistry, New York University, United States
| | - Klenise S Paranhos
- Department of Periodontology and Implant Dentistry, New York University, United States
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Tomasi C, Regidor E, Ortiz-Vigón A, Derks J. Efficacy of reconstructive surgical therapy at peri-implantitis-related bone defects. A systematic review and meta-analysis. J Clin Periodontol 2019; 46 Suppl 21:340-356. [DOI: 10.1111/jcpe.13070] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 01/07/2019] [Accepted: 01/09/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Cristiano Tomasi
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy at University of Gothenburg; Gothenburg Sweden
| | | | - Alberto Ortiz-Vigón
- Clínica Ortiz-Vigón; PerioCentrum; Bilbao Spain
- ETEP Research Group; Faculty of Odontology; University Complutense of Madrid; Madrid Spain
| | - Jan Derks
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy at University of Gothenburg; Gothenburg Sweden
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15
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16
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Roccuzzo M, Layton DM, Roccuzzo A, Heitz‐Mayfield LJ. Clinical outcomes of peri‐implantitis treatment and supportive care: A systematic review. Clin Oral Implants Res 2018; 29 Suppl 16:331-350. [DOI: 10.1111/clr.13287] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Mario Roccuzzo
- Division of Maxillofacial Surgery University of Torino Torino Italy
- Private Practice Torino Italy
| | - Danielle M. Layton
- Private Practice Brisbane Qld Australia
- School of Dentistry University of Queensland Brisbane Qld Australia
| | | | - Lisa J. Heitz‐Mayfield
- International Research Collaborative Faculty of Science The University of Western Australia Perth WA Australia
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18
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Renvert S, Roos-Jansåker AM, Persson GR. Surgical treatment of peri-implantitis lesions with or without the use of a bone substitute-a randomized clinical trial. J Clin Periodontol 2018; 45:1266-1274. [DOI: 10.1111/jcpe.12986] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 06/13/2018] [Accepted: 07/09/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Stefan Renvert
- Oral Health Sciences; Kristianstad University; Kristianstad Sweden
- School of Dental Science; Trinity College; Dublin Ireland
- Blekinge Institute of Technology; Karlskrona Sweden
| | | | - Gösta Rutger Persson
- Oral Health Sciences; Kristianstad University; Kristianstad Sweden
- Department of Periodontics; School of Dentistry; University of Washington; Seattle Washington
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19
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Mercado F, Hamlet S, Ivanovski S. Regenerative surgical therapy for peri-implantitis using deproteinized bovine bone mineral with 10% collagen, enamel matrix derivative and Doxycycline-A prospective 3-year cohort study. Clin Oral Implants Res 2018; 29:583-591. [DOI: 10.1111/clr.13256] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Faustino Mercado
- School of Dentistry and Oral Health; Griffith University; Gold Coast Qld Australia
| | - Stephen Hamlet
- School of Dentistry and Oral Health; Griffith University; Gold Coast Qld Australia
- Menzies Health Institute; Griffith University; Gold Coast Qld Australia
| | - Saso Ivanovski
- School of Dentistry and Oral Health; Griffith University; Gold Coast Qld Australia
- Menzies Health Institute; Griffith University; Gold Coast Qld Australia
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20
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Hallström H, Persson GR, Lindgren S, Renvert S. Open flap debridement of peri-implantitis with or without adjunctive systemic antibiotics: A randomized clinical trial. J Clin Periodontol 2017; 44:1285-1293. [DOI: 10.1111/jcpe.12805] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Hadar Hallström
- Department of Periodontology; School of Dentistry; Malmö University; Malmö Sweden
| | - G. Rutger Persson
- Department of Oral Health Sciences; School of Health and Society; Kristianstad University; Kristianstad Sweden
- Departments of Periodontics, and Oral Medicine; School of Dentistry; University of Washington; Seattle WA USA
| | | | - Stefan Renvert
- Department of Oral Health Sciences; School of Health and Society; Kristianstad University; Kristianstad Sweden
- School of Dental Science; Trinity College; Dublin Ireland
- Blekinge Institute of Technology; Karlskrona Sweden
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21
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Peri-Implant Bone Loss and Peri-Implantitis: A Report of Three Cases and Review of the Literature. Case Rep Dent 2016; 2016:2491714. [PMID: 27833766 PMCID: PMC5090081 DOI: 10.1155/2016/2491714] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 09/19/2016] [Accepted: 10/03/2016] [Indexed: 01/28/2023] Open
Abstract
Dental implant supported restorations have been added substantially to the clinical treatment options presented to patients. However, complications with these treatment options also arise due to improper patient selection and inadequate treatment planning combined with poor follow-up care. The complications related to the presence of inflammation include perimucositis, peri-implant bone loss, and peri-implantitis. Prevalence rates of these complications have been reported to be as high as 56%. Treatment options that have been reported include nonsurgical therapy, the use of locally delivered and systemically delivered antibiotics, and surgical protocols aimed at regenerating the lost bone and soft tissue around the implants. The aim of this article is to report on three cases and review some of the treatment options used in their management.
