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Sangkhamanee SS, Teparat-Burana T. Correction of Peri-Implant Soft Tissue Fenestration With Bony Dehiscence Associated With Intrabony Defect: A 2-Year Case Report. Case Rep Dent 2024; 2024:5895661. [PMID: 39166177 PMCID: PMC11335413 DOI: 10.1155/2024/5895661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 06/12/2024] [Accepted: 08/01/2024] [Indexed: 08/22/2024] Open
Abstract
Soft and hard tissue deficiencies around dental implants which can potentially compromise implant survival are commonly encountered. Complicated interventions are often required to address and resolve combinations of soft and hard tissue defects. This case report describes the management of peri-implant soft tissue fenestration accompanied by bony dehiscence associated with intrabony defect through soft tissue modification. A 51-year-old female was referred to the Periodontics and Oral Medicine Clinic with labial soft tissue fenestration at the maxillary left canine implant-supported crown. The patient complained of discomfort and malodor at the implant site. The implant showed mucosal fenestration and 6 mm probing depth (PD) with profuse bleeding at the distolabial site without mobility. A cone beam computed tomography (CBCT) demonstrated labial bony dehiscence associated with a 5.56-mm intrabony defect at mesial and distal surfaces. The implant was diagnosed as peri-implantitis with soft tissue deficiency. The treatment comprised oral hygiene instruction, debridement of the implant and all natural teeth, and mucogingival surgery with free connective tissue graft by the envelope technique. Two weeks after debridement, the mucosal margin of the implant disappeared, presenting soft tissue dehiscence of 4 × 4 mm. Mucogingival surgery was performed 3 weeks later. A 2-year follow-up revealed a stable mucosal margin with PD ranged 2-4 mm. In conclusion, modification of the soft tissue thickness around the implant together with excellent plaque control by the patient successfully maintained peri-implant health.
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Affiliation(s)
| | - Thitiwan Teparat-Burana
- Department of Oral Medicine and PeriodontologyFaculty of DentistryMahidol University, Bangkok 10400, Thailand
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2
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Golob Deeb J, Ha M, Carrico CK, Waldrop T, Lee PK. Effect of Implant Maintenance on Incidence of Peri-implantitis and Early Implant Failure: Retrospective Cohort Study. J ORAL IMPLANTOL 2024; 50:328-334. [PMID: 38916039 DOI: 10.1563/aaid-joi-d-24-00003] [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: 06/26/2024]
Abstract
Maintaining dental implants and managing peri-implant tissues has become integral to dental practice. Owing to the larger number of implants placed, the number of peri-implant lesions is increasing. Periodontal implant maintenance therapy (PIMT) provides a conservative long-term treatment modality to monitor and maintain implants. This study aims to investigate periodontal maintenance effects on peri-implant tissue health to add to existing evidence. A retrospective analysis included implant patients with 1-7 years of follow-up, assessing peri-implantitis and early implant failure as outcome variables. The frequency of PIMT, implant characteristics, and demographics served as predictors, and associations between peri-implantitis, implant failure, and PIMT frequency were analyzed using Fisher exact tests with the significance level set at .05. Data were collected on 501 implants from 185 patients. Twenty-nine (6%) demonstrated peri-implantitis, whereas 22 (5%) experienced early implant failure. A significant association between PIMT and peri-implantitis was observed (p-value = .0169) with the rate of peri-implantitis at 9% (n = 20) for patients without PIMT and only 4% (n = 10) for those with PIMT. Whereas PIMT was not significantly associated with early implant failure (p-value = .4372), peri-implantitis was: 25% of implants with peri-implantitis experienced early failure compared with 4% without (p-value = .0062). Considering the limitations of the present study, the absence of PIMT was found to be associated with peri-implantitis, which was itself associated with early implant failure. Implant maintenance at 6-month intervals is important in maintaining peri-implant health.
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Affiliation(s)
- Janina Golob Deeb
- Department of Periodontics, Virginia Commonwealth University, Richmond, Virginia
| | - Michael Ha
- Department of Periodontics, Virginia Commonwealth University, Richmond, Virginia
| | - Caroline K Carrico
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia
| | - Thomas Waldrop
- Department of Periodontics, Virginia Commonwealth University, Richmond, Virginia
| | - Pandora K Lee
- Department of General Practice, Virginia Commonwealth University, Richmond, Virginia
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3
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Loeffen AWM, Van Swaaij BWM, Saminsky M, Slot DE. Common practices of dental implant maintenance among dental hygienists working in the Netherlands - A survey. Int J Dent Hyg 2024. [PMID: 39072909 DOI: 10.1111/idh.12841] [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: 08/06/2023] [Revised: 02/14/2024] [Accepted: 04/23/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Dental implant maintenance is crucial to obtain and maintain a healthy peri-implant situation. Although it is part of a dental hygienists (DH) scope of practice, the knowledge and common practices among DHs in the Netherlands are unclear. MATERIALS AND METHODS A web-based survey was distributed by the Dutch Association of DHs, by spreading survey QR codes and snowballing. The role of the different DH curricula 2- or 3-year diploma and a 4-year bachelor's degree is evaluated. RESULTS In total, 165 (diploma: 73, bachelor: 92) DHs responded. Peri-implant diseases were well known (98%), indices and clinical symptoms were used to assess peri-implant tissues. A periodontal probe (97%) was used and bone loss was evaluated on radiographs (89%). Treatment was performed supra- and subgingivally (69%), mostly by titanium (45%) or plastic hand instruments (42%). Ultrasonic (52%) and air-abrasive (52%) devices were often used. The recall interval for maintenance was based on a risk-adjusted protocol (70%). DHs with a bachelor's received significantly more training compared to DHs with a diploma during primary education (p < 0.001). Diploma DHs mainly obtained their knowledge from continuing education (p = 0.04). In general, there was no significant difference in knowledge or common practices. CONCLUSIONS The primary education of DHs with a 2- or 3-year diploma and a 4-year bachelor's varies. Due to the continuing education of diploma DHs, knowledge and common practices generally do not differ. Most DHs in the Netherlands perform implant maintenance. A periodontal probe and radiographs are used for examination. Instrumentation is performed supra- and subgingivally, usually with titanium or plastic hand instruments. The recall interval is based on a patient's risk assessment.
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Affiliation(s)
- Anouk W M Loeffen
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Dental Hygiene, Hogeschool Arnhem Nijmegen (HAN), University of Applied Sciences, Nijmegen, The Netherlands
| | - Bregje W M Van Swaaij
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Dental Hygiene, Hogeschool Arnhem Nijmegen (HAN), University of Applied Sciences, Nijmegen, The Netherlands
| | - Michael Saminsky
- Department of Periodontology and Oral Implants, Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dagmar Else Slot
- Department of Dental Hygiene, Hogeschool Arnhem Nijmegen (HAN), University of Applied Sciences, Nijmegen, The Netherlands
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Katz MS, Ooms M, Winnand P, Heitzer M, Peters F, Kniha K, Hölzle F, Modabber A. Evaluation of peri-implant perfusion in patients who underwent avascular augmentation or microvascular reconstruction using laser Doppler flowmetry and tissue spectrophotometry: a prospective comparative clinical study. Clin Oral Investig 2024; 28:431. [PMID: 39017918 PMCID: PMC11255086 DOI: 10.1007/s00784-024-05825-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 07/08/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVES The aim of this study was to evaluate the peri-implant perfusion, such as oxygen saturation, the relative amount of hemoglobin, and blood flow, in implants placed in pristine bone and avascular and microvascular grafts using a non-invasive measurement method. MATERIALS AND METHODS A total of 58 patients with 241 implants were included. Among them, 106 implants were based in native bone (group I), 75 implants were inserted into avascular bone grafts (group II), and 60 implants were placed in microvascular bone grafts (group III). Gingival perfusion was measured using laser Doppler flowmetry and tissue spectrophotometry (LDF-TS). Implants with signs of gingival inflammation were excluded to analyze healthy implant perfusion in different bony envelopes. RESULTS The mean values for oxygen saturation, relative hemoglobin levels, and blood flow did not differ significantly between the groups (p = 0.404, p = 0.081, and p = 0.291, respectively). There was no significant difference in perfusion between implants that were surrounded by mucosa and implants based within cutaneous transplants (p = 0.456; p = 0.628, and p = 0.091, respectively). CONCLUSION No differences in perfusion were found between implants inserted into native bone and implants involving bone or soft tissue augmentation. However, implants based in avascular and microvascular transplants showed higher rates of peri-implant inflammation. CLINICAL RELEVANCE Peri-implant perfusion seems to be comparable for all implants after they heal, irrespective of their bony surroundings. Although perfusion does not differ significantly, other factors may make implants in avascular and microvascular transplants vulnerable to peri-implant inflammation.
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Affiliation(s)
- Marie Sophie Katz
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074, Aachen, Germany.
| | - Mark Ooms
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074, Aachen, Germany
| | - Philipp Winnand
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074, Aachen, Germany
| | - Marius Heitzer
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074, Aachen, Germany
| | - Florian Peters
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074, Aachen, Germany
| | - Kristian Kniha
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074, Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074, Aachen, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074, Aachen, Germany
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Lakkasetter Chandrashekar B, Biguetti CC, Arteaga A, Miramontes AJ, Rios E, Rodrigues DC. A microtomographic and histopathological evaluation of dental cements as late-stage peri-implant complication in a rat model. Sci Rep 2024; 14:16441. [PMID: 39013937 PMCID: PMC11252325 DOI: 10.1038/s41598-024-66353-x] [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: 01/04/2024] [Accepted: 07/01/2024] [Indexed: 07/18/2024] Open
Abstract
Cement mediated peri-implantitis accounts for 1.9-75% of dental implant failures associated with peri-implant diseases. This study evaluated the biological impact of dental cements on osseointegrated implants using Lewis rats. Twenty-two rats were distributed into 6 groups: negative control (NC) soft diet (SD), and hard diet (HD); positive control SD and HD (n = 3); Implant + bio-ceramic Cement (BC) SD and HD which included contralateral Sham sites (n = 5). Titanium implants were placed on either side of the maxillae and allowed to heal for 14 days. Later, both sides of experimental groups underwent a re-entry surgery to simulate clinical cementation. The right side received 0.60 mg of BC. At 14 days post cement application, maxillae were harvested for clinical, microtomographic, and histological evaluations. Clinical and microtomographic evaluations indicated evidence of extensive inflammation and circumferential bone resorption around BC implants in comparison to NC. Histology revealed cement particles surrounded by inflammatory infiltrate in the implant area accompanied by biofilm for SD groups. Both sides of BC indicated intensive bone resorption accompanied by signs of osteolysis when compared to NC. Cemented groups depicted significantly lower bone to implant contact when compared to NC. In conclusion, residual cement extravasation negatively impacted osseointegrated implants after re-entry surgeries.
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Affiliation(s)
| | - Claudia C Biguetti
- Department of Bioengineering, University of Texas at Dallas (UTD), 800 W. Campbell Rd, Richardson, TX, 75080, USA
- School of Podiatric Medicine, The University of Texas Rio Grande Valley, Harlingen, TX, 78550, USA
| | - Alexandra Arteaga
- Department of Bioengineering, University of Texas at Dallas (UTD), 800 W. Campbell Rd, Richardson, TX, 75080, USA
| | - Andres J Miramontes
- Department of Bioengineering, University of Texas at Dallas (UTD), 800 W. Campbell Rd, Richardson, TX, 75080, USA
| | - Evelin Rios
- Department of Bioengineering, University of Texas at Dallas (UTD), 800 W. Campbell Rd, Richardson, TX, 75080, USA
| | - Danieli C Rodrigues
- Department of Bioengineering, University of Texas at Dallas (UTD), 800 W. Campbell Rd, Richardson, TX, 75080, USA.
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Mhatre S, Gupta R, Vaz M, Bijalani D, Joshi M, Gholap P, Shetty U, Srichand R. Achieving Predictable Esthetics With Early Implant Placement and Soft Tissue Modeling: A Case Report and Literature Review. Cureus 2024; 16:e64549. [PMID: 39144901 PMCID: PMC11322853 DOI: 10.7759/cureus.64549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2024] [Indexed: 08/16/2024] Open
Abstract
In the modern era, patients are increasingly concerned about dental esthetics. Edentulism can significantly impact the appearance, occlusion, and self-esteem of the patient. Treatment options like removable dentures, fixed crown and bridge prostheses, and resin-retained bridges are available to replace missing teeth. Implant therapy is popular due to its high success rates and long-term durability. However, its efficacy can be compromised by errors in treatment planning, surgery, tissue care, and infections. Thus, meticulous planning and execution are crucial. Clinicians must have the expertise to manage difficulties during surgery and maintain stable soft tissue. The stability of tissues around osseointegrated implants affects long-term clinical stability and esthetics. Early implant placement is recommended for missing teeth in the esthetic zone, aiming to place implants in anatomically and functionally correct positions for durable and esthetic results. Patients with high cosmetic demands, thin gingival biotypes, and high smile lines pose challenges. Assessing Pink and White esthetics guides treatment planning. Advantages of early implant placement include simplified procedures and reduced post-surgical complications. Soft tissue molding is achieved using customized healing abutments and temporizing with fiber-reinforced resin-bonded prostheses. Customized healing abutments preserve socket width, prevent soft tissue collapse, and promote natural contouring, eliminating the need for secondary surgeries and aiding spontaneous healing. This case report outlines a comprehensive approach to achieving predictable esthetics through early implant placement and soft tissue modeling in a patient with a traumatically avulsed maxillary central incisor.
