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Qian SJ, Tsai YW, Koutouzis T, Lai HC, Qiao SC, Kotsakis GA. Impact of surface chemical treatment in surgical regenerative treatment of ligature-induced peri-implantitis: A canine study. J Periodontol 2024. [PMID: 38881046 DOI: 10.1002/jper.23-0634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 03/05/2024] [Accepted: 04/11/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Implant surface decontamination is a critical step in peri-implantitis treatment. The aim of this study was to assess the effect chemotherapeutic agents have on reosseointegration after treatment on ligature-inducted peri-implantitis. METHODS Six male canines had 36 implants placed and ligatures were placed around them for 28 weeks to establish peri-implantitis. The peri-implant defects were randomly treated by 1 of 3 methods: 0.12% chlorhexidine (CHX test group), 1.5% sodium hypochlorite (NaOCl test group), or saline (Control group). Sites treated with NaOCl and CHX were grafted with autogenous bone, and all sites then either received a collagen membrane or not. Histology sections were obtained at 6 months postsurgery to assess percentage of reosseointegration. RESULTS Thirty-five implants were analyzed (CHX: 13; NaOCl: 14; Control:8). NaOCl-treated sites demonstrated reosseointegration with direct bone-to-implant-contact on the previously contaminated surfaces (42% mean reosseointegration), which was significantly higher than Controls (p < 0.05). Correspondingly, clinical improvement was noted with a significant reduction in probing depth from 5.50 ± 1.24 mm at baseline to 4.46 ± 1.70 mm at 6-months postsurgery (p = 0.006). CHX-treated sites demonstrated a nonsignificant reosseointegration of 26% (p > 0.05); however, in the majority of cases, the new bone growth was at a distance from the implant surface without contact. Probing depths did not improve in the CHX group. The use of membrane did not influence reosseointegration or probing depths (all p > 0.05). CONCLUSION Titanium implants with peri-implantitis have the capacity to reosseointegrate following regenerative surgery. However, treatment response is contingent upon the chemotherapeutic agent selection. Additional chemical treatment with 1.5% NaOCl lead to the most favorable results in terms of changes in defect depth and percentage of reosseointegration as compared to CHX, which may hinder reosseointegration.
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Affiliation(s)
- Shu-Jiao Qian
- Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yi-Wen Tsai
- ITI Scholarship Center, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Theofilos Koutouzis
- Department of Periodontics, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Hong-Chang Lai
- Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, China
| | - Shi-Chong Qiao
- Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, China
| | - Georgios A Kotsakis
- ITI Scholarship Center, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
- Department of Oral Biology & Clinical Research Center, Rutgers School of Dental Medicine, Newark, New Jersey, USA
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Liu X, Deng S, Li X, Liu H, Li Z, Wu Y, Luo P, Zhong X, Huang R, Liu R, Wu X, Huang B, Chen Z, Chen Z, Chen S. A Standardized Rat Model to Study Peri-implantitis of Transmucosal Osseointegrated Implants. Biomater Res 2024; 28:0021. [PMID: 38828365 PMCID: PMC11142924 DOI: 10.34133/bmr.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/19/2024] [Indexed: 06/05/2024] Open
Abstract
With the high incidence rate, distinctive implant characteristic and unique infection pattern, peri-implantitis (PI) requires a specially designed implant animal model for the researches on the pathogenesis and treatments. Previous small-animal PI models exhibit variability in implant site selection, design, and surgical procedures resulting in unnecessary tissue damage and less effectivity. Herein, a quantitative-analysis-based standardized rat model for transmucosal PI-related research was proposed. After dissecting the anatomic structures of the rat maxilla, we determined that placing the implant anterior to the molars in the rat maxilla streamlined the experimental period and enhanced animal welfare. We standardized the model by controlling the rat strain, gender, and size. The customized implant and a series of matched surgical instruments were appropriately designed. A clear, step-by-step surgical process was established. These designs ensured the success rate, stability, and replicability of the model. Each validation method confirmed the successful construction of the model. This study proposed a quantitative-analysis-based standardized transmucosal PI rat model with improved animal welfare and reliable procedures. This model could provide efficient in vivo insights to study the pathogenesis and treatments of PI and preliminary screening data for further large-animal and clinical trials.
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Affiliation(s)
- Xingchen Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Shudan Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Xiyan Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Haiwen Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
- Department of Stomatology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Zhixin Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - You Wu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Pu Luo
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Xinyi Zhong
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Ruoxuan Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Runheng Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Xiayi Wu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Baoxin Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Zetao Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Zhuofan Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Shoucheng Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
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Woo HN, Cho YJ, Tarafder S, Lee CH. The recent advances in scaffolds for integrated periodontal regeneration. Bioact Mater 2021; 6:3328-3342. [PMID: 33817414 PMCID: PMC7985477 DOI: 10.1016/j.bioactmat.2021.03.012] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 02/06/2023] Open
Abstract
The periodontium is an integrated, functional unit of multiple tissues surrounding and supporting the tooth, including but not limited to cementum (CM), periodontal ligament (PDL) and alveolar bone (AB). Periodontal tissues can be destructed by chronic periodontal disease, which can lead to tooth loss. In support of the treatment for periodontally diseased tooth, various biomaterials have been applied starting as a contact inhibition membrane in the guided tissue regeneration (GTR) that is the current gold standard in dental clinic. Recently, various biomaterials have been prepared in a form of tissue engineering scaffold to facilitate the regeneration of damaged periodontal tissues. From a physical substrate to support healing of a single type of periodontal tissue to multi-phase/bioactive scaffold system to guide an integrated regeneration of periodontium, technologies for scaffold fabrication have emerged in last years. This review covers the recent advancements in development of scaffolds designed for periodontal tissue regeneration and their efficacy tested in vitro and in vivo. Pros and Cons of different biomaterials and design parameters implemented for periodontal tissue regeneration are also discussed, including future perspectives.
