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Gkioka M, Rausch-Fan X. Antimicrobial Effects of Metal Coatings or Physical, Chemical Modifications of Titanium Dental Implant Surfaces for Prevention of Peri-Implantitis: A Systematic Review of In Vivo Studies. Antibiotics (Basel) 2024; 13:908. [PMID: 39335082 PMCID: PMC11428254 DOI: 10.3390/antibiotics13090908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 09/08/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024] Open
Abstract
Introduction: Peri-implantitis poses a significant challenge for implant dentistry due to its association with bacterial colonization on implant surfaces and the complexity of its management. This systematic review aims to assess evidence from in vivo studies regarding the antimicrobial efficacy of titanium (Ti) dental implant surfaces following physical/chemical modifications or the application of various metal element coatings in preventing bacterial growth associated with peri-implantitis. Materials and Methods: A literature review was conducted across four scientific databases (PubMed, Embase, Scopus, Web of Science), encompassing in vivo studies published between 2013 and 2024, and 18 reports were included in the systematic review. Results: The findings suggest that titanium dental implant surfaces, following physical/chemical modifications and metal element coatings, exhibit antimicrobial effects against bacteria associated with peri-implantitis in humans and various animal models. Conclusions: The reviewed studies indicated a reduction in bacterial colonization, diminished biofilm formation, and decreased signs of inflammation in the peri-implant tissues, which provides evidence that physical/chemical alterations on titanium dental implant surfaces or metal element coatings, like silver (Ag), zinc (Zn), magnesium (Mg), and copper (Cu), demonstrate antimicrobial properties in in vivo studies. However, caution is warranted when translating findings to clinical practice due to methodological disparities and high bias risks. Further larger-scale clinical trials are imperative to assess their long-term efficacy and validate their clinical applicability.
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Affiliation(s)
- Maria Gkioka
- Department of Dentistry, Division of Oral and Maxillofacial Surgery, Vaud University Hospital Center, 1005 Lausanne, Switzerland
| | - Xiaohui Rausch-Fan
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, 1090 Vienna, Austria;
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2
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Bischof FM, Mathey AA, Stähli A, Salvi GE, Brägger U. Survival and complication rates of tooth- and implant-supported restorations after an observation period up to 36 years. Clin Oral Implants Res 2024. [PMID: 39177417 DOI: 10.1111/clr.14351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/02/2024] [Accepted: 07/29/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Tooth- and implant-supported fixed dental prostheses are well-documented and aesthetic treatment alternatives, and after a comprehensive periodontal treatment, a protocol with a good long-term prognosis if the maintenance program is strictly followed. AIM To reexamine a pre-existing patient cohort in order to obtain estimated long-term survival and complication outcomes of fixed dental prostheses. MATERIALS AND METHODS For this study, patients treated with fixed dental prostheses between 1978 and 2002 were reexamined between 2019 and 2020. The restorations were divided in single crowns and fixed dental prostheses supported by teeth (TSC, FPTDP) and implants (ISC, FPIDP). Survival and complication rates were obtained. Kaplan-Meier functions were used to model complication probabilities, and average hazard ratios of different strata were compared using weighted Cox regression. RESULTS The mean observation time of 40 patients and 223 reconstructions was 20.3 (±9.7, 1.2-36.2) years. The estimated survival rates were 84% (CI: 77%-92%) for TSC, 63% (CI: 51%-79%) for FPTDP, 87% (CI: 71%-100%) for ISC, and 64% (CI: 34%-100%) for FPIDP after 25 years. Biological complications included carious lesions (10.6%), periodontitis (7.9%), and peri-implantitis (6.8%). Technical complications included chipping (20.2%) and loss of retention (10.8%). CONCLUSION Biological complications lead to abutment loss in more than two-thirds of cases, regardless of the type of abutment (tooth or implant). Technical complications are less associated with abutment loss than biological complications.
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Affiliation(s)
- Frank M Bischof
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ayse A Mathey
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Erduran NE, Guncu GN, Akman AC, Acar B, Pinar A, Karabulut E, Nohutcu RM. Evaluation of the effect of adjunctive diode laser application on peri-implant crevicular fluid biomarker levels: a randomized controlled trial. Clin Oral Investig 2024; 28:459. [PMID: 39080143 PMCID: PMC11289239 DOI: 10.1007/s00784-024-05855-4] [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: 05/21/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVES To assess both the clinical and immunological effectiveness of diode laser therapy when used as an adjunct to non-surgical mechanical therapy in managing peri-implantitis. MATERIALS AND METHODS A cohort of 27 participants, comprising 21 females and 6 males, agreed to take part in this investigation. 37 dental implants with peri-implantitis diagnosis were randomly allocated to either the laser group (n = 19) or the control group (n = 18). Evaluation of peri-implant clinical parameters and collection peri-implant crevicular fluid (PICF) samples occurred at baseline, as well as at 3 and 6-month follow-up intervals. The level of various biomarkers (TWEAK, IL-1β, sclerostin, IL-17, RANKL, OPG and IL-10) within the PICF were quantified using enzyme-linked immunosorbent assay. RESULTS Significant time-dependent decreases in clinical and biochemical parameters were detected in both groups compared to the baseline. There were marked differences between the groups in terms of periodontal parameters, except probing depth, and IL-1β, IL-17, sclerostin levels in PICF at 3rd month follow-up. However, no statistically significant difference was detected at 6th month. CONCLUSIONS Diode laser seems to be a reliable tool as an adjunct for supporting the nonsurgical mechanical treatment during the early stages of peri-implantitis. Furthermore, the findings suggest that IL-17, sclerostin and IL-1β may serve as promising biomarkers for assessing efficacy of peri-implantitis treatment. CLINICAL RELEVANCE Based on these outcomes, clinicians may consider the application of adjunctive use of diode laser to non-surgical peri-implantitis treatment to achieve better clinical and immunological improvements than nonsurgical peri-implantitis therapy alone in just early healing period. However, it should be noted that there was no difference between the two methods in the long term.
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Affiliation(s)
- Nazan Ece Erduran
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, TR-06230, Turkey
| | - Guliz N Guncu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, TR-06230, Turkey.
| | - Abdullah C Akman
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, TR-06230, Turkey
| | - Buket Acar
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, TR-06230, Turkey
| | - Asli Pinar
- Department of Biochemistry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Erdem Karabulut
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Rahime M Nohutcu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, TR-06230, Turkey
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Konishi D, Hirata E, Takano Y, Maeda Y, Ushijima N, Yudasaka M, Yokoyama A. Near-infrared light-boosted antimicrobial activity of minocycline/hyaluronan/carbon nanohorn composite toward peri-implantitis treatments. NANOSCALE 2024; 16:13425-13434. [PMID: 38913014 DOI: 10.1039/d4nr01036a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Dental implant therapy is a reliable treatment for replacing missing teeth. However, as dental implants become more widely used, peri-implantitis increasingly has become a severe complication, making successful treatment more difficult. As a result, the development of effective drug delivery systems (DDSs) and treatments for peri-implantitis are urgently needed. Carbon nanohorns (CNHs) are carbon nanomaterials that have shown promise for use in DDSs and have photothermal effects. The present study exploited the unique properties of CNHs to develop a phototherapy employing a near-infrared (NIR) photoresponsive composite of minocycline, hyaluronan, and CNH (MC/HA/CNH) for peri-implantitis treatments. MC/HA/CNH demonstrated antibacterial effects that were potentiated by NIR-light irradiation, a property that was mediated by photothermal-mediated drug release from HA/CNH. These antibacterial effects persisted even following 48 h of dialysis, a promising indication for the clinical use of this material. We propose that the treatment of peri-implantitis using NIR and MC/HA/CNH, in combination with surgical procedures, might be employed to target relatively deep affected areas in a timely and efficacious manner. We envision that this innovative approach will pave the way for future developments in implant therapy.
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Affiliation(s)
- Daisuke Konishi
- Department of Oral Functional Prosthodontics, Faculty of Dental Medicine, Graduate school of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Sapporo 060-8586, Japan.
| | - Eri Hirata
- Department of Oral Functional Prosthodontics, Faculty of Dental Medicine, Graduate school of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Sapporo 060-8586, Japan.
| | - Yuta Takano
- Research Institute for Electronic Science, Hokkaido University, Kita-20, Nishi-10, Sapporo 001-0020, Japan.
- Graduate School of Environmental Science, Hokkaido University, Kita-10, Nishi-5, Sapporo 060-0810, Japan
| | - Yukari Maeda
- Department of Oral Functional Prosthodontics, Faculty of Dental Medicine, Graduate school of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Sapporo 060-8586, Japan.
| | - Natsumi Ushijima
- Support Section for Education and Research, Faculty of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan
| | - Masako Yudasaka
- Nanomaterials Research Institute (NMRI), National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba Central 5, 1-1-1 Higashi, Tsukuba, Ibaraki 305-8565, Japan
- Meijo University, Graduate School of Science and Technology, 1-501, Shiogamaguchi, Tenpaku, Nagoya 468-8502, Japan
| | - Atsuro Yokoyama
- Department of Oral Functional Prosthodontics, Faculty of Dental Medicine, Graduate school of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Sapporo 060-8586, Japan.
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Bellon B, Pippenger B, Stähli A, Degen M, Parisi L. Cementum and enamel surface mimicry influences soft tissue cell behavior. J Periodontal Res 2024. [PMID: 38828886 DOI: 10.1111/jre.13295] [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: 04/03/2024] [Revised: 05/06/2024] [Accepted: 05/17/2024] [Indexed: 06/05/2024]
Abstract
AIMS To test whether titanium surface roughness disparity might be used to specifically guide the behavior of gingiva fibroblasts and keratinocytes, thereby improving the quality of soft tissue (ST) integration around abutments. METHODS Titanium discs resembling the roughness of enamel (M) or cementum (MA) were created with normal or increased hydrophilicity and used as substrates for human fibroblasts and keratinocytes. Adhesion and proliferation assays were performed to assess cell-type specific responses upon encountering the different surfaces. Additionally, immunofluorescence and qPCR analyses were performed to study more in depth the behavior of fibroblasts and keratinocytes on MA and M surfaces, respectively. RESULTS While enamel-like M surfaces supported adhesion, growth and a normal differentiation potential of keratinocytes, cementum-emulating MA surfaces specifically impaired the growth of keratinocytes. Vice versa, MA surfaces sustained regular adhesion and proliferation of fibroblasts. Yet, a more intimate adhesion between fibroblasts and titanium was achieved by an increased hydrophilicity of MA surfaces, which was associated with an increased expression of elastin. CONCLUSION The optimal titanium implant abutment might be achieved by a bimodal roughness design, mimicking the roughness of enamel (M) and cementum with increased hydrophilicity (hMA), respectively. These surfaces can selectively elicit cell responses favoring proper ST barrier by impairing epithelial downgrowth and promoting firm adhesion of fibroblasts.
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Affiliation(s)
- Benjamin Bellon
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Preclinical and Translational Research, Institut Straumann AG, Basel, Switzerland
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zürich, Switzerland
| | - Benjamin Pippenger
- Preclinical and Translational Research, Institut Straumann AG, Basel, Switzerland
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Martin Degen
- Laboratory for Oral Molecular Biology, Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Ludovica Parisi
- Laboratory for Oral Molecular Biology, Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
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Öztürk A, Tosun E, Meral SE, Baştan FE, Üstel F, Kan B, Avcu E. The effects of diode and Er:YAG laser applications on the surface topography of titanium grade 4 and titanium zirconium discs with sand-blasted and acid-etched (SLA) surfaces. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101680. [PMID: 37951501 DOI: 10.1016/j.jormas.2023.101680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Laser application for the treatment of peri‑implantitis provides a variety of advantages; however, depending on the laser type and parameters, it may also have adverse effects on the implant surface qualities. This study's objective is to assess the effects of laser type and parameters on the surface properties of two different titanium-based implant materials: titanium Grade 4 (Ti-Grade 4) and titanium zirconium (Ti-Zr) discs with sand-blasted and acid-etched (SLA) surfaces under in vitro conditions. MATERIAL & METHOD Sand-blasted and acid-etched discs made of titanium grade 4 (Ti-Grade 4) and titanium zirconium (Ti-Zr) were treated using 808 nm AlGaAs (diode) and 2940 nm Er:YAG lasers with varying parameters (i.e., diode laser in continuous wave mode, Er:YAG in short pulse mode, and Er:YAG in variable square pulse mode with four different doses). Then, the surface morphology and topography of the treated discs were characterized using scanning electron microscopy and optical profilometry. RESULTS The 3D surface topographies of discs treated with a high power Er:YAG laser displayed irregular peaks and deep valleys, indicating surface deterioration. The average surface roughness values (Sa) of both discs varied with laser type and parameters (3.55-4.80 µm for Ti-Grade 4 versus 3.25-4.5 µm for Ti-Zr). With diode laser applications, the topography features of the discs were preserved despite a small number of irregular valleys and peaks. However, the surface morphologies of the discs were dramatically altered by erosion and local melting because of the Er:YAG laser treatment. CONCLUSION Diode laser application appears to be the most reliable method for treating peri‑implantitis, as diode laser-treated implants retained their overall surface quality despite a small number of irregular peaks and valleys.
