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Davó R, Fan S. 20 Years of Clinical Evolution in Zygomatic Implant Rehabilitation: Long-Term Outcomes and Current States. Oral Maxillofac Surg Clin North Am 2024:S1042-3699(24)00061-X. [PMID: 39244495 DOI: 10.1016/j.coms.2024.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
Zygoma implants are an alternative for rehabilitating severe maxillary atrophy. Since 2004, when Prof. Branemark first reported the long-term findings on zygomatic implants using the original intra-sinus approach, various surgical techniques have been introduced. In 2006, an anatomy-guided approach was developed, applying different implant trajectories based on alveolar atrophy levels and sinus concavity. The purpose of this review is to clarify the existing techniques and long-term outcomes of ZI rehabilitation over the past 20 years. Additionally, it aims to enhance the quality of current practices and identify gaps in the understanding of ZI treatment for future studies.
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Affiliation(s)
- Rubén Davó
- Department of Implantology and Maxillofacial Surgery, Vithas Davó Instituto Dental, Hospital Medimar Internacional, C/ Padre Arrupe 20, E-03016 Alicante, Spain.
| | - Shengchi Fan
- Department of Oral and Maxillofacial Surgery, Plastic Operations, University Medical Center Mainz, Mainz, Germany; Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona 08907, Spain
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2
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Mathevosyan D, Hovhannisyan S, Mashinyan K, Khachatryan L, Badalyan A, Hakobyan G. Prosthetic rehabilitation of patients with maxillary oncology defects using zygomatic implants. Int J Implant Dent 2024; 10:31. [PMID: 38856842 PMCID: PMC11164848 DOI: 10.1186/s40729-024-00545-y] [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: 04/13/2024] [Accepted: 05/21/2024] [Indexed: 06/11/2024] Open
Abstract
PURPOSE Prosthetics for patients after oncological resection of the upper jaw is a complex problem associated with the physiological and anatomical separation of the oral cavity and the nasal/paranasal region. This study reports the clinical results of the use of the zygomatic implants for prosthetic rehabilitation in patients with maxillectomy due to upper jaw tumors. MATERIALS AND METHODS The study included 16 patients who underwent prosthetic rehabilitation using a zygomatic implant after maxillectomy period from 2021 to 2023. After the tumor was removed, immediate surgical obturators were placed. Main prosthetic rehabilitation was performed 6-12 months after tumor removal, but before that, a temporary obturator was made and used. Six-twelve months after tumor resection, 1-4 zygomatic implants were inserted into the zygomatic bone unilaterally or bilaterally. A total of 42 zygomatic implants were installed, 2 of which were unsuccessful and were removed in 1 patient. The implants were placed using the surgical guide, which was planned and prepared digitally. RESULTS No postsurgical complications were seen, and the patients were discharged from the hospital after 7-10 days. The patients were able to return to a normal diet (hard food) after just 7 days following surgery, with no further complaints regarding function or pain, apart from the residual edema caused by the intervention. CONCLUSIONS The use of prostheses fixed on zygomatic implants in patients with maxillary defects is an effective method of prosthodontic rehabilitation in complex clinical cases after maxillectomy.
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Affiliation(s)
- Davit Mathevosyan
- Department of Oral and Maxillofacial Surgery, Yerevan State Medical University after M. Heratsi, Yerevan, Abovyan, Armenia
| | - Sergo Hovhannisyan
- Department of Prosthodontics, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Karen Mashinyan
- Department of Prosthodontics, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Levon Khachatryan
- Department Head and Neck Surgery Modern Implant Medicine, Yerevan, Armenia
| | - Aram Badalyan
- Department Head and Neck Surgery, NAIRI Medical Center, Yerevan, Armenia
| | - Gagik Hakobyan
- Department of Oral and Maxillofacial Surgery, Yerevan State Medical University after M. Heratsi, Yerevan, Abovyan, Armenia.