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Affiliation(s)
| | | | - Solaiman Tarafder
- Center for Dental and Craniofacial Research, Columbia University Medical Center, 630 W. 168 St., VC12-212, New York, NY, 10032, USA
| | - Chang H. Lee
- Center for Dental and Craniofacial Research, Columbia University Medical Center, 630 W. 168 St., VC12-212, New York, NY, 10032, USA
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Li Y, Nan X, Zhong TY, Li T, Li A. Treatment of Periodontal Bone Defects with Stem Cells from Inflammatory Dental Pulp Tissues in Miniature Swine. Tissue Eng Regen Med 2019; 16:191-200. [PMID: 30989045 DOI: 10.1007/s13770-018-00175-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 06/04/2018] [Accepted: 07/03/2018] [Indexed: 02/06/2023] Open
Abstract
Background Containing a certain proportion of mesenchymal stem cells, inflammatory dental tissue showed great tissue regeneration potential in recent years. However, whether it is applicable to promote tissue regeneration in vivo remains to be elucidated. Therefore, we evaluated the feasibility of stem cells from inflammatory dental pulp tissues (DPSCs-IPs) to reconstruct periodontal defects in miniature pigs. Methods The autologous pig DPSCs-IPs were first cultured, appraised and loaded onto β-tricalcium phosphate (β-TCP). The compounds were then engrafted into an artificially-created periodontal defect. Three months later, the extent of periodontal regeneration was evaluated. Clinical examination, radiological examination and immunohistochemical staining were used to assess periodontal regeneration. Results The data collectively showed that DPSCs-IPs from miniature pigs expressed moderate to high levels of STRO-1 and CD146 as well as low levels of CD34 and CD45. DPSCs-IPs have osteogentic, adipogenic and chondrogenic differentiation abilities. DPSCs-IPs were engrafted onto β-TCP and regenerated bone to repair periodontal defects by 3 months' post-surgical reconstruction. Conclusion Autologous DPSCs-IPs may be a feasible means of periodontal regeneration in miniature pigs.
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Affiliation(s)
- Ye Li
- 1Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi China.,2Department of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi Wu Road No. 98, Xi'an, 710004 Shaanxi China
| | - Xi Nan
- 2Department of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi Wu Road No. 98, Xi'an, 710004 Shaanxi China
| | - Tian-Yu Zhong
- 3Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi Wu Road No. 98, Xi'an, 710004 Shaanxi China
| | - Tong Li
- 1Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi China.,3Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi Wu Road No. 98, Xi'an, 710004 Shaanxi China
| | - Ang Li
- 1Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi China.,2Department of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi Wu Road No. 98, Xi'an, 710004 Shaanxi China
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BALCI YUCE H. Periodontoloji Alaninda Hayvan Çalışmaları: Deneysel Periodontal ve Periimplant Hastalığın İndüksiyonu. CUMHURIYET DENTAL JOURNAL 2017. [DOI: 10.7126/cumudj.307312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Kantarci A, Hasturk H, Van Dyke TE. Animal models for periodontal regeneration and peri-implant responses. Periodontol 2000 2017; 68:66-82. [PMID: 25867980 DOI: 10.1111/prd.12052] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 11/28/2022]
Abstract
Translation of experimental data to the clinical setting requires the safety and efficacy of such data to be confirmed in animal systems before application in humans. In dental research, the animal species used is dependent largely on the research question or on the disease model. Periodontal disease and, by analogy, peri-implant disease, are complex infections that result in a tissue-degrading inflammatory response. It is impossible to explore the complex pathogenesis of periodontitis or peri-implantitis using only reductionist in-vitro methods. Both the disease process and healing of the periodontal and peri-implant tissues can be studied in animals. Regeneration (after periodontal surgery), in response to various biologic materials with potential for tissue engineering, is a continuous process involving various types of tissue, including epithelia, connective tissues and alveolar bone. The same principles apply to peri-implant healing. Given the complexity of the biology, animal models are necessary and serve as the standard for successful translation of regenerative materials and dental implants to the clinical setting. Smaller species of animal are more convenient for disease-associated research, whereas larger animals are more appropriate for studies that target tissue healing as the anatomy of larger animals more closely resembles human dento-alveolar architecture. This review focuses on the animal models available for the study of regeneration in periodontal research and implantology; the advantages and disadvantages of each animal model; the interpretation of data acquired; and future perspectives of animal research, with a discussion of possible nonanimal alternatives. Power calculations in such studies are crucial in order to use a sample size that is large enough to generate statistically useful data, whilst, at the same time, small enough to prevent the unnecessary use of animals.
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Schwarz F, Sculean A, Engebretson SP, Becker J, Sager M. Animal models for peri-implant mucositis and peri-implantitis. Periodontol 2000 2017; 68:168-81. [PMID: 25867986 DOI: 10.1111/prd.12064] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2014] [Indexed: 11/30/2022]
Abstract
The treatment of infectious diseases affecting osseointegrated implants in function has become a demanding issue in implant dentistry. Since the early 1990s, preclinical data from animal studies have provided important insights into the etiology, pathogenesis and therapy of peri-implant diseases. Established lesions in animals have shown many features in common with those found in human biopsy material. The current review focuses on animal studies, employing different models to induce peri-implant mucositis and peri-implantitis.