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Affiliation(s)
- Anıl Öztürk
- DDS, Oral and Maxillofacial Surgery, İstanbul, Turkey
| | - Emre Tosun
- DDS, Hacettepe University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara, Turkey
| | - Salih Eren Meral
- DDS, Hacettepe University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara, Turkey.
| | - Fatih Erdem Baştan
- Sakarya University, Engineering Faculty, Department of Metallurgy and Materials, Engineering, Thermal Spray Research and Development Laboratory, 54187, Sakarya, Turkey
| | - Fatih Üstel
- Sakarya University, Engineering Faculty, Department of Metallurgy and Materials Engineering, Thermal Spray Research and Development Laboratory, 54187, Sakarya, Turkey
| | - Bahadır Kan
- DDS, Okan University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, İstanbul, Turkey
| | - Egemen Avcu
- Kocaeli University, Ford Otosan İhsaniye Automotive Vocational School, Machine and Metal Technologies, Surface Treatment Laboratory, 41680, Kocaeli, Turkey.
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Monje A, Galindo-Fernández P, Nart J. Supportive therapy following peri-implantitis treatment: A retrospective study on compliance. Clin Oral Implants Res 2024; 35:621-629. [PMID: 38530213 DOI: 10.1111/clr.14257] [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: 08/08/2023] [Revised: 02/07/2024] [Accepted: 03/16/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND The compliance rate with supportive therapy following peri-implantitis treatment (SPIT) remains unknown. The present retrospective study was carried out to assess the compliance rate and the factors influencing compliance in a private practice setting. MATERIALS AND METHODS Patients were divided into three groups according to compliance rate: regular compliance (RC ≥2 SPIT/year), erratic compliance (EC <2 SPIT/year), and non-compliance (NC <1 SPIT/year). Overall, 17 patient- (n = 8) and site-related variables (n = 9) were explored as potential confounders of compliance. The Chi2 test was applied to assess the association between categorical variables and determine the odds ratio (OR). RESULTS The study comprised 159 patients restored with 1075 implants, of which 469 were treated for peri-implantitis and met the inclusion criteria. A total of 57.2% were RC, 25.8% EC, and 17% NC. The multivariate analysis showed that smoking and grade C periodontitis reduced the likelihood of RC (OR = 0.28, p < .001) when compared to complete edentulism or non-smoking. Moreover, age demonstrated being associated with follow-up when SPIT was interrupted in EC and NC (OR = 0.94, p = .007). CONCLUSION Comprehensive information, provided prior to peri-implantitis treatment, regarding the importance of adhering to SPIT after peri-implantitis treatment to achieve/maintain peri-implant health, resulted in ~60% regular compliance rate (NCT05772078).
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Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
| | | | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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Roccuzzo M, Mirra D, Roccuzzo A. Surgical treatment of peri-implantitis. Br Dent J 2024; 236:803-808. [PMID: 38789758 PMCID: PMC11126382 DOI: 10.1038/s41415-024-7405-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/22/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024]
Abstract
As utilisation of dental implants continues to rise, so does the incidence of biological complications. When peri-implantitis has already caused extensive bone resorption, the dentist faces the dilemma of which therapy is the most appropriate to maintain the implant. Since non-surgical approaches of peri-implantitis have shown limited effectiveness, the present paper describes different surgical treatment modalities, underlining their indications and limitations. The primary goal in the management of peri-implantitis is to decontaminate the surface of the infected implant and to eliminate deep peri-implant pockets. For this purpose, access flap debridement, with or without resective procedures, has shown to be effective in a large number of cases. These surgical treatments, however, may be linked to post-operative recession of the mucosal margin. In addition to disease resolution, reconstructive approaches also seek to regenerate the bone defect and to achieve re-osseointegration.
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Affiliation(s)
- Mario Roccuzzo
- Private Practice, Torino, Italy; Division of Maxillofacial Surgery, University of Torino, Italy; Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.
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Cao N, Wan Z, Chen D, Tang L. Deciphering peri-implantitis: Unraveling signature genes and immune cell associations through bioinformatics and machine learning. Medicine (Baltimore) 2024; 103:e37862. [PMID: 38640305 PMCID: PMC11030017 DOI: 10.1097/md.0000000000037862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/16/2024] [Accepted: 03/20/2024] [Indexed: 04/21/2024] Open
Abstract
Early diagnosis of peri-implantitis (PI) is crucial to understand its pathological progression and prevention. This study is committed to investigating the signature genes, relevant signaling pathways and their associations with immune cells in PI. We analyzed differentially expressed genes (DEGs) from a PI dataset in the gene expression omnibus database. Functional enrichment analysis was conducted for these DEGs. Weighted Gene Co-expression Network Analysis was used to identify specific modules. Least absolute shrinkage and selection operator and support vector machine recursive feature elimination were ultimately applied to identify the signature genes. These genes were subsequently validated in an external dataset. And the immune cells infiltration was classified using CIBERSORT. A total of 180 DEGs were screened from GSE33774. Weighted Gene Co-expression Network Analysis revealed a significant association between the MEturquoise module and PI (cor = 0.6, P < .0001). Least absolute shrinkage and selection operator and support vector machine recursive feature elimination algorithms were applied to select the signature genes, containing myeloid-epithelial-reproductive tyrosine kinase, microfibrillar-associated protein 5, membrane-spanning 4A 4A, tribbles homolog 1. In the validation on the external dataset GSE106090, all these genes achieved area under curve values exceeding 0.95. GSEA analysis showed that these genes were correlated with the NOD-like receptor signaling pathway, metabolism of xenobiotics by cytochrome P450, and arachidonic acid metabolism. CIBERSORT revealed elevated levels of macrophage M2 and activated mast cells in PI. This study provides novel insights into understanding the molecular mechanisms of PI and contributes to advancements in its early diagnosis and prevention.
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Affiliation(s)
- Ning Cao
- Department of Implant Dentistry, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of the Rehabilitation and Reconstruction of Oral and Maxillofacial Research, Nanning, China
- Key Laboratory of Research and Application of Stomatological Equipment (College of Stomatology, Hospital of Stomatology, Guangxi Medical University), Education Department of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, China
| | - Ziwei Wan
- Guangxi Key Laboratory of the Rehabilitation and Reconstruction of Oral and Maxillofacial Research, Nanning, China
- Key Laboratory of Research and Application of Stomatological Equipment (College of Stomatology, Hospital of Stomatology, Guangxi Medical University), Education Department of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, China
| | - Donghui Chen
- Department of Implant Dentistry, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of the Rehabilitation and Reconstruction of Oral and Maxillofacial Research, Nanning, China
- Key Laboratory of Research and Application of Stomatological Equipment (College of Stomatology, Hospital of Stomatology, Guangxi Medical University), Education Department of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, China
| | - Li Tang
- Department of Implant Dentistry, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of the Rehabilitation and Reconstruction of Oral and Maxillofacial Research, Nanning, China
- Key Laboratory of Research and Application of Stomatological Equipment (College of Stomatology, Hospital of Stomatology, Guangxi Medical University), Education Department of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
- Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, China
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Boone K, Tjokro N, Chu KN, Chen C, Snead ML, Tamerler C. Machine learning enabled design features of antimicrobial peptides selectively targeting peri-implant disease progression. FRONTIERS IN DENTAL MEDICINE 2024; 5:1372534. [PMID: 38846578 PMCID: PMC11155447 DOI: 10.3389/fdmed.2024.1372534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Peri-implantitis is a complex infectious disease that manifests as progressive loss of alveolar bone around the dental implants and hyper-inflammation associated with microbial dysbiosis. Using antibiotics in treating peri-implantitis is controversial because of antibiotic resistance threats, the non-selective suppression of pathogens and commensals within the microbial community, and potentially serious systemic sequelae. Therefore, conventional treatment for peri-implantitis comprises mechanical debridement by nonsurgical or surgical approaches with adjunct local microbicidal agents. Consequently, current treatment options may not prevent relapses, as the pathogens either remain unaffected or quickly re-emerge after treatment. Successful mitigation of disease progression in peri-implantitis requires a specific mode of treatment capable of targeting keystone pathogens and restoring bacterial community balance toward commensal species. Antimicrobial peptides (AMPs) hold promise as alternative therapeutics through their bacterial specificity and targeted inhibitory activity. However, peptide sequence space exhibits complex relationships such as sparse vector encoding of sequences, including combinatorial and discrete functions describing peptide antimicrobial activity. In this paper, we generated a transparent Machine Learning (ML) model that identifies sequence-function relationships based on rough set theory using simple summaries of the hydropathic features of AMPs. Comparing the hydropathic features of peptides according to their differential activity for different classes of bacteria empowered predictability of antimicrobial targeting. Enriching the sequence diversity by a genetic algorithm, we generated numerous candidate AMPs designed for selectively targeting pathogens and predicted their activity using classifying rough sets. Empirical growth inhibition data is iteratively fed back into our ML training to generate new peptides, resulting in increasingly more rigorous rules for which peptides match targeted inhibition levels for specific bacterial strains. The subsequent top scoring candidates were empirically tested for their inhibition against keystone and accessory peri-implantitis pathogens as well as an oral commensal bacterium. A novel peptide, VL-13, was confirmed to be selectively active against a keystone pathogen. Considering the continually increasing number of oral implants placed each year and the complexity of the disease progression, prevalence of peri-implant diseases continues to rise. Our approach offers transparent ML-enabled paths towards developing antimicrobial peptide-based therapies targeting the changes in the microbial communities that can beneficially impact disease progression.
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Affiliation(s)
- Kyle Boone
- Institute for Bioengineering Research, University of Kansas, Lawrence, KS, United States
- Department of Mechanical Engineering, University of Kansas, Lawrence, KS, United States
| | - Natalia Tjokro
- Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry of USC, University of Southern California, Los Angeles, CA, United States
| | - Kalea N. Chu
- Institute for Bioengineering Research, University of Kansas, Lawrence, KS, United States
- Bioengineering Program, University of Kansas, Lawrence, KS, United States
| | - Casey Chen
- Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry of USC, University of Southern California, Los Angeles, CA, United States
| | - Malcolm L. Snead
- Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry of USC, University of Southern California, Los Angeles, CA, United States
- Bioengineering Program, University of Kansas, Lawrence, KS, United States
| | - Candan Tamerler
- Institute for Bioengineering Research, University of Kansas, Lawrence, KS, United States
- Department of Mechanical Engineering, University of Kansas, Lawrence, KS, United States
- Bioengineering Program, University of Kansas, Lawrence, KS, United States
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11
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Jia P, Tang Y, Niu L, Qiu L. Clinical and radiographic outcomes of a combined surgery approach to treat peri-implantitis. Int J Oral Maxillofac Surg 2024; 53:333-342. [PMID: 38154998 DOI: 10.1016/j.ijom.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 12/30/2023]
Abstract
Peri-implant infra-bony defects are difficult to treat, and data on the management of peri-implantitis are lacking. The aim of this study was to evaluate the effect of a combined surgical approach to manage peri-implantitis: implantoplasty with xenogeneic bone grafting and a concentrated growth factor membrane. Two independent examiners analysed the medical records and radiographs taken before surgery and at the last follow-up. Data were analysed at the implant level; some patient-level data (age, sex, smoking habit) were also considered. Linear regression analysis with generalized estimating equations (GEE) was used to explore the effect of variables of interest (including marginal bone level (MBL)) on implantitis treatment success and resolution rates. The effect of the prosthesis type on postoperative clinical and radiographic parameters was also explored by GEE, with adjustment for age, sex, tooth site, location, follow-up duration, and implant length (model IV including all). Thirty patients with 72 implants were investigated. The implant survival rate was 100% over a mean observation period of 3.3 years (range 2-11 years). The treatment success rate (bone loss <0.5 mm, no bleeding on probing (BOP), no suppuration, probing depth (PD) < 5 mm) was higher in females than males (50% vs 19.0%; P = 0.008). At the last postoperative follow-up, the MBL (1.51 ± 1.07 vs 4.01 ± 1.13 mm), PD (3.61 ± 0.84 vs 6.54 ± 1.01 mm), and BOP (23.38 ± 23.18% vs 79.17 ± 15.51%) were significantly reduced when compared to pre-surgery values (all P < 0.001). Furthermore, a significantly higher PD reduction (β = -1.10 mm, 95% confidence interval -1.97 to -0.23 mm, P = 0.014) was observed for implants with a single crown than a full-arch prosthesis (GEE model IV). Preliminary clinical and radiographic data indicate that implantoplasty in combination with surgery could be an effective treatment option for peri-implantitis.
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Affiliation(s)
- P Jia
- Fourth Division, Peking University School and Hospital of Stomatology, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China; Research Center of Engineering and Technology for Digital Dentistry of the Ministry of Health, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Y Tang
- Fourth Division, Peking University School and Hospital of Stomatology, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China; Research Center of Engineering and Technology for Digital Dentistry of the Ministry of Health, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - L Niu
- Fourth Division, Peking University School and Hospital of Stomatology, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China; Research Center of Engineering and Technology for Digital Dentistry of the Ministry of Health, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - L Qiu
- Fourth Division, Peking University School and Hospital of Stomatology, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China; Research Center of Engineering and Technology for Digital Dentistry of the Ministry of Health, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China.
