Knowledge and Attitude towards Retrograde Peri-Implantitis among Italian Implantologists: A Cross-Sectional Survey

Lateral Peri-Implantitis: Successful Management via Guided Bone Regeneration at Mandibular First Molar Implant

Infections occurring around implants are divided into marginal peri-implantitis and retrograde peri-implantitis (RPI). Marginal peri-implantitis starts in the crestal bone and progresses to the apical portion, and RPI starts in the apical bone and progresses to the coronal portion. However, lateral peri-implantitis (LPI) occurring on the side of the implant body has not yet been reported, and the cause is unclear. This 63-year-old male patient is a case of unusual bone resorption that occurred in the lateral portion of the implant body 26 months after lateral bone augmentation. The origin of LPI was an infection at the site of laterally augmented bone. Rather than implant removal, this report demonstrates an alternative treatment option of guided bone regeneration after the enucleation and detoxification of the implant surface with successful clinical and radiographic results for 2 years.

Evaluating the Knowledge of General Dentist Towards the Management of Peri-Implant Diseases: A Multi-Center, Cross-Sectional Study

Background:

Recently, implants have been widely considered as an option for replacing missing teeth. There are several biological conditions that must be considered for the success of an implant. Failure to satisfy any of these factors may result in complications, such as peri-implantitis or failure of the implant.

Aim:

The aim of this study was to evaluate the general dentist's attitude towards the management of peri-implant diseases in Saudi Arabia.

Methods:

A multicenter cross-sectional electronic-based questionnaire was formulated based on the validated questionnaire from a previous study. It was targeted towards the general dental practitioners in Saudi Arabia. The study sample consisted of 721 general dental practitioners. The questionnaire consisted of 17 questions divided into five sections. Pearson's chi-square test was used for inferential statistical analysis with Holm's correction, for adjusted p-value, the alpha at 95% confidence interval was 0.05, and all values below alpha were considered statistically significant.

Results:

The majority of participants had attended an implant training course (51.2%) while the rest had not (48.7%). The majority of the participants (67.3%) thought they need special instruments for the detection of peri-implantitis but only 29.5% thought they do not need any special instruments for the intended purpose. Most participants (79.3%) said they can identify and differentiate between normal and abnormal soft tissue around an implant, while 6.5% of the respondents could not. More than half of the participants (54.8%) could differentiate between peri-implant mucositis and peri-implantitis, and 19.4% had no idea about this. Amoxicillin & metronidazole was considered as the best and most effective antibiotic by the majority of respondents (76%), while only (5%) of dentists selected ciprofloxacin.

Conclusion:

This study concludes by suggesting that most of the participants have adequate knowledge about peri-implant soft tissue assessment, mechanism of periodontitis and peri-implantitis, its initiation and progression along with its management. Most of the participants found the training courses on peri-implantitis to be efficient. It is recommended to conduct more courses and studies that would aim at understanding the pathogenesis, etiology, diagnosis, and treatment of peri-implant diseases so as to increase awareness among general dentists.

Preparation and characterization of antibacterial and anti-inflammatory hyaluronic acid-chitosan-dexamethasone hydrogels for peri-implantitis repair

Numerous treatment methods for peri-implantitis have been widely used including oral cleaning, traditional metal scraping means, or local antibiotic application. However, to continuously release antibacterial and anti-inflammatory drug in location in situ for effective peri-implantitis repair is still challenging. Herein, an anti-inflammatory drug dexamethasone (DE)-incorporated hyaluronic acid (HA)-chitosan (CT) composite hydrogels system was developed to repair peri-implantitis. The physicochemical characterization and biocompatibility of the hydrogel were evaluated in vitro. The in vivo hydrogels degradation and peri-implantitis repair were assessed in mice. The results showed that the prepared multifunctional hydrogels achieved sustained release, with an equilibrium swelling of 18, and promoted the growth against NIH-3T3 fibroblast cells. The in vitro antibacterial tests showed HA-CT-DE hydrogels can inhibit methicillin-resistant Staphylococcus aureus and Escherichia coli. It down-regulated the expression levels of inflammation factor IL-1β, IL-6 and, TNF-α in peri-implantitis. The prepared HA-CT-DE composite hydrogels with integrated function is promising for the treatment of peri-implantitis.

Endodontic remnants are found more than other radiopacities in proposed implant sites

Background

Foreign bodies may be a cause of concern in dental implant failure.

Purpose

The aim of the present study was to assess the occurrence and to evaluate the types of radiopacities in dental extraction sites using cone beam computed tomography (CBCT).

Materials and methods

The incidence, location, and types of radiopacities were evaluated in 180 CBCT scans.

Results

Different radiopaque structures could be noted in 84 scans. Foreign bodies and remaining roots were frequently seen. Most of the radiopacities were attributed to remaining endodontic filling in upper and lower jaws in 25 scans in different locations. Remaining roots could be detected in 20 scans. Focal and diffuse radiopaque bony lesions were observed in 16 scans. Tissue response in the form of radiolucency could be seen more with endodontic foreign bodies. Tissue reactions to radiopaque filling remnants were seen in 6.11% of cases.

Conclusions

Foreign body remnants, mostly of endodontic fillings, were frequently seen in CBCT in upper and lower jaws. Evidence of tissue reactions to extraction remnants could be found. Endodontic filling remnants could be seen more in the upper jaw. Thorough examination of implant site for the presence of endodontic foreign body remnants should be stressed. Debridement of the extraction socket should be done carefully in endodontically treated teeth.

Awareness and Knowledge of SARS-CoV-2 Infection among Dental Professionals According to the Turkish National Dental Guidelines

The objective of the current survey was to assess the awareness of the dental professionals according to the principals described by the Turkish Dental Association (TDA). A questionnaire including the socio-demographic data, specialties/academic degree, institutions/affiliations, the knowledge about COVID-19, the number of patients examined and dental treatments performed during the COVID-19 pandemic, the knowledge of protection based on the guidelines described by TDA, contamination with COVID-19 and the psychological complaints has been used. A total of 947 (63.1%) dentists enrolled the study. The results showed satisfactory knowledge about the COVID-19 etiology, mode of transmission and the pre-procedural cautions as the majority of them had a fair level of knowledge with significantly higher knowledge among specialized respondents. The participants have also recorded a good judgment towards performing the emergency dental treatment during the current COVID-19 pandemic which corresponds with the guidelines determined by TDA. Considering the updates on the transmission of COVID-19 and protective strategies, there is an urgent need for improvement of dentists’ knowledge about risk assessment via training programs. The incidence of positive testing among dental professionals also necessitates immediately testing of asymptomatic Turkish dental professionals.