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Guler B, Uraz A, Yalım M, Bozkaya S. The Comparison of Porous Titanium Granule and Xenograft in the Surgical Treatment of Peri-Implantitis: A Prospective Clinical Study. Clin Implant Dent Relat Res 2016; 19:316-327. [DOI: 10.1111/cid.12453] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Berceste Guler
- Assistant professor, Department of Periodontology; Dumlupınar University Faculty of Dentistry; Kütahya Turkey
| | - Ahu Uraz
- Associate professor, Faculty of Dentistry, Department of Periodontology; Gazi University; Ankara Turkey
| | - Mehmet Yalım
- Faculty of Dentistry, Department of Periodontology; Professor Gazi University; Ankara Turkey
| | - Suleyman Bozkaya
- Associate professor, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery; Gazi University; Ankara Turkey
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Daugela P, Cicciù M, Saulacic N. Surgical Regenerative Treatments for Peri-Implantitis: Meta-analysis of Recent Findings in a Systematic Literature Review. J Oral Maxillofac Res 2016; 7:e15. [PMID: 27833740 PMCID: PMC5100640 DOI: 10.5037/jomr.2016.7315] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 08/19/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The purpose of the present study was to systematically review the literature on the surgical regenerative treatment of the peri-implantitis and to determine an effective therapeutic predictable option for their clinical management. MATERIAL AND METHODS The study searched MEDLINE and EMBASE databases from 2006 to 2016. Clinical human studies that had reported changes in probing depth (PD) and/or bleeding on probing (BOP) and/or radiologic marginal bone level (RBL) changes after peri-implantitis surgical treatment at 12-month follow-up or longer were included accordingly to PRISMA guidelines. RESULTS The initial search obtained 883 citations. After screening and determination of eligibility, 18 articles were included in the review. The meta-analysis of selected studies revealed that the weighted mean RBL fill was 1.97 mm (95% confidence interval [CI] = 1.58 to 2.35 mm), PD reduction was 2.78 mm (95% CI = 2.31 to 3.25 mm), and BOP reduced by 52.5% (95% CI = 41.6 to 63.1%). Defect fill in studies using and not using barrier membranes for graft coverage was 1.86 mm (95% CI = 1.36 to 2.36 mm) and 2.12 mm (95% CI = 1.46 to 2.78 mm) correspondingly. High heterogeneity among the studies regarding defects morphology, surgical protocols, and selection of biomaterials were found. CONCLUSIONS All included studies underlined an improvement of clinical conditions after the surgical regenerative treatment of peri-implantitis, however, there is a lack of scientific evidence in the literature regarding the superiority of the regenerative versus non-regenerative surgical treatment. The presence of a barrier membrane or submergence in the regenerative procedure does not seem to be fundamental in order to obtain clinical success of the surgery.
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Affiliation(s)
- Povilas Daugela
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, KaunasLithuania.
| | - Marco Cicciù
- Human Pathology Department, Messina University, MessinaItaly.
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, BernSwitzerland.