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Ramos UD, Suaid FA, Wikesjö UME, Susin C, Taba M, Novaes AB. Comparison between two antimicrobial protocols with or without guided bone regeneration in the treatment of peri-implantitis. A histomorphometric study in dogs. Clin Oral Implants Res 2017; 28:1388-1395. [DOI: 10.1111/clr.12998] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Umberto Demoner Ramos
- Department of Bucco-Maxillo-Facial Surgery and Traumatology, and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirao Preto SP Brazil
| | - Flavia Adelino Suaid
- Department of Bucco-Maxillo-Facial Surgery and Traumatology, and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirao Preto SP Brazil
| | - Ulf M. E. Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration; Dental College of Georgia; Augusta University; Augusta GA USA
| | - Cristiano Susin
- Laboratory for Applied Periodontal & Craniofacial Regeneration; Dental College of Georgia; Augusta University; Augusta GA USA
| | - Mario Taba
- Department of Bucco-Maxillo-Facial Surgery and Traumatology, and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirao Preto SP Brazil
| | - Arthur Belém Novaes
- Department of Bucco-Maxillo-Facial Surgery and Traumatology, and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirao Preto SP Brazil
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Smeets R, Henningsen A, Jung O, Heiland M, Hammächer C, Stein JM. Definition, etiology, prevention and treatment of peri-implantitis--a review. Head Face Med 2014; 10:34. [PMID: 25185675 PMCID: PMC4164121 DOI: 10.1186/1746-160x-10-34] [Citation(s) in RCA: 201] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 08/15/2014] [Indexed: 11/10/2022] Open
Abstract
Peri-implant inflammations represent serious diseases after dental implant treatment, which affect both the surrounding hard and soft tissue. Due to prevalence rates up to 56%, peri-implantitis can lead to the loss of the implant without multilateral prevention and therapy concepts. Specific continuous check-ups with evaluation and elimination of risk factors (e.g. smoking, systemic diseases and periodontitis) are effective precautions. In addition to aspects of osseointegration, type and structure of the implant surface are of importance. For the treatment of peri-implant disease various conservative and surgical approaches are available. Mucositis and moderate forms of peri-implantitis can obviously be treated effectively using conservative methods. These include the utilization of different manual ablations, laser-supported systems as well as photodynamic therapy, which may be extended by local or systemic antibiotics. It is possible to regain osseointegration. In cases with advanced peri-implantitis surgical therapies are more effective than conservative approaches. Depending on the configuration of the defects, resective surgery can be carried out for elimination of peri-implant lesions, whereas regenerative therapies may be applicable for defect filling. The cumulative interceptive supportive therapy (CIST) protocol serves as guidance for the treatment of the peri-implantitis. The aim of this review is to provide an overview about current data and to give advices regarding diagnosis, prevention and treatment of peri-implant disease for practitioners.
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Affiliation(s)
- Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistr, 52, 20246 Hamburg, Germany.
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Torres García-Denche J, Wu X, Martinez PP, Eimar H, Ikbal DJA, Hernández G, López-Cabarcos E, Fernandez-Tresguerres I, Tamimi F. Membranes over the lateral window in sinus augmentation procedures: a two-arm and split-mouth randomized clinical trials. J Clin Periodontol 2013; 40:1043-51. [DOI: 10.1111/jcpe.12153] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2013] [Indexed: 01/03/2023]
Affiliation(s)
- Jesús Torres García-Denche
- Faculty of Dentistry; Universidad Complutense; Madrid Spain
- Private practice; Clinica Dental Alcalá; Madrid Spain
| | - Xixi Wu
- Faculty of Dentistry; McGill University; Montreal QC Canada
| | | | - Hazem Eimar
- Faculty of Dentistry; McGill University; Montreal QC Canada
| | | | | | | | | | - Faleh Tamimi
- Faculty of Dentistry; McGill University; Montreal QC Canada
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Mardas N, Dereka X, Donos N, Dard M. Experimental Model for Bone Regeneration in Oral and Cranio-Maxillo-Facial Surgery. J INVEST SURG 2013; 27:32-49. [DOI: 10.3109/08941939.2013.817628] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Albuquerque C, Morinha F, Requicha J, Martins T, Dias I, Guedes-Pinto H, Bastos E, Viegas C. Canine periodontitis: The dog as an important model for periodontal studies. Vet J 2012; 191:299-305. [DOI: 10.1016/j.tvjl.2011.08.017] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Revised: 08/04/2011] [Accepted: 08/15/2011] [Indexed: 11/24/2022]
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Schwarz F, Iglhaut G, Becker J. Quality assessment of reporting of animal studies on pathogenesis and treatment of peri-implant mucositis and peri-implantitis. A systematic review using the ARRIVE guidelines. J Clin Periodontol 2012; 39 Suppl 12:63-72. [DOI: 10.1111/j.1600-051x.2011.01838.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery; Heinrich Heine University; Düsseldorf; Germany
| | | | - Jürgen Becker
- Department of Oral Surgery; Heinrich Heine University; Düsseldorf; Germany
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Becker ST, Dörfer C, Graetz C, De Buhr W, Wiltfang J, Podschun R. A pilot study: microbiological conditions of the oral cavity in minipigs for peri-implantitis models. Lab Anim 2011; 45:179-83. [DOI: 10.1258/la.2011.010174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
As peri-implantitis is an emerging problem, the development of validated animal models is mandatory. The aim of this pilot study was to provide a first step in describing the normal oral flora of minipigs. In five minipigs, samples of the oral flora were collected with sterile cotton swabs from the buccal gingiva of the lower jaw. Two swabs per animal were collected, followed by bacterial isolation under both aerobe and anaerobe conditions. Microbiological analyses included biochemical tests, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rDNA gene sequence analysis. A total of 61 taxa were detected, 14–21 different bacterial taxa from each minipig. Among the Gram-positive cocci, mainly staphylococcal and streptococcal species were identified. Different Actinomyces species were the most abundant taxa in the group of Gram-positive rods. Among the anaerobic bacteria, the Gram-negative genera Fusobacterium, Bacteroides and Prevotella were the most often observed taxa. This is the first study which begins to describe the normal oral flora in minipigs in cultures to allow for the detection of a broad spectrum. Several bacterial species identified are different from human ones. No specific species for peri-implantitis could be detected in that healthy sample.
