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Paik J, Kim D, Kim H, Kim HS. Numerical study on the three-dimensional temperature distribution according to laser conditions in photothermal therapy of peri-implantitis. Int J Implant Dent 2024; 10:19. [PMID: 38656614 PMCID: PMC11043321 DOI: 10.1186/s40729-024-00537-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024] Open
Abstract
PURPOSE Dental implants have been successfully implemented as a treatment for tooth loss. However, peri-implantitis, an inflammatory reaction owing to microbial deposition around the implant, can lead to implant failure. So, it is necessary to treat peri-implantitis. Therefore, this numerical study is aimed at investigating conditions for treating peri-implantitis. METHODS Photothermal therapy, a laser treatment method, utilizes photothermal effect, in which light is converted to heat. This technique has advantage of selectively curing inflamed tissues by increasing their temperature. Accordingly, herein, photothermal effect on peri-implantitis is studied through numerical analysis with using Arrhenius damage integral and Arrhenius thermal damage ratio. RESULTS Through numerical analysis on peri-implantitis treatment, we explored temperature changes under varied laser settings (laser power, radius, irradiation time). We obtained the temperature distribution on interface of artificial tooth root and inflammation and determined whether temperature exceeds or does not exceed 47℃ to know which laser power affects alveolar bone indirectly. We defined the Arrhenius thermal damage ratio as a variable and determined that the maximum laser power that does not exceed 47℃ at the AA' line is 1.0 W. Additionally, we found that the value of the Arrhenius thermal damage ratio is 0.26 for a laser irradiation time of 100 s and 0.50 for 500 s. CONCLUSION The result of this numerical study indicates that the Arrhenius thermal damage ratio can be used as a standard for determining the treatment conditions to help assisted laser treatment for peri-implantitis in each numerical analysis scenario.
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Affiliation(s)
- Jeeyong Paik
- Department of Mechanical Engineering, Ajou University, 16499, Suwon-si, Gyeonggi-do, Korea
| | - Donghyuk Kim
- Department of Mechanical Engineering, Ajou University, 16499, Suwon-si, Gyeonggi-do, Korea
| | - Hyunjung Kim
- Department of Mechanical Engineering, Ajou University, 16499, Suwon-si, Gyeonggi-do, Korea.
| | - Hee-Sun Kim
- Department of Dentistry, SMG_SNU Boramae Medical Center, 07061, Seoul, Korea.
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Ramanauskaite A, Schwarz F. Current Concepts for the Treatment of Peri-implant Disease. INT J PROSTHODONT 2024; 37:124-134. [PMID: 37988432 DOI: 10.11607/ijp.8750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
Peri-implant diseases are defined as bacterial plaque-induced inflammatory conditions affecting implant-surrounding tissues and are classified as peri-implant mucositis and peri-implantitis. Peri-implant mucositis is characterized by an inflammatory lesion that resides in the soft tissue compartment, whereas at peri-implantitis sites the lesions also feature progressive loss of implant-supporting bone. Inflammation resolution and disease progression arrestment are the main therapeutic endpoints of the treatment of peri-implant diseases. The present position paper displays the current evidence and clinical recommendations of the European Association for Osseointegration for the treatment of peri-implant diseases. Mechanical biofilm removal along with the reinforcement of patient-administered oral hygiene is considered the standard treatment for managing peri-implant mucositis. It is recommended to assess the outcomes of peri-implant mucositis treatment 2 to 3 months after therapy, and repeated intervention should be considered in the absence of treatment success. Peri-implantitis treatment should follow a stepwise treatment approach, starting with nonsurgical treatment followed by surgical intervention, if that is not sufficient. Surgical peri-implantitis therapies include nonreconstructive, reconstructive, and combined treatment modalities. Implantoplasty may be advocated for the treatment of supracrestal peri-implant defects, whereas reconstructive therapy is indicated at peri-implantitis sites featuring intraosseous defects with a depth ≥ 3 mm. Adjunctive reconstructive measures may be beneficial in enhancing radiographic defect fill and maintaining postoperative soft tissue levels, which may have a great impact in esthetic cases. The adjunctive use of systemic antibiotics during surgical therapy does not seem to improve the clinical outcomes. Regular supportive peri-implant therapy with biofilm removal should be an integral part of the treatment protocol for peri-implant diseases. In the presence of advanced bone loss around implants that do not play a strategic role in masticatory function, implant removal may be considered immediately.
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López-Valverde N, López-Valverde A, Blanco Rueda JA. The role of probiotic therapy on clinical parameters and human immune response in peri-implant diseases: a systematic review and meta-analysis of randomized clinical studies. Front Immunol 2024; 15:1371072. [PMID: 38686378 PMCID: PMC11056541 DOI: 10.3389/fimmu.2024.1371072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/02/2024] [Indexed: 05/02/2024] Open
Abstract
Background Peri-implant diseases (peri-implant mucositis and peri-implantitis) are pathologies of an infectious-inflammatory nature of the mucosa around dental implants. Probiotics are microorganisms that regulate host immunomodulation and have shown positive results in the treatment of peri-implant diseases. The objective of the systematic review and meta-analysis was to evaluate the efficacy of probiotics in the treatment of peri-implant oral diseases. Methods According to the PRISMA guidelines, the research question was established: Are probiotics able to favorably modify clinical and immunological biomarkers determinants of peri-implant pathologies? and an electronic search of the databases MEDLINE/PubMed, Embase, Cochrane Central, Web of Science, (until December 2023) was performed. Inclusion criteria were established for intervention studies (RCTs), according to the PICOs strategy in subjects with peri-implant pathology (participants), treated with probiotics (intervention) compared to patients with conventional treatment or placebo (control) and evaluating the response to treatment (outcomes). Results- 1723 studies were obtained and 10 were selected. Risk of bias was assessed using the Cochrane Risk of Bias Tool and methodological quality using the Joanna Briggs Institute for RCTs. Two meta-analyses were performed, one to evaluate probiotics in mucositis and one for peri-implantitis. All subgroups were homogeneous (I2 = 0%), except in the analysis of IL-6 in mucositis (I2 = 65%). The overall effect was favorable to the experimental group in both pathologies. The analysis of the studies grouped in peri-implantitis showed a tendency to significance (p=0.09). Conclusion The use of probiotics, as basic or complementary treatment of peri-implant diseases, showed a statistically significant trend, but well-designed studies are warranted to validate the efficacy of these products in peri-implant pathologies.
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Affiliation(s)
- Nansi López-Valverde
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, University of Alcalá de Henares, Madrid, Spain
| | - Antonio López-Valverde
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - José Antonio Blanco Rueda
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
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Ismail A, Al Yafi F. The Role of Radiographic Imaging in the Diagnosis and Management of Periodontal and Peri-Implant Diseases. Dent Clin North Am 2024; 68:247-258. [PMID: 38417989 DOI: 10.1016/j.cden.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This article highlights the role of dental imaging techniques, including periapical, bitewing, panoramic, and cone-beam computed tomography images, in the diagnostic and therapeutic decision-making process for patients with periodontal and peri-implant disease. A brief overview of common radiographic findings of periodontal disease, including periodontitis, and peri-implantitis is also provided.
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Affiliation(s)
- Abdo Ismail
- Private Practice, 726 Crystal Oak Lane, Arlington, TX 76005, USA
| | - Firas Al Yafi
- Private Practice, Diplomate of the American Board of Periodontology, Arab Board of Oral Surgery, 5625 Saint Thomas Dr, Plano, TX 75094-4617, USA.
