The effects of physical decontamination methods on zirconia implant surfaces: a systematic review

Evaluation of the effectiveness of diode laser therapy in conjunction with nonsurgical treatment of peri-implantitis

PURPOSE

Peri-implantitis (PI) is an inflammatory condition associated with the destruction of bone tissue around a dental implant, and diode lasers can be used to treat this disease. In this study, we aimed to evaluate the effectiveness of a 940-nm diode laser for the nonsurgical treatment of PI.

METHODS

Twenty patients (8 women and 12 men) were enrolled in a split-mouth randomized controlled study. In the control group (CG), mechanical debridement with titanium curettes accompanied by airflow was performed around the implants. The test group (TG) was treated similarly, but with the use of a diode laser. Clinical measurements (plaque index, gingival index [GI], probing pocket depth [PPD], bleeding on probing [BOP], clinical attachment level, and interleukin-1β [IL-1β] in the peri-implant crevicular fluid) were evaluated and recorded at baseline and 3 months. IL-1β levels were determined using the enzyme-linked immunosorbent assay method.

RESULTS

The symptoms were alleviated in both groups at 3 months as assessed through clinical measurements. GI, BOP, and PPD were significantly lower in the TG than in the CG (P<0.05). The IL-1β level increased post-treatment in both groups, but this increase was only statistically significant (P<0.05) in the CG.

CONCLUSIONS

The diode laser enabled improvements in clinical parameters in the peri-implant tissue. However, it did not reduce IL-1β levels after treatment. Further studies about the use of diode lasers in the treatment of PI will be necessary to evaluate the effects of diode lasers in PI treatment.

Evaluation of the Quality of Peri-implantitis Videos on YouTube

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.

The integration of peri-implant soft tissues around zirconia abutments: Challenges and strategies

Stable soft tissue integration around the implant abutment attenuates pathogen penetration, protects underlying bone tissue, prevents peri-implantitis and is essential in maintaining long-term implant stability. The desire for "metal free" and "aesthetic restoration" has favored zirconia over titanium abutments, especially for implant restorations in the anterior region and for patients with thin gingival biotype. Soft tissue attachment to the zirconia abutment surface remains a challenge. A comprehensive review of advances in zirconia surface treatment (micro-design) and structural design (macro-design) affecting soft tissue attachment is presented and strategies and research directions are discussed. Soft tissue models for abutment research are described. Guidelines for development of zirconia abutment surfaces that promote soft tissue integration and evidence-based references to inform clinical choice of abutment structure and postoperative maintenance are presented.

Thermal Effects of 445-nm Diode Laser Irradiation on Titanium and Ceramic Implants

This study aimed to evaluate temperature changes in titanium and ceramic implants after using a 445-nm diode laser under different in vitro conditions. Titanium (Ti) and ceramic (Zr) dental implants were placed into a bone analog, and an intrabony defect was created at each implant. A 445-nm diode laser was used to irradiate the defects for 30 seconds, noncontact, at 2 W in continuous wave (c.w.) and pulsed mode. The experiment was done at room temperature (21.0 ± 1°C) and in a water bath (37.0 ± 1°C). Two thermocouple probes were used to record real-time temperature changes (°C) at the coronal part of the implant (Tc) and the apex (Ta). The temperature was recorded at time 0 (To) and after 30 seconds of irradiation (Tf). The average temperature change was calculated, and a descriptive analysis was conducted (P < .05). The Ti implant resulted in the highest ΔT values coronally (29.6°C) and apically (6.7°C) using continuous wave at 21°C. The Zr implant increased to 26.4°C coronally and 5.2°C apically. In the water bath, the coronal portion of the Ti and Zr implants rose to 14.2°C and 14.01°C, respectively, using continuous waves. The ΔT values for Ti were 11.9°C coronally and 1.7°C apically when placed in a water bath using pulsed mode. The lowest ΔT occurred on the Zr implant with ΔTc and ΔTa of 4.8°C and 0.78°C, respectively. Under in vitro conditions, the 445-nm diode laser in pulsed mode seems to be safe for use on ceramic implants and should be used with caution on titanium implants.

An Umbrella Review on Low-Abrasive Air Powder Water Jet Technology in Periodontitis and Peri-Implantitis Patients

This umbrella review was conducted to assess the existing literature and scientific evidence on air powder water jet technology (APWJT) in periodontal and peri-implantitis therapy. A systematic literature search for systematic reviews and meta-analyses of the last decade on the use of APWJT in periodontitis and implant patients was performed in the databases of MEDLINE/Ovid, Embase, Cochrane library and Scopus. An additional hand search on PubMed and Google Scholar was conducted. Ten articles that fit the inclusion criteria were selected after the full-text screening. Two systematic reviews, including one with a meta-analysis, investigated the use of APWJT in active periodontal therapy. The use of APWJT as an adjunct to conventional scaling and root planing (SRP) in active periodontal treatment showed improved results in the test group. Six articles, including two with a meta-analysis, reported on the use of APWJT as a stand-alone therapy or as an adjunct in supportive periodontal therapy. Similarly significant improved results were reported for the use of APWJT. Regarding the active treatment of peri-implant mucositis and peri-implantitis, four systematic reviews could not show an improved clinical outcome when APWJT was used as an adjunct to conventional treatment measures. Furthermore, one article investigated APWJT as a stand-alone therapy or as an adjunct in supportive peri-implant mucositis and peri-implantitis therapy. In systematic reviews that also investigated patient perception, APWJT was generally well-tolerated by the patient. Within the limitations of this umbrella review, it can be concluded that the use of APWJT with low-abrasive powders such as glycine, erythritol or trehalose as an adjunct in active periodontitis therapy shows similar clinical results compared to conventional SRP alone. In surgical peri-implantitis treatment, APWJT can be used adjunctively. It could be considered that the use of APWJT in supportive periodontal treatment results in a comparable clinical outcome and an enhanced patient perception, as well as a shorter clinical time.