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Affiliation(s)
- Swapnali Mhatre
- Prosthodontics, Crown and Bridge, and Implantology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Richa Gupta
- Prosthodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Mirella Vaz
- Prosthodontics, Crown and Bridge, and Implantology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Dheeraj Bijalani
- Prosthodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Mridula Joshi
- Prosthodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Prachi Gholap
- Prosthodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Uttam Shetty
- Prosthodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Reema Srichand
- Prosthodontics, Crown and Bridge, and Implantology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
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Önder YB, Alpaslan NZ. Peri-implant phenotype, calprotectin and MMP-8 levels in cases diagnosed with peri-implant disease. Clin Oral Investig 2024; 28:404. [PMID: 38940878 PMCID: PMC11213734 DOI: 10.1007/s00784-024-05798-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 06/20/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES The purpose of this prospective cohort study is to evaluate the effect of peri-implant phenotype (PPh) on the severity of peri-implant diseases and the results of non-surgical mechanical treatment (NSMT), along with calprotectin (CLP) and MMP-8(matrix metalloproteinase-8) levels. MATERIALS AND METHODS 77 implants from 39 patients were included. The implants were categorized Group-1(peri-implant mucositis), Group-2(peri-implantitis).Baseline (0. Month-PrT) clinical parameters (PD, GI, PI, BOP, CAL) and radiographic bone loss were documented, and peri-implant crevicular fluid (PICF) samples were collected. Various intruments and methodologies were employed to assess PPh components (mucosa thickness, supracrestal tissue height, keratinized mucosa) and peri-implant attached mucosa (AM). NSMT was applied to diseased implant sites. All clinical parameters were reassessed again by taking PICF samples at the 6th month-after treatment (PT). In PICF samples obtained from both groups, MMP-8 and CLP levels were evaluated using the ELISA test. RESULTS PrT-PD,PrT-GI,PrT-CAL and PrT-BOP percentage values in Group-2 were significantly higher than Group-1.PrT-PD,PrTPI scores are significantly higher in thin biotype implants. All components of the PPh and AM were significantly lower in thin biotype. Intra-group time-dependent changes of MMP-8 and CLP were significant in both groups (p < 0.05). When the relationship between thin and thick biotype and biochemical parameters was evaluated, the change in PrT-PT didn't show a significant difference (p > 0.05). CONCLUSIONS PPh plays a role in influencing the severity of peri-implant diseases. However, the impact of phenotype on NSMT outcomes was similar in both groups. CLINICAL RELEVANCE The PPh should be considered when planning implant surgery.
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Affiliation(s)
- Yasemin Beliz Önder
- Faculty of Dentistry, Department of Periodontology, Bilecik Şeyh Edebali University, Bilecik, Turkey.
| | - Nazli Zeynep Alpaslan
- Faculty of Dentistry, Department of Periodontology, Van Yuzuncu Yil University, Van, Turkey
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Baus-Domínguez M, Oliva-Ferrusola E, Maza-Solano S, Ruiz-de-León G, Serrera-Figallo MÁ, Gutiérrez-Perez JL, Torres-Lagares D, Macías-García L. Biological Response of the Peri-Implant Mucosa to Different Definitive Implant Rehabilitation Materials. Polymers (Basel) 2024; 16:1534. [PMID: 38891480 PMCID: PMC11174483 DOI: 10.3390/polym16111534] [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: 04/28/2024] [Revised: 05/23/2024] [Accepted: 05/26/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Sealing the peri-implant tissue is a determining factor for long-term implant survival. In the transmucosal region, the cervical fraction of the prosthetic crown is in contact with these tissues, so mucointegration will also be influenced by the biomaterial used for the prosthetic restoration. This study aims to compare the tissue response generated by definitive restorative materials and polymeric materials from a histological point of view. METHODS This study performed an observational prospective cohort study in which biopsies of the peri-implant mucosa were taken after placement of implant-supported prosthetic restorations made of different materials (zirconium oxide, lithium disilicate, and PMMA). RESULTS A statistically significant difference was observed in the increase in the thickness of the non-keratinized epithelium when comparing the definitive materials (zirconium oxide/lithium disilicate) vs. the provisional material (PMMA) and in the number of collagen fibers when comparing zirconium oxide and lithium disilicate. CONCLUSIONS This study found that zirconia is the material that presents the most adequate biological response of peri-implant tissues. It shows a lower intensity of inflammatory cellular content, a total normality in the number of collagen fibers (the arrangement of the fibers is normal in 90% of the cases), and vascular proliferation of connective tissue in 83% of the cases. These parameters make it a material with a predictable response. Similarly, only the following slight statistically significant differences between the definitive and provisional materials are observed, indicating that the biological response generated by the provisional material (PMMA) is not very different from that obtained with the placement of the definitive restoration.
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Affiliation(s)
- María Baus-Domínguez
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena S/N, 41009 Seville, Spain; (E.O.-F.); (S.M.-S.); (G.R.-d.-L.); (M.-Á.S.-F.); (J.-L.G.-P.); (D.T.-L.)
| | - Elena Oliva-Ferrusola
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena S/N, 41009 Seville, Spain; (E.O.-F.); (S.M.-S.); (G.R.-d.-L.); (M.-Á.S.-F.); (J.-L.G.-P.); (D.T.-L.)
| | - Serafín Maza-Solano
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena S/N, 41009 Seville, Spain; (E.O.-F.); (S.M.-S.); (G.R.-d.-L.); (M.-Á.S.-F.); (J.-L.G.-P.); (D.T.-L.)
| | - Gonzalo Ruiz-de-León
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena S/N, 41009 Seville, Spain; (E.O.-F.); (S.M.-S.); (G.R.-d.-L.); (M.-Á.S.-F.); (J.-L.G.-P.); (D.T.-L.)
| | - María-Ángeles Serrera-Figallo
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena S/N, 41009 Seville, Spain; (E.O.-F.); (S.M.-S.); (G.R.-d.-L.); (M.-Á.S.-F.); (J.-L.G.-P.); (D.T.-L.)
| | - José-Luis Gutiérrez-Perez
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena S/N, 41009 Seville, Spain; (E.O.-F.); (S.M.-S.); (G.R.-d.-L.); (M.-Á.S.-F.); (J.-L.G.-P.); (D.T.-L.)
| | - Daniel Torres-Lagares
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena S/N, 41009 Seville, Spain; (E.O.-F.); (S.M.-S.); (G.R.-d.-L.); (M.-Á.S.-F.); (J.-L.G.-P.); (D.T.-L.)
| | - Laura Macías-García
- Department of Cytology and Normal and Pathological Histology, School of Medicine, University of Seville, Av. Sánchez Pizjuán S/N, 41009 Seville, Spain
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Hofer AM, Dadarlat-Pop A, Mester A, Nasui BA, Popa M, Picos A. The Impact of Peri-Implant Diseases on the General Status of Patients with Cardiovascular Diseases: A Literature Review. Life (Basel) 2024; 14:665. [PMID: 38929648 PMCID: PMC11204828 DOI: 10.3390/life14060665] [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: 04/21/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The aim of this study is to connect peri-implantitis to cardiovascular diseases, following the association found between periodontitis and cardiovascular conditions in recent years. MATERIALS AND METHODS PubMed, Scopus, Web of Science online databases were searched up to June 2023, with the exclusion criteria being research written in a language other than English. The MeSH search items were as follows: ["peri-implant health OR peri-implantitis OR peri-implant mucositis OR peri-implant disease"] AND ["cardiovascular diseases"]. Patient/population (P), intervention (I), comparison (C), outcome (O) framework questions were followed to identify the clinical evidence for the systematic review. Only clinical studies that used a control group to compare the relationship between cardiovascular diseases and peri-implantitis were selected. RESULTS A total of 118 studies were identified through electronic search of the keywords. After removing duplicates, there were 76 records to be screened. Upon exclusion of ineligible titles and abstracts, 27 studies remained for evaluation. Finally, 23 studies were excluded for not meeting the inclusion criteria, leaving 4 studies to be included in the qualitative analyses. CONCLUSIONS This study found there is a linear association between mucosal/gingival inflammation and carotid intima-media thickness test (c-IMT) values. Peri-implant mucosal inflammation could be a contributor to the vascular disease burden of an individual; further specific clinical studies should be performed in order to demonstrate this connection.
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Affiliation(s)
- Ana Maria Hofer
- Department of Community Health, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (A.M.H.); (B.A.N.); (M.P.)
| | | | - Alexandru Mester
- Department of Oral Health, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Bogdana Adriana Nasui
- Department of Community Health, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (A.M.H.); (B.A.N.); (M.P.)
| | - Monica Popa
- Department of Community Health, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (A.M.H.); (B.A.N.); (M.P.)
| | - Andrei Picos
- Department of Oral Prevention, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
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Montevecchi M, Valeriani L, Bellanova L, Stefanini M, Zucchelli G. In-vitro comparison of two different toothbrush bristles about peri-implant sulcus penetration. Int J Dent Hyg 2024; 22:465-470. [PMID: 37721091 DOI: 10.1111/idh.12751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 08/11/2023] [Accepted: 08/28/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE The aim of this preclinical study was to compare the ability of tapered and cylindrical bristles to penetrate the peri-implant sulcus. METHODS A full mandibular dental arch was reproduced in plaster cast. In site #3.6 a hollow glass cylinder was positioned simulating a 4 mm diameter implant and the gingival component was recreated by using dedicated silicone. A Bass brushing technique was performed from the vestibular side in humid environment. During it, the penetration of the bristles between the gum and the implant was recorded by mean of an optic fibre fixed inside the cylinder. The protocol included 5 toothbrushes per group and 10 tests per toothbrush, for a total of 50 assessments for each of the two groups. A scale of 5 grades for bristle penetration was defined: grade 0 (× < 2 mm), grade 1 (2 ≤ × < 3 mm), grade 2 (3 ≤ × < 4 mm), grade 3 (4 ≤ × < 5 mm) and grade 4 (5 ≤ × < 8 mm). From the video recordings the highest value of penetration was identified for each test. RESULTS The tapered bristles showed an 8 times greater penetration capacity (p = 0.001) in respect to the cylindrical bristles (multilevel analysis). The percentage of tests reaching depths ≥3 mm was 86% for tapered group and 28% for the cylindrical group. CONCLUSION This preclinical study shows a clear and superior penetration capacity of the tapered bristles in respect to traditional cylindrical ones. For tapered bristles, a potentially greater hygienic efficacy around dental implants is suggested.
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Affiliation(s)
- Marco Montevecchi
- Division of Periodontology and Implantology, Department of Biomedical and Neuromotor Sciences, School of Dentistry and Dental Hygiene, University of Bologna, Bologna, Italy
| | - Leoluca Valeriani
- Division of Periodontology and Implantology, Department of Biomedical and Neuromotor Sciences, School of Dentistry and Dental Hygiene, University of Bologna, Bologna, Italy
| | - Leonardo Bellanova
- Department of Biomedical and Neuromotor Sciences, School of Dentistry and Dental Hygiene, University of Bologna, Bologna, Italy
| | - Martina Stefanini
- Division of Periodontology and Implantology, Department of Biomedical and Neuromotor Sciences, School of Dentistry and Dental Hygiene, University of Bologna, Bologna, Italy
| | - Giovanni Zucchelli
- Division of Periodontology and Implantology, Department of Biomedical and Neuromotor Sciences, School of Dentistry and Dental Hygiene, University of Bologna, Bologna, Italy
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11
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Romito GA, Hassan MA, do Amaral GCLS, Villar CC. Decision-making on peri-implant mucositis management and treatment approaches. Br Dent J 2024; 236:797-801. [PMID: 38789757 DOI: 10.1038/s41415-024-7397-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 05/26/2024]
Abstract
Peri-implant mucositis is characterised by inflammation of soft tissues surrounding a dental implant without associated bone loss beyond initial remodelling. Early detection and timely intervention are critical to prevent its progression to peri-implantitis. This paper focuses on various treatment options for treating peri-implant mucositis. The cornerstone of professional treatment lies in the mechanical disruption and removal of microbial biofilms around the implant. This can be achieved through careful use of manual or powered instruments, such as ultrasonic scalers or air polishing devices. However, there is a need for further research to determine the most effective single approach for treating peri-implant mucositis. Current evidence does not support the combination of mechanical debridement with locally administered antibiotics. Contrarily, evidence strongly supports the removal, cleaning, and modifications of prostheses to improve both self-performance and professional cleanability. The use of adjunctive therapies like photodynamic therapy and diode laser, in conjunction with mechanical instrumentation, is not currently recommended due to the limited strength of available evidence. Preventive measures emphasise the importance of comprehensive oral hygiene care, encompassing professional guidance and at-home practices, to manage biofilms effectively. This encompasses oral hygiene instruction, regular debridement, and maintenance care. Supporting peri-implant therapy is also vital for ongoing implant monitoring, preventing the recurrence of mucositis, and halting its progression to peri-implantitis. This multifaceted approach is key to effectively managing and treating peri-implant mucositis.
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Affiliation(s)
- Giuseppe A Romito
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil.
| | - Mohamed A Hassan
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Cristina C Villar
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
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12
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Minnery H. The role of dental hygienists and dental therapists in supportive peri-implant care. Br Dent J 2024; 236:819-822. [PMID: 38789760 DOI: 10.1038/s41415-024-7354-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/28/2024] [Accepted: 03/02/2024] [Indexed: 05/26/2024]
Abstract
In the UK, as in many countries, dental hygienists and dental therapists are registered dental healthcare professionals who are focused on prevention and promoting good oral and general health through patient education, motivation and behaviour change. They are key members of the dental team. This paper considers the role they play in supporting patients through their implant journey and emphasises their importance in the wider clinical team as part of a patient-centred approach to care.