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Aseri AA. Clinical and Radiographic Outcomes of Adjunctive Phototherapy Versus Antibiotic Therapy Against Peri-Implant Diseases: A Systematic Review and Meta-Analysis. Photobiomodul Photomed Laser Surg 2024; 42:189-199. [PMID: 38512322 DOI: 10.1089/photob.2023.0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
Background: Peri-implantitis, an inflammatory condition in implant tissues, requires bacterial eradication and implant surface decontamination, with aPDT as a helpful surgical adjunct. Objective:This project was designed to investigate the effect of antibiotic therapy versus aPDT, as adjuncts to conventional mechanical debridement (MD), on the peri-implant clinical and/or radiographic parameters among patients with peri-implant diseases. Methods: A comprehensive search was conducted across electronic databases, including PubMed, Scopus, and Web of Science, up to and including April 2023, without any restriction on the language and year of publication, focusing the following research question: "Does adjunctive aPDT improve the peri-implant clinical and/or radiographic parameters in treating peri-implant diseases compared to antibiotic therapy?" Statistical analysis was performed on peri-implant clinical [plaque index (PI), probing depth (PD), and bleeding on probing (BOP)] and radiographic parameters [marginal bone loss (MBL)]. The study included six randomized controlled trials and one clinical (nonrandomized) study. Results: The systematic review findings indicate that the application of aPDT as an adjunct to MD is equally effective as adjunctive antibiotic therapy in improving peri-implant clinical parameters and radiographic parameters in patients with peri-implant diseases. Only two studies were classified as having a low risk of bias (RoB), two were assessed as having an unclear RoB, and the remaining three studies were determined to have a high RoB. However, the meta-analysis results revealed no statistically significant difference in peri-implant PI, PD, and MBL scores between patients treated with adjunct aPDT or adjunct antibiotic therapy. Notably, there was a statistically significant difference favoring adjunct aPDT in peri-implant BOP values compared to the control group. Conclusions: Despite the limited number of included studies and the significant heterogeneity among them, the findings suggest that aPDT yields comparable peri-implant clinical and radiographic outcomes to adjunctive antibiotic therapy, as adjuncts to MD, for the potential treatment of peri-implant diseases.
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Affiliation(s)
- Abdulrahman A Aseri
- Department of Preventive Dental Sciences, College of Dentistry, Najran University, Najran, Kingdom of Saudi Arabia
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Bazzani D, Heidrich V, Manghi P, Blanco-Miguez A, Asnicar F, Armanini F, Cavaliere S, Bertelle A, Dell'Acqua F, Dellasega E, Waldner R, Vicentini D, Bolzan M, Tomasi C, Segata N, Pasolli E, Ghensi P. Favorable subgingival plaque microbiome shifts are associated with clinical treatment for peri-implant diseases. NPJ Biofilms Microbiomes 2024; 10:12. [PMID: 38374114 PMCID: PMC10876967 DOI: 10.1038/s41522-024-00482-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 01/31/2024] [Indexed: 02/21/2024] Open
Abstract
We performed a longitudinal shotgun metagenomic investigation of the plaque microbiome associated with peri-implant diseases in a cohort of 91 subjects with 320 quality-controlled metagenomes. Through recently improved taxonomic profiling methods, we identified the most discriminative species between healthy and diseased subjects at baseline, evaluated their change over time, and provided evidence that clinical treatment had a positive effect on plaque microbiome composition in patients affected by mucositis and peri-implantitis.
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Affiliation(s)
| | | | - Paolo Manghi
- Department CIBIO, University of Trento, Trento, Italy
| | | | | | | | - Sara Cavaliere
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy
| | | | | | | | | | | | | | - Cristiano Tomasi
- PreBiomics S.r.l., Trento, Italy
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nicola Segata
- Department CIBIO, University of Trento, Trento, Italy.
| | - Edoardo Pasolli
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy.
| | - Paolo Ghensi
- PreBiomics S.r.l., Trento, Italy.
- Department CIBIO, University of Trento, Trento, Italy.
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Peng X, Guo X, Zhou Y. The Efficacy of Ten Different Adjunctive Measures in Patients with Nonsurgically Treated Peri-Implant Disease: A Network Meta-Analysis of Randomized Controlled Trials. Photobiomodul Photomed Laser Surg 2024; 42:99-124. [PMID: 38294889 DOI: 10.1089/photob.2023.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Objective: This study aimed to evaluate the impact of 10 adjunctive measures on non-surgical therapy outcomes for peri-implant disease. Methods: We formulated the study question and keywords following the Population, Intervention, Comparator, Outcome framework. Randomized controlled trials were identified through searches in PubMed, Embase, the Cochrane Library, and the Web of Science. Two researchers assessed the quality of included literature according to the Cochrane Risk of Bias Assessment Tool. Data analysis and ranking were performed using Stata 15.0 software. Results: This study, involving 51 pieces of literature and 2660 samples, conducted a network meta-analysis (NMA), which revealed that photodynamic therapy (PDT) significantly reduced probing pocket depth values in patients with peri-implant mucositis (SUCRA = 96.3%) and peri-implantitis (SUCRA = 96.7%). In addition, it showed an improvement in bleeding on probing (BOP) values for peri-implantitis (SUCRA = 91.6%). Furthermore, diode lasers improved BOP values for peri-implant mucositis (SUCRA = 76.5%). Conclusions: According to the NMA results and the surface under the cumulative ranking curve (SUCRA), PDT and diode laser outperform other adjuncts in peri-implant disease.
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Affiliation(s)
- Xuepei Peng
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xingtong Guo
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuwen Zhou
- Department of Stomatology, Jiaxing Maternal and Child Health Hospital, Jiaxing, China
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Zhu Y, Lu H, Yang S, Liu Y, Zhu P, Li P, Waal YCMD, Visser A, Tjakkes GHE, Li A, Xu S. Predictive factors for the treatment success of peri-implantitis: a protocol for a prospective cohort study. BMJ Open 2024; 14:e072443. [PMID: 38199627 PMCID: PMC10806708 DOI: 10.1136/bmjopen-2023-072443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 11/30/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Peri-implantitis, a common biological complication of dental implant, has attracted considerable attention due to its increasing prevalence and limited treatment efficacy. Previous studies have reported several risk factors associated with the onset of peri-implantitis (eg, history of periodontitis, poor plaque control and smoking). However, inadequate data are available on the association between these risk factors and successful outcome after peri-implantitis therapy. This prospective cohort study aims to identify the local and systemic predictive factors for the treatment success of peri-implantitis. METHODS AND ANALYSIS A single-centre cohort study will be conducted by recruiting 275 patients diagnosed with peri-implantitis. Sociodemographic variables, healthy lifestyles and systemic disorders will be obtained using questionnaires. In addition, clinical and radiographic examinations will be conducted at baseline and follow-up visits. Treatment success is defined as no bleeding on probing on more than one point, no suppuration, no further marginal bone loss (≥0.5 mm) and probing pocket depth ≤5 mm at the 12-month follow-up interval. After adjustment for age, sex and socioeconomic status, potential prognostic factors related to treatment success will be identified using multivariable logistic regression models. ETHICS AND DISSEMINATION This cohort study in its current version (2.0, 15 July 2022) is in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of Stomatological Hospital, Southern Medical University (EC-CT-(2022)34). The publication will be on behalf of the study site. TRIAL REGISTRATION NUMBER ChiCTR2200066262.
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Affiliation(s)
- Yuanxi Zhu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Hongye Lu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Dental Biomaterials and Devices for Zhejiang Provincial Engineering Research Center, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Zhejiang University, Hangzhou, China
| | - Shuo Yang
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Yang Liu
- Department of Oral Medicine, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Peijun Zhu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Ping Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Yvonne C M De Waal
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Anita Visser
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department for Gerodontology, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Geerten-Has E Tjakkes
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - An Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
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Chan MH, Kang J. Diagnosis and Treatment of Periimplant Mucositis and Periimplantitis: An Overview and Related Controversial Issues. Dent Clin North Am 2024; 68:167-202. [PMID: 37951632 DOI: 10.1016/j.cden.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Periimplant mucositis and periimplantitis are common complications of dental implant. This article provides a comprehensive overview of the 2017 World Workshop's new definition, clinical and radiographic presentation, pathogenesis, risk factors, and classification of periimplant diseases. Also, the authors discuss various types of instruments, materials, and techniques commonly used for treatment of nonsurgical and surgical periimplantitis. Lastly, the authors include some controversial topics surrounding this subject.