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Affiliation(s)
- Stephan T Becker
- Department of Oral and Maxillofacial Surgery, Christian-Albrechts-University Kiel, Arnold-Heller-Str 16, 24105 Kiel, Germany
| | - Christof Dörfer
- Department of Conservative Dentistry and Periodontology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Christian Graetz
- Department of Conservative Dentistry and Periodontology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Wiebke De Buhr
- Department of Cardiovascular Surgery, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery, Christian-Albrechts-University Kiel, Arnold-Heller-Str 16, 24105 Kiel, Germany
| | - Rainer Podschun
- Institute of Infection Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
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Sahrmann P, Attin T, Schmidlin PR. Regenerative treatment of peri-implantitis using bone substitutes and membrane: a systematic review. Clin Implant Dent Relat Res 2011; 13:46-57. [PMID: 19681931 DOI: 10.1111/j.1708-8208.2009.00183.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE This systematic review aimed to assess the available literature for regenerative treatment of peri-implantitis using bone graft substitutes and membranes. METHODS A search in electronic databases was conducted to assess all types of clinical studies treating bone defects derived from peri-implantitis using guided bone regeneration (GBR) techniques. RESULTS During the first screening, 399 titles were identified. Finally, 17 articles reporting on 173 implants were included. The articles mainly focused on radiographic bone fill of the defect. Qualitative measures of "bone fill" were reported: 10.4% of the implants showed complete "bone fill," whereas 85.5% revealed incomplete defect closure. No bone fill was shown in 4.0%. Little information (in 53.2%) was provided regarding the probing depth before or after treatment. Data concerning the inflammatory status of soft tissues were also scarce and only reported in three studies. A large heterogeneity concerning disinfection protocols and regenerative materials used was found. The high percentage of low-quality studies rendered a meta-analysis impossible. CONCLUSION Complete fill of the bony defect using GBR seems not to be a predictable outcome. The mucosal health status is left unconsidered in most studies. Well-controlled trials are needed to determine predictable treatment protocols for the successful regenerative treatment of peri-implantitis using GBR technique.
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Affiliation(s)
- Philipp Sahrmann
- Clinic for Preventive Dentistry, Periodontology and Cariology, Center for Dental and Oral Medicine, University of Zürich, Plattenstrasse 11, Zürich, Switzerland
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Park JB. Treatment of peri-implantitis with deproteinised bovine bone and tetracycline: a case report. Gerodontology 2011; 29:145-9. [PMID: 21457295 DOI: 10.1111/j.1741-2358.2011.00470.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective of this study is to evaluate the use of tetracycline in a patient with peri-implantitis. BACKGROUND Tetracycline is widely used in regeneration procedures owing to its positive effect with bone graft material, regeneration of extraction socket bone and its traditional antibacterial effect. However, there have been limited reports on bone graft procedures combined with tetracycline application in peri-implantitis. MATERIALS AND METHODS The detoxification procedure was performed with chlorhexidine and tetracycline, and the defect area was grafted with a 4:1 volume ratio combination of deproteinised bovine bone mixed with tetracycline. RESULTS Soft tissue healing was uneventful, and the treatment yielded improved clinical results with a reduced probing depth. CONCLUSIONS Tetracycline was used in the treatment of peri-implantitis by burnishing the implant surface and applying tetracycline in conjunction with an osseous graft to the defect area. The treatment of peri-implantitis with tetracycline seemed to show improved clinical results up to the follow-up period.
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Affiliation(s)
- Jun-Beom Park
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, Ann Arbor, MI, USA.
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Mohamed S, Polyzois I, Renvert S, Claffey N. Effect of surface contamination on osseointegration of dental implants surrounded by circumferential bone defects. Clin Oral Implants Res 2010; 21:513-9. [DOI: 10.1111/j.1600-0501.2010.01913.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Romanos G, Ko HH, Froum S, Tarnow D. The use of CO(2) laser in the treatment of peri-implantitis. Photomed Laser Surg 2009; 27:381-6. [PMID: 19569952 DOI: 10.1089/pho.2008.2280] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Different techniques have been used for the treatment of peri-implant defects. However, there are always questions about the issue of reosseointegration. The present paper explores the recent literature on the topic of peri-implantitis therapy, and presents a surgical protocol for implant surface decontamination using the CO(2) laser, grafting of the defect, and coverage with a membrane according to a clinical case. The results appear to be promising and may improve the long-term clinical outcomes of failing dental implants.
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Affiliation(s)
- George Romanos
- Division of Periodontology and General Dentistry, Unit of Laser Dentistry, Eastman Dental Center, University of Rochester, Rochester, NY 14620, USA.