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13
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Perussolo J, Donos N. Maintenance of peri-implant health in general dental practice. Br Dent J 2024; 236:781-789. [PMID: 38789755 PMCID: PMC11126374 DOI: 10.1038/s41415-024-7406-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024]
Abstract
The long-term maintenance or restoration of peri-implant tissues' health depends on the strategic implementation of preventive measures and interventions. These measures should be initiated before implant placement and continued throughout a patient's lifetime, as part of a tailored and comprehensive supportive peri-implant care (SPIC) programme. Central to the clinical efforts of maintaining and rehabilitating peri-implant tissues are several key factors, including the ongoing assessment and frequent monitoring of tissue health and stability, proactive oral health promotion, the control of risk factors and indicators and the provision of professional plaque biofilm removal. It is of paramount importance to underline that SPIC should not limit its scope exclusively to patients already in a state of peri-implant health; in fact, it is imperative that it should extend its protective effect to individuals who have been previously diagnosed and treated for peri-implant diseases, focusing on preventing its recurrence and progression, thereby avoiding further complications, such as implant loss.This narrative review presents an overview of the current literature on the maintenance of peri-implant tissues' health and the steps of SPIC providing insights into the critical factors to be considered when managing dental implant patients in the general dental practice.
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Affiliation(s)
- Jeniffer Perussolo
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, Turner Street, London, E1 2AD, UK
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, Turner Street, London, E1 2AD, UK.
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14
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Ruiz-Romero V, Figueiredo R, Toledano-Serrabona J, Abdelazim Y, Camps-Font O, Salazar-Salazar Y, Plana-Soler A, Subirà-Pifarré C, Valmaseda-Castellón E. Peri-implantitis in patients without regular supportive therapy: Prevalence and risk indicators. Clin Oral Investig 2024; 28:278. [PMID: 38671152 PMCID: PMC11052890 DOI: 10.1007/s00784-024-05673-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/21/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES To determine the prevalence of peri-implant diseases in patients treated in a university setting without a regular peri-implant supportive therapy schedule, and to identify the risk indicators associated with peri-implantitis. MATERIAL AND METHODS A retrospective cohort study was made of patients with dental implants with at least 12 months of functional loading who did not receive regular peri-implant supportive therapy. Patient- and implant-related variables were retrieved, and clinical and radiological examinations were performed. Descriptive and bivariate analyses and multilevel logistic regression analyses were performed to identify factors associated with peri-implantitis. RESULTS A total of 213 implants in 88 patients were analyzed. The patient-level prevalence of peri-implantitis and peri-implant mucositis was 26.1% (95%CI: 16.7%-35.5%) and 44.3% (95%CI: 34.0%-54.6%), respectively. Peri-implant diseases were significantly more frequent when the width of the keratinized mucosa was < 2 mm (OR = 5.26; 95%CI: 1.24-22.26; p = 0.024), and when there was 12 month post-loading bone loss (OR = 2.96; 95%CI: 1.35-6.52; p = 0.007). CONCLUSIONS Peri-implantitis is a common finding in patients without regular peri-implant supportive therapy (prevalence 16.7-35.5%). A thin peri-implant keratinized mucosa (< 2 mm) and a higher degree of bone remodeling after loading seem to be the main risk factors for peri-implantitis in this patient profile. CLINICAL RELEVANCE Patients who do not engage in supportive peri-implant maintenance have a higher risk of peri-implantitis. A thin keratinized mucosa and bone loss during the first year of loading are predisposing factors for peri-implantitis.
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Affiliation(s)
- Víctor Ruiz-Romero
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
| | - Rui Figueiredo
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
- Dental and Maxillofacial Pathology and Therapeutics Research Group, IDIBELL Research Institute, Barcelona, Spain
| | - Jorge Toledano-Serrabona
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
- Dental and Maxillofacial Pathology and Therapeutics Research Group, IDIBELL Research Institute, Barcelona, Spain
| | - Yehia Abdelazim
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
| | - Octavi Camps-Font
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain.
- Dental and Maxillofacial Pathology and Therapeutics Research Group, IDIBELL Research Institute, Barcelona, Spain.
| | - Yamil Salazar-Salazar
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
| | - Aina Plana-Soler
- Master of Adult Dental Comprehensive Dentistry, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
| | - Carles Subirà-Pifarré
- Dental and Maxillofacial Pathology and Therapeutics Research Group, IDIBELL Research Institute, Barcelona, Spain
- Master of Adult Dental Comprehensive Dentistry, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
| | - Eduard Valmaseda-Castellón
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
- Dental and Maxillofacial Pathology and Therapeutics Research Group, IDIBELL Research Institute, Barcelona, Spain
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Kao A, Tawse-Smith A, Ma S, Duncan WJ, Reid M, Atieh MA. Quantity and Size of Titanium Particles Released from Different Mechanical Decontamination Procedures on Titanium Discs: An In Vitro Study. Dent J (Basel) 2024; 12:123. [PMID: 38786521 PMCID: PMC11119952 DOI: 10.3390/dj12050123] [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: 02/20/2024] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 05/25/2024] Open
Abstract
Complications such as peri-implantitis could ultimately affect the survival of a dental implant. The prevention and treatment of peri-implant diseases require managing bacterial biofilm and controlling environmental risks, including the presence of pro-inflammatory titanium (Ti) particles in the peri-implant niche. Objectives included the evaluation of the size and quantity of Ti particles released from moderately roughened Ti surfaces during common mechanical surface decontamination methods. One hundred and forty moderately roughened Ti discs were divided into seven groups (n = 20 per group); six groups received mechanical decontamination procedures (ultrasonic scaling (US) with a metal tip and poly-ether-ketone (PEEK) under low and medium power settings, air-polishing with erythritol powder, and Ti brush), and the control group underwent air-water spray using a dental triplex. The rinsing solution was collected for Ti mass analysis using inductively coupled plasma mass spectrometry (ICPMS), as well as for Ti particle size and count analysis under scanning electron microscopy (SEM) with energy-dispersive spectroscopy (EDS). US metal tip instrumentation generated 34.00 ± 12.54 μg and 34.44 ± 6.08 μg of Ti under low and medium power settings, respectively. This amount of Ti generation was significantly higher than other instrumentation methods. The mean Ti particle size of the US groups ranged from 0.89 ± 0.27 μm to 1.25 ± 0.24 μm. No statistically significant difference was found in the particle size among US groups and Ti brush group (1.05 ± 0.11 μm), except for US with the PEEK tip, where a significantly smaller mean particle diameter was found at the low power setting (0.89 ± 0.27 μm). Mechanical instrumentation can produce Ti particulates and modify the implant surfaces. US using a metal tip generated the highest amount of Ti with smaller Ti size particles compared to all other commonly used mechanical surface instrumentations. The EDS analysis confirmed Ti in PEEK US tips. It can be suggested that deterioration from the PEEK US tip and Ti brush, as observed under SEM, is an additional source of Ti release during Ti surface decontamination.
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Affiliation(s)
- Anthony Kao
- Sir John Walsh Research Institute, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand; (A.K.); (S.M.); (W.J.D.); (M.A.A.)
| | - Andrew Tawse-Smith
- Sir John Walsh Research Institute, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand; (A.K.); (S.M.); (W.J.D.); (M.A.A.)
| | - Sunyoung Ma
- Sir John Walsh Research Institute, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand; (A.K.); (S.M.); (W.J.D.); (M.A.A.)
| | - Warwick J. Duncan
- Sir John Walsh Research Institute, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand; (A.K.); (S.M.); (W.J.D.); (M.A.A.)
| | - Malcolm Reid
- Department of Chemistry and Centre for Trace Element Analysis, Department of Geology, Dunedin 9054, New Zealand;
| | - Momen A. Atieh
- Sir John Walsh Research Institute, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand; (A.K.); (S.M.); (W.J.D.); (M.A.A.)
- Department of Oral Diagnostics and Surgical Sciences, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates
- School of Dentistry, University of Jordan, Amman 11942, Jordan
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16
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Rabel K, Blankenburg A, Steinberg T, Kohal RJ, Spies BC, Adolfsson E, Witkowski S, Altmann B. Gingival fibroblast response to (hybrid) ceramic implant reconstruction surfaces is modulated by biomaterial type and surface treatment. Dent Mater 2024; 40:689-699. [PMID: 38395737 DOI: 10.1016/j.dental.2024.02.018] [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: 11/10/2023] [Revised: 01/11/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVES Surface characteristics of implant reconstructions determine the gingival fibroblast (GF) response and thus soft tissue integration (STI). However, for monolithic implant reconstructions it is unknown whether the (hybrid) ceramic biomaterial type and its surface treatment affect GF response. Therefore, this investigation examined the influence of the implant reconstruction biomaterials hybrid ceramic (HC), lithium disilicate ceramic (LS), 4 and 5 mol% yttria partially stabilized zirconiumdioxide ceramics (4/5Y-PSZ) and their surface treatment - machining, polishing or glazing - on surface characteristics and GF response. METHODS After characterization of surface topography and wettability by scanning electron microscopy, interferometry and contact angle measurement, the adhesion, morphology, metabolic activity and proliferation of GFs from six donors was investigated by fluorescent staining and a resazurin-based assay at days 1, 3 and 7. Titanium (Ti) served as control. RESULTS Biomaterial type and surface treatment affected the GF response in a topography-dependent manner. Smooth polished and glazed surfaces demonstrated enhanced GF adhesion and earlier proliferation onset compared to rough machined surfaces. Due to minor differences in surface topography of polished and glazed surfaces, however, the GF response was similar for polished and glazed HC, LS, 4- and 5Y-PSZ as well as Ti. SIGNIFICANCE Within the limits of the present investigation, polishing and glazing of machined HC, LS and 4/5Y-PSZ can be recommended to support STI-relevant cell functions in GF. Since the GF response on polished and glazed HC, LS, 4- and 5Y-PSZ surfaces and the Ti control was comparable, this investigation proofed equal cytocompatibility of these surfaces in vitro.
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Affiliation(s)
- Kerstin Rabel
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center ‑ University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany.
| | - Andrea Blankenburg
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center ‑ University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany
| | - Thorsten Steinberg
- Department of Oral Biotechnology, Center for Dental Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany
| | - Ralf J Kohal
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center ‑ University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany
| | - Benedikt C Spies
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center ‑ University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany
| | - Erik Adolfsson
- Division Materials and Production, RISE Research Institutes of Sweden, Argongatan 30, 43153 Mölndal, Sweden
| | - Siegbert Witkowski
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center ‑ University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany
| | - Brigitte Altmann
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center ‑ University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany; G.E.R.N Research Center for Tissue Replacement, Regeneration & Neogenesis, Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center ‑ University of Freiburg, Faculty of Medicine, University of Freiburg, Engesserstr. 4, 79108 Freiburg, Germany
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17
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Nicola D, Isabella DR, Carolina C, Baldini N, Raffaele M. Treatment of peri-implant mucositis: Adjunctive effect of glycine powder air polishing to professional mechanical biofilm removal. 12 months randomized clinical study. Clin Implant Dent Relat Res 2024; 26:415-426. [PMID: 38317375 DOI: 10.1111/cid.13304] [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: 11/05/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 02/07/2024]
Abstract
INTRODUCTION To evaluate the adjunctive effect of glycine-powder air-polishing (GPAP) to full-mouth ultrasonic debridement (Fm-UD) in the treatment of peri-implant mucositis, and to determine the impact of implant and patient-level variables for disease resolution. METHODS Individuals with a diagnosis of peri-implant mucositis were consecutively included in this randomized parallel arm clinical study. All the participants received a session of Fm-UD. Only implants allocated to the test group were additionally treated with GPAP. Clinical assessments were recorded at baseline, at 3 and at 12 months following intervention. The primary outcomes were complete disease resolution (DR1), defined as absence of bleeding sites at probing per implants, and partial disease resolution (DR2), measured as the presence of less than two bleeding sites at probing per implant. A final logistic multivariate regression model was built to evaluate the predictive role of implant and patient-level variables on DR. RESULTS Fifty two patients and 157 implants were included. Both groups displayed significant reduction in the extent of bleeding on probing and plaque levels. At 12 months, DR1 was achieved in 16% and 27% of participants for the test and the control group respectively. IDR1 was best predicted by the number of bleeding sites (OR = 2.7, p = 0.04) and the greatest PPD value (OR = 2.7, p = 0.05), while IDR2 by the prosthetic connection (OR = 2.59, p = 0.02), the mean PPD (OR = 2.23, p = 0.04), the FMBS (OR = 4.09, p = 0.04), and number of implants (OR = 4.59, p = 0.02). CONCLUSIONS Despite significant improvements of clinical signs of peri-implant inflammation, the use of GPAP appears to have no adjunctive effect as compared with Fm-UD alone in the achievement of DR. Elevated initial levels of bleeding and PD predicted inferior likelihood of reaching disease resolution. The present randomized parallel arm clinical study was registered on Clinicaltrials.gov and received the following registration number: NCT05801315. This clinical trial was not registered prior to participant recruitment and randomization (https://register. CLINICALTRIALS gov/prs/app/action/SelectProtocol?sid=S0009965&selectaction=Edit&uid=U0004FXM&ts=2&cx=fje7l8).
