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Galindo-Moreno P, Catena A, Lopez-Chaichio L, Borges T, O’Valle F, Torrecillas-Martínez L, Padial-Molina M. The Influence of History of Severe Periodontitis on Estimated Long-Term Marginal Bone Loss around Implants Restored with Fixed Segmented Full-Arch Rehabilitation. J Clin Med 2023; 12:6665. [PMID: 37892803 PMCID: PMC10607884 DOI: 10.3390/jcm12206665] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
The aim of this study was to analyze the long-term marginal bone level (MBL) of implants supporting fixed full-arch restoration in patients who had previously lost their dentition due to severe periodontitis. This retrospective study included 35 patients in whom 342 implants with internal tapered conical connections were placed. MBL was analyzed radiographically over time and a long-term estimation of MBL was calculated. A mixed linear model with abutment height, graft, diameter and location (maxilla/mandible) as factors and gender, age, implant length and prosthetic variables as covariates was used to evaluate the influence on MBL. MBL in these patients showed an estimator of predictions at 4108 days after loading of -0.307 mm, SE = 0.042. Only 0.15% of implants were radiographically affected with MBL of 3 mm or more. The mixed linear model results showed a main effect of the type of opposing dentition, gender, implant diameter, and abutment height. Particularly, an abutment height of 1 mm had associated larger MBL than the remaining heights. Thus, it can be concluded that dental implants restored with fixed segmented full-arch rehabilitation in patients with a history of severe periodontal disease do not suffer important marginal bone loss if some specific factors are considered, mainly the use of long transmucosal abutments (≥2 mm).
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Affiliation(s)
- Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain; (F.O.)
| | - Andres Catena
- Department of Experimental Psychology, School of Psychology, University of Granada, 18071 Granada, Spain
| | | | - Tiago Borges
- Centre of Interdisciplinary Research in Health, and Faculty of Dentistry, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal;
| | - Francisco O’Valle
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain; (F.O.)
- Department of Pathology and IBIMER, School of Medicine, University of Granada, 18071 Granada, Spain
| | - Laura Torrecillas-Martínez
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain; (F.O.)
- Private Practice, 18008 Granada, Spain
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain; (F.O.)
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Galindo-Moreno P, Ravidà A, Catena A, O'Valle F, Padial-Molina M, Wang HL. Limited marginal bone loss in implant-supported fixed full-arch rehabilitations after 5 years of follow-up. Clin Oral Implants Res 2022; 33:1224-1232. [PMID: 36184955 PMCID: PMC10092560 DOI: 10.1111/clr.14004] [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: 04/18/2022] [Revised: 08/05/2022] [Accepted: 09/06/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE The aim of the present study was to evaluate the 5-year results in terms of marginal bone level (MBL) around implants supporting fixed full-arch metal-ceramic restorations in a series of cases of patients who had lost their teeth in that dental arch because of severe periodontal disease. MATERIAL AND METHODS A retrospective cohort study was designed to evaluate the 5-year MBL results of OsseoSpeed™ Astra Tech TX implants with internal tapered conical connection. Age, gender, bone substratum, smoking habits, history of periodontitis, and prosthetic features were recorded. Mixed linear model was used to determine the influence of the different variables on MBL. RESULTS In this series, a total of 160 implants placed in 19 patients were evaluated. No implant failure was reported during the 5 years of follow-up. Only 14 (8.75%) implants had more than 2 mm of MBL. Abutment height, F(3,142) = 6.917, p < .001, and implant diameter, F(1,141) = 15.059, p < .001, were determined to be statistically associated with MBL. No other effect was significant. Pairwise comparisons showed that MBL was larger for abutment height = 1 (MBL = -0.987, SE = 0.186) compared with the remaining heights [-0.335 (0.171), -0.169 (0.192) and -0.247 (0.267), 2, 4 and 6 mm, respectively]. MBL was larger for narrow (-0.510, SE = 0.169) than for wide implants (-0.364, SE = 0.190). CONCLUSION The current study demonstrates that the vast majority of internal conical connection implants supporting fixed full-arch metal-ceramic restorations do not suffer from relevant MBL after 5 years in function. Particularly, those implants with transmucosal abutments longer than 2 mm show less than 0.5 mm from the implant shoulder to the marginal bone.