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12
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Bianconi S, Romanos G, Testori T, Del Fabbro M. Management of Advanced Peri-Implantitis by Guided Bone Regeneration in Combination with Trabecular Metal Fixtures, Two Months after Removal of the Failed Implants: Two-Year Results of a Single-Cohort Clinical Study. J Clin Med 2024; 13:713. [PMID: 38337407 PMCID: PMC10856143 DOI: 10.3390/jcm13030713] [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: 12/27/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Background: Implant replacement is among the treatment options for severe peri-implantitis. The aim of this single-cohort study was to evaluate the feasibility of replacing compromised implants affected by advanced peri-implantitis with new implants with a porous trabecular metal (TM) structure. Materials and Methods: Patients with one or more implants in the posterior region showing a defect depth >50% of implant length, measured from the residual crest, were consecutively included. Two months after implant removal, patients received a TM implant combined with a xenograft and a resorbable membrane. The implant stability quotient (ISQ) was measured at placement and re-assessed five months later (at uncovering), then after 6, 12, and 24 months of function. Marginal bone loss was radiographically evaluated. Results: Twenty consecutive cases were included. One patient dropped out due to COVID-19 infection, and nineteen cases were evaluated up to 24 months. At placement, the mean ISQ was 53.08 ± 13.65 (standard deviation), which increased significantly to 69.74 ± 9.01 after five months of healing (p < 0.001) and to 78.00 ± 7.29 after six months of loading (p < 0.001). Thereafter, the ISQ remained stable for up to 24 months (80.55 ± 4.73). All implants successfully osseointegrated and were restored as planned. After two years, the average marginal bone level change was -0.41 ± 0.38 mm (95% confidence interval -0.60, -0.21), which was limited yet significantly different from the baseline (p < 0.05). Conclusions: The treatment of advanced peri-implant defects using TM implants inserted two months after explantation in combination with guided bone regeneration may achieve successful outcomes up to two years follow-up, even in the presence of low primary stability.
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Affiliation(s)
- Stefano Bianconi
- Department of Oral Surgery and Dentistry, General Hospital, 39100 Bolzano, Italy;
| | - Georgios Romanos
- Department of Periodontics and Endodontics, Stony Brook University, Stony Brook, NY 11794, USA;
| | - Tiziano Testori
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy;
- Department of Implantology and Oral Rehabilitation, Dental Clinic, IRCCS Ospedale Galeazzi-Sant’Ambrogio, 20157 Milan, Italy
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA 01451, USA
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy;
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
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13
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Cheng Y, Jin W, Zheng L, Huang X, Luo S, Hong W, Liao J, Samruajbenjakun B, Leethanakul C. The role of autophagy in SIM mediated anti-inflammatory osteoclastogenesis through NLRP3 signaling pathway. Immun Inflamm Dis 2024; 12:e1145. [PMID: 38270300 PMCID: PMC10777745 DOI: 10.1002/iid3.1145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/23/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Inflammatory bone resorption is a prominent risk factor for implantation failure. Simvastatin (SIM) has anti-inflammatory effects independent of cholesterol lowering and reduces osteoclastogenesis by decreasing both the number and activity of osteoclasts. However, the specific mechanism of inflammatory bone loss alleviation by SIM remains to be elucidated. We hypothesized that SIM relieves inflammatory bone loss by modulating autophagy and suppressing the NOD-like receptor family pyrin domain-containing protein 3 (NLRP3) signaling pathway. METHODS AND RESULTS RAW264.7 cells were stimulated by lipopolysaccharide (LPS) after being pretreated with various concentrations of SIM. Osteoclast (OC) differentiation, formation and activity were evaluated by tartrate-resistant acid phosphatase staining, F-actin ring staining and bone resorption pit assays, respectively. We observed autophagosomes by transmission electron microscopy. Then NLRP3 inhibitor MCC950 was used to further explore the corresponding molecular mechanism underlying anti-inflammatory bone resorption, the expression of autophagy-related proteins and NLRP3 signaling pathway factors in pre-OCs were evaluated by western blot analysis, and the expression of OC-specific molecules was analyzed using reverse transcription-quantitative polymerase chain reaction. The results showed that SIM decreased the expression of tumor necrosis factor-α, whereas increased Interleukin-10. In addition, SIM inhibited LPS-induced OC differentiation, formation, bone resorption activity, the level of autophagosomes, and OC-specific markers. Furthermore, SIM significantly suppressed autophagy by downregulating LC3II, Beclin1, ATG7, and NLRP3-related proteins expression while upregulating P62 under inflammatory conditions. CONCLUSIONS SIM may reduce autophagy secretion to attenuate LPS-induced osteoclastogenesis and the NLRP3 signaling pathway participates in this process, thus providing theoretical basis for the application of this drug in peri-implantitis.
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Affiliation(s)
- Yuting Cheng
- Faculty of DentistryPrince of Songkla UniversityHat YaiThailand
- School/Hospital of StomatologyGuizhou Medical UniversityGuiyangChina
| | - Wenjun Jin
- School/Hospital of StomatologyGuizhou Medical UniversityGuiyangChina
| | - Lin Zheng
- School/Hospital of StomatologyGuizhou Medical UniversityGuiyangChina
| | | | - Shanshan Luo
- School/Hospital of StomatologyGuizhou Medical UniversityGuiyangChina
| | - Wei Hong
- Key Laboratory of Endemic and Ethnic Diseases, Ministry of EducationGuizhou Medical UniversityGuiyangChina
| | - Jian Liao
- School/Hospital of StomatologyGuizhou Medical UniversityGuiyangChina
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14
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Benitez AF, Mezquida MM, Tocarruncho O, Garzon HS. Evaluation of Late Implant Placement in Vertically Regenerated Sites: A Systematic Review. J Long Term Eff Med Implants 2024; 34:25-34. [PMID: 37938202 DOI: 10.1615/jlongtermeffmedimplants.2023046364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Few studies with long-term follow-up show evidence of implants placed late in vertically regenerated sites. This has not allowed for generalizing about the prognosis and outcome of implants in these conditions. The objective was to evaluate the available scientific literature on the behavior of late-placed dental implants in vertically regenerated sites on three primary clinical outcomes: survival rate, marginal bone loss, and complications. A systematic search was performed in MEDLINE through Pubmed, Ebsco, Cochrane and Lilacs. Cohort studies (CTs) and controlled clinical trials (RCTs) conducted in humans, with a follow-up of ≥ 1 year, published between 2008 and 2021, were included. The data extraction process was also independent in a matrix for the variables of interest: type of surgery, technique, follow-up time, number of implants, number of patients, implant placement, prosthetic load, type of graft, and type of membrane complications. Of 3229 initial records, after deduplication and screening, 6 studies fully met the selection criteria. The included articles added 442 late implants to vertical bone regeneration in 178 patients. There was a loss of 14 implants (3.16%), overall survival was 96.8%, overall mean bone loss was 0.95 mm in a follow-up time of 1 to 10 years, and the most frequent complication was post-infection. With a 10-year follow-up, late implants placed in vertically regenerated sites have a survival rate (of 96.8%) like those placed in native bone or simultaneous to regeneration, with an average marginal bone loss of 0.98 mm. The most common complication is infection.
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Affiliation(s)
- A F Benitez
- Institución Universitaria Colegios de Colombia, UNICOC, Bogotá, Colombia 11011
| | - M M Mezquida
- Institución Universitaria Colegios de Colombia, UNICOC, Bogotá, Colombia 11011
| | - O Tocarruncho
- Centro de Investigación Colegio Odontológico, Institución Universitaria Colegios de Colombia, UNICOC, Bogotá, Colombia 11011
| | - Hernan S Garzon
- Centro de Investigación Colegio Odontológico, Institución Universitaria Colegios de Colombia, UNICOC, Bogotá, Colombia 11011
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15
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Risolo M, Cevik-Aras H, Sayardoust S. The effect of reconstructive techniques as treatment modality for peri-implant osseous defects - a systematic review and meta-analysis. Acta Odontol Scand 2023; 81:569-577. [PMID: 37551914 DOI: 10.1080/00016357.2023.2243325] [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: 04/19/2023] [Accepted: 07/27/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVES The aim of this systematic review is to compare conventional peri-implant flap surgery and reconstructive surgical techniques regarding evidence of remission from peri-implantitis. MATERIAL AND METHODS Searches were made among randomized controlled trials evaluating clinical aspects and the changes in marginal bone level before and after surgical treatment of peri-implantitis, with and without bone substitute. RESULTS Nine published articles and 442 patients were eligible for inclusion in the study. Reconstructive techniques exhibited a greater extent of defect fill than conventional surgical techniques alone. No significant differences could be found for clinical measures of peri-implant disease (bleeding on probing and reduction of probing depth) from baseline to the 12-month follow-up. CONCLUSIONS With regards to the clinical measures of disease, our review shows that there are no differences between open flap debridement and regenerative surgery. From an esthetic standpoint, it may however be that regenerative measures may lead to improvement but further publications with this focus will be necessary to verify this.
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Affiliation(s)
- Massimo Risolo
- Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden
| | - Hülya Cevik-Aras
- Department of Oral Pathology and Medicine, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- NÄL Hospital, Trollhättan, Sweden
| | - Shariel Sayardoust
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Oral Rehabilitation, Linköping, Sweden
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16
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Bariş K, Karşiyaka Hendek M, Olgun E. Evaluation of the Quality of Peri-implantitis Videos on YouTube. J Craniofac Surg 2023; 34:1813-1816. [PMID: 37226301 DOI: 10.1097/scs.0000000000009392] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/06/2023] [Indexed: 05/26/2023] Open
Abstract
Although many studies have evaluated the quality of YouTube videos related to dentistry, just one study has evaluated the quality of YouTube videos related to peri-implantitis. The aim of the cross-sectional study was to evaluate the quality of peri-implantitis-related YouTube videos. Two periodontists evaluated 47 videos that met the inclusion criteria, such as the country of upload, source of videos, number of views, likes and dislikes, viewing rate, interaction index, number of days since upload, duration of the video, usefulness score, global quality scale score, and comments. Peri-implantitis was evaluated using a 7-question system of the videos, 44.7% and 55.3% were uploaded by commercial companies and health care professionals, respectively. Although the usefulness score of the videos uploaded by health care professionals was statistically significantly higher ( P =0.022), the number of views, numbers of likes and dislikes were similar between the groups ( P >0.050). Although the usefulness score and global quality scale score of the perfect videos were statistically different between the groups ( P <0.001; P <0.001, respectively), the number of views, numbers of likes, and dislikes were similar. A strong positive correlation was found between the number of views and the number of likes ( P ˂0.001). A strong negative correlation was found between the interaction index and the number of days since upload ( P ˂0.001). As a result, YouTube videos on peri-implantitis were limited in number and had poor quality. Thus, videos of perfect quality should be uploaded.
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Affiliation(s)
- Kubilay Bariş
- Department of Periodontology, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey
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17
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Castro F, Bouzidi AS, Fernandes JCH, Bottino MC, Fernandes GVO. Bone tissue regeneration in peri-implantitis: A systematic review of randomized clinical trials. Saudi Dent J 2023; 35:589-601. [PMID: 37817791 PMCID: PMC10562100 DOI: 10.1016/j.sdentj.2023.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 10/12/2023] Open
Abstract
Objectives The goal of this systematic review was to analyze, in randomized controlled clinical trials (RCTs), regenerative techniques used to treat peri-implantitis (PI). Methods Three databases (PubMed/Medline, EMBASE, and On-Line Knowledge Library) were accessed, applying the PICO strategy (Population [P], Intervention [I], Comparison [C], and Outcomes [O]), with the following focused questions: (i) "In patients who received regenerative treatments for peri-implantitis (P), is the regenerative surgical treatment (I) clinically effective and predictable compared to non-regenerative (C) to treat PI (O)?"; and (ii) "In patients who received regenerative treatments for peri-implantitis (P), the regenerative approach (I), compared to non-regenerative (C), significantly increase the prognosis and implant survival rate in the mid- and long-term (O)?" The inclusion criteria were RCTs published in English between 2012 and 2022, with at least a one-year follow-up, which applied regenerative techniques to treat peri-implantitis. Cochrane's collaboration tool for assessing the risk of bias was used. Main results Nine articles were included with 404 patients (225 females and 179 males; mean age of 60.44 years). One study evaluated patients after 48 months and another after 88 months. The techniques and devices used were: (i) implantoplasty with Er:YAG laser, (ii) blood concentrate (growth factors), and (iii) EMD, with no statistically significant outcome. Two studies considered the use of titanium granules with a significant increase in radiographic bone identification, whereas regenerative techniques with bone graft (autogenous, alloplastic, and xenograft) were the majority chosen, associated or not, with a collagen membrane. Xenograft had better results radiographically when compared to the autogenous bone graft and presented better results for bone level. There was an overall decrease in bleeding on probing, independent of the control or test group, and a reduction in pocket depth in the groups analyzed. Titanium granules, EMD, Er:YAG laser, and CGF had non-significant results; better results were observed when using bone grafts. The RoB showed a low risk in four studies (44.44%), three with moderate (33.33%), and two with high risk (22.23%). Conclusion Surgical regenerative treatment was a predictable option in the management of PI and in improving the clinical parameters of peri-implant tissues in the short term, mainly when using porous titanium granules, alloplastic bone grafts, and xenografts.