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Assessment of replication of research evidence from animals to humans in studies on peri-implantitis therapy. J Dent 2009; 37:737-47. [DOI: 10.1016/j.jdent.2009.06.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Revised: 05/29/2009] [Accepted: 06/16/2009] [Indexed: 11/21/2022] Open
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22
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Renvert S, Polyzois I, Maguire R. Re-osseointegration on previously contaminated surfaces: a systematic review. Clin Oral Implants Res 2009; 20 Suppl 4:216-27. [DOI: 10.1111/j.1600-0501.2009.01786.x] [Citation(s) in RCA: 173] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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23
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Romanos GE, Gutknecht N, Dieter S, Schwarz F, Crespi R, Sculean A. Laser wavelengths and oral implantology. Lasers Med Sci 2009; 24:961-70. [DOI: 10.1007/s10103-009-0676-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2009] [Accepted: 04/10/2009] [Indexed: 10/20/2022]
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Abstract
OBJECTIVES To review the literature on surgical treatment of peri-implantitis. MATERIAL AND METHODS A search of PubMed and as well as a hand search of articles were conducted. Publications and articles accepted for publication up to November 2007 were included. RESULTS A total of 43 studies were selected for the review. Only 13 of these were studies in humans and only one study directly addressed disease resolution. Thus the available evidence for surgical treatment of peri-implantitis is extremely limited. ANIMAL STUDIES Re-osseointegration can occur on previously contaminated surfaces. The surface characteristics are decisive for regeneration and re-osseointegration. No single surface decontamination method appears to be distinctly superior. Open debridement with surface decontamination can achieve resolution. HUMAN STUDIES Access surgery has been investigated in one study demonstrating that resolution occurred in 58% of the lesions. No single method of surface decontamination (chemical agents, air abrasives and lasers) was found to be superior. The use of regenerative procedures such as bone graft techniques with or without the use of barrier membranes has been reported with various degrees of success. However, it must be stressed that such techniques do not address disease resolution but rather merely attempt to fill the osseous defect.
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Affiliation(s)
- Noel Claffey
- School of Dental Sciences, Trinity College, Dublin, Ireland.
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Liu Y, Zheng Y, Ding G, Fang D, Zhang C, Bartold PM, Gronthos S, Shi S, Wang S. Periodontal ligament stem cell-mediated treatment for periodontitis in miniature swine. Stem Cells 2008; 26:1065-73. [PMID: 18238856 DOI: 10.1634/stemcells.2007-0734] [Citation(s) in RCA: 416] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Periodontitis is a periodontal tissue infectious disease and the most common cause for tooth loss in adults. It has been linked to many systemic disorders, such as coronary artery disease, stroke, and diabetes. At present, there is no ideal therapeutic approach to cure periodontitis and achieve optimal periodontal tissue regeneration. In this study, we explored the potential of using autologous periodontal ligament stem cells (PDLSCs) to treat periodontal defects in a porcine model of periodontitis. The periodontal lesion was generated in the first molars area of miniature pigs by the surgical removal of bone and subsequent silk ligament suture around the cervical portion of the tooth. Autologous PDLSCs were obtained from extracted teeth of the miniature pigs and then expanded ex vivo to enrich PDLSC numbers. When transplanted into the surgically created periodontal defect areas, PDLSCs were capable of regenerating periodontal tissues, leading to a favorable treatment for periodontitis. This study demonstrates the feasibility of using stem cell-mediated tissue engineering to treat periodontal diseases.
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Affiliation(s)
- Yi Liu
- Salivary Gland Disease Center and the Molecular Laboratory for Gene Therapy, Capital Medical University School of Stomatology, Beijing 100050, China
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Wang S, Liu Y, Fang D, Shi S. The miniature pig: a useful large animal model for dental and orofacial research. Oral Dis 2008; 13:530-7. [PMID: 17944668 DOI: 10.1111/j.1601-0825.2006.01337.x] [Citation(s) in RCA: 205] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Compared with small animal models such as rodents, large animal models are superior in many aspects for the study of human diseases and pre-clinical therapies. Since the development of the Minnesota miniature pig in 1949 at the Hormel Institute (USA), miniature pigs have been used as a large animal model in medical studies for scientific, economic, and ethical reasons. The oral maxillofacial region of miniature pigs is similar to that of humans in anatomy, development, physiology, pathophysiology, and disease occurrence. In this review, we describe the anatomical characteristics of the oral maxillofacial system of the miniature pig, established models of oral diseases in this animal, and other uses of the miniature pig in orofacial research.
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Affiliation(s)
- S Wang
- Salivary Gland Disease Center and Molecular Laboratory for Gene Therapy, Capital Medical University School of Stomatology, Beijing, China.
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Shibli JA, Martins MC, Ribeiro FS, Garcia VG, Nociti FH, Marcantonio E. Lethal photosensitization and guided bone regeneration in treatment of peri-implantitis: an experimental study in dogs. Clin Oral Implants Res 2006; 17:273-81. [PMID: 16672022 DOI: 10.1111/j.1600-0501.2005.01167.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The purpose of this study was to evaluate the effect of lethal photosensitization and guided bone regeneration (GBR) on the treatment of ligature-induced peri-implantitis in different implant surfaces. The treatment outcome was evaluated by clinical and histometric methods. A total of 40 dental implants with four different surface coatings (10 commercially pure titanium surface (cpTi); 10 titanium plasma-sprayed (TPS); 10 acid-etched surface; 10 surface-oxide sandblasted) were inserted into five mongrel dogs. After 3 months, the animals with ligature-induced peri-implantitis were subjected to surgical treatment using a split-mouth design. The controls were treated by debridment and GBR, while the test side received an additional therapy with photosensitization, using a GaAlAs diode laser, with a wavelength of 830 nm and a power output of 50 mW for 80 s (4 J/cm2), and sensitized toluidine blue O (100 microg/ml). The animals were sacrificed 5 months after therapy. The control sites presented an earlier exposition of the membranes on all coating surfaces, while the test group presented a higher bone height gain. Re-osseointegration ranged between 41.9% for the cpTi surface and 31.19% for the TPS surface in the test sites; however differences were not achieved between the surfaces. The lethal photosensitization associated with GBR allowed for better re-osseointegration at the area adjacent to the peri-implant defect regardless of the implant surface.