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Affiliation(s)
- Discepoli Nicola
- Department of Medical Biotechnologies, Unit of Periodontics, Università degli Studi di Siena, Siena, Italy
| | - De Rubertis Isabella
- Department of Medical Biotechnologies, Unit of Periodontics, Università degli Studi di Siena, Siena, Italy
| | - Ciocci Carolina
- Department of Medical Biotechnologies, Unit of Periodontics, Università degli Studi di Siena, Siena, Italy
| | - Nicola Baldini
- Department of Medical Biotechnologies, Unit of Oral Surgery, Università degli Studi di Siena, Siena, Italy
| | - Mirra Raffaele
- Department of Medical Biotechnologies, Unit of Periodontics, Università degli Studi di Siena, Siena, Italy
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18
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Harada A, Sasaki H, Asami Y, Hanazawa K, Miyazaki S, Sekine H, Yajima Y. Effects of the application of low-temperature atmospheric plasma on titanium implants on wound healing in peri-implant connective tissue in rats. Int J Implant Dent 2024; 10:15. [PMID: 38509336 PMCID: PMC10954594 DOI: 10.1186/s40729-024-00524-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/17/2024] [Indexed: 03/22/2024] Open
Abstract
PURPOSE This study aimed to clarify the effects of surface modification of titanium (Ti) implants by low-temperature atmospheric pressure plasma treatment on wound healing and cell attachment for biological sealing in peri-implant soft tissue. METHODS Hydrophilization to a Ti disk using a handheld low-temperature atmospheric pressure plasma device was evaluated by a contact angle test and compared with an untreated group. In in vivo experiments, plasma-treated pure Ti implants using a handheld plasma device (experimental group: PL) and untreated implants (control group: Cont) were placed into the rat upper molar socket, and samples were harvested at 3, 7 and 14 days after surgery. Histological evaluation was performed to assess biological sealing, collagen- and cell adhesion-related gene expression by reverse transcription quantitative polymerase chain reaction, collagen fiber detection by Picrosirius Red staining, and immunohistochemistry for integrins. RESULTS In in vivo experiments, increased width of the peri-implant connective tissue (PICT) and suppression of epithelial down growth was observed in PL compared with Cont. In addition, high gene expression of types I and XII collagen at 7 days and acceleration of collagen maturation was recognized in PL. Strong immunoreaction of integrin α2, α5, and β1 was observed at the implant contact area of PICT in PL. CONCLUSIONS The handheld low-temperature atmospheric pressure plasma device provided hydrophilicity on the Ti surface and maintained the width of the contact area of PICT to the implant surface as a result of accelerated collagen maturation and fibroblast adhesion, compared to no plasma application.
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Affiliation(s)
- Atsuro Harada
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Hodaka Sasaki
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan.
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan.
| | - Yosuke Asami
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Kiyotoshi Hanazawa
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Sota Miyazaki
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Hideshi Sekine
- Department of Fixed Prosthodontics, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Yasutomo Yajima
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
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Ilyes I, Boariu M, Rusu D, Iorio-Siciliano V, Vela O, Boia S, Kardaras G, Șurlin P, Calniceanu H, Jentsch H, Lodin A, Stratul SI. A Single Dose of Piperacillin Plus Tazobactam Gel as an Adjunct to Professional Mechanical Plaque Removal (PMPR) in Patients with Peri-Implant Mucositis: A 6-Month Double-Blind Randomized Clinical Trial. Antibiotics (Basel) 2024; 13:269. [PMID: 38534704 DOI: 10.3390/antibiotics13030269] [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: 02/13/2024] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024] Open
Abstract
OBJECTIVES This randomized, placebo-controlled, double-masked clinical trial aimed to evaluate the clinical and microbiological efficacy of professional mechanical plaque removal (PMPR) with or without adjunctive application of piperacillin plus tazobactam gel in the treatment of peri-implant mucositis (PiM) for up to 6 months. MATERIALS AND METHODS The study included 31 patients with peri-implant mucositis (bleeding on probing (BoP) > 1 at at least one site at baseline, absence of peri-implant bone loss compared with a previous radiograph). After randomized assignment to test and control groups, patients received full-mouth supragingival scaling with or without piperacillin plus tazobactam gel. Clinical examination was performed at baseline and after 3 and 6 months, and a microbiological examination was performed at baseline and after 3 months. RESULTS After six months, both treatment modalities resulted in significant reductions and improvements in clinical parameters at the implant sites. Neither study group achieved a complete resolution of PiM (i.e., BoP ≤ 1 per implant). The number of implants with BoP decreased statistically significantly between subsequent time points (p < 0.001) in both the test and the control group. Significant BoP differences (p = 0.039) were observed between groups at 6 months (difference to baseline) following therapy. CONCLUSIONS Within the limitations of the present study, the single use of a slow-release, locally applied antibiotic combination of piperacillin and tazobactam gel, adjunctive to PMPR, showed an improvement in clinical variable of implants diagnosed with PiM. The adjunctive treatment resulted in higher BoP reduction when compared to the control, but no significant differences were observed regarding the changes in other clinical and microbiological parameters.
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Affiliation(s)
- Ioana Ilyes
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marius Boariu
- Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | | | - Octavia Vela
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Simina Boia
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Georgios Kardaras
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Petra Șurlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Horia Calniceanu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Holger Jentsch
- Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Alexandru Lodin
- Department Basis of Electronics, Faculty of Electronics, Telecommunications and Information Technology, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania
| | - Stefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Hoffmann KJ, Büsch C, Moratin J, Ristow O, Hoffmann J, Mertens C. Peri-implant health after microvascular head and neck reconstruction-A retrospective analysis. Clin Oral Implants Res 2024; 35:187-200. [PMID: 38010660 DOI: 10.1111/clr.14214] [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: 04/21/2023] [Revised: 10/04/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Prosthodontic rehabilitation after reconstruction with microvascular revascularized free flaps following ablative tumor surgery is challenging due to the altered anatomical and functional conditions. The aim of this retrospective study was to determine whether the type of graft and the type of peri-implant tissue have an effect on peri-implant inflammatory parameters and implant survival. MATERIALS AND METHODS Patients who received a free flap reconstruction with subsequent implant-prosthetic rehabilitation between 2010 and 2022 were retrospectively included. The primary outcome variable was the probing depth (PPD) at a minimum of 1 year after completion of prosthetic restoration. Predictive variables were type of free flap, emergence profile, and history of radiation. RESULTS Seventy-one patients after free flap reconstruction were included in the analysis. At a minimum of 24 months after implant insertion the primary outcome, PPD showed no clinically relevant differences between the types of free flaps used. The emergence profile through a skin island resulted in an increase in BOP compared to native mucosa in the descriptive analysis (p-value > .05). The analysis showed a 5-year implant survival of 96.2% (95% CI: 0.929-0.996) in cases without irradiation and 87.6% (95% CI: 0.810-0.948) with irradiation of the region evaluated (p-value .034). CONCLUSION Flap and associated soft tissue type had no significant effect on 5-year implant survival or peri-implant inflammatory parameters. However, the large heterogeneity of the patient population indicates that further prolonged studies are required for a more differentiated assessment of the long-term success.
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Affiliation(s)
- Korbinian Jochen Hoffmann
- Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Christopher Büsch
- Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany
| | - Julius Moratin
- Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Oliver Ristow
- Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Jürgen Hoffmann
- Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Mertens
- Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
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Toia M, Parpaiola A, Stevanello N, Tattan M, Saleh MHA, Ravidà A. Clinical outcomes of implant- versus abutment-level connection in screw-retained fixed dental prostheses: A 5-year randomized controlled trial. Clin Oral Implants Res 2024; 35:230-241. [PMID: 38012845 DOI: 10.1111/clr.14217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 09/26/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
AIM The aim of the study was to evaluate the 5 years clinical outcomes associated with implant-level connection (IL) versus abutment-level connection (AL) for implants with an internal conical connection (ICC) supporting a screw-retained fixed partial denture. MATERIALS AND METHODS Fifty patients with 119 implants were randomly allocated to either the AL or IL group. Radiographic (Marginal bone loss) and clinical outcomes (Bleeding on Probing, probing pocket depth, plaque accumulation, incidence of peri-implantitis and peri-implant mucositis as well as prosthetic complications) were collected and compared at 1, 2, 3, and 5 years. A linear mixed model was used to evaluate the differences between groups. RESULTS Five years after treatment, the MBL change was not significantly different between the groups at any point. The MBL was 0.23 ± 0.64 mm (AL) and 0.23 ± 0.29 mm (IL). The bleeding on Probing was 44% (AL) and 45% (IL) (p = .89). The mean probing depth was 2.91 ± 1.01 mm (AL) and 3.51 ± 0.67 mm (IL). This difference between the groups was statistically significant but clinical insignificant. Presence of plaque was slightly higher (p = .06) in the IL group (34.4%) compared with the AL group (26.3%). The overall technical, biological, and prosthetic complication rates were similar between groups. None of the implants developed peri-implantitis during the entire follow-up period. CONCLUSION The results of this clinical trial indicated that all clinical and radiographical parameters were clinically comparable between the study groups.
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Affiliation(s)
- Marco Toia
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Andrea Parpaiola
- Department Clinic-Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | | | - Mustafa Tattan
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Andrea Ravidà
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
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Peng X, Guo X, Zhou Y. The Efficacy of Ten Different Adjunctive Measures in Patients with Nonsurgically Treated Peri-Implant Disease: A Network Meta-Analysis of Randomized Controlled Trials. Photobiomodul Photomed Laser Surg 2024; 42:99-124. [PMID: 38294889 DOI: 10.1089/photob.2023.0109] [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: 02/02/2024] Open
Abstract
Objective: This study aimed to evaluate the impact of 10 adjunctive measures on non-surgical therapy outcomes for peri-implant disease. Methods: We formulated the study question and keywords following the Population, Intervention, Comparator, Outcome framework. Randomized controlled trials were identified through searches in PubMed, Embase, the Cochrane Library, and the Web of Science. Two researchers assessed the quality of included literature according to the Cochrane Risk of Bias Assessment Tool. Data analysis and ranking were performed using Stata 15.0 software. Results: This study, involving 51 pieces of literature and 2660 samples, conducted a network meta-analysis (NMA), which revealed that photodynamic therapy (PDT) significantly reduced probing pocket depth values in patients with peri-implant mucositis (SUCRA = 96.3%) and peri-implantitis (SUCRA = 96.7%). In addition, it showed an improvement in bleeding on probing (BOP) values for peri-implantitis (SUCRA = 91.6%). Furthermore, diode lasers improved BOP values for peri-implant mucositis (SUCRA = 76.5%). Conclusions: According to the NMA results and the surface under the cumulative ranking curve (SUCRA), PDT and diode laser outperform other adjuncts in peri-implant disease.
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Affiliation(s)
- Xuepei Peng
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xingtong Guo
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuwen Zhou
- Department of Stomatology, Jiaxing Maternal and Child Health Hospital, Jiaxing, China
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Cardoso JM, Ribeiro AC, Botelho J, Proença L, Noronha S, Alves RC. The Influence of Genetic Polymorphisms on the Expression of Interleukin-1beta, Prostaglandin E2 and Tumor Necrosis Factor Alpha in Peri-Implant Crevicular Fluid: A Cross-Sectional Study. Int J Mol Sci 2024; 25:651. [PMID: 38203822 PMCID: PMC10779319 DOI: 10.3390/ijms25010651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
The aim of this study was to evaluate the possible relationships between polymorphisms in the interleukin-1 (IL-1) A, IL-1B, and IL-1RN genes and concentrations of the inflammatory mediators IL-1β, tumor necrosis factor-alpha (TNF-α), and prostaglandin E2 (PGE2) in peri-implant crevicular fluid (PICF). A cross-sectional analytical study was conducted on 51 patients with dental implants. Samples from the buccal mucosa were obtained, and genetic analysis was performed using the real-time polymerase chain reaction (PCR) technique for IL-1A and IL-1B and PCR and restriction fragment length polymorphism analysis for IL-1RN. For the biochemical analysis, the concentrations of IL-1β and TNF-α were analyzed using multiplexed fluorescent sphere immunoassays, and PGE2 by enzyme-linked immunosorbent assay. In patients with detected IL-1RN polymorphism, there was an increase in the concentration of the three mediators with statistically significant differences in the mean values of TNF-α and PGE2, regardless of peri-implant health status (p = 0.002 and p = 0.049, respectively). The concentrations of all three mediators were positively and significantly correlated (IL-1β vs. TNF-α Rho = 0.480, p < 0.001; IL-1β vs. PGE2 Rho = 0.382, p = 0.006; and TNF-α vs. PGE2 Rho = 0.528, p < 0.001). We can conclude that the IL-1RN polymorphism exerts an influence on the PICF immune response, which may explain the influence of this genetic polymorphism on the occurrence of peri-implantitis.
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Affiliation(s)
- José Maria Cardoso
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Campus Universitário, Quinta da Granja, 2829-511 Almada, Portugal; (A.C.R.); (J.B.); (L.P.); (R.C.A.)
- Periodontology Department, Egas Moniz School of Health & Science, Campus Universitário, Quinta da Granja, 2829-511 Almada, Portugal
| | - Ana Clara Ribeiro
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Campus Universitário, Quinta da Granja, 2829-511 Almada, Portugal; (A.C.R.); (J.B.); (L.P.); (R.C.A.)
- Molecular Biology Laboratory, Egas Moniz School of Health & Science, Campus Universitário, Quinta da Granja, 2829-511 Almada, Portugal
| | - João Botelho
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Campus Universitário, Quinta da Granja, 2829-511 Almada, Portugal; (A.C.R.); (J.B.); (L.P.); (R.C.A.)
| | - Luís Proença
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Campus Universitário, Quinta da Granja, 2829-511 Almada, Portugal; (A.C.R.); (J.B.); (L.P.); (R.C.A.)
| | - Susana Noronha
- Periodontology Department, Faculdade de Medicina Dentária da Universidade de Lisboa, Cidade Universitária, R. Prof. Teresa Ambrósio, 1600-277 Lisboa, Portugal;
| | - Ricardo Castro Alves
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Campus Universitário, Quinta da Granja, 2829-511 Almada, Portugal; (A.C.R.); (J.B.); (L.P.); (R.C.A.)