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Affiliation(s)
- Filipe Castro
- FP-I3ID, FSC, Universidade Fernando Pessoa, 4249-004 Porto, Portugal
| | | | | | - Marco C. Bottino
- Department of Cariology, Restorative Sciences, and Endodontics at the University of Michigan School of Dentistry, Ann Arbor, USA
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18
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Vargas SM, Johnson TM, Pfaff AS, Bumpers AP, Wagner JC, Retrum JK, Colamarino AN, Bunting ME, Wilson JP, McDaniel CR, Herold RW, Stancoven BW, Lincicum AR. Clinical protocol selection for alveolar ridge augmentation at sites exhibiting slight, moderate, and severe horizontal ridge deficiencies. Clin Adv Periodontics 2023; 13:174-196. [PMID: 36760073 DOI: 10.1002/cap.10239] [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: 10/07/2022] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
FOCUSED CLINICAL QUESTION What factors identify the optimal bone augmentation techniques for managing slight, moderate, and severe horizontal alveolar ridge deficiency (ARD) at dental implant sites? SUMMARY Horizontal ARD is a concern at a high proportion of sites receiving dental implants, and clinicians have developed a variety of surgical procedures to address such defects. In a particular case, selection of the optimal treatment may depend predominantly on defect severity, location (anterior versus posterior), and configuration (contained versus noncontained). This report provides a framework for selecting an augmentation method when presented with a slight, moderate, or severe horizontal ARD at a site requiring dental implant placement. CONCLUSION Multiple treatment options are available for planned implant sites exhibiting horizontal ARD; severe posterior and slight anterior defects intuitively call for different approaches. Although rigid guidelines for selecting the optimal augmentation method do not exist, some techniques are poorly suited for esthetically demanding sites. A framework considering defect severity, location, and configuration may help guide clinical decisions on this topic.
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Affiliation(s)
- Sarah M Vargas
- Department of Periodontics, United States Army Dental Health Activity, Fort Bragg, North Carolina, USA
| | - Thomas M Johnson
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Aaron S Pfaff
- Department of Periodontics, United States Army Dental Health Activity, Fort Wainwright, Alaska, USA
| | - April P Bumpers
- Department of Periodontics, United States Army Dental Health Activity, Fort Jackson, South Carolina, USA
| | - Jennah C Wagner
- Department of Periodontics, United States Army Dental Health Activity, Fort Meade, Maryland, USA
| | - Joseph K Retrum
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Aaron N Colamarino
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Megan E Bunting
- Department of Periodontics, United States Army Dental Health Activity, Fort Drum, New York, USA
| | - James P Wilson
- Department of Periodontics, United States Army Dental Health Activity, Fort Campbell, Kentucky, USA
| | - Carsen R McDaniel
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Robert W Herold
- Department of Periodontics, Veterans Administration Medical Center, Augusta, Georgia, USA
| | - Brian W Stancoven
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Adam R Lincicum
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
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Fan W, Tang J, Xu H, Huang X, Wu D, Zhang Z. Early diagnosis for the onset of peri-implantitis based on artificial neural network. Open Life Sci 2023; 18:20220691. [PMID: 37671094 PMCID: PMC10476483 DOI: 10.1515/biol-2022-0691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/16/2023] [Accepted: 07/29/2023] [Indexed: 09/07/2023] Open
Abstract
The aim of this study is to construct an artificial neural network (ANN) based on bioinformatic analysis to enable early diagnosis of peri-implantitis (PI). PI-related datasets were retrieved from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) and functional enrichment analyses were performed between PI and the control group. Furthermore, the infiltration of 22 immune cells in PI was analyzed using CIBERSORT. Hub genes were identified with random forest (RF) classification. The ANN model was then constructed for early diagnosis of PI. A total of 1,380 DEGs were identified. Enrichment analysis revealed the involvement of neutrophil-mediated immunity and the NF-kappa B signaling pathway in PI. Additionally, higher proportion of naive B cells, activated memory CD4 T cells, activated NK cells, M0 macrophages, M1 macrophages, and neutrophils were observed in the soft tissues surrounding PI. From the RF analysis, 13 hub genes (ST6GALNAC4, MTMR11, SKAP2, AKR1B1, PTGS2, CHP2, CPEB2, SYT17, GRIP1, IL10, RAB8B, ABHD5, and IGSF6) were selected. Subsequently, the ANN model for early diagnosis of PI was constructed with high performance. We identified 13 hub genes and developed an ANN model that accurately enables early diagnosis of PI.
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Affiliation(s)
- Wanting Fan
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Jianming Tang
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Huixia Xu
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Xilin Huang
- Department of Obstetrics, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Donglei Wu
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Zheng Zhang
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
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20
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Baus-Domínguez M, Bakkali S, Hermida-Cabrera P, Serrera-Figallo MA, Gutiérrez-Pérez JL, Torres-Lagares D. A Systematic Review and Meta-Analysis of Systemic and Local Antibiotic Therapy in the Surgical Treatment of Peri-Implantitis. Antibiotics (Basel) 2023; 12:1223. [PMID: 37508319 PMCID: PMC10376060 DOI: 10.3390/antibiotics12071223] [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: 06/26/2023] [Revised: 07/12/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Given the existing controversy regarding the use of antibiotics in the treatment of peri-implantitis, this systematic review and meta-analysis aim to ascertain how beneficial the role of systemic and local antibiotics is in peri-implant surgical therapy, considering the harmful effects that they represent and the abuse of antibiotics in terms of global health. (2) Methods: To determine the therapeutic efficacy of the administration of antibiotics in the surgical treatment of peri-implantitis in terms of probing pocket depth (PPD) and bleeding on probing (BoP), electronic and manual bibliographic searches were carried out in the Embase and PubMed databases, collecting data that related to before and after treatment. (3) Results: The adjunctive use of local antibiotics provides significant improvements in PPD (MD = 1.29; 95% CI: 0.56 to 2.02; p ≤ 0.0006; I2 = 0%) when compared with surgical treatment alone. No significant differences were found in the other subgroup; that is, the use of systemic antibiotics did not significantly improve PPD changes in the surgical treatment of peri-implantitis (MD = 0.40; 95% CI: -0.15 to 0.95; p = 0.15; I2 = 0). (4) Conclusions: The use of local antibiotics in the surgical treatment of peri-implantitis seems to offer treatment improvements in terms of PPD and BoP, unlike that observed with the use of systemic antibiotics. However, these results should be taken with caution as they also depend on the type of surgical technique used, whether regenerative or resective. More research is needed on this topic to understand the role of local and systemic antibiotics in the treatment of peri-implantitis.
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Affiliation(s)
- María Baus-Domínguez
- Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, 41009 Sevilla, Spain
| | - Sara Bakkali
- Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, 41009 Sevilla, Spain
| | - Paula Hermida-Cabrera
- Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, 41009 Sevilla, Spain
| | | | - José-Luis Gutiérrez-Pérez
- Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, 41009 Sevilla, Spain
- Hospital Universitario Virgen del Rocío, Universidad de Sevilla, 41013 Sevilla, Spain
| | - Daniel Torres-Lagares
- Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, 41009 Sevilla, Spain
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21
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Reis INRD, do Amaral GCLS, Hassan MA, Villar CC, Romito GA, Spin-Neto R, Pannuti CM. The influence of smoking on the incidence of peri-implantitis: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34:543-554. [PMID: 36939434 DOI: 10.1111/clr.14066] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 03/21/2023]
Abstract
OBJECTIVE The aim of this study was to systematically analyze the influence of smoking on the incidence of peri-implantitis. MATERIALS AND METHODS The search was performed in the National Library of Medicine (MEDLINE-PubMed), SCOPUS, EMBASE, and ISI Web of Science databases (finished on November 30, 2022). Systematic review and meta-analysis were conducted according to PRISMA statement. Prospective cohort studies that evaluate the incidence of peri-implantitis in smokers and non-smokers were included. Two authors independently searched for eligible studies, screened titles, and abstracts, did the full-text analysis, extracted data, and performed the risk-of-bias assessment. The results were summarized through random-effects meta-analyses. The GRADE method was used to determine the certainty of evidence. RESULTS A total of 7 studies with 702 patients and 1959 implants were included for analysis. The meta-analysis revealed a significant difference between smokers and non-smokers for the risk of peri-implantitis in the implant-based (p < .0001) and patient-based analysis (p = .003). A strong association between smoking and the risk for peri-implantitis was verified at the implant level (RR: 2.04, 95% CI: 1.46-1.85) and the patient level (RR: 2.79, 95% CI: 1.42-5.50). CONCLUSIONS Moderate certainty evidence suggests that smoking is associated with peri-implantitis compared to non-smoking at the patient and implant levels.
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Affiliation(s)
| | | | - Mohamed Ahmed Hassan
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Cristina Cunha Villar
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Giuseppe Alexandre Romito
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section for Oral Radiology, School of Dentistry, Aarhus University, Aarhus, Denmark
| | - Claudio Mendes Pannuti
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Roccuzzo A, Imber JC, Salvi GE, Roccuzzo M. Peri-implantitis as the consequence of errors in implant therapy. Periodontol 2000 2023; 92:350-361. [PMID: 36744582 DOI: 10.1111/prd.12482] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 09/04/2022] [Accepted: 12/22/2022] [Indexed: 02/07/2023]
Abstract
Peri-implantitis is a plaque-associated pathologic condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone. It is a highly prevalent disease, as extensively estimated by large-population, cross-sectional studies. As peri-implant diseases represent opportunistic infections, it is reasonable to assume that nonideal conditions, local and/or general, may favor the progression of peri-implant inflammation. Some of these conditions could be a result of poor planning and/or inadequate execution of any step of the entire process treatment. This article describes the major possible factors in implant therapy that may lead to peri-implantitis. For some of these (ie, inappropriate patient selection, insufficient periodontal therapy, lack of diagnosis and management of peri-implant mucositis, erratic supportive peri-implant/periodontal therapy) there is a good level of evidence, whereas for others (ie, wrong implant placement, poor postoperative care, inadequate prosthetic reconstruction, lack of assessment and management of peri-implant soft-tissue deficiencies) there is little scientific evidence. More research is therefore needed to clearly identify the errors and/or complications possibly leading to peri-implantitis, particularly over the long term.
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Affiliation(s)
- Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Oral and Maxillo-Facial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni Edoardo Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mario Roccuzzo
- Specialist Periodontal Private Practice, Torino, Italy
- Division of Maxillo-facial Surgery, University of Torino, Torino, Italy
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
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23
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Hwang S, Lee HM, Yun PY, Kim YK. Survival analysis of implants after surgical treatment of peri-implantitis based on bone loss severity and surgical technique: a retrospective study. BMC Oral Health 2023; 23:308. [PMID: 37217906 DOI: 10.1186/s12903-023-02981-5] [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: 10/05/2022] [Accepted: 04/19/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Few trials have compared the results of surgical treatment for peri-implantitis based on severity of peri-implantitis and surgical method. This study investigated the survival rate of implants based on type of surgical method used and initial severity of peri-implantitis. Classification of severity was determined based on bone loss rate relative to fixture length. METHODS Medical records of patients who underwent peri-implantitis surgery from July 2003 to April 2021 were identified. Classification of peri-implantitis was divided into 3 groups (stage 1: bone loss < 25% (of fixture length), stage 2: 25% < bone loss < 50%, stage 3: bone loss > 50%) and performance of resective or regenerative surgery was investigated. Kaplan-Meier survival curves and Cox hazards proportional models were used to analyze the cumulative survival rate of implants. Median survival time, predicted mean survival time, hazard ratio (HR), and 95% confidence interval (CI) were calculated. RESULTS Based on Kaplan-Meier analysis, 89 patients and 227 implants were included, and total median postoperative survival duration was 8.96 years. Cumulative survival rates for stage 1, 2, and 3 were 70.7%, 48.9%, and 21.3%, respectively. The mean survival time for implants in stage 1, 2, and 3 was 9.95 years, 7.96 years, and 5.67 years, respectively, with statistically significant difference (log-rank p-value < 0.001). HRs for stage 2 and stage 3 were 2.25 and 4.59, respectively, with stage 1 as reference. Significant difference was not found in survival time between resective and regenerative surgery groups in any peri-implantitis stage. CONCLUSIONS The initial bone loss rate relative to the fixture length significantly correlated with the outcome after peri-implantitis surgery, demonstrating a notable difference in the long-term survival rate. Difference was not found between resective surgery and regenerative surgery in implant survival time. Bone loss rate could be utilized as a reliable diagnostic tool for evaluating prognosis after surgical treatment, regardless of surgical method used. TRIAL REGISTRATION Retrospectively registered. (KCT0008225).
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Affiliation(s)
- Sooshin Hwang
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi‑ro 173beon‑gil, Bundang‑gu, 13620, Seongnam, Korea
| | - Hee-Min Lee
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi‑ro 173beon‑gil, Bundang‑gu, 13620, Seongnam, Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi‑ro 173beon‑gil, Bundang‑gu, 13620, Seongnam, Korea
- Department of Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro Jongno-gu, Seoul, 03080, Korea
| | - Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi‑ro 173beon‑gil, Bundang‑gu, 13620, Seongnam, Korea.