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Affiliation(s)
- Jamil Awad Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
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Schou S, Holmstrup P, Jørgensen T, Skovgaard LT, Stoltze K, Hjørting-Hansen E, Wenzel A. Anorganic porous bovine-derived bone mineral (Bio-Oss) and ePTFE membrane in the treatment of peri-implantitis in cynomolgus monkeys. Clin Oral Implants Res 2003; 14:535-47. [PMID: 12969357 DOI: 10.1034/j.1600-0501.2003.00911.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of the present study was to evaluate the effect of anorganic porous bovine-derived bone mineral (Bio-Oss) and expanded polytetrafluoroethylene (ePTFE) membrane in the treatment of peri-implantitis. A total of 64 implants with a titanium plasma-sprayed (TPS) surface was inserted in eight cynomolgus monkeys (Macaca fascicularis). After a 3-month healing period with plaque control, experimental peri-implantitis characterized by a bone loss of 4-6 mm was induced during a period of 9-18 months. Surgical treatment involving Bio-Oss+membrane, Bio-Oss, membrane, or a conventional flap procedure (control) only was carried out. The animals were sacrificed six months after treatment. Evaluation by clinical parameters, radiography including quantitative digital subtraction radiography, histology, and stereology demonstrated healthy peri-implant tissue irrespective of the applied surgical procedure. However, the amount of re-osseointegration and the total amount of bone (Bio-Oss and regenerated bone) were significantly higher in defects treated with membrane-covered Bio-Oss as compared with the other three treatment procedures. A mean bone-to-implant contact of 36% was obtained within defects treated with membrane-covered Bio-Oss. The corresponding values for the three other treatment procedures were 13-23%. The Bio-Oss particles were in general highly integrated within the regenerated bone, but the particles in the occlusal part of the defects were entirely surrounded by connective tissue irrespective of membrane coverage. The present study demonstrates that surgical treatment involving Bio-Oss covered by an ePTFE membrane is a useful treatment modality of experimental peri-implantitis around implants with a TPS surface in cynomolgus monkeys. However, the treatment outcome is not as encouraging as seen with membrane-covered autogenous bone graft particles documented in a study with same experimental design.
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Affiliation(s)
- Søren Schou
- Departments of Oral and Maxillofacial Surgery, School of Dentistry, University of Copenhagen and University Hospital (Rigshospitalet), Institute of Experimental Clinical Research, University of Aarhus, Aarhus, Denmark.
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Schou S, Holmstrup P, Skovgaard LT, Stoltze K, Hjørting-Hansen E, Gundersen HJG. Autogenous bone graft and ePTFE membrane in the treatment of peri-implantitis. II. Stereologic and histologic observations in cynomolgus monkeys. Clin Oral Implants Res 2003; 14:404-11. [PMID: 12869002 DOI: 10.1034/j.1600-0501.2003.120910.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of the present study was to evaluate the effect of autogenous bone graft particles and expanded polytetrafluoroethylene (ePTFE) membrane in the treatment of peri-implantitis with stereologic and histologic methods. Clinical and radiographic findings are reported elsewhere. Experimental peri-implantitis with a bone loss of 4-6 mm was established during 14-22 months around 64 implants with a titanium plasma-sprayed (TPS) surface in eight cynomolgus monkeys (Macaca fascicularis). The defects were treated with autogenous bone+membrane (B+M), autogenous bone (B), membrane (M), or a conventional flap procedure (control) (C). The animals were killed 6 months after surgery. Healthy peri-implant tissue was established irrespective of the applied treatment procedure. However, the amount of bone (autogenous bone graft particles and regenerated bone) and re-osseointegration were significantly higher in defects treated with B+M as compared with the three other treatment modalities. A mean bone-to-implant contact of 45% was estimated within defects treated with B+M. The corresponding values for the B, M, and C groups were 22, 21, and 14%. The present study therefore demonstrates that autogenous bone graft particles covered by an ePTFE membrane is a useful surgical treatment procedure of experimental peri-implantitis around implants with a TPS surface in cynomolgus monkeys. Obviously, there is a background for long-term evaluation in humans.
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Affiliation(s)
- Søren Schou
- Departments of Oral and Maxillofacial Surgery, School of Dentistry, University of Copenhagen and University Hospital (Rigshospitalet), Denmark.