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Affiliation(s)
- Michael H Chan
- Oral & Maxillofacial Surgery, Department of Veterans Affairs, New York Harbor Healthcare System (Brooklyn Campus), 800 Poly Place (Bk-160), Brooklyn, NY 11209, USA; Oral & Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 DeKalb Avenue (Box-187), Brooklyn, NY 11201, USA.
| | - Joseph Kang
- Oral & Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 DeKalb Avenue (Box-187), Brooklyn, NY 11201, USA
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Madi M, Tabassum A, Attia D, Al Muhaish L, Al Mutiri H, Alshehri T, Zakaria O, Aljandan B. Knowledge and attitude of dental students regarding etiology, diagnosis, and treatment of peri-implantitis. J Dent Educ 2024; 88:100-108. [PMID: 37870085 DOI: 10.1002/jdd.13397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 09/06/2023] [Accepted: 10/12/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE The objective of this study was to assess the level of knowledge and attitude of dental students about the etiology, diagnosis, and management of peri-implantitis. METHODS An online cross-sectional study that targeted senior undergraduate dental students at the College of Dentistry was conducted. A closed-ended survey consisting of 28 questions was designed. Three sections were created: 1) participants' characteristics; 2) Knowledge of peri-implantitis etiology, risk factors, diagnosis, and complications; 3) The use of antibiotics in peri-implantitis, diagnosis, and treatment methods. SPSS version 22 (IBM Corp.) was used for data analysis. Counts and percentages were calculated for correct answers in each section. RESULTS A total of 267 dental students responded to the questionnaire. The majority of the participants (81.6%) were knowledgeable about peri-implantitis being an inflammatory reaction, and a lesser percentage (77.9%) knew that bacterial plaque is an etiologic factor for peri-implant diseases. 82.0% of the participants identified smoking as a risk factor, followed by periodontitis (80.5%). Regarding implant complications, 57.3% of the participants considered implant mobility as a definitive indication for implant removal. More than half of the participants reported using crater-like bone defects surrounding implants to diagnose peri-implantitis. The most commonly used antibiotic was amoxicillin (34.1%), followed by amoxicillin combined with metronidazole (26.9%). CONCLUSION Most participants had a basic understanding of the etiology and risk factors of peri-implantitis. On the other hand, more courses addressing peri-implantitis diagnosis are needed.
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Affiliation(s)
- Marwa Madi
- Department of Preventive Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Afsheen Tabassum
- Department of Preventive Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Dina Attia
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Luba Al Muhaish
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hadeel Al Mutiri
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Turki Alshehri
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Osama Zakaria
- Department of Biomedical Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Badr Aljandan
- Department of Biomedical Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Ramanauskaite A, Krüger N, Obreja K, Borchert F, Dahmer I, Schwarz F. Influence of antiresorptive/antiangiogenic therapy on the surgical treatment outcomes of experimentally induced peri-implantitis lesions. Clin Oral Investig 2023; 27:6657-6666. [PMID: 37783801 PMCID: PMC10630228 DOI: 10.1007/s00784-023-05275-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/23/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVE To investigate the influence of various antiresorptive and antiangiogenic medications on the resolution of experimentally induced peri-implantitis lesions after different surgical treatment approaches. MATERIALS AND METHODS Forty-eight albino rats randomly received a dual application of the following medications: (1) amino-bisphosphonate (zoledronate (Zo)) (n = 8), (2) RANKL inhibitor (denosumab (De)) (n = 8), (3) antiangiogenic (bevacizumab (Be)) (n = 8), (4) Zo + Be (n = 8), (5) De + Be (n = 8), or (6) no medication (control (Co)) (n = 8). Ligature-induced peri-implantitis lesions were established at 2 maxillary implants over 16 weeks. Afterward, animals were randomly treated either with open flap debridement (OFD) or reconstructive therapy (RT). Treatment procedures were followed by a 12-week healing period. The histological outcomes included residual defect length (DL); defect width (DW) at the bone crest (BC-DW); 25%, 50%, and 75% of the DL; and areas of inflammatory cell infiltrate (ICT). When present, areas of bone sequester (BS) were assessed considering the animal as a statistical unit. RESULTS A total of 21 animals were analyzed (Zo: RT = 3, OFD = 1; De: RT = 3, OFD = 2; Be: OFD = 1; Zo + Be: RT = 2, OFD = 2; Co: RT = 3, OFD = 2). Implant loss rates were comparable among the experimental groups. Except for the 25% and 75% DW values that were significantly higher in the Zo + Be group compared to the Co group (p = 0.04 and p = 0.03, respectively), no significant differences were found among the experimental groups for the DL (lowest-Be: 0.56 mm; highest-Co: 1.05 mm), BC-DW (lowest-De: 0.86 mm, highest-Co: 1.07 mm), 50% DW (lowest-De: 0.86 mm; highest-Be + Zo: 1.29 mm), and ICT (lowest-Be: 0.56 mm2; highest-Be + Zo: 1.65 mm2). All groups, except for the Zo and Be following RT, showed presence of BS. CONCLUSIONS The present findings did not reveal a marked effect of various antiresorptive/antiangiogenic medications on the resolution of experimentally induced peri-implantitis lesions, regardless of the surgical approach employed (OFD and RT). CLINICAL RELEVANCE Resolution of peri-implantitis lesions may not be affected by the investigated antiresorptive/antiangiogenic medications.
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Affiliation(s)
- Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt am Main, Germany
| | - Nadine Krüger
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt am Main, Germany
| | - Karina Obreja
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt am Main, Germany
| | - Fanya Borchert
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt am Main, Germany
| | - Iulia Dahmer
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt am Main, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt am Main, Germany.
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Afrasiabi S, Heidari M, Younespour S, Chiniforush N. Evaluating the effect of mechanical debridement with adjunctive antimicrobial photodynamic therapy in comparison with mechanical debridement alone on the peri-implant parameters in type 2 diabetic mellitus patients with peri-implantitis: a systematic review and meta-analysis. BMC Oral Health 2023; 23:751. [PMID: 37828479 PMCID: PMC10571232 DOI: 10.1186/s12903-023-03337-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/19/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a major risk factor for localized diseases such as peri-implantitis that may affect ideal implant treatment. This study was aimed to evaluate the effect of mechanical debridement (MD) + antimicrobial photodynamic therapy (a-PDT) in patients with peri-implantitis who have T2DM in terms of bleeding on probing (BOP) and probing depth (PD) as primary outcomes and plaque index (PI) and crestal bone loss (CBL) as secondary outcomes. METHODS Publications compared outcomes between MD + aPDT and MD alone in T2DM patients with peri-implantitis, containing more than 3-month follow-up duration, were involved in the systematic review and meta-analysis. Literature until July 2023 using MEDLINE (through PubMed), Scopus, Cochrane Library, Embase, Web of Science, and Google Scholar were collected. RESULTS Two randomized controlled trials (RCTs, 88 individuals) and one controlled clinical trial (CCT, 67 individuals) with follow-up periods ranged from 3 to 12 months were recruited. All studies used diode laser with wavelengths ranged from 660 to 810 nm. The results demonstrated that the MD + aPDT group showed significant benefits for BOP reduction after 6 months (SMD = -2.15, 95% CI: -3.78 to -0.51, p = 0.01). However, a great amount of heterogeneity was observed (I2 = 91.52%, p < 0.001). Moreover, there was a significant difference between MD + aPDT and MD alone groups in CBL (SMD = -0.69, 95% CI: -1.07 to -0.30, p < 0.001). In addition, homogeneity assumption was satisfied (I2 = 22.49%, p = 0.28). Significant differences in PD and PI reduction were not found except for PI reduction after 3 months (SMD = -0.79, 95% CI: -1.24 to -0.33, p < 0.001. Also, no heterogeneity was observed (I2 = 0.00%, p = 0.47). CONCLUSION Given that high heterogeneity in BOP and PD outcome was found in this systematic review, future long-term CTs with MD + aPDT should be examined to arrive at a firm conclusion.