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Sabri H, Wang HL. Peri-implantitis: A bibliometric network analysis of top 100 most-cited research articles. Clin Implant Dent Relat Res 2023; 25:284-302. [PMID: 36688267 DOI: 10.1111/cid.13177] [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: 11/17/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Over the past decades, there has been an increase in research publications focusing on peri-implantitis. When facing limited healthcare resources, bibliometric analyses can guide researchers and funding parties toward areas where reallocation or more focus on research activity is warranted. The main objective of this study was to identify the trends of the top 100 cited articles on peri-implantitis research as the first study of its kind. METHODS A Web of Science search, using the keywords "peri-implantitis or periimplantitis" was built to create a database of the most-cited articles. Articles were ranked by citation count and screened by two independent reviewers. The bibliometric characteristics of the studies were gathered and analyzed using several bibliometric software. Author collaborations, author clusters, and keyword co-occurrence network analyses were also performed. The correlation between the citation count and the age of each article was tested. RESULTS The top 100 cited papers were published from 1994 to 2018 and the total citation counts ranged from 119 to 972 with 244.5 citations/paper on average. There was no correlation between the age of the articles and the citation count (p-value = 0.67). 21% of the studies consisted of prospective clinical studies. 35% of the papers focused on treatment and prevention of peri-implantitis while 65% concerned epidemiology. The top three most prolific countries were Sweden (n = 31), Germany (n = 15), and Switzerland (n = 13). We found 12 authors who had greater than five publications on the list. Also, the most published journal was Clinical Oral Implants Research. CONCLUSION This study provides insight into the characteristics and quality of the most highly cited peri-implantitis literature. This revealed a deficiency in terms of the number of studies on treatment strategies as well as a higher level of evidence studies among the most- impactful papers on peri-implantitis at the moment.
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Affiliation(s)
- Hamoun Sabri
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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25
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Hadzik J, Kubasiewicz-Ross P, Gębarowski T, Waloszczyk N, Maciej A, Stolarczyk A, Gedrange T, Dominiak M, Szajna E, Simka W. An Experimental Anodized Titanium Surface for Transgingival Dental Implant Elements-Preliminary Report. J Funct Biomater 2023; 14:jfb14010034. [PMID: 36662081 PMCID: PMC9861871 DOI: 10.3390/jfb14010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 12/27/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023] Open
Abstract
The characteristics such as microtopography, physical and chemical properties influence the behavior of an implant in a soft tissue. Anodization-as a potent method of titanium alloy surface modification-of the transgingival abutment or healing screw, has achieved some improvement. One of the possible surface treatment method is low-pressure radiofrequency oxygen plasma treatment. The aim of the study was to evaluate the chemical properties and cytocompatibility of the experimental surface. Titanium discs made of grade-23 titanium alloy (Ti-6Al-4V) anodized (A sample) with different voltage parameters (28, 67, 78, and 98 V) were included in the study. Half of the samples regarded as the "S" group were additionally treated with low-pressure radiofrequency oxygen plasma treatment. The surfaces were characterized using scanning electron microscopy, X-ray spectroscopy and Raman spectroscopy, and electrochemically investigated via a corrosion test. Furthermore, two cell lines were used, including the CHO-compatible reference line and a primary human fibroblast line for the MTT assay; direct (contact) cytotoxicity of the materials was tested with the cells, and the growth of fibroblasts on the surfaces of the different materials was tested. The morphology of the "S"-treated samples did not differ from the morphology of only-anodized samples. However, the oxygen concentration on the surface in that group slightly increased by about 1% as a result of post-trial treatment. The highest corrosion resistance was observed for both A-78 V and S-78 V samples. The cytotoxicity assay revealed no changes in cell morphology or vitality. The MTT test proved comparable culture viability among all groups; however, the "S" samples showed statistically significantly higher fibroblast proliferation and adhesion scores compared to the "A" samples. Through the in vitro study, the low-pressure radiofrequency oxygen plasma treatment of the anodized Ti-6Al-4V alloy presented itself as an auspicious option in the field of transgingival element surface modification of implants.
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Affiliation(s)
- Jakub Hadzik
- Department of Dental Surgery, Faculty of Medicine and Dentistry, Medical University of Wroclaw, 50-425 Wroclaw, Poland
| | - Paweł Kubasiewicz-Ross
- Department of Dental Surgery, Faculty of Medicine and Dentistry, Medical University of Wroclaw, 50-425 Wroclaw, Poland
- Correspondence: (P.K.-R.); (W.S.)
| | - Tomasz Gębarowski
- Department of Biostructure and Animal Physiology, Wroclaw University of Environmental and Life Sciences, 51-631 Wroclaw, Poland
| | - Natalia Waloszczyk
- Faculty of Chemistry, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Artur Maciej
- Faculty of Chemistry, Silesian University of Technology, 44-100 Gliwice, Poland
| | | | - Tomasz Gedrange
- Department of Dental Surgery, Faculty of Medicine and Dentistry, Medical University of Wroclaw, 50-425 Wroclaw, Poland
- Department of Orthodontics, TU Dresden, 01069 Dresden, Germany
| | - Marzena Dominiak
- Department of Dental Surgery, Faculty of Medicine and Dentistry, Medical University of Wroclaw, 50-425 Wroclaw, Poland
| | - Ernest Szajna
- WEA Techlab sp. z o.o., 41-301 Dąbrowa Górnicza, Poland
| | - Wojciech Simka
- Faculty of Chemistry, Silesian University of Technology, 44-100 Gliwice, Poland
- Correspondence: (P.K.-R.); (W.S.)
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Bessa LJ, Botelho J, Machado V, Alves R, Mendes JJ. Managing Oral Health in the Context of Antimicrobial Resistance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16448. [PMID: 36554332 PMCID: PMC9778414 DOI: 10.3390/ijerph192416448] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 05/25/2023]
Abstract
The oral microbiome plays a major role in shaping oral health/disease state; thus, a main challenge for dental practitioners is to preserve or restore a balanced oral microbiome. Nonetheless, when pathogenic microorganisms install in the oral cavity and are incorporated into the oral biofilm, oral infections, such as gingivitis, dental caries, periodontitis, and peri-implantitis, can arise. Several prophylactic and treatment approaches are available nowadays, but most of them have been antibiotic-based. Given the actual context of antimicrobial resistance (AMR), antibiotic stewardship in dentistry would be a beneficial approach to optimize and avoid inappropriate or even unnecessary antibiotic use, representing a step towards precision medicine. Furthermore, the development of new effective treatment options to replace the need for antibiotics is being pursued, including the application of photodynamic therapy and the use of probiotics. In this review, we highlight the advances undergoing towards a better understanding of the oral microbiome and oral resistome. We also provide an updated overview of how dentists are adapting to better manage the treatment of oral infections given the problem of AMR.
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Affiliation(s)
- Lucinda J. Bessa
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
| | - João Botelho
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
- Clinical Research Unit (CRU), CiiEM, Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
| | - Vanessa Machado
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
- Clinical Research Unit (CRU), CiiEM, Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
| | - Ricardo Alves
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
- Clinical Research Unit (CRU), CiiEM, Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
| | - José João Mendes
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
- Clinical Research Unit (CRU), CiiEM, Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
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Crauste E, Struillou X, Lanoiselee E, Cloitre A. GUIDED PERI-IMPLANT AUTOGENOUS SOFT TISSUE GRAFTING: CASE REPORT. J ORAL IMPLANTOL 2022; 48:489035. [PMID: 36473180 DOI: 10.1563/aaid-joi-d-21-00201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 06/22/2022] [Accepted: 07/12/2022] [Indexed: 02/17/2024]
Abstract
This case report showed the proof-of-concept of a guided free gingival graft around a dental implant. A 65-year-old male presented to replace his 30 and 31. Once the osseointegration of the 2 implants placed by guided surgery has been achieved, a free gingival graft was indicated. The surgical planning of this graft was performed using the Cone Beam Computed Tomography and archs digital scanning already used for implant placement. The greater palatine foramen and gutter were radiologically located to protect their arterial content. Two surgical guides were designed, one for the palatal donor site and one for the recipient site. The first one will serve both as an incision guide and as a post-operative protective plate. The procedure was free of adverse events. At the 1-year recall, the average gain in keratinized tissue width amounted 2.5 mm. This guided surgery could be used in a patient with insufficient amount of keratinized tissue around a posterior implant. For the first time, it makes it possible to anticipate, accelerate and secure the intervention, to improve the practitioner's comfort and potentially the outcomes of free gingival grafts. Further research and clinical are needed to validate this protocol and to assess its long-term impact on peri-implant health.
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Affiliation(s)
- Eleonore Crauste
- Nantes University: Universite de Nantes Faculté d'odontologie 1, place Alexis Ricordeau FRANCE NANTES Loire Atlantique 44000
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Sousa V, Spratt D, Davrandi M, Mardas N, Beltrán V, Donos N. Oral Microcosm Biofilms Grown under Conditions Progressing from Peri-Implant Health, Peri-Implant Mucositis, and Peri-Implantitis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14088. [PMID: 36360970 PMCID: PMC9654334 DOI: 10.3390/ijerph192114088] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/05/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Peri-implantitis is a disease influenced by dysbiotic microbial communities that play a role in the short- and long-term outcomes of its clinical treatment. The ecological triggers that establish the progression from peri-implant mucositis to peri-implantitis remain unknown. This investigation describes the development of a novel in vitro microcosm biofilm model. Biofilms were grown over 30 days over machined titanium discs in a constant depth film fermentor (CDFF), which was inoculated (I) with pooled human saliva. Following longitudinal biofilm sampling across peri-implant health (PH), peri-implant mucositis (PM), and peri-implantitis (PI) conditions, the characterisation of the biofilms was performed. The biofilm analyses included imaging by confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM), selective and non-selective culture media of viable biofilms, and 16S rRNA gene amplification and sequencing. Bacterial qualitative shifts were observed by CLSM and SEM across conditions, which were defined by characteristic phenotypes. A total of 9 phyla, 83 genera, and 156 species were identified throughout the experiment. The phyla Proteobacteria, Bacteroidetes, Firmicutes, Fusobacteria, and Actinobacteria showed the highest prevalence in PI conditions. This novel in vitro microcosm model provides a high-throughput alternative for growing microcosm biofilms resembling an in vitro progression from PH-PM-PI conditions.
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Affiliation(s)
- Vanessa Sousa
- Periodontology and Periodontal Medicine, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Dave Spratt
- Microbial Diseases, Eastman Dental Institute, University College London, London WC1E 6BT, UK
| | - Mehmet Davrandi
- Microbial Diseases, Eastman Dental Institute, University College London, London WC1E 6BT, UK
| | - Nikos Mardas
- Centre for Oral Clinical Research, Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London E1 2AD, UK
| | - Víctor Beltrán
- Clinical Investigation and Dental Innovation Center (CIDIC), Dental School and Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco 4780000, Chile
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London E1 2AD, UK
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Short versus standard implants at sinus augmented sites: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:6681-6698. [PMID: 36070150 DOI: 10.1007/s00784-022-04628-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Short implants are proposed as a less invasive alternative with fewer complications than standard implants in combination with sinus lift. The aim of this systematic review and meta-analysis was to state the efficacy of placing short implants (≤ 6 mm) compared to standard-length implants (≥ 8 mm) performing sinus lift techniques in patients with edentulous posterior atrophic jaws. Efficacy will be evaluated through analyzing implant survival (IS) and maintenance of peri-implant bone (MBL). METHODS Screening process was done using the National Library of Medicine (MEDLINE by PubMed), EMBASE, the Cochrane Oral Health, and Web of Science (WOS). The articles included were randomized controlled trials. Risk of bias was evaluated according to The Cochrane Collaboration's tool. Weighted means were calculated. Heterogeneity was determined using Higgins (I2). A random-effects model was applied. Secondary outcomes such as surgical time, patient satisfaction, mucositis and peri-implantitis, pain, and swelling were analyzed. RESULTS Fourteen studies (597 patients and 901 implants) were evaluated. IS was 1.02 risk ratio, ranging from 1.00 to 1.05 (CI 95%) (p = 0.09), suggesting that IS was similar when both techniques were used. MBL was higher in patients with standard-length implants plus sinus lift elevation (p = 0.03). MBL was 0.11 (0.01-0.20) mm (p = 0.03) and 0.23 (0.07-0.39) mm (p = 0.005) before and after 1 year of follow-up, respectively, indicating that the marginal bone loss is greater for standard-length implants. DISCUSSION Within the limitations of the present study, as relatively small sample size, short dental implants can be used as an alternative to standard-length implants plus sinus elevation in cases of atrophic posterior maxilla. Higher MBL was observed in the groups where standard-length implants were used, but implant survival was similar in both groups. Moreover, with short implants, it was observed a reduced postoperative discomfort, minimal invasiveness, shorter treatment time, and reduced costs. CLINICAL CLINICAL RELEVANCE The low MBL promoted by short implants does contribute to a paradigm shift from sinus grafting with long implants to short implants. Further high-quality long-term studies are required to confirm these findings.