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Schou S, Holmstrup P, Jørgensen T, Skovgaard LT, Stoltze K, Hjørting-Hansen E, Wenzel A. Implant surface preparation in the surgical treatment of experimental peri-implantitis with autogenous bone graft and ePTFE membrane in cynomolgus monkeys. Clin Oral Implants Res 2003; 14:412-22. [PMID: 12869003 DOI: 10.1034/j.1600-0501.2003.00912.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of the present investigation was to assess the effect of four implant surface preparation methods used in the surgical treatment of experimental peri-implantitis with autogenous bone graft and expanded polytetrafluoroethylene (ePTFE) membrane. The methods were air-powder abrasive unit+citric acid, air-powder abrasive unit, gauze soaked in saline+citric acid, and gauze soaked alternately in chlorhexidine and saline. A total of 64 implants with a titanium plasma-sprayed (TPS) surface was placed in eight cynomolgus monkeys (Macaca fascicularis). After a 3-month period with plaque control, experimental peri-implantitis was induced. A bone loss of 4-6 mm was established after 9-17 months and plaque control was re-implemented. The peri-implantitis defects were surgically exposed, granulation tissue was removed, and each implant surface was prepared by one of the above-mentioned procedures. The defects were then filled with autogenous bone graft particles and covered by an ePTFE membrane. The animals were sacrificed after 6 months. Evaluation by clinical parameters, radiography including quantitative digital subtraction radiography, histology, and stereology did not reveal significant differences between the methods. Almost total bone regeneration and considerable re-osseointegration were obtained irrespective of the method applied. A mean bone-to-implant contact of 39-46% was observed within the defects. Therefore, the present study of implants with a TPS surface in cynomolgus monkeys indicates that the simplest method involving gauze soaked alternately in chlorhexidine and saline should be the preferred implant surface preparation method in the surgical treatment of peri-implantitis involving autogenous bone graft and ePTFE membrane.
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Affiliation(s)
- Søren Schou
- Departments of Oral and Maxillofacial Surgery, School of Dentistry, University of Copenhagen and University Hospital (Rigshospitalet), Denmark.
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Klinge B, Gustafsson A, Berglundh T. A systematic review of the effect of anti-infective therapy in the treatment of peri-implantitis. J Clin Periodontol 2003; 29 Suppl 3:213-25; discussion 232-3. [PMID: 12787221 DOI: 10.1034/j.1600-051x.29.s3.13.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this systematic review was to assess the treatment of peri-implantitis with special emphasis on the role of anti-infective therapy. No randomized controlled clinical trial was available for analysis. Of 145 peri-implant studies initially screened, 21 studies (six human and 15 animal studies) were analysed regarding the outcome of treatment of peri-implantitis. A multitude of treatment regimens, including anti-infective therapy, was reported. The antibiotic regimens varied between studies. No standardized medication protocol was used. Type of antibiotic, dosage, duration and time for initiation of antibiotic treatment were different for all studies, but details were not always reported. A non-medicated control group was reported in one animal experiment only. The outcomes following anti-infective treatment of peri-implantitis are highly variable. The evidence for a consistent and clinically relevant advantage using antibiotics can be questioned in this context. There are to date no data available to support specific treatment protocols. It is suggested that randomized human controlled clinical trials for the treatment of peri-implantitis be initiated.
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Affiliation(s)
- Björn Klinge
- Department of Periodontology, Institute of Odontology, Karolinska Institutet, Huddinge, Sweden.
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Abstract
OBJECTIVES The purpose of the present paper is to review available information on the treatment of peri-implant mucositis and peri-implantitis. MATERIALS AND METHODS The results of animal research and human studies are presented. Proposed strategies for the treatment of peri-implantitis presented in the literature are also included. RESULTS Most of the information accessible at this time derives from case reports. The reports provide evidence that efforts to reduce the submucosal infection may result in short-term improvements of the peri-implant lesion. They also indicate that regenerative procedures in intrabony peri-implant defects can result in the formation of new bone. CONCLUSIONS Several uncertainties remain regarding the treatment of peri-implantitis. Properly conducted long-term follow-ups of consecutively treated cases would seem to be a realistic avenue for accumulation of more information. This may assist in establishing the predictability, magnitude and stability of improvements that can be achieved.
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Shibli JA, Martins MC, Nociti FH, Garcia VG, Marcantonio E. Treatment of ligature-induced peri-implantitis by lethal photosensitization and guided bone regeneration: a preliminary histologic study in dogs. J Periodontol 2003; 74:338-45. [PMID: 12710753 DOI: 10.1902/jop.2003.74.3.338] [Citation(s) in RCA: 119] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of this pilot study was to evaluate the healing potential and reosseointegration in ligature-induced peri-implantitis defects adjacent to various dental implant surfaces following lethal photosensitization. METHODS A total of 36 dental implants with 4 different surface coatings (9 commercially pure titanium surface [CPTi]; 9 titanium plasma-sprayed [TPS]; 9 hydroxyapatite [HA]; and 9 acid-etched [AE]) were inserted in 6 male mongrel dogs 3 months after extraction of mandibular premolars. After a 2-month period of ligature-induced peri-implantitis and 12 months of natural peri-implantitis progression, only 19 dental implants remained. The dogs underwent surgical debridement of the remaining dental implant sites and lethal photosensitization by combination of toluidine blue O (100 microg/ml) and irradiation with diode laser. All exposed dental implant surfaces and bone craters were meticulously cleaned by mechanical means, submitted to photodynamic therapy, and guided bone regeneration (GBR) using expanded polytetrafluoroethylene (ePTFE) membranes. Five months later, biopsies of the implant sites were dissected and prepared for ground sectioning and analysis. RESULTS The percentage of bone fill was HA: 48.28 +/- 15.00; TPS: 39.54 +/- 12.34; AE: 26.88 +/- 22.16; and CPTi: 26.70 +/- 16.50. The percentage of reosseointegration was TPS: 25.25 +/- 11.96; CPTi: 24.91 +/- 17.78; AE: 17.30 +/- 15.41; and HA: 15.83 +/- 9.64. CONCLUSION These data suggest that lethal photosensitization may have potential in the treatment of peri-implantitis.