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Affiliation(s)
- Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohadeseh Heidari
- Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Younespour
- Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.
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Horowitz RA, Kurtzman GM. Utilization of Low-Magnitude High-Frequency Vibration (LMHFV) as an Aid in Treating Peri-Implantitis: Case Presentations. J ORAL IMPLANTOL 2023; 49:501-509. [PMID: 36975737 DOI: 10.1563/aaid-joi-d-21-00038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 12/21/2022] [Accepted: 03/09/2023] [Indexed: 03/29/2023]
Abstract
Peri-implantitis is an inflammatory process initiating in the soft tissue and then progressing to the hard tissue surrounding dental implants leading to loss of osseous support and potential loss of the implant if not identified early in the process. This process initiates in the soft tissue, which become inflamed spreading to the underlying bone leading to decreases in bone density with subsequent crestal resorption and thread exposure. In the absence of treatment of the peri-implantitis, the bone loss at the osseous implant interface progresses with inflammatory mediated decrease in the bone density that moves apically, eventually leading to mobility of the implant and its failure. Low-magnitude high-frequency vibration (LMHFV) has been shown to improve bone density, stimulate osteoblastic activity, and arrest progression of peri-implantitis with improvement of the bone or graft around the affected implant with or without surgery as part of the treatment. Two cases are presented using LMHFV to augment treatment.
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Affiliation(s)
- Robert A Horowitz
- Department of Periodontology and Implant Dentistry, NYU School of Dentistry, New York, New York
- Private practice, Scarsdale, New York
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14
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Ichioka Y, Trullenque-Eriksson A, Ortiz-Vigón A, Guerrero A, Donati M, Bressan E, Ghensi P, Schaller D, Tomasi C, Karlsson K, Abrahamsson I, Dionigi C, Regidor E, Berglundh T, Derks J. Factors influencing outcomes of surgical therapy of peri-implantitis: A secondary analysis of 1-year results from a randomized clinical study. J Clin Periodontol 2023; 50:1282-1304. [PMID: 37461197 DOI: 10.1111/jcpe.13848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/15/2023] [Accepted: 06/24/2023] [Indexed: 09/14/2023]
Abstract
AIM To identify predictors of treatment outcomes following surgical therapy of peri-implantitis. MATERIALS AND METHODS We performed a secondary analysis of data from a randomized controlled trial (RCT) comparing access flap with or without bone replacement graft. Outcomes at 12 months were probing pocket depth (PPD), bleeding on probing (BOP), soft-tissue recession (REC) and marginal bone level (MBL) change. Multilevel regression analyses were used to identify predictors. We also built an explanatory model for residual signs of inflammation. RESULTS Baseline PPD was the most relevant predictor, showing positive associations with final PPD, REC and MBL gain, and negative association with probability of pocket closure. Smokers presented higher residual PPD. Absence of keratinized mucosa at baseline increased the probability of BOP but was otherwise not indicative of outcomes. Plaque at 6 weeks was detrimental in terms of residual PPD and BOP. Treatment allocation had an effect on REC. Final BOP was explained by residual PPD ≥6 mm and plaque at more than two sites. CONCLUSIONS Baseline PPD was the most relevant predictor of the outcomes of surgical therapy of peri-implantitis. Pocket closure should be a primary goal of treatment. Bone replacement grafts may be indicated in aesthetically demanding cases to reduce soft-tissue recession. The importance of smoking cessation and patient-performed plaque control is also underlined.
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Affiliation(s)
- Yuki Ichioka
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Anna Trullenque-Eriksson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Alberto Ortiz-Vigón
- Clínica Ortiz-Vigón, PerioCentrum, Bilbao, Spain
- ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | | | - Mauro Donati
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Eriberto Bressan
- Department of Neuroscience, Faculty of Odontology, University of Padua, Padua, Italy
| | - Paolo Ghensi
- Department CIBIO, University of Trento, Trento, Italy
| | | | - Cristiano Tomasi
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Karolina Karlsson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Clinic of Periodontics, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Ingemar Abrahamsson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Clinic of Periodontics, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Carlotta Dionigi
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Erik Regidor
- Clínica Ortiz-Vigón, PerioCentrum, Bilbao, Spain
| | - Tord Berglundh
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Clinic of Periodontics, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Clinic of Periodontics, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
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15
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Heitz-Mayfield LJA, Heitz F, Koong B, Huang T, Chivers P. Surgical peri-implantitis treatment with and without guided bone regeneration. A randomized controlled trial. Clin Oral Implants Res 2023; 34:892-910. [PMID: 37382408 DOI: 10.1111/clr.14116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/20/2023] [Accepted: 06/07/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE To evaluate the efficacy of reconstructive peri-implantitis treatment. MATERIALS AND METHODS Forty participants, with peri-implantitis and a contained intraosseous defect, were randomized to access flap (control) or access flap with xenograft and collagen membrane (test). All received systemic antimicrobials. Blinded examiners recorded probing depths (PD), bleeding and suppuration on probing (BOP & SOP), soft tissue levels, and marginal bone levels (MBL) at baseline and 12 months. Patient reported outcomes were recorded. The primary outcome was PD change. RESULTS All 40 participants (40 implants) completed the 12-month study. The mean (standard deviation) PD reduction (deepest site) was 4.2 (1.8) mm in the control and 3.7 (1.9) mm in the test group. MBL gain (deepest site) was 1.7 (1.6) mm in the control and 2.4 (1.4) mm in the test group. Absence of BOP & SOP was observed at 60% of both control and test implants. Buccal recession was 0.9 (1.6) mm in the control and 0.4 (1.1) mm in the test group. A successful outcome (absence of PD ≥ 5 mm with BOP, absence of SOP and absence of progressive bone loss) was achieved for 90% of the control and 85% of test group implants. No statistically significant differences in clinical or radiographic parameters were found between treatment groups. 30% of participants experienced mild gastro-intestinal disturbances. Reporting followed CONSORT guidelines. CONCLUSION Similar clinical and radiographic improvements at 12 months were observed with high levels of patient satisfaction for both the access flap and xenograft covered by collagen membrane groups. Registered clinical trials.gov. ID:NCT03163602 (23/05/2017).
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Affiliation(s)
- Lisa J A Heitz-Mayfield
- International Research Collaborative, Oral Health and Equity, School of Human Anatomy and Biology, The University of Western Australia, Crawley, Western Australia, Australia
- Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Sydney, New South Wales, Australia
- Perth Periodontal Specialists, West Leederville, Western Australia, Australia
| | - Fritz Heitz
- Perth Periodontal Specialists, West Leederville, Western Australia, Australia
| | - Bernard Koong
- Envision Medical Imaging, Wembley, Western Australia, Australia
| | - Tom Huang
- Envision Medical Imaging, Wembley, Western Australia, Australia
| | - Paola Chivers
- Institute for Health Research, The University of Notre Dame, Fremantle, Western Australia, Australia
- School of Medical and Health Sciences, ECU, Joondalup, Western Australia, Australia
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Farsai PS. OVERVIEW OF SYSTEMATIC REVIEWS SUGGESTS THAT VARIOUS NONSURGICAL THERAPIES (NSTS) MAY BE EFFECTIVE FOR THE TREATMENT OF PERI-IMPLANT MUCOSITIS. J Evid Based Dent Pract 2023; 23:101893. [PMID: 37689453 DOI: 10.1016/j.jebdp.2023.101893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Overview of systematic reviews and meta-analyses investigating the efficacy of different nonsurgical therapies for the treatment of peri-implant diseases. Joshi A. A., Gaikwad, A. M., Padhye, A. M., Nadgere, J.B. Int J Oral Maxillofac Implants 2022; 37:e13-e27. SOURCE OF FUNDING Not reported. TYPE OF STUDY/DESIGN Overview of systematic reviews and meta-analyses.