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Schwarz F, Schmucker A, Becker J. Efficacy of alternative or adjunctive measures to conventional treatment of peri-implant mucositis and peri-implantitis: a systematic review and meta-analysis. Int J Implant Dent 2015; 1:22. [PMID: 27747644 PMCID: PMC5005629 DOI: 10.1186/s40729-015-0023-1] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 07/28/2015] [Indexed: 01/06/2023] Open
Abstract
In patients with peri-implant mucositis and peri-implantitis, what is the efficacy of nonsurgical (i.e. referring to peri-implant mucositis and peri-implantitis) and surgical (i.e. referring to peri-implantitis) treatments with alternative or adjunctive measures on changing signs of inflammation compared with conventional nonsurgical (i.e. mechanical/ultrasonic debridement) and surgical (i.e. open flap debridement) treatments alone? After electronic database and hand search, a total of 40 publications (reporting on 32 studies) were finally considered for the qualitative and quantitative assessment. The weighted mean changes (WM)/ and WM differences (WMD) were estimated for bleeding on probing scores (BOP) and probing pocket depths (PD) (random effect model). Peri-implant mucositis: WMD in BOP and PD reductions amounted to -8.16 % [SE = 4.61] and -0.15 mm [SE = 0.13], not favouring adjunctive antiseptics/antibiotics (local and systemic) over control measures (p > 0.05). Peri-implantitis (nonsurgical): WMD in BOP scores amounted to -23.12 % [SE = 4.81] and -16.53 % [SE = 4.41], favouring alternative measures (glycine powder air polishing, Er:YAG laser) for plaque removal and adjunctive local antibiotics over control measures (p < 0.001), respectively. Peri-implantitis (surgical): WMD in BOP and PD reductions did not favour alternative over control measures for surface decontamination. WM reductions following open flap surgery (±resective therapy) and adjunctive augmentative therapy amounted to 34.81 and 50.73 % for BOP and 1.75 and 2.20 mm for PD, respectively. While mechanical debridement alone was found to be effective for the management of peri-implant mucositis, alternative/adjunctive measures may improve the efficacy over/of conventional nonsurgical treatments at peri-implantitis sites. Adjunctive resective and/or augmentative measures are promising; however, their beneficial effect on the clinical outcome of surgical treatments needs to be further investigated.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery, Westdeutsche Kieferklinik, Universitätsklinikum Düsseldorf, D-40225, Düsseldorf, Germany.
| | - Andrea Schmucker
- Department of Oral Surgery, Westdeutsche Kieferklinik, Universitätsklinikum Düsseldorf, D-40225, Düsseldorf, Germany
| | - Jürgen Becker
- Department of Oral Surgery, Westdeutsche Kieferklinik, Universitätsklinikum Düsseldorf, D-40225, Düsseldorf, Germany
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26
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Fletcher P, Constantinides C. Resolution of a Peri-Implantitis Defect Using Sterile Saline for Implant Surface Detoxification: A Case Report With Clinical Re-Entry. Clin Adv Periodontics 2015. [DOI: 10.1902/cap.2014.140020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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27
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Jepsen K, Jepsen S, Laine M, Anssari Moin D, Pilloni A, Zeza B, Sanz M, Ortiz-Vigon A, Roos-Jansåker A, Renvert S. Reconstruction of Peri-implant Osseous Defects. J Dent Res 2015; 95:58-66. [DOI: 10.1177/0022034515610056] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There is a paucity of data for the effectiveness of reconstructive procedures in the treatment of peri-implantitis. The objective of this study was to compare reconstruction of peri-implant osseous defects with open flap debridement (OFD) plus porous titanium granules (PTGs) compared with OFD alone. Sixty-three patients (36 female, 27 male; mean age 58.4 y [SD 12.3]), contributing one circumferential peri-implant intraosseous defect, were included in a multinational, multicenter randomized trial using a parallel-group design. After OFD and surface decontamination using titanium brushes and hydrogen peroxide, 33 defects received PTGs. The implants were not submerged. All patients received adjunctive perioperative systemic antibiotics. The primary outcome variable (defect fill) was assessed on digitalized radiographs. Clinical measurements of probing depth (PPD), bleeding on probing (BoP), suppuration, and plaque were taken by blinded examiners. After 12 mo, the test group (OFD plus PTG) showed a mean radiographic defect fill (mesial/distal) of 3.6/3.6 mm compared with 1.1/1.0 in the control group (OFD). Differences were statistically significant in favor of the test group ( P < 0.0001). The OFD plus PTG group showed a mean reduction in PPD of 2.8 mm compared with 2.6 mm in the OFD group. BoP was reduced from 89.4% to 33.3% and from 85.8% to 40.4% for the test and control groups, respectively. There was no significant difference in complete resolution of peri-implantitis (PPD ≤4 mm and no BoP at six implant sites and no further bone loss), because this finding was accomplished at 30% of implants in the test group and 23% of implants in the control group. Reconstructive surgery using PTGs resulted in significantly enhanced radiographic defect fill compared with OFD. However, limitations in the lack of ability to discern biomaterial from osseous tissue could not be verified to determine new bone formation. Similar improvements according to clinical measures were obtained after both surgical treatment modalities (ClinicalTrials.gov NCT02406001).
