Surgical Treatment of Severe Peri-Implantitis Using a Round Titanium Brush for Implant Surface Decontamination: A Case Report With Clinical Reentry

Characteristics, level of evidence, and impact of clinical studies on peri-implantitis: 2017 to 2021

BACKGROUND

The level of evidence (LOE) is an important tool in current evidence-based practice and clinical research. However, in clinical studies on peri-implantitis, the present status of the LOE and its association with research impact remains to be determined. The present study aimed to gather the characteristics and LOE of clinical studies on peri-implantitis conducted from 2017 to 2021 and assess the association of the LOE with social and scientific impact.

METHODS

The PubMed database was searched to retrieve clinical studies that evaluated peri-implantitis-related healthcare interventions and were published between 2017 and 2021. A 4-level modified Oxford 2011 LOE tool was used to determine the LOE of these studies. Citation count and Altmetric Attention Scores (AAS) were derived from the Web of Science and Altmetric Explorer, respectively. Multivariate generalized estimation equation (GEE) analysis was conducted to explore relationships between the LOE and citation count, and between the LOE and AAS; the publication year was considered the grouping factor for adjusting for potential clustering effects.

RESULTS

Two hundred and thirty-five studies were considered eligible. The percentages by level from Level-1 to Level-4 were 9.8%, 35.7%, 28.9%, and 25.5%. Multivariable GEE analyses revealed that studies with higher LOE ratings had significantly greater citation counts (p = 0.008). However, no significant association (p = 0.872) was observed between the LOE and AAS.

CONCLUSIONS

From 2017 to 2021, more than 40% of studies published on peri-implantitis each year had high-LOE ratings. High-LOE studies showed a tendency to have greater scientific impact.

A Multi-Element-Doped Porous Bioactive Glass Coating for Implant Applications

Objectives: The objectives of the study were (1) to develop a novel multi-element-doped porous 58S bioactive glass coating for titanium implants and (2) to investigate the physiochemical, cell cytotoxic and antibacterial properties of this novel coating for titanium implants. Methods: This study employed the sol–gel method to develop a silver-, cobalt (II) oxide- and titanium dioxide-doped 58S bioactive glass coating. The surface topography and in vitro bioactivity of the new bioactive glass-coated implants were studied using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy. The surface nanohardness and coating degradation were evaluated using atomic force microscopy (AFM) and inductively coupled plasma atomic emission spectroscopy (ICP-AES), respectively. The cell cytotoxicity was assessed using cell viability of osteoblast-like mouse cells. The antibacterial property was examined using colony-forming units (CFUs) of the implant coating against Porphyromonas gingivalis. Results: The multi-element-doped porous 58S bioactive glass-coated titanium implant was synthesized. SEM showed that calcium phosphate was formed on the novel coating but not on the 58S bioactive glass coating. The mean surface nanohardness of the novel coating and the 58S coating were 124 ± 24 and 50 ± 17 MPa, respectively (p < 0.001). ICP-AES showed that the releases of Si, Ca and P ions of the novel coating were significantly higher than that of a 58S bioactive glass-coated implant. No significant difference in cell cytotoxicity was found between the novel coating and the 58S coating (p > 0.1). The mean CFUs of the novel coating and the conventional coating were 120 × 10⁶ and 49 × 10⁶ /mL. Conclusion: A novel multielement-doped porous bioactive glass coating for titanium implants was developed. The coating displays promising biocompatibility and antibacterial activity. Clinical significance: the coating can be used to improve the clinical success of dental implants for patient care if it shows success in clinical trials.