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Mancuso E. Polishing matters. Int J Esthet Dent 2023; 18:310. [PMID: 37593964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
The goal of this section ist o bring our readers eye-catching and high quality images related to novel techniques, clinical challenges and emerging trends relevant to esthetic dentistry. The section portrays the clinical image, the photographer, the camera and a short caption of the story behind the photograph.
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Lähteenmäki H, Pätilä T, Pärnänen CP, Räisänen I, Tervahartiala T, Gupta S, Sorsa T. aMMP-8 point-of-care - diagnostic methods and treatment modalities in periodontitis and peri-implantitis. Expert Opin Ther Targets 2023; 27:627-637. [PMID: 37522314 DOI: 10.1080/14728222.2023.2240014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
INTRODUCTION When collected in a standardized fashion, oral fluid analysis can refine the diagnosis of periodontal and peri-implant disease. In practice, dental professionals can perform active matrix metalloproteinase (aMMP-8) analysis chairside. AREAS COVERED Periodontal tissues are mainly made up of type I collagen, and collagen breakdown is one of the main events in periodontal and peri-implantitis destructive lesions. In addition to traditional measurements, their diagnosis can be refined with tests utilizing oral fluids. The active matrix metalloproteinase-8 (aMMP-8) is possible to be determined from the gingival crevicular fluid (GCF), peri-implant sulcus fluid (PISF), and other oral fluids such as mouth rinse and saliva. We also investigated the applicability of aMMP-8 chair-side test kits in the evaluation of oral health benefits of different adjunctive host-modulating periodontal therapies including fermented lingonberry mouthwash (FLJ) and antibacterial photodynamic therapy (aPDT). EXPERT OPINION The aMMP-8 levels can more reliably detect early activation of periodontal and peri-implant disease as compared to traditional diagnostic methods that assess the experienced health status or past disease, rather than the present or future pathology. Novel therapies like, fermented lingonberry juice as a mouthrinse or aPDT, are potential host-modulating adjunctive treatments to reduce the signs of oral inflammation and infection.
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Affiliation(s)
- Hanna Lähteenmäki
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Tommi Pätilä
- Department of Pediatric Heart Surgery and Organ Transplantation, New Children's Hospital, Helsinki University, Helsinki, Finland
| | - C Pirjo Pärnänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Ismo Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Shipra Gupta
- Unit of Periodontology, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Barbato L, Cavalcanti R, Rupe C, Scartabelli D, Serni L, Chambrone L, Cairo F. Clinical efficacy of adjunctive methods for the non-surgical treatment of peri-implantitis: a systematic review and meta-analysis. BMC Oral Health 2023; 23:375. [PMID: 37296382 PMCID: PMC10251565 DOI: 10.1186/s12903-023-03058-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND The aim of this systematic review (SR) was to evaluate the clinical efficacy of different adjunctive methods/therapies to the non-surgical treatment (NST) of peri-implantitis. MATERIALS AND METHODS The protocol of the review was registered in PROSPERO database (CRD42022339709) and was designed according to PRISMA statement. Electronic and hand searches were performed to identify randomized clinical trials (RCTs) comparing non-surgical treatment of peri-implantitis alone versus NST plus any adjunctive method/treatment. The primary outcome was probing pocket depth (PPD) reduction. RESULTS Sixteen RCTs were included. Only 2 out of 1189 implants were lost and follow-up ranged from 3 to 12 months. PPD reduction across the studies varied from 0.17 to 3.1 mm, while defect resolution from 5.3% to 57.1%. Systemic antimicrobials were associated to higher PPD reduction (1.56 mm; [95% CI 0.24 to 2.89]; p = 0.02) with high heterogeneity, and treatment success (OR = 3.23; [95% CI 1.17 to 8.94]; p = 0.02), compared to NST alone. No differences were found with adjunctive local antimicrobials and lasers for PPD and bleeding on probing (BoP) reduction. CONCLUSIONS Non-surgical treatment with or without adjunctive methods may reduce PPD and BoP even if complete resolution of the pocket is unpredictable. Among possible adjunctive methods, only systemic antibiotics seems to provide further benefits, but their usage should be considered with caution.
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Affiliation(s)
- Luigi Barbato
- Department of Clinical and Experimental Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence (Italy), Via Casentino, 29, Florence, Italy.
| | - Raffaele Cavalcanti
- Department of General Surgery and Surgical-Medical Specialties, University of Catania (Italy), Catania, Italy
| | - Cosimo Rupe
- Department of Clinical and Experimental Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence (Italy), Via Casentino, 29, Florence, Italy
| | - Daniele Scartabelli
- Department of Clinical and Experimental Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence (Italy), Via Casentino, 29, Florence, Italy
| | - Lapo Serni
- Department of Clinical and Experimental Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence (Italy), Via Casentino, 29, Florence, Italy
| | - Leandro Chambrone
- Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
- Unit of Basic Oral Investigation (UIBO), Universidad El Bosque, Bogotá, Colombia
- Department of Periodontics, School of Dental Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Francesco Cairo
- Department of Clinical and Experimental Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence (Italy), Via Casentino, 29, Florence, Italy
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20
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Cosgarea R, Roccuzzo A, Jepsen K, Sculean A, Jepsen S, Salvi GE. Efficacy of mechanical/physical approaches for implant surface decontamination in non-surgical submarginal instrumentation of peri-implantitis. A systematic review. J Clin Periodontol 2023; 50 Suppl 26:188-211. [PMID: 36550060 DOI: 10.1111/jcpe.13762] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/02/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
AIM To evaluate the efficacy of non-surgical submarginal peri-implant instrumentation with mechanical/physical decontamination compared to non-surgical submarginal instrumentation alone or with placebo decontamination in patients with peri-implantitis. MATERIALS AND METHODS Three focused questions were addressed, and a systematic search for randomized controlled clinical trials (RCTs), controlled clinical trials, and prospective cohort studies with definitions of peri-implantitis and a minimal follow-up of 6 months was conducted. The main outcome variables were reduction in pocket probing depth (PD) and bleeding on probing (BOP). Suppuration on probing, marginal peri-implant bone level changes, patient-related outcomes and adverse events, implant survival, treatment success, and disease resolution were assessed as secondary outcomes. RESULTS Out of 239 findings, full-text articles were assessed for eligibility, and 9 (n = 9 RCTs) were included in the present review. Five studies evaluated the effects of various laser types, and in four studies efficacy of air-abrasive mechanisms and of a novel ultrasonic device was determined. At 6 months, PD reductions were observed in nine studies but only Er, Cr:YSGG laser-treated group showed statistically significant higher reductions compared to the control group. BOP was statistically significantly reduced at 6 months in two studies following the application of Er:YAG laser compared to controls. One study reported statistically significant reduction in BOP following application of air-polishing device compared to control treatment. No statistically significant differences between treatment groups were reported for the secondary outcome variables. Owing to the large heterogeneity of study designs, no meta-analysis was performed. CONCLUSIONS Available evidence on the efficacy of non-surgical submarginal peri-implant instrumentation with mechanical/physical decontamination is limited by the small number of controlled studies and the high heterogeneity of study protocols. Clinical and patient-reported benefits remain to be demonstrated.