- Periodontology Department, Egas Moniz School of Health & Science, Campus Universitário, Quinta da Granja, 2829-511 Almada, Portugal
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24
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Leone FD, Blasi G, Amerio E, Valles C, Nart J, Monje A. Influence of the level of compliance with preventive maintenance therapy upon the prevalence of peri-implant diseases. J Periodontol 2024; 95:40-49. [PMID: 37436695 DOI: 10.1002/jper.23-0048] [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: 01/23/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND A study was made to evaluate peri-implant conditions in compliers and erratic compliers with peri-implant maintenance therapy (PIMT), and to assess the role of site-specific confounders. METHODS Erratic PIMT compliers (EC) were defined as presenting attendance < 2×/year, while regular compliers (RC) attended ≥ 2×/year. Generalized estimating equations (GEE) were employed to perform a multivariable multilevel analysis in which the peri-implant condition was established as dependent variable. RESULTS Overall, 86 non-smoker patients (42 RC and 44 EC) attending the Department of Periodontology of the Universitat Internacional de Catalunya were recruited consecutively on a cross-sectional basis. The mean period of loading was 9.5 year. An implant placed in an erratic patient has 88% higher probability of presenting peri-implant diseases versus RC. Furthermore, the probability of diagnosis of peri-implantitis was significantly higher in EC versus RC (odds ratio [OR] 5.26; p = 0.009). Among other factors, history of periodontitis, non-hygienic prosthesis, period of implant loading, and modified plaque index (mPI) at implant level were shown to significantly increase the risk of peri-implantitis diagnosis. Although not associated with peri-implantitis diagnosis risk, keratinized mucosa (KM) width, and vestibular depth (VD) were significantly associated to plaque accumulation (mPI). CONCLUSIONS Compliance with PIMT was found to be significantly associated with peri-implant condition. In this sense, attending PIMT < 2×/year may be ineffective to prevent peri-implantitis.
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Affiliation(s)
- Francesco Di Leone
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Gonzalo Blasi
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ettore Amerio
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Cristina Valles
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
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25
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Müller F, Al-Nawas B, Storelli S, Quirynen M, Hicklin S, Castro-Laza J, Bassetti M, Srinivasan M. Small-diameter titanium grade IV and titanium-zirconium implants in edentulous mandibles: Ten-year results from a double-blind, randomised controlled split-mouth core-trial. Clin Oral Implants Res 2024; 35:77-88. [PMID: 37942666 DOI: 10.1111/clr.14199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/11/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023]
Abstract
The goal of this extension study was to compare the 10-year outcome of 3.3 mm diameter titanium-zirconium (TiZr) or grade IV titanium (Ti) implants in mandibular implant-overdentures. MATERIALS AND METHODS This study is the 10-year follow-up from a randomised, controlled, double-blind, split-mouth multicentre clinical trial. Patients with edentulous mandibles had received two implants in the interforaminal region (bone-level, diameter 3.3 mm, microrough surface), one of TiZr (test) and one of Ti (control). Implant survival and success, plaque and sulcus bleeding indices, probing pocket depth, gingival margin, clinical attachment level and radiographic crestal bone levels were evaluated. RESULTS Fifty of 91 patients with implants were available for the 10-year examination and 36 patients were valid for the intent-to-treat (ITT) analysis. The implant success rate was calculated as 94.6% and 91.9% for the TiZr implants and the Ti implants respectively. Four implants were lost (TiZr = 1; Ti = 3) in the entire study period. Kaplan-Meier survival analyses estimated 10- year implant survival rate for TiZr to 98.9% and Ti 95.8%.The mean of total and functional crestal bone loss was 1.49 mm (±1.37 mm) and 0.82 mm (±1.09 mm) in the TiZr group and 1.56 mm (±1.34 mm) and 0.85 mm (±1.16 mm) in the Ti group. CONCLUSIONS This split-mouth design RCT on mandibular implant-overdentures evidenced, bearing in mind its follow-up time-related reduced cohort size, high 10-year implant success- and survival rates. These results confirm TiZr as well-suited implant material for realising small-diameter implants. Registered on www. CLINICALTRIALS gov: NCT01878331.
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Affiliation(s)
- Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | | | - Stefano Storelli
- Dental Clinic, San Paolo Hospital, University of Milan, Milan, Italy
| | - Marc Quirynen
- School of Dentistry, Catholic University Leuven, Leuven, Belgium
| | - Stefan Hicklin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
- Clinic of General, Special Care and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | | | - Mario Bassetti
- Clinic for Oral and Maxillofacial Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Murali Srinivasan
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
- Clinic of General, Special Care and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
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Choudhary A, Rajasekar A. Efficacy of Ozonated Olive Oil Gel in the Management of Peri-Implant Mucositis. J Long Term Eff Med Implants 2024; 34:69-73. [PMID: 38305372 DOI: 10.1615/jlongtermeffmedimplants.2023047323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Peri-implant mucosistis is similar to gingivitis, the former affects the mucosa around implants without bone loss. The aim of this study was to determine the effectiveness of ozonated olive oil gel in the management of peri-implant mucositis. A randomized controlled clinical trial was conducted among 50 patients with peri-implant mucositis within the age group of 25-50 years. They were randomly divided into two groups with 25 participants in each group based on the intervention [Group A (Ozonated olive oil gel), Group B (Chlorhexidine gel)]. Silness and Loe plaque index (PI) and Loe and Silness gingival index (GI) were recorded at baseline and after 4 weeks. Paired t-test and independent t-test was used to test the significance. Within the groups, there was a statistically significant reduction in PI and GI from baseline (P < 0.05). However, the difference in PI and GI between both the groups was statistically insignificant (P > 0.05). Ozonated olive oil gel was equally effective to chlorhexidine gel in the management of peri-implant mucositis.
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Affiliation(s)
- Apurva Choudhary
- Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Arvina Rajasekar
- Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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Involvement of the Notch signaling system in alveolar bone resorption. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:38-47. [PMID: 36880060 PMCID: PMC9985033 DOI: 10.1016/j.jdsr.2023.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 02/05/2023] [Accepted: 02/16/2023] [Indexed: 03/05/2023] Open
Abstract
The Notch pathway is an evolutionarily preserved signaling pathway involved in a variety of vital cell functions. Additionally, it is one of the key regulators of inflammation, and controls the differentiation and function of different cells. Moreover, it was found to be involved in skeletal development and bone remodeling process. This review provides an overview of the involvement of the Notch signaling pathway in the pathogenesis of alveolar bone resorption in different forms of pathological conditions such as apical periodontitis, periodontal disease, and peri-implantitis. In vitro and in vivo evidence have confirmed the involvement of Notch signaling in alveolar bone homeostasis. Nonetheless, Notch signaling system, along with complex network of different biomolecules are involved in pathological process of bone resorption in apical periodontitis, periodontitis, and peri-implantitis. In this regard, there is a substantial interest to control the activity of this pathway in the treatment of disorders associated with its dysregulation. This review provides knowledge on Notch signaling and outlines its functions in alveolar bone homeostasis and alveolar bone resorption. Further investigations are needed to determine whether inhibition of the Notch signaling pathways might be beneficial and safe as a novel approach in the treatment of these pathological conditions.
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Lombardo G, D'Agostino A, Nocini PF, Signoriello A, Zangani A, Pardo A, Lonardi F, Trevisiol L. Clinical outcomes and periodontal conditions of dental implants placed in free fibula flaps (FFF): a retrospective study with a mean follow-up of 6 years. Clin Oral Investig 2023; 27:7737-7751. [PMID: 37917356 PMCID: PMC10713700 DOI: 10.1007/s00784-023-05364-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/24/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVES Up-to-date literature regarding long-term success of implant rehabilitations after microvascular reconstructions with free fibula flap (FFF) is still very scarce. This study aimed to evaluate clinical outcomes, especially related to oral hygiene conditions, of patients rehabilitated with this technique. MATERIALS AND METHODS A total of 25 patients who underwent maxillofacial reconstructive surgery with FFF were retrospectively evaluated for soft tissues conditions, oral hygiene habits, and implant survival and success, assessed with a mean follow-up of 6 (range 2-15) years after loading. RESULTS Fourteen patients received full-arch fixed prostheses and 11 removable bar-supported overdentures. At the follow-up evaluation, 52% of prostheses did not allow proper accessibility for oral hygiene. Overall prosthetic survival was 100%, and implant survival and success were respectively 93.6% and 72%. Prevalence of peri-implantitis was 29% at implant level and that at patient level 96%. CONCLUSIONS Six-year clinical outcomes of this study reveal that poor oral hygiene practices and compliance by patients who underwent maxillofacial reconstruction with FFF are significantly associated with peri-implant disease. CLINICAL RELEVANCE Findings of the present study underline the need by clinicians for a careful assessment, in reference to a specific implant therapy, of patient's prosthetic accessibility for oral hygiene procedures.
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Affiliation(s)
- Giorgio Lombardo
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Antonio D'Agostino
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Pier Francesco Nocini
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Annarita Signoriello
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy.
| | - Alessandro Zangani
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Alessia Pardo
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Fabio Lonardi
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Lorenzo Trevisiol
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
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Zhao D, Leng Y, Liu Y, Zhou X. Effect of calcium hydrothermal treatment of zirconia abutments on human gingival fibroblasts. J Biomed Mater Res B Appl Biomater 2023; 111:1883-1889. [PMID: 37289176 DOI: 10.1002/jbm.b.35291] [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: 03/01/2023] [Revised: 05/07/2023] [Accepted: 05/31/2023] [Indexed: 06/09/2023]
Abstract
Zirconia materials have been increasingly used in implant rehabilitation due to their excellent physical and esthetic properties. Stable peri-implant epithelial tissue adhesion to the transmucosal implant abutment may significantly enhance the efficacy of implant long-term stability. However, it is difficult to form stable chemical or biological bindings with peri-implant epithelial tissue due to the strong biological inertia of zirconia materials. In the present study, we investigated whether calcium hydrothermal treatment of zirconia promotes sealing of peri-implant epithelial tissue. In vitro experiments were performed to analyze the effects of calcium hydrothermal treatment on zirconia surface morphology and composition by scanning electron microscopy and energy dispersive spectrometry. Immunofluorescence staining of adherent proteins, namely, F-actin and integrin β1, in human gingival fibroblast line (HGF-l) cells was performed. In the calcium hydrothermal treatment group, there was higher expression of these adherent proteins and increased HGF-l cell proliferation. An in vivo study was conducted by extracting the maxillary right first molars of rats and replacing them with mini-zirconia abutment implants. The calcium hydrothermal treatment group showed better attachment at the zirconia abutment surface, which inhibited horseradish peroxidase penetration at 2 weeks post-implantation. These results demonstrated that calcium hydrothermal treatment of zirconia improves the seal between the implant abutment and surrounding epithelial tissues, potentially increasing the long-term stability of the implant.
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Affiliation(s)
- Dan Zhao
- Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Yanjun Leng
- School of Stomatology, Central South University, Changsha, China
| | - Yishu Liu
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xudiyang Zhou
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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30
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Clementini M, Fabrizi S, Discepoli N, Minoli M, De Sanctis M. Evaluation of the adjunctive use of Er:YAG laser or erythritol powder air-polishing in the treatment of peri-implant mucositis: A randomized clinical trial. Clin Oral Implants Res 2023; 34:1267-1277. [PMID: 37655744 DOI: 10.1111/clr.14167] [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: 03/10/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 09/02/2023]
Abstract
AIM To assess the efficacy of Er:YAG laser (ERL) and erythritol powder air-polishing (AP) in addition to the submarginal instrumentation in the non-surgical treatment of peri-implant mucositis (PM). MATERIALS AND METHODS Patients with at least one implant diagnosed with PM were included in the present 6-month randomized clinical trial (RCT). Implants were randomly assigned to one of the three treatment groups after submarginal instrumentation: AP (test 1 group), ERL (test 2 group) or no adjunctive methods (control group). The primary and secondary outcomes were, respectively, bleeding on probing (BoP) reduction and, complete disease resolution (total absence of BoP) and probing pocket depth (PPD) changes. The patient and the implant were considered the statistical unit. A multivariate logistic regression analysis was performed. RESULTS A total of 75 patients were enrolled in the study. At each time point, significant BoP and PPD reductions were observed within each group. Intergroup analysis did not show statistically significant differences. Complete disease resolution ranged between 29% and 31%. The logistic regression showed that supramucosal restoration margin, PPD < 4 mm and vestibular keratinized mucosa (KM) significantly influenced the probability to obtain treatment success. CONCLUSION The adjunctive use of AP and ERL in PM non-surgical therapy does not seem to provide any significant or clinically relevant benefit in terms of BoP and PPD reductions and complete disease resolution, over the use of submarginal instrumentation alone. Baseline PPD < 4 mm, presence of buccal KM and supramucosal restoration margin may play a role in the complete resolution of PM.