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Sousa V, Mardas N, Spratt D, Hassan IA, Walters NJ, Beltrán V, Donos N. The Effect of Microcosm Biofilm Decontamination on Surface Topography, Chemistry, and Biocompatibility Dynamics of Implant Titanium Surfaces. Int J Mol Sci 2022; 23:ijms231710033. [PMID: 36077428 PMCID: PMC9456268 DOI: 10.3390/ijms231710033] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Since the inception of dental implants, a steadily increasing prevalence of peri-implantitis has been documented. Irrespective of the treatment protocol applied for the management of peri-implantitis, this biofilm-associated pathology, continues to be a clinical challenge yielding unpredictable and variable levels of resolution, and in some cases resulting in implant loss. This paper investigated the effect of microcosm biofilm in vitro decontamination on surface topography, wettability, chemistry, and biocompatibility, following decontamination protocols applied to previously infected implant titanium (Ti) surfaces, both micro-rough -Sandblasted, Large-grit, Acid-etched (SLA)-and smooth surfaces -Machined (M). Microcosm biofilms were grown on SLA and M Ti discs. These were treated with TiBrushes (TiB), combination of TiB and photodynamic therapy (PDT), combination of TiB and 0.2%CHX/1%NaClO, plus or minus Ultraviolet-C (UV-C) radiation. Surface topography was evaluated by Scanning Electron Microscopy (SEM) and Laser Surface Profilometry. Surface function was analysed through wettability analysis. Surface chemistry evaluation of the discs was performed under SEM/Energy-dispersive X-ray spectroscopy (EDX) and X-ray photoelectron spectroscopy (XPS). Biocompatibility was tested with the cytocompatibility assay using human osteoblast-like osteosarcoma cell line (MG-63) cells. Elemental analysis of the discs disclosed chemical surface alterations resulting from the different treatment modalities. Titanium, carbon, oxygen, sodium, aluminium, silver, were identified by EDX as the main components of all the discs. Based on the data drawn from this study, we have shown that following the decontamination of Ti surfaces the biomaterial surface chemistry and topography was altered. The type of treatment and Ti surface had a significant effect on cytocompatibility (p = 0.0001). Although, no treatment modality hindered the titanium surface biocompatibility, parameters such as the use of chemical agents and micro-rough surfaces had a higher cytotoxic effect in MG-63 cells. The use of smooth surfaces, and photofunctionalisation of the TiO2 layer had a beneficial effect on cytocompatibility following decontamination.
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Affiliation(s)
- Vanessa Sousa
- Periodontology and Periodontal Medicine, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
- Correspondence:
| | - Nikos Mardas
- Centre for Oral Clinical Research, Centre for Oral Immunobiology & Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London E1 2AD, UK
| | - Dave Spratt
- Microbial Diseases, Eastman Dental Institute, University College London, London WC1E 6BT, UK
| | - Iman A. Hassan
- Materials Chemistry Centre, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - Nick J. Walters
- Natural Resources Institute Finland, Latokartanonkaari 9, 00790 Helsinki, Finland
| | - Víctor Beltrán
- Clinical Investigation and Dental Innovation Center, Dental School and Center for Translational Medicine, Universidad de La Frontera, Temuco 4780000, Chile
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Centre for Oral Immunobiology & Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London E1 2AD, UK
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Gene Correlation Network Analysis to Identify Biomarkers of Peri-Implantitis. Medicina (B Aires) 2022; 58:medicina58081124. [PMID: 36013591 PMCID: PMC9416455 DOI: 10.3390/medicina58081124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/01/2022] [Accepted: 08/14/2022] [Indexed: 12/02/2022] Open
Abstract
Background and Objectives: The histopathological and clinical conditions for transforming peri-implant mucositis into peri-implantitis (PI) are not fully clarified. We aim to uncover molecular mechanisms and new potential biomarkers of PI. Materials and Methods: Raw GSE33774 and GSE57631 datasets were obtained from the Gene Expression Omnibus (GEO) database. The linear models for microarray data (LIMMA) package in R software completes differentially expressed genes (DEGs). We conducted a weighted gene co-expression network analysis (WGCNA) on the top 25% of altered genes and identified the key modules associated with the clinical features of PI. Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed using the R software. We constructed a protein–protein interaction (PPI) network through the STRING database. After that we used Cytohubba plug-ins of Cytoscape to screen out the potential hub genes, which were subsequently verified via receiver operating characteristic (ROC) curves in another dataset, GSE178351, and revalidation of genes through the DisGeNET database. Results: We discovered 632 DEGs (570 upregulated genes and 62 downregulated genes). A total of eight modules were screened by WGCNA, among which the turquoise module was most correlated with PI. The Cytohubba plug-ins were used for filtering hub genes, which are highly linked with PI development, from the candidate genes in the protein–protein interaction (PPI) network. Conclusions: We found five key genes from PI using WGCNA. Among them, ICAM1, CXCL1, and JUN are worthy of further study of new target genes, providing the theoretical basis for further exploration of the occurrence and development mechanism of PI.
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Luengo F, Solonko M, Sanz-Esporrín J, Sanz-Sánchez I, Herrera D, Sanz M. Clinical, Microbiological, and Biochemical Impact of the Surgical Treatment of Peri-Implantitis-A Prospective Case Series. J Clin Med 2022; 11:jcm11164699. [PMID: 36012939 PMCID: PMC9410201 DOI: 10.3390/jcm11164699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/01/2022] [Accepted: 08/09/2022] [Indexed: 11/24/2022] Open
Abstract
Background: The aim of this study, a prospective case series, was to evaluate the clinical, microbiological, and biochemical impact of the surgical treatment of peri-implantitis. Methods: Thirty subjects with diagnosis of peri-implantitis were treated following a surgical protocol including access flaps, surface decontamination with ultrasonics and glycine powder air-polishing, and systemic antibiotics. Disease resolution was defined by the composite outcome including presence of probing depths (PD) ≤5 mm, absence of bleeding on probing (BoP)/suppuration, and no additional radiographic bone loss (>1 mm). Regression analysis was used to evaluate the patient-, implant-, and prosthetic-related factors possibly influencing treatment outcomes. Results: Patients were evaluated at 6 months post treatment, demonstrating statistically significant reductions in PD (2.14 ± 1.07 mm) and increase in mucosal recession (1.0 ± 0.77 mm). Plaque, BoP, and suppuration were also reduced by 40.56%, 62.22%, and 7.78%, respectively. Disease resolution was achieved in 56.67% of patients. No significant changes were detected in microbiological parameters except for a significant reduction in proportions of Parvimonas micra. Similarly, the levels of the biomarker interleukin-8 in crevicular fluid were significantly lower at 6 months. Conclusions: The proposed surgical treatment of peri-implantitis demonstrated statistically significant clinical improvements although the impact on microbiological and biochemical parameters was scarce.
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Affiliation(s)
- Fernando Luengo
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
| | - Myroslav Solonko
- Section of Periodontology, Faculty of Odontology, University Complutense, 28040 Madrid, Spain
| | - Javier Sanz-Esporrín
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
| | - Ignacio Sanz-Sánchez
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
- Correspondence:
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
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Moraschini V, Kischinhevsky ICC, Sartoretto SC, de Almeida Barros Mourão CF, Sculean A, Calasans-Maia MD, Shibli JA. Does implant location influence the risk of peri-implantitis? Periodontol 2000 2022; 90:224-235. [PMID: 35913455 DOI: 10.1111/prd.12459] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Peri-implantitis is characterized by nonreversible and progressive loss of supporting bone and is associated with bleeding and/or suppuration on probing. Peri-implant disease is considered as the main etiologic factor related to implant failure. Peri-implant disease has a pathogenesis similar to that of periodontal disease, both being triggered by an inflammatory response to the biofilm accumulation. Although the prevalence of peri-implantitis has been evaluated by several clinical studies with different follow-ups, there are currently little data on the impact of implant location and the prevalence of peri-implantitis. The aim of this review, therefore, was to summarize the evidence concerning the prevalence of peri-implantitis in relation to implant location and associated risk predictors. Even though most studies evaluating the prevalence of peri-implantitis in relation to implant location are cross-sectional or retrospective, they suggest that the occurrence of peri-implantitis is most prevalent in the anterior regions of the maxilla and mandible. Moreover, it seems that there is a higher prevalence of peri-implantitis in the maxilla than in the mandible.
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Affiliation(s)
- Vittorio Moraschini
- Department of Periodontology, Dental Research Division, School of Dentistry, Veiga de Almeida University, Rio de Janeiro, Brazil.,Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | - Suelen Cristina Sartoretto
- Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Monica Diuana Calasans-Maia
- Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Jamil Awad Shibli
- Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, São Paulo, Brazil
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Roccuzzo A, Klossner S, Stähli A, Imber JC, Eick S, Sculean A, Salvi GE. Non-surgical mechanical therapy of peri-implantitis with or without repeated adjunctive diode laser application. A 6-month double-blinded randomized clinical trial. Clin Oral Implants Res 2022; 33:900-912. [PMID: 35775311 PMCID: PMC9546299 DOI: 10.1111/clr.13969] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/14/2022] [Accepted: 06/24/2022] [Indexed: 11/27/2022]
Abstract
Objectives The objective of this study is to investigate the outcomes following non‐surgical therapy of peri‐implantitis (PI) with or without adjunctive diode laser application. Materials and methods A double‐blinded randomized controlled clinical trial was carried out in 25 subjects with 25 implants diagnosed with PI. Following curettage of granulation tissue, test implants (T) were treated with adjunctive application of a diode laser for 90 s (settings: 810 nm, 2.5 W, 50 Hz, 10 ms), while at control implants (C) non‐activated adjunctive diode laser was applied. The entire treatment procedure was performed at days 0 (i.e., baseline), 7 and 14. The primary outcome measure was change in mean pocket probing depth (PPD). Clinical and microbiological outcomes, as well as host‐derived inflammatory markers were evaluated at baseline, 3 and 6 months, while radiographic outcomes were assessed at baseline and at the 6‐month follow‐up. Results No statistically significant differences with respect to baseline patient characteristic were observed. After 6 months, both test and control implants yielded statistically significant PPD changes compared with baseline (T: 1.28 and C: 1.47 mm) but without statistically significant difference between groups (p = .381). No statistically significant changes in peri‐implant marginal bone levels were detected (p = .936). No statistically significant differences between test and control implants were observed with respect to microbiological and host‐derived parameters (p > .05). At the 6‐month follow‐up, treatment success was observed in 41.7% (n = 5) of test and 46.2% (n = 6) of control patients, respectively (p = .821). Conclusion Repeated adjunctive application of diode laser in the non‐surgical management of PI failed to provide significant benefits compared with mechanical instrumentation alone.
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Affiliation(s)
- Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sabrina Klossner
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Muñoz S, Johnson TM, Dutner JM, Lancaster DD, Lincicum AR, Stancoven BW. Implant site development requirements in an advanced dental education program: A series of 290 implants. J Dent Educ 2022; 86:1425-1434. [PMID: 35616247 DOI: 10.1002/jdd.12952] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/21/2022] [Accepted: 05/05/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE Our purpose was to assess the frequency and impact of various site development procedures provided before, during, and after implant placement in an advanced dental education program. METHODS We evaluated all implant cases completed by two residents in each of three consecutive periodontics residency classes. Dependent variables included implant failure, complication occurrence, presence of radiographic bone loss, and need for tissue augmentation. We analyzed these outcomes against a panel of explanatory covariates. RESULTS Our study sample involved 370 site development procedures at 290 implant sites in 160 patients. Three factors exhibited statistically significant associations with need for tissue augmentation: alveolar ridge preservation (ARP) (odds ratio [OR] 0.28; 95% confidence interval [CI] 0.13, 0.57), immediate implant placement (IIP) (OR 0.21; 95% CI 0.10, 0.47), and implant submergence (OR 8.3; 95% CI 4.5, 15.3). Four factors predicted treatment complications: ARP (OR 6.1; 95% CI 1.3, 29.1), IIP (OR 6.1; 95% CI 1.06, 35.3), implant submergence (OR 5.3; 95% CI 1.1, 24.9), and mandibular arch (OR 31.3; 95% CI 1.9, 500). Anterior sites (OR 2.7; 95% CI 1.3, 5.8) were more likely to receive IIP. CONCLUSIONS In the evaluated sample, implant placement at a site exhibiting a favorable volume of native bone was rare. Seventy-eight percent of sites received hard tissue grafting during the treatment phase. The use of ARP or IIP at tooth extraction reduced subsequent tissue augmentation requirements. Education and training in ARP and other site development procedures may enhance the clinical practice and treatment outcomes of implant surgeons.
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Affiliation(s)
- Sergio Muñoz
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, Georgia, USA
| | - Thomas M Johnson
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, Georgia, USA
| | - Joseph M Dutner
- Department of Endodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, Georgia, USA
| | - Douglas D Lancaster
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, Georgia, USA
| | - Adam R Lincicum
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, Georgia, USA
| | - Brian W Stancoven
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, Georgia, USA
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Rakasevic D, Lazic Z, Soldatovic I, Scepanovic M, Gabric D. Influence of titanium implant macrodesign on peri-implantitis occurrence: a cross-sectional study. Clin Oral Investig 2022; 26:5237-5246. [PMID: 35460428 DOI: 10.1007/s00784-022-04492-z] [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: 01/22/2022] [Accepted: 04/13/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To assess whether implant macrodesign parameters interacting with implant time in function (Tf) could influence the peri-implantitis occurrence. MATERIALS AND METHODS One hundred and two patients (55.17 ± 11.2 years old) with diagnosed early/moderate peri-implantitis around endosseous implants with implant-supported prosthetics reconstruction (n = 139) were recruited. Implant macrodesign (implant shape, thread number, implant collar), clinical parameters (peri-implant probing depth (PPD), clinical attachment level (CAL), keratinised tissue width (KTW), plaque index, bleeding on probe), implant placement localisation and region, and Tf were assessed and compared. RESULTS Peri-implantitis occurred approximately 6.1 ± 3.38 years after implant loading. There was a significant positive correlation between the implant macrodesign and Tf. Peri-implantitis rates were statistically significantly higher in implants with a cylindric shape and triple-thread in the posterior part of the mandible (p = 0.037 and 0.012, respectively). The thread number and implant shape interacting with Tf showed statistically significant influences on CAL and PPD increase (p < 0.05). Results indicated a statistically positive interaction between Tf and KTW decrease around the implants with microthreaded collar (p < 0.001). CONCLUSION Peri-implantitis might be presented as a time-dependent disease. Implant-based factors, such as Tf and implant macrodesign, could influence peri-implantitis occurrence, exacerbate clinical parameters, and promote progressive bone loss. CLINICAL RELEVANCE Peri-implantitis can be affected by implant macrodesign and Tf. The implant body shape, thread number, and design of the implant collar may be considered peri-implantitis-related risk indicators that should be taken into account in proper implant planning and therapy.