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Affiliation(s)
- Raluca Cosgarea
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
- Department of Periodontology and Peri-implant Diseases, University of Marburg, Marburg, Germany
- School of Dental Medicine, University Iuliu-Hatieganu, Cluj-Napoca, Romania
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Karin Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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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: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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22
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Madi M, Smith S, Alshehri S, Zakaria O, Almas K. Influence of Smoking on Periodontal and Implant Therapy: A Narrative Review. Int J Environ Res Public Health 2023; 20:5368. [PMID: 37047982 PMCID: PMC10094532 DOI: 10.3390/ijerph20075368] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/15/2023] [Accepted: 03/28/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND smoking is considered the most modifiable risk factor for periodontal disease. OBJECTIVE the aim of this narrative review is to emphasize the effect of smoking on periodontal and implant therapy. METHODS The authors reviewed the literature reporting the clinical outcomes of smoking on periodontal surgical and nonsurgical treatment. The impact of smoking on implant therapy and sinus lifting procedures were also reviewed. RESULTS Periodontal and implant therapy outcomes are adversely affected by smoking. Smokers respond less favorably to periodontal therapy and periodontal flap procedures as compared to nonsmokers. Clinical outcomes for smokers are 50-75% worse than for nonsmokers. Studies reveal that smokers experience a significantly lower reduction in pocket depth compared to nonsmokers as well as less bone growth after treating infra-bony defects with guided tissue regeneration. The relative risk of implant failure is significantly higher in patients who smoke 20 cigarettes or more per day compared to nonsmokers. Additionally, smoking has also been shown to increase postoperative wound dehiscence and infection rates following sinus floor elevation. Longitudinal studies on smoke cessation have shown a reduction in bone loss and probing depths for periodontitis patients after cessation compared to those who smoke. CONCLUSION Smoking cessation can reduce probing depths and improve clinical attachment after nonsurgical periodontal therapy. There is insufficient evidence regarding the effect of smoking on peri-implantitis, as well as the loss of implants in the long-term.
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Affiliation(s)
- Marwa Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Steph Smith
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Sami Alshehri
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Osama Zakaria
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Khalid Almas
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
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Zakir M, Thomas D, Adams R, Farnell D, Claydon N. A Systematic Review and Meta-Analysis of the Clinical Outcomes for Adjunctive Physical, Chemical, and Biological Treatment of Dental Implants With Peri-Implantitis. J ORAL IMPLANTOL 2023; 49:168-178. [PMID: 37071563 DOI: 10.1563/aaid-joi-d-21-00204] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
The present systematic review evaluated the efficacy of adjunctive therapies in the treatment of peri-implantitis. Studies comparing the outcome of conventional surgical- or nonsurgical mechanical debridement with the addition of an adjunctive therapeutic modality were identified through an electronic and hand search of available literature. Following data extraction, meta-analyses were performed on the primary outcome measures. The effects of the adjunctive therapies on bleeding on probing (13 studies), probing pocket depth (9 studies), and radiographic bone level changes (7 studies) were analyzed to evaluate potential clinical benefit. Heterogeneity was expressed as the I2 index. Fixed and random effect models were demonstrated. The potential benefit of adjunctive therapies over control procedures was evaluated in 18 studies, representing a total of 773 implants. Quality assessment of the studies found only 3 studies to be at a low risk of bias. Meta-analysis among the different additional modalities revealed chemical therapy demonstrating significant effects in probing pocket depth reduction (0.58 mm; 0.44-0.72) and radiographic bone level gain (0.54 mm; 0.16-0.92). No significant improvements in bleeding on probing reduction were found using any adjunctive therapy. Available evidence on the benefits of adjunctive therapy to nonsurgical or surgical mechanical debridement in the treatment of peri-implantitis is limited by low numbers of standardized, controlled studies for individual therapies, heterogeneity between studies, and a variety of outcome measures. The lack of effect of any adjunctive therapy in reducing bleeding on probing questions the overall effectiveness over conventional treatment. The long-term clinical benefit potential of these therapies is not demonstrated.
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Affiliation(s)
- Mehreen Zakir
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, United Kingdom
| | - David Thomas
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, United Kingdom
| | - Robert Adams
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, United Kingdom
| | - Damian Farnell
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, United Kingdom
| | - Nicholas Claydon
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, United Kingdom
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24
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Alssum LR, Alghofaily MM, Aleyiydi AS, Alomar SA, Alsalleeh FM. The Incidence of Retrograde Peri-Implantitis in a Single University Dental Hospital Training Center: A Retrospective Analysis. Medicina (B Aires) 2023; 59:medicina59030560. [PMID: 36984561 PMCID: PMC10051226 DOI: 10.3390/medicina59030560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/15/2023] Open
Abstract
Background and objective: Retrograde peri-implantitis (RPI) is a periapical radiolucent lesion developed around the implant apex. This study aimed to investigate the Incidence of RPI in a single university dental hospital training center. Materials and Methods: All records of patients who received single Implants between 2016–2020 were screened. For cases that met inclusion criteria, clinical and radiographic data were analyzed. Results: A total of 215 were included and categorized as follows, Category A: implants were placed next to endodontically treated teeth (n = 58, 27%); category B, implants placed at the sites with previous endodontic involvement within 6 months of tooth extraction (n = 25, 11.6%); Category AB: implants placed at sites that fulfill the criteria of groups A and B (n = 18, 8.4%); and Category C: Implants that were placed next to vital teeth and at a site with no previous endodontic treatment or a site that was allowed to heal for more than six (n = 114, 53%). Categories A, B and AB served as the endodontically involved (EI) group, while category C served as non- endodontically involved (NEI) group. Only two sites (0.9%) were confirmed as RPI, both from group A (3.4%). Comparing all groups studied showed no statistically significant difference in RPI incidence. Conclusions: The incidence of RPI is low; however, endodontically treated teeth with periapical lesions (PALs) next to an implant site could contribute to RPI.
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Affiliation(s)
- Lamees R. Alssum
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
- Correspondence: ; Tel.: +966-506975695
| | - Maha M. Alghofaily
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Asrar S. Aleyiydi
- College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Sadeem A. Alomar
- College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Fahd M. Alsalleeh
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
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25
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Amodeo AA, Butera A, Lattari M, Stablum G, Abbinante A, Agneta MT, Lanzetti J, Tomassi D, Piscicelli S, Luperini M, Colavito A, Chiavistelli L, Politangeli R, Castaldi M, Nardi GM. Consensus Report of the Technical-Scientific Associations of Italian Dental Hygienists and the Academy of Advanced Technologies in Oral Hygiene Sciences on the Non-Surgical Treatment of Peri-Implant Disease. Int J Environ Res Public Health 2023; 20:2268. [PMID: 36767633 PMCID: PMC9916275 DOI: 10.3390/ijerph20032268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The recent publication of the new classification of periodontal and peri-implant disease has given clear indications on the parameters to be taken into consideration to correctly diagnose the different phases of these diseases. To date, however, there are no equally clear indications on the treatments to be implemented to solve these diseases. The objective of this Consensus Report is to provide guidance for the non-surgical management of peri-implant mucositis and peri-implantitis. For the drafting of the consensus, the most recent scientific literature was analysed. MATERIALS AND METHODS A group of 15 expert Italian dental hygienists were selected by the Italian technical-scientific societies (AIDI, UNID and ATASIO) and, starting from the literature review, they formulated indications according to the GRADE method (Grading of Recommendations, Assessment, Development, and Evaluation, a tool for rating the quality of evidence, used to draw up systematic reviews and clinical guidelines) on the treatment of peri-implant mucositis, peri-implantitis and on management of the various implanting surfaces. CONCLUSIONS in accordance with the international literature, non-surgical therapy alone can resolve peri-implant mucositis, but not peri-implantitis. Several adjunctive therapies have been considered and some appear to be helpful in managing inflammation.