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Affiliation(s)
- Marco Clementini
- Department of Periodontology, Vita-Salute San Raffaele University, Milan, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Simone Fabrizi
- Department of Periodontology, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicola Discepoli
- Department of Medical Biotechnologies, Unit of Periodontics, University of Siena, Siena, Italy
| | - Margherita Minoli
- Department of Periodontology, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo De Sanctis
- Department of Periodontology, Vita-Salute San Raffaele University, Milan, Italy
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Jose EP, Paul P, Reche A. Soft Tissue Management Around the Dental Implant: A Comprehensive Review. Cureus 2023; 15:e48042. [PMID: 38034248 PMCID: PMC10688389 DOI: 10.7759/cureus.48042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
In the modern world, there is an increasing concern among people regarding dental esthetics. Edentulism can impact one's appearance, affect the regular bite, and can even affect mental well-being. There are various options to replace the missing teeth, such as removable dentures, fixed crown and bridge prostheses, and resin-retained bridges. Various factors are evaluated before giving a suitable prosthesis for missing teeth. Implant installation is highly desired by patients as it has a high success and long-term survival rate when used to replace lost teeth. However, several difficulties relating to errors in treatment planning, surgery, soft tissue, and hard tissue care, and infections may compromise the efficacy of implant therapy. An increasing body of research indicates that long-term clinical stability and esthetics may be significantly impacted by the stability of the soft tissues around osseointegrated dental implants. Consequently, when implant therapy is planned, the dental surgeon has to have the necessary expertise to appropriately handle any possible causes of difficulties in addition to being able to carry out the necessary actions to maintain or develop stable soft tissue. Various augmentation procedures can be done for the correction of any deformity or inadequacy of soft tissues. Osseointegration is a fundamental part of the success of the implant treatment. It is the formation of a biological and functional connection between the bone and the implant increasing the stability of implant prosthesis. After the treatment, the patient should be counseled for regular and proper oral hygiene practices suitable for the implant. A proper follow-up has to be done after implant treatment in regular intervals. Any postoperative soft tissue complications, such as peri-implantitis or peri-implant mucositis, should be addressed immediately, and appropriate treatment has to be given. This article reviews about the procedures before and after the implant placement to prevent or treat soft tissue complications, ultimately leading to the success of the implant.
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Affiliation(s)
- Elizabeth P Jose
- Public Health Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Priyanka Paul
- Public Health Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amit Reche
- Public Health Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Pelekos G, Chin B, Wu X, Fok MR, Shi J, Tonetti MS. Association of crown emergence angle and profile with dental plaque and inflammation at dental implants. Clin Oral Implants Res 2023; 34:1047-1057. [PMID: 37461128 DOI: 10.1111/clr.14134] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 06/06/2023] [Accepted: 07/06/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The shape of implant restorations is critical for function and aesthetics. It may also be important in peri-implant tissue health preservation. This study aimed to associate the restorative contour of a single crown with marginal dental plaque accumulation, tissue inflammation and probing depths. METHODS Subjects with a single screw-retained implant restoration were clinically examined. The presence of dental biofilm, tissue inflammation and probing pocket depths were the dependent variables. The emergence angle, profile and depth of the mucosal tunnel were measured on superimposed digital scans of the crown soft-tissue complex, the removed crown mounted on an analogue and the soft tissue. RESULTS One hundred twenty two subjects (46.7% female, 68.9% never smokers, 77% with treated periodontitis and 52.5% participating in regular supportive peri-implant care) were examined. The emergence angles at the mucosal margin were 15.3 ± 9.4°, 12.7 ± 8.5°, 31.3 ± 11.8° and 19.2 ± 9.8° for the mesial, distal, vestibular and oral aspects of the crowns. The largest emergence profile angles were observed on the vestibular aspect (74.6% of cases), reaching a maximum of 61.7°, and profiles were convex in 59% of cases. Generalized estimating equations indicated that the site-specific platform-level emergence angle and profile and depth of the mucosal tunnel were significantly associated with the presence of detectable plaque accumulation (p < .01) and bleeding on probing (p < .02). CONCLUSIONS Subtle variations in the shape of the restorative crown are associated with biofilm accumulation and mucosal inflammation. These findings are important for 3D implant planning/positioning and preservation of peri-implant tissue health.
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Affiliation(s)
- George Pelekos
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Bonnie Chin
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Xinyu Wu
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Melissa R Fok
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Junyu Shi
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Maurizio S Tonetti
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- European Research Group on Periodontology, Genoa, Italy
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Gönder A, Polat S, Kılıçarslan MA, Ocak M, Tamam E. How can excess residual cement be reduced in implant-supported restorations?: An in vitro study. Clin Implant Dent Relat Res 2023; 25:807-814. [PMID: 37232125 DOI: 10.1111/cid.13229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/11/2023] [Accepted: 05/14/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the effect of different cements and cementation techniques used in implant-supported restorations and the application of various vent modifications and extraoral replica techniques on the amount of overflowing cement in cemented systems. MATERIALS AND METHODS In this study, three different abutment designs were used as fully closed, occlusal vented, and occlusal + proximal vented. An extraoral replica was produced by milling the CAD/CAM ceramic block. The number of groups with and without replicas was determined as six (n = 10). For the cementation procedures, three different cements were tested: dual-cure resin, eugenol-free zinc oxide, and polycarboxylate cements. Cobalt-chromium superstructures to be cemented to the implant analog-abutment complex were produced by direct metal laser sintering method. Twenty-four hours after the cementation process, residual cement were measered with Micro-CT. In comparisons between groups, ANOVA test was used for normally distributed variables and Kruskall-Wallis H test was used for non-normally distributed variables at a significance level of p < 0.05. RESULTS The difference in residual cement volumes between the groups in terms of both cementation techniques (whether or not to use an extraoral replica and different vent desings) and cement types was found to be statistically significant (p < 0.05). There was significantly less residual cement in all groups that used extraoral replicas than those that did not. As for the cement types, the most residual cement occurred in the resin cement. CONCLUSION The use of extraoral replicas and vent designs on the abutment significantly reduces the amount of residual cement. Regardless of the cementation technique, the type of cement used affects the amount of excess cement. CLINICAL RELEVANCE To reduce residual cement, both the type of cement and the cementation technique used must be considered.
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Affiliation(s)
- Aykut Gönder
- Republic of Türkiye Social Security Institution (SGK), Ankara, Turkey
- Faculty of Dentistry, Department of Prosthodontics, Ankara Medipol University, Ankara, Türkiye
| | - Serdar Polat
- Faculty of Dentistry, Department of Prosthodontics, Gazi University, Ankara, Turkey
| | | | - Mert Ocak
- Faculty of Dentistry, Department of Anatomy, Ankara University, Ankara, Turkey
| | - Evşen Tamam
- Faculty of Dentistry, Department of Prosthodontics, Gazi University, Ankara, Turkey
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Ding Y, Zhou H, Zhang W, Chen J, Zheng Y, Wang L, Yang F. Evaluation of a platform-switched Morse taper connection for all-on-four or six treatment in edentulous or terminal dentition treatment: A retrospective study with 1-8 years of follow-up. Clin Implant Dent Relat Res 2023; 25:815-828. [PMID: 37248812 DOI: 10.1111/cid.13228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/07/2023] [Accepted: 05/14/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND The survival rate, marginal bone loss and soft tissue health of the Ankylos implants and the balanced base abutments in all-on-four or six implant restoration of edentulous or terminal dentition patients has not been reported in the clinical research. PURPOSE This retrospective study aimed to evaluate the Ankylos implants and the balanced base abutments in all-on-four or six implant restoration of edentulous or terminal dentition patients after 1-8 years of follow-up. MATERIALS AND METHODS A retrospective study was conducted based on the medical records of 33 patients who received all-on-four or six treatments from April 2014 to May 2020. Four radiographic examinations [immediate postoperative (T0), definitive restorations (T1), 1-3 years after prosthetic restorations (T2), and more than 3 years after prosthetic restorations (T3)] were obtained to evaluate vertical bone height (VBH). We also calculated the survival rate and examined the condition of soft tissue with this implant system in edentulous or terminal dentition patients. Three-level linear model analyses were used to explore potential risk factors for VBH changes on the mesial and distal sides. The generalized linear model was used to analyze the influencing factors of BOP and plaque. RESULTS A total of 218 implants were included in this study. The cumulative survival rate of the implants was 97.25% before the definitive prosthesis, 96.33% within 3 years of follow-up and 95.32% after more than 3 years of follow-up. The mean ± standard deviation (SD) bone losses of the VBH were 0.27 ± 0.05 mm (T1-T3) on the mesial side and 0.49 ± 0.06 mm (T1-T3) on the distal side. During 1-8 years of follow-up, the height and angle of the abutment (p < 0.001), the mandible implant site (p < 0.001), the length of the implant (p = 0.014 < 0.05) and age (p = 0.029 < 0.05) showed statistically significant effects on vertical mesial bone height (VMBH) and vertical distal bone height (VDBH). The risk of BOP among participants who brushed three times a day was lower than those who brushed less than three times. The plaque risk of short abutment height was higher than the long abutment. CONCLUSION The current study showed that the Ankylos implants with the balanced base abutments in all-on-four or six implants treatment is a viable and predictable option with a high survival rate and low marginal bone loss in edentulous or terminal dentition patients. VBH around the implants was strongly associated with the mandible implant site, abutment height and angle, the length of the implant and age. Moreover, teeth-brushing times and abutment height significantly affect soft tissue health.
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Affiliation(s)
- Yude Ding
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Huajun Zhou
- College of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wentao Zhang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jianping Chen
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yuanna Zheng
- College of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Linhong Wang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Fan Yang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
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Sanavia C, Vallerga E, Alessi F, Tealdo T, Bevilacqua M, Alberti C, Menini M, Pesce P. Five Steps for the Maintenance and Interception of Complications in Zygomatic Implants. Dent J (Basel) 2023; 11:226. [PMID: 37886911 PMCID: PMC10605483 DOI: 10.3390/dj11100226] [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: 08/11/2023] [Revised: 09/15/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
Zygomatic implants are used for the rehabilitation of the upper jaw of patients with severe and moderate bone atrophy. Possible post-surgical complications include soft tissue dehiscence, sinusitis, and prosthodontic fractures, and maintaining an accurate control is crucial. Additionally, zygomatic implants have a unique peri-implant anatomy, making traditional periodontal parameters unsuitable. The present paper aims to provide guidelines for the maintenance and interception of complications in patients rehabilitated with these kinds of implants. The proposed protocol includes: 1. intra/extraoral and temporo-mandibular joint examination; 2. soft tissue and transmucosal path observation with magnifiers; 3. peri-implant health indices and digital stimulation of tissues; 4. examination of prosthodontic devices; and 5. photographic recording. These steps facilitate the comprehensive evaluation and monitoring of clinical conditions of zygomatic-supported rehabilitations, including dehiscence and occlusal wear during follow-up appointments.
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Affiliation(s)
- Consuela Sanavia
- Department of Surgical Sciences, University of Genoa, 16126 Genoa, Italy; (C.S.); (T.T.); (M.B.)
| | | | - Fanny Alessi
- Independent Researcher, 36027 Rosà, Italy; (F.A.); (C.A.)
| | - Tiziano Tealdo
- Department of Surgical Sciences, University of Genoa, 16126 Genoa, Italy; (C.S.); (T.T.); (M.B.)
| | - Marco Bevilacqua
- Department of Surgical Sciences, University of Genoa, 16126 Genoa, Italy; (C.S.); (T.T.); (M.B.)
| | | | - Maria Menini
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences, University of Genoa, 16126 Genoa, Italy;
| | - Paolo Pesce
- Department of Surgical Sciences, University of Genoa, 16126 Genoa, Italy; (C.S.); (T.T.); (M.B.)
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Jervøe-Storm PM, Jepsen S, Marder M, Kraus D, Stoilov M, Enkling N. Prevention of internal bacterial colonization of dental implants: A comparative longitudinal observational study. Clin Oral Implants Res 2023; 34:979-986. [PMID: 37394702 DOI: 10.1111/clr.14124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/17/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES Previous studies have indicated a progressive internal bacterial colonization of implants and possible implications for peri-implant bone loss. The aim of this study was to evaluate a decontamination protocol, two disinfectants, and a sealant for their ability to prevent such a colonization. MATERIALS AND METHODS Bacterial samples were harvested from the peri-implant sulcus (external) and following abutment removal from the implant cavity (internal) during routine supportive peri-implant care in 30 edentulous patients 2 years after they had obtained two implants. In a split-mouth design, implants were randomly assigned to receive either internal decontamination alone (10% H2 O2 , brush) or additional placement of either sealant (GS), disinfectant agent (CHX-varnish) or disinfectant gel (1% CHX-gel), in the internal cavity before remounting of abutment/suprastructure. Twelve months later, internal and external sampling was repeated. Total bacterial counts (TBCs) were determined using real-time PCR in a total of 240 samples (eight per patient). RESULTS Total bacterial counts in the internal cavity significantly reduced overall treatment modalities 1 year after the treatments (4.0 [2.3-6.9]-fold reduction; p = .000). No significant differences between the four treatment types were found (p = .348). Comparison of internal and external sampling points revealed significant correlation (R2 = .366; p = .000) with systematically higher TBC counts in external samples. CONCLUSIONS Within the limitations of the present study, it can be concluded that the use of disinfectant agents or a sealant did not show an additional benefit in the prevention of internal bacterial colonization of implants compared to a decontamination protocol alone.