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Affiliation(s)
- Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Andrea Ravidà
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,PhD Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain
| | - Andrés Catena
- Department of Experimental Psychology, School of Psychology, University of Granada, Granada, Spain
| | - Francisco O'Valle
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Pathology, School of Medicine and IBIMER, University of Granada, Granada, Spain
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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Al Najam Y, Tahmaseb A, Wiryasaputra D, Wolvius E, Dhamo B. Outcomes of dental implants in young patients with congenital versus non-congenital missing teeth. Int J Implant Dent 2021; 7:92. [PMID: 34423396 PMCID: PMC8380590 DOI: 10.1186/s40729-021-00362-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/28/2021] [Indexed: 11/10/2022] Open
Abstract
Objective This cross-sectional study aims to investigate the effect of the cause of missing teeth on the survival and subjective success of dental implant treatment (DIT) in young patients with missing teeth due to non-congenital causes (tooth loss) in comparison to patients with missing teeth because of congenital causes (hypodontia and oligodontia). Material and methods All patients were asked 7 questions to extract information about the survival and subjective success of DIT. Implant survival function was designed using the Kaplan-Meier analysis. Differences in implant success outcomes were studied using binary logistic regression analysis. Results One hundred ten patients aged 18 to 40 years old were included, whereof 32 patients with tooth loss, 25 patients with hypodontia and 53 patients with oligodontia. In the tooth loss group, implant survival reached 96.9%; in the hypodontia group 96.0%; and in the oligodontia group 88.7%. Regarding subjective implant success, patient satisfaction was significantly higher (p < 0.040) among patients with congenital missing teeth in comparison to patients with tooth loss. Other implant success components showed no statistically significant difference (p > 0.050) between the groups. Conclusion The cause of missing teeth does not influence implant survival. However, the cause of missing teeth does have a significant impact on patient satisfaction (implant success), ascertaining young patients with congenital missing teeth as more satisfied of DIT than young patients with tooth loss. Clinical relevance Young patients with tooth agenesis and with an increased number of missing teeth are more content about the treatment with dental implants than patients with tooth loss. Furthermore, a consensus regarding the assessment of implant success is an essential concern for clarification. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-021-00362-7.
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Affiliation(s)
- Yousef Al Najam
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, PO Box 2040, CA, 3000, Rotterdam, the Netherlands
| | - Ali Tahmaseb
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, PO Box 2040, CA, 3000, Rotterdam, the Netherlands
| | - Dorothee Wiryasaputra
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, PO Box 2040, CA, 3000, Rotterdam, the Netherlands
| | - Eppo Wolvius
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, PO Box 2040, CA, 3000, Rotterdam, the Netherlands
| | - Brunilda Dhamo
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, PO Box 2040, CA, 3000, Rotterdam, the Netherlands.
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Ravidà A, Rodriguez MV, Saleh MHA, Galli M, Qazi M, Troiano G, Wang HL, Moreno PG. The correlation between history of periodontitis according to staging and grading and the prevalence/severity of peri-implantitis in patients enrolled in maintenance therapy. J Periodontol 2021; 92:1522-1535. [PMID: 33720410 DOI: 10.1002/jper.21-0012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND The aim of this study was to determine if a previous history of periodontitis according to the preset definitions of the 2017 World Workshop is correlated with increased implant failure, and occurrence and severity of peri-implantitis (PI). METHODS A retrospective analysis of patients with a history of periodontitis who received nonsurgical and, if indicated, surgical corrective therapy prior to implant placement was performed. Periodontitis stage and grade were determined for each included patient based on data from the time of initiation of active periodontal therapy. Cox Proportional Hazard Frailty models were built to analyze the correlation between stage and grade of periodontitis at baseline with implant failure, as well as occurrence and severity of PI. RESULTS Ninety-nine patients with a history of periodontitis receiving 221 implants were followed for a mean duration of 10.6 ± 4.5 years after implant placement. Six implants (2.7%) failed and a higher rate of implant failure due to PI was found for grade C patients (P < 0.05), whereas only an increased trend was seen for stages III and IV compared with I and II. Grading significantly influenced the risk of marginal bone loss (MBL) >25% of the implant length (P = 0.022) in PI-affected implants. However, a direct correlation between higher-level stage and grade and PI prevalence was not recorded. CONCLUSION No statistically significant association between periodontitis stage or grade and the prevalence of PI was found. However, when PI was diagnosed, there was a relationship between periodontitis grade and severity of PI or the occurrence of implant failure.