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Affiliation(s)
- Dragana Rakasevic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, 4, Dr Subotica, 11000, Beograd, Serbia
| | - Zoran Lazic
- Department of Implantology, Medical Military Academy, 4, Crnotravska, 11000, Belgrade, Serbia
| | - Ivan Soldatovic
- Institute for Biomedical Statistics, Faculty of Medicine, University of Belgrade, 6, Dr Subotica, 11000, Beograd, Serbia
| | - Miodrag Scepanovic
- Department of Prosthodontics, School of Dental Medicine, University of Belgrade, 4, Dr Subotica, 11000, Beograd, Serbia
| | - Dragana Gabric
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, 5, Gunduliceva, 10000, Zagreb, Croatia. .,University Hospital Centre Zagreb, 5, Gunduliceva, 10000, Zagreb, Croatia.
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Comparison of Two Risk Assessment Scores in Predicting Peri-Implantitis Occurrence during Implant Maintenance in Patients Treated for Periodontal Diseases: A Long-Term Retrospective Study. J Clin Med 2022; 11:jcm11061720. [PMID: 35330046 PMCID: PMC8948905 DOI: 10.3390/jcm11061720] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/12/2022] [Accepted: 03/17/2022] [Indexed: 12/11/2022] Open
Abstract
Background: There is a need for reliable risk assessment tools to better predict peri-implantitis occurrence. This study compared the long-term prognosis value of two models of risk assessment scoring in predicting peri-implantitis. Methods: Seventy-three patients with treated periodontitis representing 232 implants and attending long-term implant maintenance were evaluated. The Periodontal Risk Assessment (PRA) score, which combines only periodontal risk factors/indicators, and the Implant Risk Assessment (IRA) score, which combines both periodontal and implant risk factors/indicators, were calculated during implant maintenance. Peri-implantitis was defined by the presence of probing depth ≥6 mm with bleeding on probing/suppuration and bone level ≥3 mm. Analyses were performed at the patient level. Results: The mean implant follow-up was 6.5 years. Peri-implantitis incidence was 17.8%, and high-risk PRA and IRA percentages were 36.9% and 27.3%, respectively. High-risk PRA and IRA were significantly associated with peri-implantitis incidence, with hazard ratio (HR) = 4.8 and 3.65, respectively. Risk factors/indicators considered separately showed reduced associations with peri-implantitis. Conclusions: The PRA score combining periodontal parameters and IRA score combining both periodontal and implant parameters have comparable value in predicting peri-implantitis. These scores could allow practicians to intercept the risk of peri-implantitis and to manage follow-up modalities in patients with treated periodontitis.
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Bosshardt DD, Brodbeck UR, Rathe F, Stumpf T, Imber JC, Weigl P, Schlee M. Evidence of re-osseointegration after electrolytic cleaning and regenerative therapy of peri-implantitis in humans: a case report with four implants. Clin Oral Investig 2022; 26:3735-3746. [PMID: 35244779 PMCID: PMC8979896 DOI: 10.1007/s00784-021-04345-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/10/2021] [Indexed: 11/21/2022]
Abstract
Objective To evaluate re-osseointegration after electrolytic cleaning and regenerative therapy of dental implants with peri-implantitis in humans. Material and methods Four dental implants that developed peri-implantitis underwent electrolytic cleaning followed by regenerative therapy with guided bone regeneration. All four implants developed recurrent peri-implantitis and were therefore explanted 6 to 13 months later. Radiographic bone level, probing depth, and bleeding on probing were determined at the time of surgery, 6 months later, and before implant retrieval. The peri-implant tissues were histologically and histomorphometrically analyzed. Results All four implants demonstrated radiographic and histological bone gain, reduced probing depth, and bleeding on probing. Radiographic bone gain was 5.8 mm mesially and 4.8 mm distally for implant #1, 3.3 mm and 2.3 mm for implant #2, 3.1 mm and 0.5 mm for implant #3, and 3.5 mm and 2.8 mm for implant #4. The histometric mean and maximum vertical bone gain for implant #1 to #4 was 1.65 mm and 2.54 mm, 3.04 mm and 3.47 mm, 0.43 mm and 1.27 mm, and 4.16 mm and 5.22 mm, respectively. The percentage of re-osseointegration for implant #1 to #4 was 21.0%, 36.9%, 5.7%, and 39.0%, respectively. In one implant, the newly formed bone was deposited directly onto calculus on the implant surface. Conclusions We found that (1) re-osseointegration is possible on a formerly contaminated implant surface and (2) the electrolytic cleaning process seems to be effective enough at sites with calculus residues. Clinical relevance Since re-osseointegration can be achieved by electrolytic cleaning, this decontamination technique may be considered as a future treatment concept.
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Affiliation(s)
- Dieter D Bosshardt
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Urs R Brodbeck
- Private Practice, Zahnmedizin Zurich Nord, Herzogenmühlestrasse 14, CH-8051, Zürich, Switzerland.
| | - Florian Rathe
- Private Practice, Forchheim, Germany.,Department of Prosthodontics, Danube University, Krems, Austria
| | | | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Paul Weigl
- Department of Medical Technology Research, Carolinum University Dental Institute, Faculty of Medicine at J.W. Goethe-University, Frankfurt am Main, Germany
| | - Markus Schlee
- Private Practice, Forchheim, Germany.,Department of Maxillofacial Surgery, Goethe University, Frankfurt am Main, Germany
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Khouly I, Pardiñas López S, Díaz Prado SM, Ferrantino L, Kalm J, Larsson L, Asa’ad F. Global DNA Methylation in Dental Implant Failure Due to Peri-Implantitis: An Exploratory Clinical Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19021020. [PMID: 35055840 PMCID: PMC8775395 DOI: 10.3390/ijerph19021020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 12/14/2022]
Abstract
Background: Peri-implantitis (PIT) is highly prevalent in patients with dental implants and is a challenging condition to treat due to the limited outcomes reported for non-surgical and surgical therapies. Therefore, epigenetic therapeutics might be of key importance to treat PIT. However, developing epigenetic therapeutics is based on understanding the relationship between epigenetics and disease. To date, there is still scarce knowledge about the relationship between epigenetic modifications and PIT, which warrants further investigations. Aim: The purpose of this study was to evaluate the level of global DNA methylation associated with implant failure (IF) due to PIT compared to periodontally healthy (PH) patients. Material and Methods: A total of 20 participants were initially enrolled in this pilot, exploratory, single-blinded, cross-sectional clinical human study in two groups: 10 in the PH group and 10 in the IF group. In the participants who have completed the study, gingival tissue and bone samples were harvested from each participant and were used to perform global DNA methylation analysis. The percentage of global DNA methylation (5-mC%) was compared (1) between groups (PH and IF); (2) between the subgroups of gingival tissue and bone separately; (3) in the whole sample, comparing gingival tissue and bone; (4) within groups, comparing gingival tissue and bone. Demographic, periodontal, and peri-implant measurements as well as periodontal staging, were also recorded. All statistical comparisons were made at the 0.05 significance level. Results: Out of the initially enrolled 20 patients, only 19 completed the study and, thus, were included in the final analysis; 10 patients in the PH group and 9 patients in the IF group, contributing to a total of 38 samples. One patient from the IF group was excluded from the study due to systemic disease. The mean implant survival time was 10.8 years (2.17–15.25 years). Intergroup comparison, stratified by group, indicated a similar 5-mC% between the PH and IF groups in both gingival tissue and bone (p = 0.599), only in bone (p = 0.414), and only in gingival tissue (p = 0.744). Intragroup comparison, stratified by the type of sample, indicated a significantly higher 5-mC% in gingival tissue samples compared to bone in both the PH and IF groups (p = 0.001), in the PH group (p = 0.019), and in the IF group (p = 0.009). Conclusions: Within the limitations of this study, higher global DNA methylation levels were found in gingival tissue samples compared to bone, regardless of the study groups. However, similar global DNA methylation levels were observed overall between the IF and PH groups. Yet, differences in the global DNA methylation levels between gingival tissues and bone, regardless of the study group, could reflect a different epigenetic response between various tissues within the same microenvironment. Further studies are necessary to elucidate the present findings and to evaluate the role of epigenetic modifications in IF due to PIT.
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Affiliation(s)
- Ismael Khouly
- Department of Oral and Maxillofacial Surgery, College of Dentistry, New York University, New York, NY 10010, USA
- Correspondence:
| | - Simon Pardiñas López
- Periodontology and Oral Surgery, Clínica Médico Dental Pardiñas, Real 66, 3°, 15003 A Coruña, Spain;
- Institute of Biomedical Research of A Coruña (INIBIC), Galician Health Service (SERGAS), University Hospital Complex A Coruña (CHUAC), 15006 A Coruña, Spain;
- Centro de Investigaciones Científicas Avanzadas (CICA), University of A Coruña, Rúa As Casballeiras, 15071 A Coruña, Spain
- Cell Therapy and Regenerative Medicine Group, Department of Physiotherapy, Medicine and Biomedical Sciences, Faculty of Health Sciences, University of A Coruña (UDC), 15006 A Coruña, Spain
| | - Silvia María Díaz Prado
- Institute of Biomedical Research of A Coruña (INIBIC), Galician Health Service (SERGAS), University Hospital Complex A Coruña (CHUAC), 15006 A Coruña, Spain;
- Centro de Investigaciones Científicas Avanzadas (CICA), University of A Coruña, Rúa As Casballeiras, 15071 A Coruña, Spain
- Cell Therapy and Regenerative Medicine Group, Department of Physiotherapy, Medicine and Biomedical Sciences, Faculty of Health Sciences, University of A Coruña (UDC), 15006 A Coruña, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
| | - Luca Ferrantino
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, 20122 Milan, Italy;
- Department of Aesthetic Dentistry, Istituto Stomatologico Italiano, 20122 Milan, Italy
| | - Josephine Kalm
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, SE-405 30 Göteborg, Sweden; (J.K.); (L.L.)
| | - Lena Larsson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, SE-405 30 Göteborg, Sweden; (J.K.); (L.L.)
| | - Farah Asa’ad
- Department of Biomaterials, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, SE-405 30 Göteborg, Sweden;
- Department of Oral Biochemistry, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, SE-405 30 Göteborg, Sweden
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Kajikawa T, Mastellos DC, Hasturk H, Kotsakis GA, Yancopoulou D, Lambris JD, Hajishengallis G. C3-targeted host-modulation approaches to oral inflammatory conditions. Semin Immunol 2022; 59:101608. [PMID: 35691883 DOI: 10.1016/j.smim.2022.101608] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Periodontitis is an inflammatory disease caused by biofilm accumulation and dysbiosis in subgingival areas surrounding the teeth. If not properly treated, this oral disease may result in tooth loss and consequently poor esthetics, deteriorated masticatory function and compromised quality of life. Epidemiological and clinical intervention studies indicate that periodontitis can potentially aggravate systemic diseases, such as, cardiovascular disease, type 2 diabetes mellitus, rheumatoid arthritis, and Alzheimer disease. Therefore, improvements in the treatment of periodontal disease may benefit not only oral health but also systemic health. The complement system is an ancient host defense system that plays pivotal roles in immunosurveillance and tissue homeostasis. However, complement has unwanted consequences if not controlled appropriately or excessively activated. Complement overactivation has been observed in patients with periodontitis and in animal models of periodontitis and drives periodontal inflammation and tissue destruction. This review places emphasis on a promising periodontal host-modulation therapy targeting the complement system, namely the complement C3-targeting drug, AMY-101. AMY-101 has shown safety and efficacy in reducing gingival inflammation in a recent Phase 2a clinical study. We also discuss the potential of AMY-101 to treat peri-implant inflammatory conditions, where complement also seems to be involved and there is an urgent unmet need for effective treatment.
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Affiliation(s)
- Tetsuhiro Kajikawa
- University of Pennsylvania, Penn Dental Medicine, Department of Basic and Translational Sciences, Philadelphia, PA, USA; Tohoku University Graduate School of Dentistry, Department of Periodontology and Endodontology, Sendai, Miyagi, Japan
| | - Dimitrios C Mastellos
- National Center for Scientific Research 'Demokritos', Division of Biodiagnostic Sciences and Technologies, INRASTES, Athens, Greece
| | - Hatice Hasturk
- The Forsyth Institute, Center for Clinical and Translational Research, Cambridge, MA, USA
| | - Georgios A Kotsakis
- University of Texas Health Science Center at San Antonio, School of Dentistry, Department of Periodontics, San Antonio, TX, USA
| | | | - John D Lambris
- University of Pennsylvania, Perelman School of Medicine, Department of Pathology and Laboratory Medicine, Philadelphia, PA, USA
| | - George Hajishengallis
- University of Pennsylvania, Penn Dental Medicine, Department of Basic and Translational Sciences, Philadelphia, PA, USA.