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Affiliation(s)
- Pia-Merete Jervøe-Storm
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Michael Marder
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Bonn, Germany
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Bonn, Germany
| | - Milan Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Bonn, Germany
| | - Norbert Enkling
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Bonn, Germany
- Department of Reconstructive Dentistry & Gerodontology, University of Bern, Bern, Switzerland
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Jervøe-Storm PM, Marder M, Hagner M, Menn I, Menn P, Jepsen S. Prevalence of Peri-Implant Disease in Patients with Stage III or IV Periodontitis: Results of a Long-Term Follow-Up from a Specialized Periodontal Practice. J Clin Med 2023; 12:5547. [PMID: 37685613 PMCID: PMC10488241 DOI: 10.3390/jcm12175547] [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: 07/18/2023] [Revised: 08/09/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
The aim of this study was to examine the conditions of implants that had been in function for 5-17 years in stage III/IV periodontitis patients of a specialized periodontal practice. There were 83 patients (43 female/40 male, mean age 64.4 (9.69) years), with a total of 213 implants, who participated in the study. Assessments included periodontal and peri-implant probing depths, bleeding and plaque scores, and a radiographic examination. Smoking habits, participation in a supportive care program (SCP), and the Implant Disease Risk Assessment (IDRA) scores were recorded. A total of 44 patients presented with stage III periodontitis, and 39 with stage IV. In all, 85% of patients had adhered to regular SCP. On an implant/patient level, peri-implant health was found in 37.1.7% (79 implants)/24.1% (20 patients), peri-implant mucositis in 58.7% (125 implants)/66.3% (55 patients), and peri-implantitis in 4.2% (9 implants)/9.6% (8 patients). IDRA scores showed 30.5% of implants at moderate and 69.5% at high risk. The present long-term analysis shows a high prevalence of peri-implant disease in patients treated for advanced periodontitis. These findings underline the challenges involved in the long-term maintenance of oral health in stage III/IV periodontitis patients restored with dental implants.
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Affiliation(s)
- Pia-Merete Jervøe-Storm
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Welschnonnenstrasse 17, 53111 Bonn, Germany;
| | - Michael Marder
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Welschnonnenstrasse 17, 53111 Bonn, Germany;
| | - Martin Hagner
- Practice for Interdisciplinary Dentistry, Im Mühlenbach 2b, 53127 Bonn, Germany;
| | - Ina Menn
- Practice for Interdisciplinary Dentistry Dr. Menn, Dammstraße 4, 57271 Hilchenbach, Germany; (I.M.); (P.M.)
| | - Philipp Menn
- Practice for Interdisciplinary Dentistry Dr. Menn, Dammstraße 4, 57271 Hilchenbach, Germany; (I.M.); (P.M.)
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Welschnonnenstrasse 17, 53111 Bonn, Germany;
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Sakkas A, Westendorf S, Thiele OC, Schramm A, Wilde F, Pietzka S. Prosthetically guided oral implant surgery. A retrospective cohort study evaluating the 5-year surgical outcome. GMS INTERDISCIPLINARY PLASTIC AND RECONSTRUCTIVE SURGERY DGPW 2023; 12:Doc06. [PMID: 37693294 PMCID: PMC10486885 DOI: 10.3205/iprs000176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Purpose This study primarily evaluated the 5-year implant survival and success rate of prosthetically guided inserted implants. The secondary aim was to evaluate the impact of clinical variables on the development of mucositis, peri-implant bone resorption, peri-implantitis, as well as early and late implant failure. Materials and methods An observational retrospective single-centre study was conducted on patients who were treated with dental implants in the department of oral and plastic maxillofacial surgery of the military hospital of Ulm University between 2008 and 2010. In all patients, computer-assisted 3D planning after wax-up of the prosthetic restoration and template-guided surgery with titanium implants were performed. Bone augmentation procedures were performed primarily if needed. Intraoperative and postoperative complications as well as technical and mechanical complications after prosthesis loading were evaluated. In a 5-year clinical and radiological follow-up, implant success and implant survival were assessed using descriptive statistics. A multivariable regression analysis evaluated the potential impact of augmentation procedures, wound healing complications, smoking, history of periodontitis, and preoperative API (approximal plaque index) and SBI (sulcus bleeding index) values on peri-implant mucositis, peri-implant bone resorption, peri-implantitis, as well as early and late implant failure. Results In this study, 466 implants in 283 patients were considered for inclusion, and sufficient data were obtained for analysis from 368 (78.9%) implants in 229 (80.9%) patients. An overall implant survival rate of 98.1% (n=361/368) at the 5-year follow-up was revealed. According to the success criteria of the study, the 5-year success rate was 97.04% (n=263/271). An early implant failure of 1.07% (n=5/466) was recorded. 48.2% of the implants were affected by peri-implant mucositis (n=122/253), while peri-implant bone resorption was detected in 21.7% of the radiologically examined implants (n=59/271). Fifteen cases of peri-implantitis (5.5%) were detected. Peri-implant bone resorption increased significantly after bone augmentation procedures (p=0.028). Wound healing complications after implantation significantly increased the prevalence of late implant failure in the maxilla (p<0.001). Peri-implant bone resorption and peri-implantitis were significantly more prevalent in smokers (p=0.022/p=0.043). Implants in patients with API>20% presented significantly higher rates of peri-implant mucositis (p=0.042). Wound healing complications after augmentation, history of periodontitis, and SBI>20% had no significant impact on the study parameters. Conclusions The study confirms the reliability of prosthetically guided implant surgery, showing a high implant survival and success rate in a 5-year follow-up. Intraoperative complications and technical or mechanical complications after prosthesis loading remain within acceptable clinical limits. The rate of peri-implant mucositis, peri-implant bone resorption, and peri-implantitis was within the current literature range. Optimizing periodontal health and reducing smoking would improve the outcome. Further studies need to clarify the clinical indications and investigate the long-term surgical outcome of this treatment concept.
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Affiliation(s)
- Andreas Sakkas
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
| | - Stefan Westendorf
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
| | - Oliver Christian Thiele
- Department of Oral and Plastic Maxillofacial Surgery, Ludwigshafen Hospital, Ludwigshafen, Germany
| | - Alexander Schramm
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
| | - Frank Wilde
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
| | - Sebastian Pietzka
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
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Lee SJ, Alamri O, Cao H, Wang Y, Gallucci GO, Lee JD. Occlusion as a predisposing factor for peri-implant disease: A review article. Clin Implant Dent Relat Res 2023; 25:734-742. [PMID: 36373771 DOI: 10.1111/cid.13152] [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: 08/24/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 08/04/2023]
Abstract
BACKGROUND The restoration of dental implants presents a unique challenge due to the intrinsic biomechanical differences between osseointegrated implants and natural teeth, and their subsequent responses to occlusal loading. However, controversy exists regarding the role that occlusion plays in the physiology of the peri-implant complex. PURPOSE To provide an overview of the scientific literature regarding occlusion as it relates to implant dentistry and peri-implant disease. MATERIALS AND METHODS This article presents a narrative review on occlusal loading and its potential effects on the peri-implant complex, as well as some generally accepted guidelines for occlusion in implant dentistry. RESULTS AND CONCLUSIONS Although there is strong evidence linking occlusal factors to mechanical complications of dental implants, the same cannot be said regarding biological complications. There is no clear scientific evidence on the relationship between occlusal overload and peri-implant disease. However, occlusal overload may be an accelerating factor for peri-implant disease in the presence of inflammation. As the biomechanical properties of dental implants differ from that of the natural dentition, modifications to classic concepts of occlusion may be necessary when dental implants are involved. Thus, clinical recommendations are proposed which function to minimize unfavorable occlusal forces on implant restorations and reduce the associated biological and mechanical complications.
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Affiliation(s)
- Sang J Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Osamah Alamri
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Huilin Cao
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Yujun Wang
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jason D Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Sirinirund B, Siqueira R, Li J, Mendonça G, Zalucha J, Wang HL. Effects of crown contour on artificial biofilm removal efficacy with interdental cleaning aids: An in vitro study. Clin Oral Implants Res 2023; 34:783-792. [PMID: 37269176 DOI: 10.1111/clr.14105] [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: 11/20/2022] [Revised: 05/15/2023] [Accepted: 05/20/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To evaluate the efficacy of various interdental cleaning aids for artificial biofilm removal on different implant-supported crown designs. METHODS Mandibular models with missing first molar were fabricated and installed with single implant analogs and loaded with crowns of different designs (concave, straight, and convex). Artificial biofilm was made with occlusion spray. Thirty volunteers (periodontists, dental hygienists, and laypersons) were asked to clean the interproximal areas. The crowns were unscrewed and photographed in a standardized setting. The outcome was measured by the cleaning ratio which represents the cleaned surfaces in relation to the area of the tested surface. RESULTS A significant difference in favor of concave crown (p < .001) on the basal surface was cleaned by all tools, except the water flosser. There was evidence of an overall effect of "cleaning tool," "surface," and "crown design" (p < .0001) except for the "participant" factor. The mean cleaning ratio for each cleaning tool and overall combined surfaces were (in%): dental floss: 43.02 ± 23.93, superfloss: 42.51 ± 25.92, electric interspace brush: 36.21 ± 18.78, interdental brush: 29.10 ± 15.95, and electric water flosser: 9.72 ± 8.14. Dental floss and superfloss were significantly better (p < .05) than other tools in removing plaque. CONCLUSIONS Concave crown contour had the greatest artificial biofilm removal, followed by straight and convex crowns at the basal surface. Dental floss and superfloss were the most effective interdental cleaning devices for artificial biofilm removal. None of the tested cleaning devices were able to completely remove the artificial biofilm from the interproximal/basal surfaces.
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Affiliation(s)
- Benyapha Sirinirund
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Rafael Siqueira
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Junying Li
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Gustavo Mendonça
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Janet Zalucha
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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Farina R, Riccardi O, Schincaglia GP, Severi M, Trombelli L, Simonelli A. Six-year extension results of a randomized trial comparing transcrestal and lateral sinus floor elevation at sites with 3-6 mm of residual bone. Clin Oral Implants Res 2023; 34:813-821. [PMID: 37303113 DOI: 10.1111/clr.14110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/23/2023] [Accepted: 05/31/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To comparatively evaluate the 6-year outcomes of transcrestal and lateral sinus floor elevation (tSFE and lSFE, respectively). METHODS The 54 patients representing the per-protocol population of a randomized trial comparing implant placement with simultaneous tSFE versus lSFE at sites with a residual bone height of 3-6 mm were invited to participate in the 6-year follow-up visit. Study assessments included: peri-implant marginal bone level at the mesial (mMBL) and distal (dMBL) aspects of the implant, proportion of the entire implant surface in direct contact with the radiopaque area (totCON%), probing depth, bleeding on probing, suppuration on probing, and modified plaque index. Also, the conditions of the peri-implant tissues at 6-year visit were diagnosed according to the case definitions of peri-implant health, mucositis, and peri-implantitis from the 2017 World Workshop. RESULTS Forty-three patients (21 treated with tSFE and 22 treated with lSFE) participated in the 6-year visit. Implant survival was 100%. At 6 years, totCON% was 96% (IR: 88%-100%) in tSFE group and 100% (IR: 98%-100%) in lSFE group (p = .036). No significant intergroup difference in patient distribution according to the diagnosis of peri-implant health/disease was observed. Median dMBL was 0.3 mm in tSFE group and 0 mm in lSFE group (p = .024). CONCLUSIONS At 6 years following placement concomitantly with tSFE and lSFE, implants showed similar conditions of peri-implant health. Peri-implant bone support was high in both groups and was slightly but significantly lower in tSFE group.
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Affiliation(s)
- Roberto Farina
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (A.U.S.L.), Ferrara, Italy
| | | | | | - Mattia Severi
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (A.U.S.L.), Ferrara, Italy
| | - Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (A.U.S.L.), Ferrara, Italy
| | - Anna Simonelli
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (A.U.S.L.), Ferrara, Italy
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Laleman I, Lambert F. Implant connection and abutment selection as a predisposing and/or precipitating factor for peri-implant diseases: A review. Clin Implant Dent Relat Res 2023; 25:723-733. [PMID: 36825512 DOI: 10.1111/cid.13185] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/17/2023] [Indexed: 02/25/2023]
Abstract
Peri-implant mucosal integration is becoming a critical aspect for long term implant health and can be triggered the selection of implant components. The aim of this review is therefore to investigate the evidence concerning implant connection and abutment characteristics (abutment materials, design, handling) as predisposing or precipitating factor for peri-implant mucositis and peri-implantitis. Although the evidence that these features can directly predispose/precipitate peri-implant diseases is limited, there are -few- studies showing a potential role of the implant connection, trans-mucosal configuration, and handling in the development of early bone loss and/or peri-implantitis. With bone level implants, conical internal connections (with inherent platform switching) might be preferred over internal flat-flat and external connections to decrease the risk of early bone loss and potentially the risk of peri-implant disease. Moreover, there is a trend suggesting moving the prosthetic interface coronally (to the juxta-mucosal level) as soon as possible to reduce the number of disconnections and to limit the risk of cements remnants. This can be achieved by choosing a tissue-level implant or to place a trans-mucosal abutment (one abutment-one time approach) to optimize the peri-implant soft tissue seal. In absence of evidence for the biocompatibility regarding several restorative materials, biocompatible materials such as titanium or zirconia should be preferred in the trans-mucosal portion. Finally, higher implants (≥2mm) with an emergence angle below 30° seem more favourable. It should however be noted that some of this information is solely based on indirect information (such as early bone loss) and more research is needed before making firm recommendations about abutment choice. [Correction added on 13 March 2023, after first online publication: 'longer implants (≥2mm)' was changed to 'higher implants (≥2mm)' in this version.].