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Affiliation(s)
- Andrea Ravidà
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Maria Vera Rodriguez
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Muhammad H A Saleh
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Matthew Galli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Musa Qazi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Ramesh A, Ravi S, Kaarthikeyan G. Comprehensive rehabilitation using dental implants in generalized aggressive periodontitis. J Indian Soc Periodontol 2018; 21:160-163. [PMID: 29398863 PMCID: PMC5771115 DOI: 10.4103/jisp.jisp_213_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Generalized aggressive periodontitis (GAP) is a debilitating form of the disease and it results in deteriorating effects on the esthetic and functional aspects of the oral cavity. This case report describes the comprehensive rehabilitation of GAP patient using dental implants. The treatment planning involved thorough scaling and root planning (SRP) with oral hygiene instructions. The patient was motivated to adhere to a strict oral hygiene regimen following which periodontal flap surgery employing guided tissue regeneration and bone grafts was performed. Bacterial culture for anaerobic microorganisms was done using a gas pack pre- and postperiodontal treatment to confirm the effectiveness of the periodontal treatment regimen and also to proceed with dental implant placement. The rigorous maintenance program ensured the stability of the periodontium following which immediate placement of dental implants in the maxillary and mandibular anterior region was done. The fixed metal-ceramic prosthesis was fabricated in a step-by-step process and the patient was recalled on a periodic basis over a 3-year follow-up duration. This case is a testimonial to the postperiodontal treatment long-term stability with excellent patient cooperation and strict maintenance protocol.
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Affiliation(s)
- Asha Ramesh
- Department of Periodontics, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Sheethalan Ravi
- Department of Periodontics, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India
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Mengel R, Heim T, Thöne-Mühling M. Mucositis, peri-implantitis, and survival and success rates of oxide-coated implants in patients treated for periodontitis 3- to 6-year results of a case-series study. Int J Implant Dent 2017; 3:48. [PMID: 29181639 PMCID: PMC5704031 DOI: 10.1186/s40729-017-0110-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 10/26/2017] [Indexed: 11/12/2022] Open
Abstract
Aim The aim of this case-series study is to evaluate the prevalence of mucositis, peri-implantitis, and survival and success rates of oxide-coated implants in subjects treated for periodontitis. Materials and methods Twenty-four subjects treated for generalized chronic periodontitis (GCP) and five treated for generalized aggressive periodontitis (GAP) were orally rehabilitated with a total of 130 dental implants. Subjects were examined 2 to 4 weeks prior to extraction of non-retainable teeth and at insertion of superstructure. Additional examinations were performed during a 3-month recall schedule over a 3- to 6-year follow-up period. Radiographs were taken after insertion of the superstructure and 1, 3, and 5 years later. Results The results showed implant survival rates of 97.1% in GCP subjects versus 96.2% in GAP subjects. The implant success rate was 77.9% in GCP subjects and 38.5% in GAP subjects. In GCP subjects, mucositis was present in 7.7% and peri-implantitis in 12.5% of the implants. In GAP subjects, 28.0% of the implants showed mucositis and 32.0% peri-implantitis. Implant failure, mucositis, and peri-implantitis were more evident in GAP subjects. Peri-implantitis was more prevalent for implants in the maxilla and implants >10 mm. After 5 years, the mean peri-implant bone loss in GAP subjects was 2.89 mm and in GCP subjects 1.38 mm. Conclusions Periodontally diseased subjects treated in a supportive periodontal therapy can be successfully rehabilitated with oxide-coated dental implants for a follow-up period of 3- to 6-years. Implants in the maxilla and GAP subjects were more susceptible to mucositis and peri-implantitis, with lower implant survival and success rates.