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Affiliation(s)
- K. Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - S. Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - M.L. Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - D. Anssari Moin
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - A. Pilloni
- Section of Periodontics, University of Rome, Sapienza, Italy
| | - B. Zeza
- Section of Periodontics, University of Rome, Sapienza, Italy
| | - M. Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - A. Ortiz-Vigon
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - A.M. Roos-Jansåker
- Department of Periodontology, Public Dental Health Service,
Kristianstad, Sweden
- Department of Oral Sciences, Kristianstad University, Kristianstad, Sweden
| | - S. Renvert
- Department of Periodontology, Public Dental Health Service,
Kristianstad, Sweden
- Department of Oral Sciences, Kristianstad University, Kristianstad, Sweden
- Blekinge Institute of Technology, Karlskrona, Sweden
- School of Dental Sciences, Trinity College, Dublin, Ireland
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Naval-Gías L, Rodriguez-Campo F, Naval-Parra B, Sastre-Pérez J. Pathological mandibular fracture: A severe complication of periimplantitis. J Clin Exp Dent 2015; 7:e328-32. [PMID: 26155355 PMCID: PMC4483346 DOI: 10.4317/jced.52305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 02/15/2015] [Indexed: 11/05/2022] Open
Abstract
Nowadays, dental implant treatment is a very common option for patients even in medical compromised conditons. Some complications related to them have been described. Periimplantitis (PI) is one of the biggest concerns complications of these kind of treatments, probably has a multifactorial aethiology. Usually the consequences of PI are the loss of the implants and prostheses, expenses of money and time for dentists and patients. Very often PI implies the necesity of repeating the treatment . Pathological mandibular fracture due to PI is a severe but infrequent complication after dental implant treatment, especially after PI. In this study we present three cases of mandibular pathologic fractures among patients with different medical and dental records but similar management: two of them had been treated years ago of oral squamous cell carcinoma with surgery and radiotherapy, the other patient received oral bisphosphonates for osteoporosis some years after implantation. We analized the causes, consequences and posible prevention of these fractures as well as the special features of this kind of mandibular fractures and the different existing treatments. Key words:Periimplantitis, pathological mandibular fracture, mandibular atrophy, bicortical implants.
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Affiliation(s)
- Luis Naval-Gías
- PhD, DMD. Maxillofacial Surgeon. Oral and Maxillofacial Surgery Department. Hospital Universitario La Princesa. Madrid. Spain
| | - Francisco Rodriguez-Campo
- MD. Maxillofacial Surgeon. Oral and Maxillofacial Surgery Department. Hospital Universitario La Princesa. Madrid. Spain
| | | | - Jesús Sastre-Pérez
- MD. Maxillofacial Surgeon. Oral and Maxillofacial Surgery Department. Hospital Universitario La Princesa. Madrid. Spain
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Decontamination using a desiccant with air powder abrasion followed by biphasic calcium sulfate grafting: a new treatment for peri-implantitis. Case Rep Dent 2015; 2015:474839. [PMID: 26000178 PMCID: PMC4427007 DOI: 10.1155/2015/474839] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/31/2015] [Accepted: 04/15/2015] [Indexed: 11/17/2022] Open
Abstract
Peri-implantitis is characterized by inflammation and crestal bone loss in the tissues surrounding implants. Contamination by deleterious bacteria in the peri-implant microenvironment is believed to be a major factor in the etiology of peri-implantitis. Prior to any therapeutic regenerative treatment, adequate decontamination of the peri-implant microenvironment must occur. Herein we present a novel approach to the treatment of peri-implantitis that incorporates the use of a topical desiccant (HYBENX), along with air powder abrasives as a means of decontamination, followed by the application of biphasic calcium sulfate combined with inorganic bovine bone material to augment the intrabony defect. We highlight the case of a 62-year-old man presenting peri-implantitis at two neighboring implants in positions 12 and 13, who underwent access flap surgery, followed by our procedure. After an uneventful 2-year healing period, both implants showed an absence of bleeding on probing, near complete regeneration of the missing bone, probing pocket depth reduction, and clinical attachment gain. While we observed a slight mucosal recession, there was no reduction in keratinized tissue. Based on the results described within, we conclude that the use of HYBENX and air powder abrasives, followed by bone defect grafting, represents a viable option in the treatment of peri-implantitis.