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Affiliation(s)
- Alessio A. Amodeo
- RDH DHA, Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- RDH DHA, IRCCS Foundation, Ca’Granda General Hospital in Milan, 20122 Milan, Italy
| | - Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | | | - Giulia Stablum
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Antonia Abbinante
- RDH, AIDI (Associazione Igienisti Dentali Italiani), University of Bari, 70121 Bari, Italy
| | | | | | - Domenico Tomassi
- RDH DHA, Catholic University of the Sacred Hear, 00168 Roma, Italy
| | | | - Maurizio Luperini
- RDH DHA, UNID, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Arcangela Colavito
- RDH DHA, ATASIO (Accademia Tecnologie Avanzate nelle Scienze di Igiene Orale), 70121 Bari, Italy
| | - Lorella Chiavistelli
- RDH DHA, ATASIO (Accademia Tecnologie Avanzate nelle Scienze di Igiene Orale), 70121 Bari, Italy
| | - Rita Politangeli
- RDH DHA, ATASIO (Accademia Tecnologie Avanzate nelle Scienze di Igiene Orale), 70121 Bari, Italy
| | - Matteo Castaldi
- RDH DHA, ATASIO (Accademia Tecnologie Avanzate nelle Scienze di Igiene Orale), 70121 Bari, Italy
| | - Gianna Maria Nardi
- RDH DHA, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
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Kang P, Sanz-Miralles E, Li J, Linden E, Momen-Heravi F. Efficacy of Er,Cr:YSGG Laser Application in Nonsurgical Treatment of Peri-implantitis: A Human Randomized Controlled Trial. INT J PERIODONT REST 2023; 43:e1-e9. [PMID: 36661870 DOI: 10.11607/prd.6384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This investigation was designed to evaluate the efficacy of an erbium, chromium-doped yttrium, scandium, gallium and garnet (Er,Cr:YSGG) laser (laser group) compared to conventional mechanical debridement (control group) in the treatment of peri-implantitis. In a double-blinded, randomized, controlled clinical trial, 32 patients with 88 implants with peri-implantitis were randomly assigned to either group. Statistical analyses were performed at 9 months for both groups. The laser-treated group showed a statistically significant reduction in probing depth (PD) compared to the control group (P = .04), but no statistically significant differences were observed for clinical attachment level gain (P = .29) or reduction of bleeding on probing (P = .09). In the subgroup analysis, mandibular single implants with screw-retained restorations treated with Er,Cr:YSGG demonstrated a statistically significant decrease in PD (P < .05) compared to all other groups. A complete resolution of peri-implantitis was achieved in 21% of implants in the test group and 5% of implants in the control group. Er,Cr:YSGG laser is an efficacious therapeutic tool to treat peri-implantitis, achieving greater PD reduction than conventional mechanical debridement alone. Er,Cr:YSGG laser also showed increased benefits in the treatment of mandibular, screw-retained, and single-unit implants compared to the sole use of conventional mechanical debridement.
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27
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Gong J, Zhao R, Yu Z, Li J, Mei M. A novel histopathological classification of implant periapical lesion: A systematic review and treatment decision tree. PLoS One 2022; 17:e0277387. [PMID: 36548276 PMCID: PMC9778521 DOI: 10.1371/journal.pone.0277387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Implant periapical lesion (IPL), as a peri-implant disease originating from implant apex, maintains coronal osseointegration in the early stage. With the understanding to IPL increasingly deepened, IPL classification based on different elements was proposed although there still lacks an overall classification system. This study, aiming to systematically integrate the available data published in the literature on IPL associated with histopathology, proposed a comprehensive classification framework and treatment decision tree for IPL. METHODS AND FINDINGS English articles on the topic of "implant periapical lesion", "retrograde peri-implantitis" and "apical peri-implantitis" were searched on PubMed, Embase and Web of Science from 1992 to 2021, and citation retrieval was performed for critical articles. Definite histopathology and radiology of IPL are indispensable criteria for including the article in the literature. The protocol was registered in PROSPERO (CRD42022378001). A total of 509 papers identified, 28 studies were included in this review. In only one retrospective study, 37 of 39 IPL were reported to be at the inflammatory or abscess stage. 27 cases (37 implants) were reported, including acute non-suppurative (1/37, developed to chronic granuloma), chronic granuloma (5/37), acute suppurated (2/37), chronic suppurated-fistulized (6/37), implant periapical cyst (21/37), poor bone healing (2/37), foreign body reaction (1/37). Antibiotics alone did not appear to be effective, and the consequence of surgical debridement required cautious interpretation because of the heterogeneity of lesion course and operation. Implant apicoectomy and marsupialization were predictable approaches in some cases. CONCLUSIONS The diversiform nature of IPL in the case reports confirms the need for such histopathological classification, which may enhance the comparison and management of different category.
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Affiliation(s)
- Jiaming Gong
- Department of Stomatology, The 940th Hospital of Joint Logistics Support Force of People’s Liberation Army, Lanzhou, Gansu, China
- Department of Stomatology, Quzhou Hospital Affiliated to Wenzhou Medical University (Quzhou people’s Hospital), Quzhou, China
| | - Ruimin Zhao
- Department of Stomatology, The 940th Hospital of Joint Logistics Support Force of People’s Liberation Army, Lanzhou, Gansu, China
| | - Zhanhai Yu
- School/Hospital of Stomatology, Lanzhou University, Gansu, China
| | - Jianxue Li
- Department of Stomatology, The 940th Hospital of Joint Logistics Support Force of People’s Liberation Army, Lanzhou, Gansu, China
| | - Mei Mei
- Department of Stomatology, The 940th Hospital of Joint Logistics Support Force of People’s Liberation Army, Lanzhou, Gansu, China
- * E-mail:
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28
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Moaven H, Giacaman A, Beltrán V, Sam YH, Betancur D, Mainas G, Tarjomani SA, Donos N, Sousa V. Biomarker Expression of Peri-Implantitis Lesions before and after Treatment: A Systematic Review. Int J Environ Res Public Health 2022; 19:14085. [PMID: 36360962 PMCID: PMC9659150 DOI: 10.3390/ijerph192114085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/05/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
The need to predict, diagnose and treat peri-implant diseases has never been greater. We present a systematic review of the literature on the changes in the expression of biomarkers in peri-implant crevicular fluid (PICF) before and after treatment of peri-implantitis. Bacterial composition, clinical and radiographic parameters, and systemic biomarkers before and after treatment are reported as secondary outcomes. A total of 17 studies were included. Treatment groups were non-surgical treatment or surgical treatment, either alone or with adjunctive therapy. Our findings show that non-surgical treatment alone does not influence biomarker levels or clinical outcomes. Both adjunctive photodynamic therapy and local minocycline application resulted in a reduction of interleukin (IL)-1β and IL-10 twelve months after treatment. Non-surgical treatments with adjunctive use of lasers or antimicrobials were more effective at improving the clinical outcomes in the short-term only. Access flap debridement led to matrix metalloproteinase (MMP)-8 and tumour necrosis factor-α reduction twelve months post-surgery. Surgical debridement with adjunctive antimicrobials achieved a decrease in MMP-8 at three months. Adjunctive use of Emdogain™ (EMD) was associated with a reduction in 40 PICF proteins compared to access flap surgery alone. Surgical interventions were more effective at reducing probing pocket depth and bleeding on probing both in the short- and long-term. Surgical treatment in combination with EMD was found to be more effective in resolving inflammation up to twelve months.