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Zhang Q, Xu T, Bai N, Tan F, Zhao H, Liu J. Lectin‑type oxidized LDL receptor 1 modulates matrix metalloproteinase 2 production in peri‑implantitis. Exp Ther Med 2021; 23:171. [PMID: 35069852 DOI: 10.3892/etm.2021.11094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/27/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Qian Zhang
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Tao Xu
- School of Stomatology of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Na Bai
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Fei Tan
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Hongmei Zhao
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Jie Liu
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
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Das D, Shenoy N. Peri-Implant Diseases. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2021. [DOI: 10.1055/s-0041-1736452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AbstractOsseointegrated dental implants have become an increasingly popular modality of treatment for the replacement of absent or lost teeth because of its high rates of long-term survival when used to support various types of dental prostheses. However, complications and implant failure can still occur and are considered by many clinicians as a major obstacle for implant treatment. Biological complications mainly refer to inflammatory conditions of the soft tissues and bone surrounding implants and their restorative components, which are induced by the accumulation of bacterial biofilm. Two clinical varieties may be distinguished: peri-implant mucositis and peri-implantitis. Peri-implant mucositis is a reversible, plaque-induced inflammatory lesion confined to the peri-implant soft tissue unit, whereas peri-implantitis is an extension of peri-implant mucositis to involve the bone supporting the implant. Diagnosing and managing these biological complications is of utmost importance for the implant surgeon and dental practitioner. This review encompasses the etiology, diagnostic aspects, prevention, and management of biological complications.
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Affiliation(s)
- Dipanjan Das
- Department of Periodontics, AB Shetty Memorial Institute of Dental Sciences, Nitte (deemed to be) University, Derlakatte, Mangalore, India
| | - Nina Shenoy
- Department of Periodontics, AB Shetty Memorial Institute of Dental Sciences, Nitte (deemed to be) University, Derlakatte, Mangalore, India
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González Regueiro I, Martínez Rodriguez N, Barona Dorado C, Sanz-Sánchez I, Montero E, Ata-Ali J, Duarte F, Martínez-González JM. Surgical approach combining implantoplasty and reconstructive therapy with locally delivered antibiotic in the treatment of peri-implantitis: A prospective clinical case series. Clin Implant Dent Relat Res 2021; 23:864-873. [PMID: 34651432 DOI: 10.1111/cid.13049] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Nonsurgical treatment, resective surgery, reconstructive surgery, or combined approaches have been proposed for the treatment of peri-implantitis, with variable results. PURPOSE To evaluate the 1-year clinical and radiographic outcomes following combined resective and reconstructive surgical treatment with topical piperacillin/tazobactam antibiotic in the management of peri-implantitis. MATERIAL AND METHODS Forty-three patients diagnosed with peri-implantitis were included. Surgical treatment consisted of implantoplasty of the supra-crestal component of the defect, the application of a topical antibiotic solution over the implant surface, and subsequent reconstruction of the intra-osseous component of the peri-implant defect. The primary outcome was disease resolution, defined as the absence of bleeding on probing (BoP) and/or suppuration on probing (SoP), a peri-implant pocket probing depth (PPD) ≤5 mm, and no bone loss >0.5 mm 1 year after surgery. Secondary outcomes included changes in BoP, PPD, SoP, and peri-implant marginal bone levels. One implant per patient was included in the analysis. RESULTS The treatment success rate of the 43 dental implants included in the study was 86% at 1 year after surgery. Mean PPD and BoP decreased from 6.41 ± 2.11 mm and 100% at baseline to 3.19 ± 0.99 mm (p < 0.001) and 14% (p < 0.001) at 1 year, respectively. SoP was significantly reduced from 48.8% at baseline to 0% 1 year after surgery (p < 0.001). Radiographically, a mean defect fill of 2.64 ± 1.59 mm was recorded (p < 0.001). CONCLUSIONS The combination of a resective and reconstructive surgical approach together with locally delivered antibiotic achieved a high disease resolution rate after 1 year of follow-up and constitutes a viable option for the management of peri-implantitis.
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Affiliation(s)
| | | | | | - Ignacio Sanz-Sánchez
- Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - Eduardo Montero
- Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - Javier Ata-Ali
- Faculty of Health Sciences, Department of Dentistry, Universidad Europea de Valencia, Valencia, Spain.,Public Dental Health Service, Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, Valencia, Spain.,Department of Surgery and Medical-Surgical Specialities, Area of Orthodontics, University Medical and Dental School, University of Oviedo (Spain), Instituto Asturiano de Odontologia, Oviedo, Spain
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Jin Q, Teng F, Cheng Z. Association between common polymorphisms in IL-1 and TNFα and risk of peri-implant disease: A meta-analysis. PLoS One 2021; 16:e0258138. [PMID: 34610045 PMCID: PMC8491952 DOI: 10.1371/journal.pone.0258138] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/20/2021] [Indexed: 11/19/2022] Open
Abstract
Background Pro-inflammatory cytokines interleukin-1 (IL-1) and tumor necrosis factor α (TNFα) play important roles in host immune response and bone metabolism during dental implant osseointegration. Whether the functional polymorphisms in IL-1α, IL-1β and TNFα were associated with peri-implant disease was unclear, and we performed the present meta-analysis for this purpose. Methods Eligible studies investigating IL-1α C-889T, IL-1β C+3954T and C-511T, TNFα G-308A, composite genotype of IL-1α C-889T and IL-1β C+3954T for association with peri-implant disease, including peri-implantitis (PI), marginal bone loss (MBL) and implant failure/loss (IF/IL), were searched on several literature databases prior to April 30, 2021. Odds ratio (OR) and corresponding 95% confidence interval (CI) were calculated for each polymorphism in different genetic models and for composite genotype comparing carriers to non-carriers. Results Twenty-seven studies (1324 cases with peri-implant disease and 1808 controls with healthy implants) were included. There was significant correlation between IL-1α C-889T and peri-implant disease in all genetic models. IL-1β C+3954T was associated with peri-implant disease risk in allelic (OR = 1.66, 95%CI 1.17–2.35, p = 0.004) and dominant model (OR = 1.74, 95%CI 1.19–2.53, p = 0.004), and in subgroups of Asians, Caucasians, non-smokers, IF/IL and PI. TT genotype of IL-1β C-511T increased the risk of peri-implant disease (OR = 1.68, 95%CI 1.15–2.43, p = 0.007) and MBL (OR = 4.33, 95%CI 1.72–10.9, p = 0.002) compared to CC+CT genotypes. We did not observed a significant association between TNFα G-308A and peri-implant diseases in overall or subgroups analysis. Carriers of positive composite genotype of IL-1α C-889T and IL-1β C+3954T had 1.95-fold (95%CI 1.35–2.80, p<0.001) risk of peri-implant disease and 1.76-fold (95%CI 1.05–2.95, p = 0.032) risk of IF/IL than non-carriers. Conclusion Functional polymorphisms of IL-1α (C-889T), IL-1β (C+3954T, C-511T) and composite genotype of IL-1 can be used as predictive markers for peri-implant disease, whereas TNFα G-308A polymorphism was not associated with peri-implant disease.
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Affiliation(s)
- Qiuchen Jin
- Department of Stomatology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fangjun Teng
- Department of Stomatology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhigang Cheng
- Department of Stomatology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- * E-mail:
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Roccuzzo M, Mirra D, Pittoni D, Ramieri G, Roccuzzo A. Reconstructive treatment of peri-implantitis infrabony defects of various configurations: 5-year survival and success. Clin Oral Implants Res 2021; 32:1209-1217. [PMID: 34352140 PMCID: PMC9290544 DOI: 10.1111/clr.13818] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 05/30/2021] [Accepted: 07/07/2021] [Indexed: 12/28/2022]
Abstract
Aim To present the 5 years outcomes of a reconstructive surgical protocol for peri‐implantitis defects with different morphologies, by means of deproteinized bovine bone mineral with 10% collagen (DBBMC). Material and Methods The original population of this case series consisted of 75 patients with one crater‐like defect and probing depth (PD) ≥6 mm. After flap elevation, defects were assigned to one characteristic class and treated by means of DBBMC. Following healing, patients were enrolled in an individualized supportive periodontal/peri‐implant (SPT) program. Results Fifty‐one patients reached the 5 years examination, as 11 patients were lost to follow‐up and 13 implants were removed. Overall treatment success was registered in 29 patients (45.3%). Mean PD and BOP significantly decreased at one year and remained stable for the rest of observation period. No correlation was found between implant survival rate and defect configuration (p = 0.213). Patients, who did not fully adhere to the SPT, experienced more complications and implant loss than those who regularly attended recall appointments (p = 0.009). Conclusions The proposed reconstructive treatment resulted in a high 5 years implant survival rate in patients who fully adhered to SPT. The resolution of the peri‐implantitis defect does not seem significantly associated with the defect configuration at the time of treatment.
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Affiliation(s)
- Mario Roccuzzo
- Private practice, Torino, Italy.,Department of Maxillo-facial Surgery, University of Torino, Torino, Italy.,Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | | | | | - Guglielmo Ramieri
- Department of Maxillo-facial Surgery, University of Torino, Torino, Italy
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillo-facial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
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Wychowański P, Starzyńska A, Adamska P, Słupecka-Ziemilska M, Sobocki BK, Chmielewska A, Wysocki B, Alterio D, Marvaso G, Jereczek-Fossa BA, Kowalski J. Methods of Topical Administration of Drugs and Biological Active Substances for Dental Implants-A Narrative Review. Antibiotics (Basel) 2021; 10:919. [PMID: 34438969 PMCID: PMC8388631 DOI: 10.3390/antibiotics10080919] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 12/15/2022] Open
Abstract
Dental implants are, nowadays, established surgical devices for the restoration of lost teeth. Considered as an alternative for traditional prosthetic appliances, dental implants surpass them in reliability and patient feedback. Local drug delivery around the implants promotes osseointegration and reduces peri-implantitis. However, there are currently no methods of a multiple, precise topical administration of drugs to the implant area. Engineering coatings on the implants, drug application on carriers during implantation, or gingival pockets do not meet all requirements of dental surgeons. Therefore, there is a need to create porous implants and other medical devices that will allow a multiple drug delivery at a controlled dose and release profile without traumatic treatment. Due to the growing demand for the use of biologically active agents to support dental implant treatment at its various stages (implant placement, long-term use of dental superstructures, treatment of the peri-implant conditions) and due to the proven effectiveness of the topical application of pharmacological biologically active agents to the implant area, the authors would like to present a review and show the methods and devices that can be used by clinicians for local drug administration to facilitate dental implant treatment. Our review concludes that there is a need for research in the field of inventions such as new medical devices or implants with gradient solid-porous structures. These devices, in the future, will enable to perform repeatable, controllable, atraumatic, and repeatable injections of active factors that may affect the improvement of osteointegration and the longer survival of implants, as well as the treatment of peri-implantitis.
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Affiliation(s)
- Piotr Wychowański
- Department of Oral Surgery, Medical University of Warsaw, 6 St. Binieckiego Street, 02-097 Warsaw, Poland;
| | - Anna Starzyńska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (B.K.S.)
| | - Paulina Adamska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (B.K.S.)
| | - Monika Słupecka-Ziemilska
- Department of Human Epigenetics, Mossakowski Medical Research Center, Polish Academy of Sciences, 5 Pawińskiego Street, 02-106 Warsaw, Poland;
| | - Bartosz Kamil Sobocki
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (B.K.S.)
- International Research Agenda 3P—Medicine Laboratory, Medical University of Gdańsk, 3a Marii Skłodowskiej-Curie Street, 80-210 Gdańsk, Poland
| | - Agnieszka Chmielewska
- Faculty of Material Science and Engineering, Warsaw University of Technology, 141 Wołoska Street, 02-507 Warsaw, Poland;
- Department of Materials Science and Engineering, The Ohio State University, 140 W 19th Ave, Columbus, OH 43210, USA
| | - Bartłomiej Wysocki
- Center of Digital Science and Technology, Cardinal Stefan Wyszyński University in Warsaw, Woycickiego 1/3 Street, 01-938 Warsaw, Poland;
- Additive Manufacturing Research Center, College of Engineering, Youngstown State University, Youngstown, OH 44555, USA
| | - Daniela Alterio
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20141 Milan, Italy; (D.A.); (G.M.); (B.A.J.-F.)
| | - Giulia Marvaso
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20141 Milan, Italy; (D.A.); (G.M.); (B.A.J.-F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 7 Festa del Perdono Street, 20112 Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20141 Milan, Italy; (D.A.); (G.M.); (B.A.J.-F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 7 Festa del Perdono Street, 20112 Milan, Italy
| | - Jan Kowalski
- Department of Periodontology and Oral Medicine, Medical University of Warsaw, 6 St. Binieckiego Street, 02-097 Warsaw, Poland;
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