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30
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Renvert S, Polyzois IN. Clinical approaches to treat peri-implant mucositis and peri-implantitis. Periodontol 2000 2015; 68:369-404. [DOI: 10.1111/prd.12069] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2014] [Indexed: 12/21/2022]
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31
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Abstract
Appropriate treatment of implants is becoming increasingly important for the general dentist as the number of implants placed per year continues to increase. Early diagnosis of peri-implantitis is imperative; initiating the correct treatment protocol depends on a proper diagnosis. Several risk factors exist for the development of peri-implantitis, which can guide patient selection and treatment planning. Treatment of peri-implantitis should be tailored to the severity of the lesion (as outlined by the cumulative interceptive supportive treatment protocol), ranging from mechanical debridement to explantation. Several surgical and nonsurgical treatment alternatives exist. There is little consensus on superior treatment methods.
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Affiliation(s)
- Kevin Robertson
- Division of Oral and Maxillofacial Surgery and Dental Medicine, Department of Surgery, Loyola University Medical center, 2160 S. First Ave., Maywood, Illinois 60153, USA
| | - Timothy Shahbazian
- Division of Oral and Maxillofacial Surgery and Dental Medicine, Department of Surgery, Loyola University Medical center, 2160 S. First Ave., Maywood, Illinois 60153, USA.
| | - Stephen MacLeod
- Division of Oral and Maxillofacial Surgery and Dental Medicine, Department of Surgery, Loyola University Medical center, 2160 S. First Ave., Maywood, Illinois 60153, USA
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The utilization of a diode laser in the surgical treatment of peri-implantitis. A randomized clinical trial. Clin Oral Investig 2015; 19:1851-60. [PMID: 25623382 DOI: 10.1007/s00784-014-1397-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 12/29/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES A comparison of different treatment modalities of peri-implantitis can lead to the development and application of more effective and efficient methods of therapy in clinical practice. This study compares the effectiveness of open flap debridement used alone, with an approach employing the additional use of a diode laser for the treatment of peri-implantitis. MATERIALS AND METHODS Nineteen patients were divided into two groups and treated for peri-implantitis. In the control group (C group), the therapy utilized access flaps, plastic curettes, and sterilized gauzes soaked in saline. The test group (L group) was treated similarly but with additional irradiation using a diode laser. The parameters studied were pocket depth (PD) as the primary outcome variable, clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI) as secondary variables. Measurements were performed at three different time points, baseline (BSL), 3 months, and 6 months after treatment. Three months after treatment, a mean PD reduction of 1.19 mm for the control group and 1.38 mm for the laser group was recorded. The corresponding BOP changes were 72.9 and 66.7%, respectively. These changes were significant and remained at the same levels at the 6-month examination (p < 0.05). CAL was reduced significantly only in group L from 5.25 mm at baseline to 4.54 mm at 3 months, remaining at this level at 6 months (p < 0.05). PI was reduced significantly in group C at 3 months from 37.5 to 6.3%. The 6-month data showed no statistically significant difference (p < 0.05) from the 3-month measurements. RESULTS The two methods of therapy for peri-implantitis examined seemed to be equally efficient in the reduction of the PD and BOP 3 months after surgery, with the results sustained at the same levels after 6 months. CAL significantly improved only in the test group after 3 months. PI was reduced and maintained at low levels in both groups. CONCLUSIONS Surgical treatment of peri-implantitis by access flaps leads to improvement of all clinical parameters studied while the additional use of diode laser does not seem to have an extra beneficiary effect. CLINICAL RELEVANCE The additional use of a diode laser in the surgical treatment of peri-implantitis offers a limited clinical benefit.