Salvage of Dental Implant Located in Mandibular Odontogenic Cyst. A Conservative Surgical Treatment Proposal

The aim of this case report was to evaluate the use of Partsch I cystotomy in order to preserve a dental implant located in an odontogenic cyst extended from 3.2 to 4.4. A 50 year-old woman showed a circular, well-defined unilocular radiolucent area, Ø2.5 cm, in the right mandibular region with an oral implant intruding inside it. The overdenture in the mandibular right site showed no clinical mobility. The authors decided to perform a surgical treatment aimed to preserve the implant. The patient underwent Partsch I surgery followed by iodoform gauze insertion replaced weekly for one month, revision of the previous orthograde endodontic treatments, and an acrylic resin obturator prosthesis application for the following two months. The twelve month follow-up showed no clinical mobility of the right lateral mandibular implant prostheses. Radiographical analysis revealed cystic lesion healing and perimplant bone regeneration. This report highlights the opportunity to apply cystotomy when the cyst involves a dental implant and undermines its stability. This possibility is offered by the peculiar clinical scenario where the implant was stabilized by the presence of a previous prosthetic fixation. Our study led to the application of an operative protocol that allowed for the preservation of the implant.

Successful Management of Dental Implants in Postoperative Maxillary Cyst: A Case Report With a 13-Year Follow-Up

The report is presenting a case of implant placement in the postoperative maxillary cyst (POMC) with a follow-up of 13 years. The POMC is a complication associated with various surgical interventions involving maxillary sinus diseases such as Caldwell-Luc operation, orthognathic surgery, and sinus grafting procedures. The lesion of POMC is believed to develop as a result of the changes of ciliated cells or the blockage of ostia inside the maxillary sinus. Two dental implants were placed near the lesion that was later confirmed to be POMC. Of the 2 dental implants placed, one was explanted and the other was successfully managed with surface debridement followed by guided bone regeneration. The removed specimen inclusive of the implant and surrounding tissue was evaluated with clinical photographs, radiographs, and histology and the findings are described in the paper.

Optimal number of implants for complete-arch implant-supported prostheses with a follow-up of at least 5 years: A systematic review and meta-analysis

STATEMENT OF PROBLEM

Consensus is lacking regarding the optimal number of implants for supporting complete-arch prostheses with good survival rates and lower prosthetic complications and marginal bone loss.

PURPOSE

The purpose of this systematic review was to evaluate the influence of the number of implants used for complete-arch prostheses with at least 5 years of follow-up.

MATERIAL AND METHODS

A search was performed in the PubMed/MEDLINE, Scopus, and Cochrane Library databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and was registered in The International Prospective Register of Systematic Reviews (CRD42016048468). The following was the population, intervention, comparison, outcome (PICO) question: Does the number of implants influence the longevity of complete-arch prostheses?

RESULTS

Nineteen studies including 1006 patients with a mean age of 61.44 years were selected for evaluation. The number of implants per jaw ranged between 2 and 9 in the maxilla, mandible, or both jaws. For implant survival rate in complete-arch prostheses with fewer than 5 implants per jaw, the pooled weighted event rate was 1.4% (I²=25.26%; P=.211) and 4.2% (I²=81.35%; P<.001) for complete arches with more than 4 implants per jaw. For the prosthesis survival rate, the pooled weighted event rate for a complete-arch with fewer than 5 implants per jaw was 1.5% (I²=0%; P=.677) and 9% (I²=17.33%; P=.304) for complete arches with more than 4 implants per jaw. For prosthesis complications for complete arches with fewer than 5 implants per jaw, the pooled weighted event rate was 19.9% (I²=93.5%; P<.001) and 24.5% (I²=88.89; P<.001) for complete arches with more than 4 implants per jaw. The mean marginal bone loss for complete arches with fewer than 5 implants per jaw was 1.22 ±0.49 mm (I²=99.46; P<.001) and 1.46 ±0.46 mm (I²=99.6; P <.001) for more than 4 implants per jaw.

CONCLUSIONS

The current systematic review indicated no relationship of the number of implants used to support a complete-arch prosthesis with implant survival rate, prosthesis survival rate, prosthesis complications, or marginal bone loss in studies with follow-up periods of between 5 and 15 years.