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Affiliation(s)
- Jamil Awad Shibli
- Department of Periodontology, Dental School of Araraquara, State University of São Paulo, Araraquara, SP, Brazil
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Persson LG, Berglundh T, Lindhe J, Sennerby L. Re-osseointegration after treatment of peri-implantitis at different implant surfaces. An experimental study in the dog. Clin Oral Implants Res 2001; 12:595-603. [PMID: 11737103 DOI: 10.1034/j.1600-0501.2001.120607.x] [Citation(s) in RCA: 124] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Peri-implantitis is a condition that includes soft tissue inflammation and rapid loss of bone. Treatment of peri-implantitis includes both antimicrobial and bone augmenting methods. The question of whether true re-osseointegration may occur following treatment of peri-implantitis is controversial. The aim of this study was to investigate whether the character of the implant surface was of importance for the occurrence of re-osseointegration following treatment of peri-implantitis. Four beagle dogs were used. The mandibular premolars were extracted. After 12 months, 3 ITI(R) solid screw dental implants were placed in each side of the mandible. In the left side, implants with a turned surface (Turned sites) were used, while in the right side implants with a SLA surface (SLA sites) were placed. After 3 months of healing, peri-implantitis was induced by ligature placement and plaque accumulation. When about 50% of the initial bone support was lost, the ligatures were removed. Five weeks later, treatment was initiated. Each animal received tablets of Amoxicillin and Metronidazole for a period of 17 days. Three days after the start of the antibiotic regimen, one implant site (experimental site) in each quadrant was exposed to local therapy. Following flap elevation, the exposed titanium surface was cleaned with the use of cotton pellets soaked in saline. The implants were submerged. Six months later, biopsies were obtained. Treatment resulted in a 72% bone fill of the bone defects at Turned sites and 76% at SLA sites. The amount of re-osseointegration was 22% at Turned sites and 84% at SLA sites. A treatment regimen that included (i) systemic administration of antibiotics combined with (ii) granulation tissue removal and implant surface cleaning resulted in resolution of peri-implantitis and bone fill in adjacent bone defects. Further, while substantial "re-osseointegration" occurred to an implant with a rough surface (SLA), bone growth on a previously exposed smooth surface (Turned) was minimal.
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Affiliation(s)
- L G Persson
- Department of Periodontology, Faculty of Odontology, Göteborg University, Box 450, SE-405 30 Göteborg, Sweden.
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Khoury F, Buchmann R. Surgical therapy of peri-implant disease: a 3-year follow-up study of cases treated with 3 different techniques of bone regeneration. J Periodontol 2001; 72:1498-508. [PMID: 11759861 DOI: 10.1902/jop.2001.72.11.1498] [Citation(s) in RCA: 108] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Advanced peri-implant intrabony defects require comprehensive surgical treatment regimens different from periodontal therapy strategies. The purpose of this longitudinal trial was to evaluate the peri-implant outcomes following guided bone regeneration with 3 treatment protocols. METHODS In 25 patients, 41 peri-implant defects with supporting bone loss >50% of the implant length were treated with flap surgery plus autogenous bone grafts alone (FG) (controls, n = 12) plus non-resorbable (FGM) (test 1, n = 20) or bioabsorbable barriers (FGRM) (test 2, n = 9) and supportive antimicrobial therapy. Following submerged healing, the membranes were removed (FGM), and the peri-implant probing depths (PD), probing bone levels (BL), mobility scores (PT), and intrabony defect height (DH) were radiographically evaluated at baseline, 6 months, and 1 and 3 years post-therapy. RESULTS Non-surgical/anti-infective therapy resulted in a limited improvement of PD scores after 6 months. At the 3-year visit, surgical treatment revealed significant changes from baseline for the controls and both of the test groups for PD: 5.1 +/- 2.7 mm (FG), 5.4 +/- 3.0 mm (FGM), and 2.6 +/- 1.6 mm (FGRM), and for BL: 3.2 +/- 2.4 mm (FG), 3.4 +/- 2.4 mm (FGM), and 2.3 +/- 1.6 mm (FGRM), Mann-Whitney test, P < or = 0.05. The changes for DH and PT were significant only for FG- and FGM-treated subjects. The overall improvement for FGRM-treated patients during the 3-year observation was less marked. However, the differences between the 3 surgical treatment protocols did not affect the treatment outcomes after 3 years. CONCLUSIONS Autogenous bone grafting is an appropriate treatment regimen to augment open crater-formed peri-implant defects. Although certain clinical situations require an additional fixation of barrier membranes, their routine application should be approached with caution.
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Affiliation(s)
- F Khoury
- Department of Oral and Maxillofacial Surgery, Westfalian Wilhelm-University, Münster, Germany.
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Abstract
When compared with any other surgical or prosthodontic procedure, osseointegration has offered the greatest improvement in quality of life for patients who suffer with the effects of an edentulous condition. Results have been dramatic both functionally and from the aspect of patient satisfaction. However, a level of complication and compromise remains that limits overall patient and practitioner satisfaction. This article critically analyzes the existing literature relative to prosthodontic problems and complications of osseointegration for the edentulous patient. An attempt is made to compare the documented frequency of complication versus the perceived potential for complications, including implant failure, prosthesis misfit, component fracture, and screw loosening.
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Affiliation(s)
- T D Taylor
- Department of Prosthodontics, School of Dental Medicine, University of Connecticut Health Center, Farmington, USA
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