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Geisinger ML, Holmes CM, Vassilopoulos PJ, Geurs NC, Reddy MS. Is Laser Disinfection an Effective Adjunctive Treatment to Bone Augmentation for Peri-Implantitis? A Review of Current Evidence. Clin Adv Periodontics 2014; 4:274-279. [DOI: 10.1902/cap.2013.130048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 07/05/2013] [Indexed: 11/13/2022]
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Roos-Jansåker AM, Persson GR, Lindahl C, Renvert S. Surgical treatment of peri-implantitis using a bone substitute with or without a resorbable membrane: a 5-year follow-up. J Clin Periodontol 2014; 41:1108-14. [PMID: 25195613 DOI: 10.1111/jcpe.12308] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2014] [Indexed: 11/29/2022]
Abstract
AIM To compare two regenerative surgical treatments for peri-implantitis over 5 years. MATERIAL & METHODS Twenty-five individuals with peri-implantitis remained at study endpoint. They were treated with a bone substitute and a resorbable membrane (13 individuals with 23 implants) [Group 1], or with bone substitute alone (12 individuals with 22 implants) [Group 2]. All study individuals were kept on a strict maintenance programme every third month. RESULTS Five-year follow-up demonstrated clinical and radiographic improvements in both groups. No implants were lost due to progression of peri-implantitis. Probing depths were reduced by 3.0 ± 2.4 mm in Group 1, and 3.3 ± 2.09 mm in Group 2 (NS). In both groups, radiographic evidence of bone gain was significant (p < 0.001). At year 5, the average defect fill was 1.3 mm (SD ± 1.4 mm) in Group 1 and 1.1 mm (SD ± 1.2 mm) in Group 2 (mean diff; 0.4 95% CI -0.3, 1.2, p = 0.24). Bleeding on probing decreased in both groups. Baseline and year 5 plaque scores did not differ between groups and was reduced from 50% to 15%. CONCLUSION Both procedures resulted in stable conditions. Additional use of a membrane does not improve the outcome.
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Affiliation(s)
- Ann-Marie Roos-Jansåker
- Department of Periodontology, Public Dental Health Service, Kristianstad, Sweden; Department of Oral Sciences, Kristianstad University, Kristianstad, Sweden
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Romanos GE, Javed F, Delgado-Ruiz RA, Calvo-Guirado JL. Peri-implant diseases: a review of treatment interventions. Dent Clin North Am 2014; 59:157-78. [PMID: 25434564 DOI: 10.1016/j.cden.2014.08.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The ideal management of peri-implant diseases focuses on infection control, detoxification of implant surfaces, regeneration of lost tissues, and plaque-control regimens via mechanical debridement (with or without raising a surgical flap). However, a variety of other therapeutic modalities also have been proposed for the management of peri-implantitis. These treatment strategies encompass use of antiseptics and/or antibiotics, laser therapy, guided bone regeneration, and photodynamic therapy. The aim of this article was to review indexed literature with reference to the various therapeutic interventions proposed for the management of peri-implant diseases.
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Affiliation(s)
- Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, 106 Rockland Hall, Stony Brook, NY 11794-8700, USA.
| | - Fawad Javed
- Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Laboratory, College of Applied Medical Sciences, King Saud University, Derriyah, P.O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Rafael Arcesio Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, 1103 Westchester Hall, Stony Brook, NY 11794-8712, USA
| | - José Luis Calvo-Guirado
- Faculty of Medicine and Dentistry, Hospital Morales Meseguer, University of Murcia, 2° Planta Clínica Odontológica Calle Marques de los Velez S/n, Murcia 30007, Spain
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36
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Figuero E, Graziani F, Sanz I, Herrera D, Sanz M. Management of peri-implant mucositis and peri-implantitis. Periodontol 2000 2014; 66:255-73. [DOI: 10.1111/prd.12049] [Citation(s) in RCA: 194] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2013] [Indexed: 11/28/2022]
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37
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Chan HL, Lin GH, Suarez F, MacEachern M, Wang HL. Surgical Management of Peri-Implantitis: A Systematic Review and Meta-Analysis of Treatment Outcomes. J Periodontol 2014; 85:1027-41. [DOI: 10.1902/jop.2013.130563] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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38
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Serino G, Turri A, Lang NP. Maintenance therapy in patients following the surgical treatment of peri-implantitis: a 5-year follow-up study. Clin Oral Implants Res 2014; 26:950-956. [DOI: 10.1111/clr.12418] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Giovanni Serino
- Specialistic Clinic in Periodontics; Södra Älvsborg Hospital; Borås Sweden
- Research and developments Unit; Borås Sweden
| | - Alberto Turri
- The Brånemark Clinic; Odontologen; Göteborg Sweden
- BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy; Göteborg Sweden
| | - Niklaus P. Lang
- Prince Philip Dental Hospital; The University of Hong Kong; Hong Kong SAR China
- University of Zurich; Zurich Switzerland
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39
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Fu PS, Wu YM, Wang JC, Huang TK, Chen WC, Tseng YC, Hung CC. Surgical Management of Severe Peri-Implantitis in the Esthetic Zone: A Case Report With a 6-Year Follow-Up. J ORAL IMPLANTOL 2014; 42:86-92. [PMID: 24773170 DOI: 10.1563/aaid-joi-d-13-00160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Po-Sung Fu