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3
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Abi Rached S, Chakar C, Samarani R, Menassa G, Sembronio S, Pucci R, Calabrese L, Cantore S, Malcangi A, Spirito F, DI Cosola M. Radiographic marginal bone level evaluation around two different tissue-level implant systems: a one-year prospective study. Minerva Dent Oral Sci 2023; 72:298-311. [PMID: 37326504 DOI: 10.23736/s2724-6329.23.04786-1] [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: 06/17/2023]
Abstract
BACKGROUND Marginal bone loss, is a frequently reported variable in the evaluation of dental implants. The primary objective of this study was to evaluate radiographic marginal bone level changes around the two different tissue-level implant systems placed adjacently in the posterior maxilla or mandible. The influence of implant macro-geometry and vertical soft tissue thickness on marginal bone loss were also evaluated. METHODS Seven patients were included in the study and a total of 18 implants were analyzed. Each patient received two different implants placed adjacently in the maxilla or the mandible. The implants used in our study were either Straumann® SP cylindrical implants or JD Octa® tapered implants. During the surgery, vertical soft-tissue thickness was measured with a periodontal probe placed on the top of the bony crest and in the center of the future implant site. Healing abutments were then seated. Three months following implant placement, impressions were taken, and screw-retained metal ceramic prostheses were delivered. Standardized intraoral radiographs were taken immediately after implant placement and one year following implant loading in order to assess marginal bone level changes. RESULTS Results showed a mean marginal bone loss of 0.55±0.5 mm for Straumann® SP implants and 0.39±0.49 mm for JD Octa® implants after one year of loading and the difference was not statistically significant between the two systems. A statistically significant correlation was found between soft tissue thickness and marginal bone loss; in sites with thin mucosal tissues (≤2 mm), there was significantly greater bone loss compared to sites with thick, soft tissues (> 2 mm) in both implants. CONCLUSIONS Radiographic marginal bone loss was not statistically different between the two implant systems at the one-year examination period. Moreover, vertical soft tissue thickness influenced marginal bone loss regardless of the implant system used.
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Affiliation(s)
- Sandrine Abi Rached
- Department of Periodontology, Faculty of Dental Medicine, Cranio-Facial Research Laboratory, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Carole Chakar
- Department of Periodontology, Faculty of Dental Medicine, Cranio-Facial Research Laboratory, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Rawad Samarani
- Department of Periodontology, Faculty of Dental Medicine, Cranio-Facial Research Laboratory, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Gabriel Menassa
- Department of Periodontology, Faculty of Dental Medicine, Cranio-Facial Research Laboratory, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Salvatore Sembronio
- Department of Maxillofacial Surgery, Academic Hospital of Udine, University of Udine, Udine, Italy
| | - Resi Pucci
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Leonardo Calabrese
- Department of Oral Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Stefania Cantore
- Regional Dental Community Service "Sorriso & Benessere - Ricerca e Clinica", Bari, Italy -
| | | | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Michele DI Cosola
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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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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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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Brennand Roper M, Vissink A, Dudding T, Pollard A, Gareb B, Malevez C, Balshi T, Brecht L, Kumar V, Wu Y, Jung R. Long-term treatment outcomes with zygomatic implants: a systematic review and meta-analysis. Int J Implant Dent 2023; 9:21. [PMID: 37405545 DOI: 10.1186/s40729-023-00479-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/09/2023] [Indexed: 07/06/2023] Open
Abstract
PURPOSE The purpose of this study was to perform a systematic review with meta-analysis on the long-term survival rates of zygomatic implants (ZI). ZI success, prostheses survival and success, sinus pathology and patient reported outcomes were also investigated. METHODS Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed. Embase and OvidMedline databases were searched alongside the grey literature. The systematic review was recorded in PROSPERO (CRD42022358024). Studies reporting titanium/titanium alloy ZI survival data, ZI-supported prosthesis data, ZIs directly compared to any other implant therapy including grafted sites, a minimum follow-up time of 3 years and a minimum number of 10 patients were included. All study designs were considered if they met the inclusion criteria. Studies