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Affiliation(s)
- Isabelle Laleman
- Department of Periodontology and oro-dental Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
- Dental Biomaterials Research Unit (d-BRU), Faculty of Medicine, University of Liège, Liège, Belgium
| | - France Lambert
- Department of Periodontology and oro-dental Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
- Dental Biomaterials Research Unit (d-BRU), Faculty of Medicine, University of Liège, Liège, Belgium
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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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Ravindran N, Sudhakar U, Mithradas N, Suresh S, Asirvatham SL, J S, Kotaru JL, A B, K R S, B B. Insight Into the Laboratory Diagnosis of Periimplantitis Using Reactive Oxygen Metabolite Levels - A Biochemical Study. Cureus 2023; 15:e41324. [PMID: 37539392 PMCID: PMC10396069 DOI: 10.7759/cureus.41324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Aim The study aims to substantiate the quantitative role of the predominant periodontopathogen (Porphyromonas gingivalis) associated with peri-implantitis and evaluate the reactive oxygen metabolite levels in peri-implantitis patients. Methodology A total of 40 participants were taken from the department of periodontology, Thai Moogambigai Dental College and Hospital, Chennai, and divided into groups I (control) and II (test). Group I included 20 participants with healthy peri-implant tissue, and group II included 20 participants with infected peri-implant tissues. The predominant periodontopathogen was detected by using a quantitative real-time polymerase chain reaction. Samples (gingival crevicular fluid (GCF), saliva, and plasma) were collected, and a biochemical assay was conducted for reactive oxygen metabolites (ROM) analysis in healthy implants (control group) and peri-implantitis conditions (test group). ROM levels of the patients were statistically analyzed. Results The qualitative and quantitative profiles of Porphyromonas gingivalis (P. gingivalis) associated with Peri-implantitis were analyzed, and the levels of ROM in periimplantitis patients were assessed. The study results substantiate the quantitative picture of Porphyromonas gingivalis in the detection of periimplantitis. The saliva and GCF samples showed significant differences in ROM levels between the test and control groups. Conclusion This is one of the few studies to detect the predominant bacterial pathogen associated with peri-implantitis and assess the ROM levels in periimplantitis patients. The study gives a correlation between the periopathogens and ROM levels, thereby facilitating the attainment of the best possible treatment options.
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Affiliation(s)
- Navina Ravindran
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Uma Sudhakar
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Nimisha Mithradas
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Snophia Suresh
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | | | - Steffy J
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Jhansi L Kotaru
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Bakkiya A
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Sundaran K R
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Bhavishya B
- Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
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Ambili R, Nazimudeen NB. Adjunctive benefit of probiotic supplementation along with nonsurgical therapy for peri-implant diseases - A systematic review and meta-analysis. J Indian Soc Periodontol 2023; 27:352-361. [PMID: 37593565 PMCID: PMC10431221 DOI: 10.4103/jisp.jisp_308_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 08/19/2023] Open
Abstract
Peri-implant diseases are prevalent conditions, but a predictable management strategy is still lacking. The objective of the present article was to evaluate the adjunctive benefits of probiotics with nonsurgical therapy in the management of peri-implant diseases. The review protocol was registered in PROSPERO and prepared according to PRISMA guidelines. Randomized controlled clinical trials in patients diagnosed with the peri-implant disease where probiotic was used as an adjunct to nonsurgical therapy were included in the study. The risk difference of percentage reduction in bleeding on probing, plaque accumulation, and mean difference in probing pocket depth reductions at implant level were estimated using a random effect model due to high heterogeneity among studies. Four studies fulfilled the criteria for selection. Two of them presented data on both peri-implantitis and peri-implant mucositis and they were considered separate studies during meta-analysis. Significant reduction in percentage of bleeding on probing was noticed at 1 and 3 months (-0.28 [-0.48, -0.09], P = 0.004 and - 0.19 [-0.35, -0.02], P = 0.03, respectively), but the reduction was not statistically significant at 6 months. Similar results were also observed for plaque accumulation. No statistically significant reduction in probing pocket depth was observed in the probiotic group during any of the re-evaluations. Conclusion Adjunctive therapy of probiotics may improve the efficacy of nonsurgical therapy of peri-implant diseases for up to 3 months. However, moderate certainty was observed for a reduction in bleeding on probing after 1-month re-evaluation alone.
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Affiliation(s)
- R. Ambili
- Department of Periodontics, PMS College of Dental Sciences and Research, Thiruvananthapuram, Kerala, India
| | - Nias Bin Nazimudeen
- Department of Periodontics, PMS College of Dental Sciences and Research, Thiruvananthapuram, Kerala, India
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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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Pergolini D, Palaia G, De Angelis R, Rocchetti F, Podda GM, Tenore G, Del Vecchio A, Relucenti M, Romeo U. SEM Evaluation of Thermal Effects Produced by a 445 nm Laser on Implant Surfaces. Dent J (Basel) 2023; 11:148. [PMID: 37366671 DOI: 10.3390/dj11060148] [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: 03/06/2023] [Revised: 05/11/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023] Open
Abstract
The aim of this in vitro study was to evaluate thermal effects on implant surfaces using a 445 nm diode laser (Eltech K-Laser Srl, Treviso, Italy) with different power settings and irradiation modalities. Fifteen new implants (Straumann, Basel, Switzerland) were irradiated to evaluate surface alteration. Each implant was divided into two zones: the anterior and posterior areas. The anterior coronal areas were irradiated with a distance of 1 mm between the optical fiber and the implant; the anterior apical ones were irradiated with the fiber in contact with the implant. Instead, the posterior surfaces of all of the implants were not irradiated and used as control surfaces. The protocol comprised two cycles of laser irradiation, lasting 30 s each, with a one-minute pause between them. Different power settings were tested: a 0.5 W pulsed beam (T-on 25 ms; T-off 25 ms), a 2 W continuous beam and a 3 W continuous beam. Lastly, through a scanning electron microscopy (SEM) analysis, dental implants' surfaces were evaluated to investigate surface alterations. No surface alterations were detected using a 0.5 W laser beam with a pulsed mode at a distance of 1 mm. Using powers of irradiation of 2 W and 3 W with a continuous mode at 1 mm from the implant caused damage on the titanium surfaces. After the irradiation protocol was changed to using the fiber in contact with the implant, the surface alterations increased highly compared to the non-contact irradiation modality. The SEM results suggest that a power of irradiation of 0.5 W with a pulsed laser light emission mode, using an inactivated optical fiber placed 1 mm away from the implant, could be used in the treatment of peri-implantitis, since no implant surface alterations were detected.
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Affiliation(s)
- Daniele Pergolini
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Gaspare Palaia
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Riccardo De Angelis
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Federica Rocchetti
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Gian Marco Podda
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Gianluca Tenore
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Alessandro Del Vecchio
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Michela Relucenti
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Section of Human Anatomy, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Umberto Romeo
- Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
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Roccuzzo A, Imber JC, Salvi GE, Roccuzzo M. Peri-implantitis as the consequence of errors in implant therapy. Periodontol 2000 2023; 92:350-361. [PMID: 36744582 DOI: 10.1111/prd.12482] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 09/04/2022] [Accepted: 12/22/2022] [Indexed: 02/07/2023]
Abstract
Peri-implantitis is a plaque-associated pathologic condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone. It is a highly prevalent disease, as extensively estimated by large-population, cross-sectional studies. As peri-implant diseases represent opportunistic infections, it is reasonable to assume that nonideal conditions, local and/or general, may favor the progression of peri-implant inflammation. Some of these conditions could be a result of poor planning and/or inadequate execution of any step of the entire process treatment. This article describes the major possible factors in implant therapy that may lead to peri-implantitis. For some of these (ie, inappropriate patient selection, insufficient periodontal therapy, lack of diagnosis and management of peri-implant mucositis, erratic supportive peri-implant/periodontal therapy) there is a good level of evidence, whereas for others (ie, wrong implant placement, poor postoperative care, inadequate prosthetic reconstruction, lack of assessment and management of peri-implant soft-tissue deficiencies) there is little scientific evidence. More research is therefore needed to clearly identify the errors and/or complications possibly leading to peri-implantitis, particularly over the long term.
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Affiliation(s)
- Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Oral and Maxillo-Facial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni Edoardo Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mario Roccuzzo
- Specialist Periodontal Private Practice, Torino, Italy
- Division of Maxillo-facial Surgery, University of Torino, Torino, Italy
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Park L, Kim HS, Jang W, Ji MK, Ryu JH, Cho H, Lim HP. Antibacterial Evaluation of Zirconia Coated with Plasma-Based Graphene Oxide with Photothermal Properties. Int J Mol Sci 2023; 24:ijms24108888. [PMID: 37240234 DOI: 10.3390/ijms24108888] [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: 03/27/2023] [Revised: 05/01/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
The alternative antibacterial treatment photothermal therapy (PTT) significantly affects oral microbiota inactivation. In this work, graphene with photothermal properties was coated on a zirconia surface using atmospheric pressure plasma, and then the antibacterial properties against oral bacteria were evaluated. For the graphene oxide coating on the zirconia specimens, an atmospheric pressure plasma generator (PGS-300, Expantech, Suwon, Republic of Korea) was used, and an Ar/CH4 gas mixture was coated on a zirconia specimen at a power of 240 W and a rate of 10 L/min. In the physiological property test, the surface properties were evaluated by measuring the surface shape of the zirconia specimen coated with graphene oxide, as well as the chemical composition and contact angle of the surface. In the biological experiment, the degree of adhesion of Streptococcus mutans (S. mutans) and Porphyromonas gingivalis (P. gingivalis) was determined by crystal violet assay and live/dead staining. All statistical analyzes were performed using SPSS 21.0 (SPSS Inc., Chicago, IL, USA). The group in which the zirconia specimen coated with graphene oxide was irradiated with near-infrared rays demonstrated a significant reduction in the adhesion of S. mutans and P. gingivalis compared with the group not irradiated. The oral microbiota inactivation was reduced by the photothermal effect on the zirconia coated with graphene oxide, exhibiting photothermal properties.
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Affiliation(s)
- Lydia Park
- Department of Prosthodontics, School of Dentistry, Chonnam National University, 33 Yongbong-ro, Buk-gu, Gwangju 61186, Republic of Korea
| | - Hee-Seon Kim
- Department of Prosthodontics, School of Dentistry, Chonnam National University, 33 Yongbong-ro, Buk-gu, Gwangju 61186, Republic of Korea
| | - Woohyung Jang
- Department of Prosthodontics, School of Dentistry, Chonnam National University, 33 Yongbong-ro, Buk-gu, Gwangju 61186, Republic of Korea
| | - Min-Kyung Ji
- Dental 4D Research Center, Chonnam National University, 33 Yongbong-ro, Buk-gu, Gwangju 61186, Republic of Korea
| | - Je-Hwang Ryu
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Republic of Korea
| | - Hoonsung Cho
- School of Materials Science & Engineering, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Republic of Korea
| | - Hyun-Pil Lim
- Department of Prosthodontics, School of Dentistry, Chonnam National University, 33 Yongbong-ro, Buk-gu, Gwangju 61186, Republic of Korea
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Robles D, Brizuela A, Fernández-Domínguez M, Gil J. Corrosion Resistance and Titanium Ion Release of Hybrid Dental Implants. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16103650. [PMID: 37241275 DOI: 10.3390/ma16103650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/02/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023]
Abstract
One of the strategies for the fight against peri-implantitis is the fabrication of titanium dental implants with the part close to the neck without roughness. It is well known that roughness favors osseointegration but hinders the formation of biofilm. Implants with this type of structure are called hybrid dental implants, which sacrifice better coronal osseointegration for a smooth surface that hinders bacterial colonization. In this contribution, we have studied the corrosion resistance and the release of titanium ions to the medium of smooth (L), hybrid (H), and rough (R) dental implants. All implants were identical in design. Roughness was determined with an optical interferometer and residual stresses were determined for each surface by X-ray diffraction using the Bragg-Bentano technique. Corrosion studies were carried out with a Voltalab PGZ301 potentiostat, using Hank's solution as an electrolyte at a temperature of 37 °C. Open-circuit potentials (Eocp), corrosion potential (Ecorr), and current density (icorr) were determined. Implant surfaces were observed by JEOL 5410 scanning electron microscopy. Finally, for each of the different dental implants, the release of ions into Hank's solution at 37 °C at 1, 7, 14, and 30 days of immersion was determined by ICP-MS. The results, as expected, show a higher roughness of R with respect to L and compressive residual stresses of -201.2 MPa and -20.2 MPa, respectively. These differences in residual stresses create a potential difference in the H implant corresponding to Eocp of -186.4 mV higher than for the L and R of -200.9 and -192.2 mV, respectively. The corrosion potentials and current intensity are also higher for the H implants (-223 mV and 0.069 μA/mm2) with respect to the L (-280 mV and 0.014 μA/mm2 and R (-273 mV and 0.019 μA/mm2). Scanning electron microscopy revealed pitting in the interface zone of the H implants and no pitting in the L and R dental implants. The titanium ion release values to the medium are higher in the R implants due to their higher specific surface area compared to the H and L implants. The maximum values obtained are low, not exceeding 6 ppb in 30 days.
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Affiliation(s)
- Daniel Robles
- Department of Translational Medicine CEU, San Pablo University, Urbanización Montepríncipe, Alcorcón, 28925 Madrid, Spain
- Facultad de Odontología, Universidad Europea Miguel de Cervantes, C/del Padre Julio Chevalier 2, 47012 Valladolid, Spain
| | - Aritza Brizuela
- Facultad de Odontología, Universidad Europea Miguel de Cervantes, C/del Padre Julio Chevalier 2, 47012 Valladolid, Spain
| | - Manuel Fernández-Domínguez
- Department of Oral and Maxillofacial Surgery, Hospital Monteprincipe, University CEU San Pablo, Av. de Montepríncipe s/n, Alcorcón, 28668 Madrid, Spain
| | - Javier Gil
- Bioengineering Institute of Technology, Facultad de Medicina y Ciencias de la Salud, Universidad Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallés, 08195 Barcelona, Spain
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