- 1 Department of Family Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yi-Min Wu
- 2 Department of Periodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jen-Chyan Wang
- 3 Department of Prosthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ta-Ko Huang
- 4 School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Cheng Chen
- 5 Department of Fiber and Composite Materials, Feng Chia University, Taichung, Taiwan
| | - Yu-Chuan Tseng
- 4 School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Cheng Hung
- 3 Department of Prosthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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40
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Abstract
UNLABELLED While the clinical science of managing peri-implant diseases is progressing, careful monitoring and preventive care of peri-implant tissue health during maintenance is paramount. BACKGROUND Implants have become a routine treatment option for missing dentition. The biological complications of restored dental implants and associated supra-structures share similarities with the biofilm infections of natural dentition. Our existing paradigms of periodontal disease treatment can partially be applied to management of peri-implant disease. APPROACH A critical analysis of the peri-implant disease literature was conducted, anchored by a search on the MEDLINE database (2005 to present) by way of Ovid Medline(®). Search terms peri-implantitis, peri-implant mucositis and peri-implant diseases were utilized. Select references within bibliographies of review articles were sought. CONCLUSION The dental team must play a critical role in educating patients to control plaque-biofilm associated with peri-implant tissues and associated restorations. Routine assessments at maintenance appointments allow early treatment intervention to prevent escalation of peri-implant disease. Given the infancy of clinical science surrounding peri-implantitis treatment, further, high-quality evidence based studies are expected.
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41
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Treatment Alternatives to Negotiate Peri-Implantitis. Adv Med 2014; 2014:487903. [PMID: 26556414 PMCID: PMC4590969 DOI: 10.1155/2014/487903] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 04/26/2014] [Accepted: 04/28/2014] [Indexed: 12/15/2022] Open
Abstract
Peri-implant diseases are becoming a major health issue in dentistry. Despite the magnitude of this problem and the potential grave consequences, commonly acceptable treatment protocols are missing. Hence, the present paper reviews the literature treatment of peri-implantitis in order to explore their benefits and limitations. Treatment of peri-implantitis may include surgical and nonsurgical approaches, either individually or combined. Nonsurgical therapy is aimed at removing local irritants from the implants' surface with or without surface decontamination and possibly some additional adjunctive therapies agents or devices. Systemic antibiotics may also be incorporated. Surgical therapy is aimed at removing any residual subgingival deposits and additionally reducing the peri-implant pockets depth. This can be done alone or in conjunction with either osseous respective approach or regenerative approach. Finally, if all fails, explantation might be the best alternative in order to arrest the destruction of the osseous structure around the implant, thus preserving whatever is left in this site for future reconstruction. The available literature is still lacking with large heterogeneity in the clinical response thus suggesting possible underlying predisposing conditions that are not all clear to us. Therefore, at present time treatment of peri-implantitis should be considered possible but not necessarily predictable.
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Lagervall M, Jansson LE. Treatment Outcome in Patients With Peri-Implantitis in a Periodontal Clinic: A Retrospective Study. J Periodontol 2013; 84:1365-73. [DOI: 10.1902/jop.2012.120555] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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43
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Academy Report: Peri-Implant Mucositis and Peri-Implantitis: A Current Understanding of Their Diagnoses and Clinical Implications. J Periodontol 2013; 84:436-43. [DOI: 10.1902/jop.2013.134001] [Citation(s) in RCA: 245] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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44
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Schwarz F, Sahm N, Becker J. Combined surgical therapy of advanced peri-implantitis lesions with concomitant soft tissue volume augmentation. A case series. Clin Oral Implants Res 2013; 25:132-6. [DOI: 10.1111/clr.12103] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery; Heinrich-Heine-University; Düsseldorf Germany
| | - Narja Sahm
- Department of Oral Surgery; Heinrich-Heine-University; Düsseldorf Germany
| | - Juergen Becker
- Department of Oral Surgery; Heinrich-Heine-University; Düsseldorf Germany
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45
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Sakka S, Idrees M, Alissa R, Kujan O. Ailing and failing oral implants: initial therapy and surgical management. ACTA ACUST UNITED AC 2012. [PMID: 23188772 DOI: 10.1111/jicd.12011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The distinction between ailing and failing implants is clinically important. Changes in the peri-implant soft or hard tissues will indicate whether the implant is ailing, failing, or has failed. This article discusses these clinical situations and provides an overview and description of peri-implant diseases and their treatment alternatives.