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Affiliation(s)
- Reiner Mengel
- Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University, Marburg/Lahn, Germany.
| | | | - Miriam Thöne-Mühling
- Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University, Marburg/Lahn, Germany
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7
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Surgical and Patient Factors Affecting Marginal Bone Levels Around Dental Implants. IMPLANT DENT 2017; 26:303-315. [DOI: 10.1097/id.0000000000000565] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Al-Zahrani MS, Elfirt EY, Al-Ahmari MM, Yamany IA, Alabdulkarim MA, Zawawi KH. Comparison of Cone Beam Computed Tomography-Derived Alveolar Bone Density Between Subjects with and without Aggressive Periodontitis. J Clin Diagn Res 2017; 11:ZC118-ZC121. [PMID: 28274060 PMCID: PMC5324485 DOI: 10.7860/jcdr/2017/22767.9305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 10/06/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Understanding the changes in bone density of patients affected by aggressive periodontitis could be useful in early disease detection and proper treatment planning. AIM The aim of this study was to compare alveolar bone density in patients affected with aggressive periodontitis and periodontally healthy individuals using Cone Beam Computed Tomography (CBCT). MATERIALS AND METHODS This cross-sectional study was conducted on 20 patients with a confirmed diagnosis of aggressive periodontitis. Twenty periodontally healthy patients attending the dental clinics for implant placement or extraction of impacted third molars served as controls. Alveolar bone density was measured using CBCT scanning. Comparisons between aggressive periodontitis group and controls for age and alveolar bone density of the anterior and posterior regions were performed using an independent sample t-test. Multivariable linear regression models were also performed. RESULTS The differences between groups in regard to age, anterior and posterior alveolar bone density was not statistically significant (p<0.05). In the posterior region, the multivariable regression model showed that bone density was not associated with age, gender or the study groups. Whereas, in the anterior region, patient's age was found to be significantly associated with bone density, p=0.014. CONCLUSION Alveolar bone density as measured by CBCT in aggressive periodontitis patients was not different from periodontally healthy individuals. Further studies are needed to confirm these findings.
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Affiliation(s)
- Mohammad S. Al-Zahrani
- Professor, Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Eman Y. Elfirt
- Associate Professor, Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia and Cairo University, Cairo, Egypt
| | - Manea M. Al-Ahmari
- Resident, Department of Periodontics, Assir Dental Center, Ministry of Health, Abha, Saudi Arabia
| | - Ibrahim A. Yamany
- Assistant Professor, Department of Oral Diagnostic Sciences, Division of Oral and Maxillofacial Radiology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Maher A. Alabdulkarim
- Consultant, Department of Periodontics, King Saud Medical Complex, Ministry of Health, Riyadh, Saudi Arabia
| | - Khalid H. Zawawi
- Professor, Department of Orthodntics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Theodoridis C, Grigoriadis A, Menexes G, Vouros I. Outcomes of implant therapy in patients with a history of aggressive periodontitis. A systematic review and meta-analysis. Clin Oral Investig 2016; 21:485-503. [PMID: 28013438 DOI: 10.1007/s00784-016-2026-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 12/05/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the outcomes of implant therapy in partially dentate patients treated for aggressive periodontitis (GAgP) in comparison to periodontally healthy (HP) and patients treated for chronic periodontitis (CP) utilizing radiographic and clinical parameters. MATERIAL AND METHODS An electronic search of databases, supplemented by hand searching, was conducted to identify relevant clinical studies. Sequential screenings at the title, abstract and full-text levels were performed independently and in duplicate. A random effects meta-analysis was conducted and bias corrected bootstrap 95 % confidence intervals were estimated for group comparisons. RESULTS The search strategy revealed a total of 899 results. After title screening, abstract scanning, and full-text reading, seven articles fulfilled the inclusion criteria. The 3-year survival rate for CP and HP patients was 100 % while in GAgP subjects, the respective value was 97.98 %; this difference being statistically significant. The 3-year mean marginal bone loss (MBL) was 1.07 mm for the GAgP group, 0.47 mm for the CP group, and 0.69 mm for the HP group. A significant difference between the GAgP and CP groups was identified (p < 0.05). The weighted mean differences of MBL concerning the above groups were also calculated and examined for statistical significance in both 1 and 3 years. CONCLUSIONS The 3-year survival rate and peri-implant marginal bone loss was found statistically significantly lower in GAgP subjects (SR 97.98 % vs 100 %) in comparison to HP and CP individuals. CLINICAL RELEVANCE The outcome of implant therapy in terms of survival rate and marginal bone loss is considered very important for the clinician in decision making when placing implants in patients with a history of aggressive periodontitis.