not involving ZIs, ZIs not made from titanium/titanium alloy, a follow-up time of < 3 years or < 10 patients, animal studies and in vitro studies were excluded. Long-term follow-up has not been defined in the literature. A minimum of 3 years follow-up was considered acceptable to capture survival after initial healing, alongside in-function prosthesis data via delayed or immediate load protocols. ZI success, was predominantly defined as ZI survival without biological or neurological complications. Meta-analyses were performed for ZI survival, ZI failure incidence, ZI success, loading protocol, prosthesis survival, and prevalence of sinusitis using random effects models. Descriptive analysis was used for ZI success, prosthesis success and patient reported outcome measures. RESULTS Five hundred and seventy-four titles were identified, of which 18 met the inclusion criteria. Eligible studies included 1349 ZIs in 623 patients. Mean follow-up period was 75.4 months (range 36-141.6). The mean survival of ZIs was 96.2% [95% CI: 93.8; 97.7] at 6 years. Mean survival for delayed loading was 95% [95% CI: 91.7; 97.1] and 98.1% [95% CI: 96.2; 99.0] for immediate loading (p = 0.03). Annual incidence rate of ZI failure was 0.7% [95% CI 0.4; 1.0]. Mean ZI success was 95.7% [95% CI 87.8; 98.6]. Mean prosthesis survival was 94% [95% CI 88.6; 96.9]. Sinusitis prevalence was 14.2% [95% CI 8.8; 22.0] at 5 years. Patients' reported increased satisfaction with ZIs. CONCLUSIONS ZIs have long-term survival comparable to conventional implants. Immediate loading showed a statistically significant increase in survival over delayed loading. Prosthesis survival was similar to that of prostheses supported by conventional implants, with similar complications. Sinusitis was the most frequently encountered biological complication. Patients reported improved outcome measures with ZI use.
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Affiliation(s)
- Matthew Brennand Roper
- Department of Restorative Dentistry, University Hospitals Bristol and Weston Foundation Trust, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY, UK.
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, Universtitair Medisch Centrum Gronigen, Groningen, The Netherlands
| | - Tom Dudding
- Department of Restorative Dentistry, University Hospitals Bristol and Weston Foundation Trust, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY, UK
| | - Alex Pollard
- Department of Restorative Dentistry, University Hospitals Bristol and Weston Foundation Trust, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY, UK
| | - Barzi Gareb
- Department of Oral and Maxillofacial Surgery, Universtitair Medisch Centrum Gronigen, Groningen, The Netherlands
| | - Chantal Malevez
- Department of Oral and Maxillofacial Surgery, Clinique Saint-Jean, Brussels, Belgium
| | | | - Lawrence Brecht
- Division of Prosthodontics and Restorative Dentistry, NYC College of Dentistry, New York City, NY, USA
| | - Vinay Kumar
- Department of Oral and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
| | - Yiqun Wu
- Department of Oral Implantology, Second Dental Center, Ninth People's Hospital Affiliated with Shanghai Jaio Tong University, School of Medicine, Shanghai, China
| | - Ronald Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Grecchi F, D'Ambrogio RG, Stefanelli LV, Grivetto F, Goker F, Del Fabbro M, Schreiber A, Piazza C, Salgarello S, Dosio C, Grecchi E. Guided Zygomatic Implantology for Oral Cancer Rehabilitation: A Case Report. J Clin Med 2023; 12:jcm12113653. [PMID: 37297847 DOI: 10.3390/jcm12113653] [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: 04/26/2023] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Oral rehabilitation after maxillary oncological resection is challenging. This case report presents the rehabilitation of a 65-year-old Caucasian male adenoid cystic carcinoma patient using a myo-cutaneous thigh flap, zygomatic implant placement, and an immediate fixed provisional prosthesis made with computer-aided technologies. The patient presented complaints of asymptomatic enlarged swelling of 5-mm on the right hard hemi-palate. There was an oro-antral communication deriving from a previous local excision. Preoperative radiographs showed the involvement of the right maxilla, maxillary sinus, and nose with a suspect involvement of the maxillary division of the trigeminal nerve. Treatment was planned through a fully digital workflow. A partial maxillectomy was performed endoscopically, and maxilla was reconstructed using an anterolateral thigh free flap. Two zygomatic implants were inserted simultaneously. A provisional fix full-arch prosthesis was manufactured preoperatively through a fully digital workflow and was placed in the operating room. Following post-operative radiotherapy, the patient received a final hybrid prosthesis. During the follow-up period of two years, the patient reported good function, aesthetics, and significant enhancement in quality of life. According to the results of this case, the protocol represented can be a promising alternative for oral cancer patients with large defects, and can lead to an improved quality of life.