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Affiliation(s)
- Salah Sakka
- Department of Oral Surgery, Al-Farabi Dental College, Riyadh, Kingdom of Saudi Arabia; Department of Oral Surgery, Faculty of Dentistry, Al-Baath University, Hama, Syria
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46
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Kim JE, Kim HY, Huh JB, Lee JY, Shin SW. A two-stage surgical approach to the treatment of severe peri-implant defect: a 30-month clinical follow-up report. J ORAL IMPLANTOL 2012; 40:299-305. [PMID: 23110578 DOI: 10.1563/aaid-joi-d-12-00030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
With the advance of dental implant technology and the consequential increase in its success rate, the implant has become a highly predictable treatment method. Despite this, related complications are on the rise, with peri-implant mucositis and peri-implantitis being the most commonly observed. As in the case of conventional periodontitis, many patients experience peri-implant mucositis and peri-implantitis. In this case presentation, extensive bone loss occurred around the implant due to peri-implantitis, and the infection was first treated by applying chlorhexidine-soaked gauze and topical antibiotics. Then the guided bone regeneration procedure was performed using a bovine bone material and a collagen membrane, which resulted in the recovery of the lesion. With follow-ups of the healing process for 30 months, a successful outcome was observed that is reported herein.
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Affiliation(s)
- Jong-Eun Kim
- 1 Postgraduate School of Clinical Dentistry, Institute for Clinical Dental Research, Korea University Medical Center, Korea University, Seoul, South Korea
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47
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Renvert S, Polyzois I, Claffey N. Surgical therapy for the control of peri-implantitis. Clin Oral Implants Res 2012; 23 Suppl 6:84-94. [DOI: 10.1111/j.1600-0501.2012.02554.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Ioannis Polyzois
- Dublin Dental University Hospital; Trinity College; Dublin; Ireland
| | - Noel Claffey
- Dublin Dental University Hospital; Trinity College; Dublin; Ireland
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48
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Peñarrocha-Diago MA, Flichy-Fernández AJ, Alonso-González R, Peñarrocha-Oltra D, Balaguer-Martínez J, Peñarrocha-Diago M. Influence of implant neck design and implant-abutment connection type on peri-implant health. Radiological study. Clin Oral Implants Res 2012; 24:1192-200. [DOI: 10.1111/j.1600-0501.2012.02562.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2012] [Indexed: 11/30/2022]
Affiliation(s)
- M. A. Peñarrocha-Diago
- Oral Surgery and Implantology; Valencia University Medical and Dental School; Valencia; Spain
| | - A. J. Flichy-Fernández
- Oral Surgery and Implantology; Valencia University Medical and Dental School; Valencia; Spain
| | - R. Alonso-González
- Oral Surgery and Implantology; Valencia University Medical and Dental School; Valencia; Spain
| | - D. Peñarrocha-Oltra
- Oral Surgery and Implantology; Valencia University Medical and Dental School; Valencia; Spain
| | - J. Balaguer-Martínez
- Oral Surgery and Implantology; Valencia University Medical and Dental School; Valencia; Spain
| | - M. Peñarrocha-Diago
- Oral Surgery and Implantology; Valencia University Medical and Dental School; Valencia; Spain
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49
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Donovan TE, Anderson M, Becker W, Cagna DR, Hilton TJ, McKee JR, Metz JE. Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2012; 108:15-50. [DOI: 10.1016/s0022-3913(12)60104-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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50
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Schwarz F, John G, Mainusch S, Sahm N, Becker J. Combined surgical therapy of peri-implantitis evaluating two methods of surface debridement and decontamination. A two-year clinical follow up report. J Clin Periodontol 2012; 39:789-97. [DOI: 10.1111/j.1600-051x.2012.01867.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery; Heinrich Heine University; Düsseldorf; Germany
| | - Gordon John
- Department of Oral Surgery; Heinrich Heine University; Düsseldorf; Germany
| | - Saskia Mainusch
- Department of Oral Surgery; Heinrich Heine University; Düsseldorf; Germany
| | - Narja Sahm
- Department of Oral Surgery; Heinrich Heine University; Düsseldorf; Germany
| | - Jürgen Becker
- Department of Oral Surgery; Heinrich Heine University; Düsseldorf; Germany
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