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Affiliation(s)
- Charis Theodoridis
- Department of Dentoalveolar Surgery, Implant Surgery and Radiology, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Grigoriadis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Georgios Menexes
- School of Agriculture, Laboratory of Agronomy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Vouros
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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10
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Sousa V, Mardas N, Farias B, Petrie A, Needleman I, Spratt D, Donos N. A systematic review of implant outcomes in treated periodontitis patients. Clin Oral Implants Res 2015; 27:787-844. [DOI: 10.1111/clr.12684] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Vanessa Sousa
- Department of Clinical Research; Periodontology Unit; UCL Eastman Dental Institute; London UK
| | - Nikos Mardas
- Centre for Adult Oral Health, Periodontology Unit; QMUL Bart's and The London School of Dentistry and Hospital; London UK
| | - Bruna Farias
- Federal University of Pernambuco; Recife-Pernambuco Brazil
| | - Aviva Petrie
- Biostatistics Unit; UCL Eastman Dental Institute; London UK
| | - Ian Needleman
- Department of Clinical Research; Periodontology Unit; UCL Eastman Dental Institute; London UK
- International Centre for Evidence-Based Oral Health; UCL Eastman Dental Institute; London UK
| | - David Spratt
- Department of Microbial Diseases; UCL Eastman Dental Institute; London UK
| | - Nikolaos Donos
- Department of Clinical Research; Periodontology Unit; UCL Eastman Dental Institute; London UK
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11
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12
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Saunders WP. Treatment planning the endodontic-implant interface. Br Dent J 2014; 216:325-30. [PMID: 24651338 DOI: 10.1038/sj.bdj.2014.202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2013] [Indexed: 11/09/2022]
Abstract
One of the most challenging treatment planning decisions in restorative dentistry is the retention of a root filled tooth or its extraction and replacement with an implant. Making an informed judgement relies upon not only clinical experience and expertise but also interpretation of the published clinical evidence. In the last few years, more robust data and closer scrutiny of the evidence has helped to understand the advantages and disadvantages of each of these treatment modalities. The purpose of this paper is to provide a narrative review of some of the factors that may influence treatment planning for root canal treated teeth and indications for whether these teeth would be better replaced by an implant. From the evidence presented it is clear that both treatments have a place in contemporary restorative dental treatment and that survival for both root filled teeth and implants are similar. Unsurprisingly, both these treatment choices require high standards of clinical expertise and careful planning to ensure the best outcome.
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Affiliation(s)
- W P Saunders
- Emeritus Professor of Endodontology, School of Dentistry, University of Dundee, Park Place, Dundee, DD1 4HN
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13
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Sgolastra F, Petrucci A, Severino M, Gatto R, Monaco A. Periodontitis, implant loss and peri-implantitis. A meta-analysis. Clin Oral Implants Res 2013; 26:e8-e16. [PMID: 24382358 DOI: 10.1111/clr.12319] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2013] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aim of the present systematic review and meta-analysis was to assess the role of periodontal disease as a risk factor for implant loss, peri-implantitis and implant-bone loss. MATERIALS AND METHODS Six electronic database and a manual search resulted in 7391 unique publications; after selection only 16 studies were included in systematic review. Dichotomous data were expressed as risk ratio (RR) and 95% confidence interval (CI), while continuous data were expressed as standardized mean difference (SMD). Due to the expected inter-study heterogeneity, a random effect model was used for both type of data. The pooled effect was considered significant for a P < 0.05. RESULTS Meta-analysis revealed that an higher and significant risk for implant loss was present in patients affected by PD (RR: 1.69, 95% CI: 1.31-2.17, P < 0.0001). A higher and significant IBL was present in patients with periodontal disease, when compared with patients periodontally healthy (SMD: 0.38, 95% CI: 0.18-0.58, P = 0.0002). Patients periodontally compromised showed an increased risk of PI, when compared with patients without periodontitis (RR: 2.17, 95% CI: 1.51-3.12, P < 0.0001) No evidence of significant heterogeneity was detected for the three outcomes. CONCLUSION Strong evidence suggests that periodontitis is a risk factor for implant loss; moderate evidence revealed that periodontitis is a risk factor for peri-implantitis and that patients with periodontitis have higher implant-bone loss.