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Affiliation(s)
| | - Roberto Giuseppe D'Ambrogio
- Department of Surgical Specialties, Dental Clinic, School of Dentistry, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy
| | | | - Fabrizio Grivetto
- Azienda Ospedaliero Universitaria Maggiore Della Carità Largo Bellini, 28100 Novara, Italy
| | - Funda Goker
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, 20122 Milan, Italy
- Dental and Maxillo-Facial Surgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, 20122 Milan, Italy
- Dental and Maxillo-Facial Surgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Alberto Schreiber
- Department of Surgical Specialties, Ear, Nose and Throat Clinic, School of Dentistry, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy
| | - Cesare Piazza
- Department of Surgical Specialties, Ear, Nose and Throat Clinic, School of Dentistry, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy
| | - Stefano Salgarello
- Department of Surgical Specialties, Dental Clinic, School of Dentistry, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy
| | - Camilla Dosio
- Azienda Ospedaliero Universitaria Maggiore Della Carità Largo Bellini, 28100 Novara, Italy
| | - Emma Grecchi
- Private Practice, Via Boccaccio 34, 20123 Milan, Italy
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8
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Dioguardi M, Cantore S, Scacco S, Quarta C, Sovereto D, Spirito F, Alovisi M, Troiano G, Aiuto R, Garcovich D, Crincoli V, Laino L, Covelli M, Malcangi A, Lo Muzio L, Ballini A, Di Cosola M. From Bench to Bedside in Precision Medicine: Diabetes Mellitus and Peri-Implantitis Clinical Indices with a Short-Term Follow-Up: A Systematic Review and Meta-Analysis. J Pers Med 2022; 12:jpm12020235. [PMID: 35207724 PMCID: PMC8878354 DOI: 10.3390/jpm12020235] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/31/2022] [Accepted: 02/05/2022] [Indexed: 02/04/2023] Open
Abstract
Background and objective: Diabetes mellitus (DM) refers to a group of metabolic disorders characterized by hyperglycemia resulting from impaired secretion or action of insulin. The high levels of glucose in the blood can negatively affect the healing processes through alterations in vascularization, bone remodeling, and with increased susceptibility to infections. Diabetes mellitus is therefore a risk factor not only for many systemic diseases, but also for localized problems such as peri-implantitis. The objective of this systematic review was to identify a clear relationship between peri-implant inflammation indices and glycemic levels, through the investigation of prospective studies that report data on a short-term follow-up period. Our hypothesis was that peri-implant inflammatory indices may already present themselves in a statistically significant way as altered in patients with DM compared to patients without DM. Materials and methods: This review was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Results: More than 992 records were identified in the PubMed, Scopus, and Cochrane Central Register of Controlled Trial electronic databases and only seven studies were included in the meta-analysis. The results of the meta-analysis report worse outcomes in patients with DM, even in the short period of six months, for peri-implatitis inflammation indices, such as Marginal bone loss (standardized (Std). mean difference (MD) 12\6 months 0.81 [0.45, 1.17]\1.82 [0.53, 3.10]), Bleeding on probing (Std. MD 12\6 months 2.84 [1.34, 4.34]\3.44 [1.41, 5.50]), Probing depth (Std. MD 12\6 months 1.14 [0.60, 1.68]\2.24 [0.66, 3.83]), and the plaque index (Std. MD 12 months 2.83 [0.09, 5.57]). Conclusion: The literature linking glycaemic control to peri-implant disease is highly heterogeneous due to lack of consistency of the definition of peri-implantitis and its clinical indicators among studies. Therefore, interpretation of finding and relevance to clinical practice should be considered on individual bases. In the era of personalized medicine, the clinician should utilize individualized information from translational researches and analyze all risk factors to provide the patient with evidence-based treatment options.
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Affiliation(s)
- Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (M.D.); (C.Q.); (D.S.); (F.S.); (G.T.); (L.L.M.); (M.D.C.)
| | - Stefania Cantore
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari “Aldo Moro”, 70124 Bari, Italy;
- Faculty of Dentistry (Fakulteti i Mjekësisë Dentare-FMD), University of Medicine, 1001 Tirana, Albania
- Correspondence: (S.C.); (S.S.); (A.B.)
| | - Salvatore Scacco
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari “Aldo Moro”, 70124 Bari, Italy;
- Correspondence: (S.C.); (S.S.); (A.B.)
| | - Cristian Quarta
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (M.D.); (C.Q.); (D.S.); (F.S.); (G.T.); (L.L.M.); (M.D.C.)
| | - Diego Sovereto
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (M.D.); (C.Q.); (D.S.); (F.S.); (G.T.); (L.L.M.); (M.D.C.)
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (M.D.); (C.Q.); (D.S.); (F.S.); (G.T.); (L.L.M.); (M.D.C.)
| | - Mario Alovisi
- Department of Surgical Sciences, Dental School, University of Turin, 10127 Turin, Italy;
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (M.D.); (C.Q.); (D.S.); (F.S.); (G.T.); (L.L.M.); (M.D.C.)
| | - Riccardo Aiuto
- Department of Biomedical, Surgical, and Dental Science, University of Milan, 20122 Milan, Italy;
| | - Daniele Garcovich
- Department of Dentistry, Universidad Europea de Valencia, Paseo de la Alameda 7, 46010 Valencia, Spain;
| | - Vito Crincoli
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy;
| | - Michele Covelli
- Interuniversity Research Center “Population, Environment and Heath”—CIRPAS, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Annarita Malcangi
- Public Local Health Company (Azienda Sanitaria Locale, ASL), B.A.T, 76125 Trani, Italy;
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (M.D.); (C.Q.); (D.S.); (F.S.); (G.T.); (L.L.M.); (M.D.C.)
| | - Andrea Ballini
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari “Aldo Moro”, 70124 Bari, Italy;
- Faculty of Dentistry (Fakulteti i Mjekësisë Dentare-FMD), University of Medicine, 1001 Tirana, Albania
- School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Correspondence: (S.C.); (S.S.); (A.B.)
| | - Michele Di Cosola
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (M.D.); (C.Q.); (D.S.); (F.S.); (G.T.); (L.L.M.); (M.D.C.)
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Nocini R, Di Cosola M, Cazzolla AP, Cantore S, Castellaneta F, Covelli M. Efficacy of a Non-addictive Nasal Irrigation Based on Sea Salt Enriched with Natural Enzymes among Patients with Sinusitis: An In Vivo, Randomized, Controlled Trial. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Chronic rhinosinusitis (CRS) is a common condition that is defined as inflammation of the nose and paranasal sinuses. Nasal irrigation plays an important role in the treatment of CRS. Evidence from basic research favors hypertonic saline over isotonic saline for mucociliary clearance, but evidence from clinical studies is controversial.
AIM: This study aims to investigate the hypothesis that the use of daily nasal irrigation based on sea salt, enriched with natural enzymes and lysozyme, may be useful in patients with CRS.
PATIENT AND METHODS: Patients (30 men and 30 women) 18–55 years old (mean age 41 ± 3 y.o.), with two episodes of acute sinusitis or one episode of chronic sinusitis per year for 2 consecutive years, were enrolled stratified by sex and age and randomly divided into two groups supplementation: Group A (test) and Group B (control/placebo). Moreover, an exit questionnaire was asked to Group A subjects to report whether their sinus-related quality of life has gotten worse, stayed the same, or improved (scale from 0 to ±100%).
RESULTS: The result showed that in the test group (A) from T0 to T1, a reduction of 17.65% for the symptoms related headache and/or facial pressure and a reduction of the 18.18%, for the symptoms relates to congestion and/or nasal discharge. On the other hand, the control group (B) shown less difference between T0 and T1.
CONCLUSIONS: This study strengthens the argument that the tested formulation is a safe, well-tolerated, long-term therapy that patients with chronic sinonasal complaints can and will use at home with minimal training and follow-up.
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