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Affiliation(s)
- F Sgolastra
- Department of Life Health and Environmental Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy
| | - A Petrucci
- Department of Life Health and Environmental Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy
| | - M Severino
- Department of Life Health and Environmental Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy
| | - R Gatto
- Department of Life Health and Environmental Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy
| | - A Monaco
- Department of Life Health and Environmental Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy
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14
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Kämmerer PW, Palarie V, Schiegnitz E, Hagmann S, Alshihri A, Al-Nawas B. Vertical osteoconductivity and early bone formation of titanium-zirconium and titanium implants in a subperiosteal rabbit animal model. Clin Oral Implants Res 2013; 25:774-80. [DOI: 10.1111/clr.12175] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2013] [Indexed: 12/28/2022]
Affiliation(s)
- Peer W. Kämmerer
- Department of Oral; Maxillofacial and Plastic Surgery; University Medical Centre Mainz; Mainz Germany
- Harvard Medical School; Boston MA USA
| | - Victor Palarie
- Department of Oral and Maxillofacial Surgery; University of Chisinau; Chisinau Moldova
| | - Eik Schiegnitz
- Department of Oral; Maxillofacial and Plastic Surgery; University Medical Centre Mainz; Mainz Germany
| | - Sebastien Hagmann
- Department of Orthopedics; University of Heidelberg; Heidelberg Germany
| | - Abdulmonem Alshihri
- Department of Restorative and Biomaterial Sciences; Harvard School of Dental Medicine; Boston MA USA
| | - Bilal Al-Nawas
- Department of Oral; Maxillofacial and Plastic Surgery; University Medical Centre Mainz; Mainz Germany
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TIZZONI R, VENERONI L, CLERICI C. A patient with meningeal melanomatosis treated for periodontal disease with a bone regeneration procedure and dental implants: clinical and behavioral management to support medical compliance. ORAL & IMPLANTOLOGY 2013; 6:75-81. [PMID: 24772265 PMCID: PMC3982304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND During the last three decades dental implants have become increasingly used in partially edentulous periodontally compromised patients. The type of bacteria in the peri-implant sulcus is influenced by the periodontal bacteria present on the surfaces of the remaining teeth. Peri-implant sulci of partially edentulous individuals harbour more motile rods and spirochetes than those of fully edentulous individuals. If Peri-implantitis arises, it may lead to implant failure. This complication occurs more frequently in patients with poor oral hygiene. This is a site-specific bacterial infection similar to that caused by periodontal bacteria around teeth and it should be prevented. AIM This study was conducted to radiographically evaluate hard tissue response around 6 implants, over a 2-year period, in a previously surgically treated patient affected by severe chronic periodontitis. Psychological considerations and behavioral management of the patient are described. MATERIALS AND METHODS A complex implant-perio-prosthodontic case of a 54-year-old man affected by meningeal melanomatosis with a history of generalized severe chronic periodontitis was recruited. A comprehensive periodontal examination around teeth was accomplished before periodontal and implant treatment. After diagnostic work-up, compromised teeth from 1.3 to 2.3 and from 3.2 to 4.2 were extracted. Tooth 1.7 was also extracted. Afterwards fixed provisional restoration rehabilitated all the natural dentition and the missing teeth. Endodonthic therapies were conducted on all the teeth due to high dentinal sensitivity and pre-prosthodontic crown reconstructions performed. Periodontal surgery with modified Widman flaps were then accomplished on all the teeth. Three months later four maxillary implants in position 1.3,1.1,2.1,2.3 and two mandibular implants in position 4.2,3.2 were inserted. During mandibular implants positioning, the mental mussels were isolated and detached to achieve proper guided bone regeneration. During implant surgery, due to systemic conditions concern, the patient underwent intravenous sedation. Five months later the implants and the teeth were rehabilitated with fixed metal-ceramic bridges. Regarding the upper prosthetic rehabilitation, the incisors marginal edges were kept vertical to the nasal spine, due to lack of previous reference points. According to the reference points previously determined, the difference in bone level between radiographs taken at implants insertion and at the maintenance appointments was calculated. RESULTS The health of the periodontally treated teeth resulted greatly enhanced. The mean alveolar bore loss was 0,30 mm after a 2-year observation period. CONCLUSIONS The control of the periodontal disease before implant insertion in patients with severe chronic periodontitis is of paramount importance, as well as a regular maintenance program is essential for the health of the periodontal and peri-implant tissues. The management of patients with complex needs requires a multidisciplinary team designed to meet all the patient's needs on various levels.
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Affiliation(s)
| | - L. VENERONI
- Department of Pathophysiology and Transplantation - University of Milan, Milan, Italy
| | - C.A. CLERICI
- Specialist in Clinical Psychology, Department of Pathophysiology and Transplantation - University of Milan, Milan, Italy
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