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Affiliation(s)
- Haniyeh Moaven
- 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
| | - Annesi Giacaman
- Center of Excellence in Translational Medicine, Faculty of Medicine, Universidad de la Frontera, Temuco 4780000, Chile
| | - Víctor Beltrán
- Clinical Investigation and Dental Innovation Center, Dental School & Center for Translational Medicine, Universidad de La Frontera, Temuco 4780000, Chile
| | - Ye Han Sam
- Periodontology and Periodontal Medicine, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Daniel Betancur
- Discipline of Periodontology, Department of Surgical Stomatology, Faculty of Dentistry, Universidad de Concepción, Concepción 4030000, Chile
| | - Giuseppe Mainas
- Periodontology and Periodontal Medicine, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Seyed Ali Tarjomani
- Periodontology and Periodontal Medicine, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - 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
| | - Vanessa Sousa
- Periodontology and Periodontal Medicine, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
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29
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Moldovan S. A Healthy Foundation: Regeneration Advances in Dental Implant Therapy. Compend Contin Educ Dent 2022; 43:520-522. [PMID: 36170633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
To achieve successful dental implant therapy, a healthy bone and tissue foundation is paramount at the time of placement and must be maintained long term. Often, attaining a healthy peri-implant foundation requires bone regeneration if peri-implantitis has affected the implant(s). This article reviews techniques and materials available today, and looks at future advances, that aid in hard- and soft-tissue regeneration in dental implant therapy. It also discusses important nutritional factors to consider when regeneration is indicated.
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Affiliation(s)
- Sanda Moldovan
- Private Practice, Beverly Hills, California; Diplomate, American Academy of Periodontology
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30
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Di Gianfilippo R, Chambrone L, Prato GP, Nevins M, Franceschi D. Paradigm Shifts in the Evolution of Implant Therapy. INT J PERIODONT REST 2022; 42:605-612. [PMID: 36044690 DOI: 10.11607/prd.6188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Making treatment decisions in dental implantology has evolved over the last five decades. These decisions and the clinical management of sites thereafter are selected based on recent changes, including the achievement of osseointegration, reestablishment of biologic width bone remodeling, the peri-implant soft tissue phenotype, the way peri-implantitis is defined, and advancements in digital technology. This article discusses these key aspects and their effects and influence on implant therapy.
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31
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Dos Santos Martins BG, Fernandes JCH, Martins AG, de Moraes Castilho R, de Oliveira Fernandes GV. Surgical and Nonsurgical Treatment Protocols for Peri-implantitis: An Overview of Systematic Reviews. Int J Oral Maxillofac Implants 2022; 37:660-676. [PMID: 35904822 DOI: 10.11607/jomi.9659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The goal of this overview was to systematically verify the best available literature on surgical and nonsurgical treatments of peri-implantitis to determine evidence-based treatment protocols for peri-implantitis. Three databases (MEDLINE/PubMed, Web of Science, and Cochrane Library/Evidence) were searched by two independent reviewers, including systematic reviews (SRs) that involved randomized controlled trials (RCTs). The search was limited to articles between January 2014 to January 2021 with an English language restriction. In total, 437 articles were initially found, of which only 34 were selected for full-text reading. Nine SRs were included in this study, enrolling 59 different RCTs. Some studies investigated both surgical and nonsurgical techniques, while others focused on only one approach or the other. In total, six of the studies included nonsurgical techniques, and eight included surgical techniques (ie, augmentative, regenerative, and corrective/resective techniques). Nonsurgical interventions appeared to offer some degree of clinical improvements, especially in bleeding on probing levels, but they were not enough to fully treat peri-implantitis. Whereas surgical techniques seemed to be more effective in improving overall clinical parameters, especially probing depth, bleeding on probing, and to some extent, marginal bone level, no specific surgical technique or material (graft or membrane) had a clear advantage over others. Therefore, resective surgical and implantoplasty techniques demonstrated significant improvements in clinical parameters. Although surgical interventions are more indicated to treat peri-implantitis than nonsurgical procedures, the predictability is still a concern due to titanium particles scattered within the local tissue.
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32
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Rosen PS, Froum SJ, Sarmiento H, Wadhawani CP. A Revised Peri-implantitis Classification Scheme: Adding Three-Dimensional Considerations to Facilitate Prognosis and Treatment Planning. INT J PERIODONT REST 2022; 42:291-299. [PMID: 35472104 DOI: 10.11607/prd.5876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Historically, diagnosing peri-implantitis is done based on whether the disease is present, evaluated using the arbitrary thresholds of probing depths and bone loss. Using this approach as a tool to ascertain meaningful information regarding prevalence and treatment is limited. Efforts have been made to improve upon this, but to date, only one of these classifications has provided a simple method to communicate disease severity based on the amount of bone loss. A modified version of this simplified classification is proposed here, including information regarding the implant position, as emerging information suggests that this is a crucial factor in the etiology and prognosis of peri-implantitis. This enhancement to the classification better serves both researchers and clinicians in their discussion about peri-implantitis and helps to determine and recommend the most effective methods of management.
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33
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Zeng C, Wang Z, Cai Y, Zeng T, Yang Y, Wang Y. Role of decontamination treatment for implant surface in the treatment of peri-implantitis. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2022; 47:521-528. [PMID: 35545348 PMCID: PMC10930156 DOI: 10.11817/j.issn.1672-7347.2022.210119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Indexed: 06/15/2023]
Abstract
Peri-implantitis, characterized by inflammation of tissues around implants and gradual loss of supporting bone tissue, has become one of the main causes for implant failure. Thoroughly removing the plaque biofilm on the implant surface is the first principle in the treatment of peri-implantitis. For this reason, various decontamination methods have been proposed, which can be divided into 2 categories: Removing biofilm and killing microorganisms according to the effect of plaque biofilm on the implant surface. However, at present, there is no decontamination method that can completely remove the plaque biofilm on the implant surface, and it lacks of clinical recommended guidelines. To understand the advantages and disadvantages, effectiveness and safety for different implant surface decontamination methods is of great significance to guide the clinical selection for peri-implantitis treatment.
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Affiliation(s)
- Chunyu Zeng
- Key Laboratory of Oral Health Research of Hunan Province; Academician Wang Songling Expert Workstation of Oral and Maxillofacial Regeneration; 3D Printing Oral Medical Engineering Technology Research Center of Hunan Province; Xiangya School of Stomatology (Xiangya Stomatological Hospital), Central South University, Changsha 410008, China.
| | - Zhefu Wang
- Key Laboratory of Oral Health Research of Hunan Province; Academician Wang Songling Expert Workstation of Oral and Maxillofacial Regeneration; 3D Printing Oral Medical Engineering Technology Research Center of Hunan Province; Xiangya School of Stomatology (Xiangya Stomatological Hospital), Central South University, Changsha 410008, China
| | - Yunzhou Cai
- Key Laboratory of Oral Health Research of Hunan Province; Academician Wang Songling Expert Workstation of Oral and Maxillofacial Regeneration; 3D Printing Oral Medical Engineering Technology Research Center of Hunan Province; Xiangya School of Stomatology (Xiangya Stomatological Hospital), Central South University, Changsha 410008, China
| | - Ting Zeng
- Key Laboratory of Oral Health Research of Hunan Province; Academician Wang Songling Expert Workstation of Oral and Maxillofacial Regeneration; 3D Printing Oral Medical Engineering Technology Research Center of Hunan Province; Xiangya School of Stomatology (Xiangya Stomatological Hospital), Central South University, Changsha 410008, China
| | - Yanqing Yang
- Key Laboratory of Oral Health Research of Hunan Province; Academician Wang Songling Expert Workstation of Oral and Maxillofacial Regeneration; 3D Printing Oral Medical Engineering Technology Research Center of Hunan Province; Xiangya School of Stomatology (Xiangya Stomatological Hospital), Central South University, Changsha 410008, China
| | - Yuehong Wang
- Key Laboratory of Oral Health Research of Hunan Province; Academician Wang Songling Expert Workstation of Oral and Maxillofacial Regeneration; 3D Printing Oral Medical Engineering Technology Research Center of Hunan Province; Xiangya School of Stomatology (Xiangya Stomatological Hospital), Central South University, Changsha 410008, China.
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34
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Greenstein G, Eskow R. High Prevalence Rates of Peri-implant mucositis and Peri-implantitis Post Dental Implantations Dictate Need for Continuous Peri-implant Maintenance. Compend Contin Educ Dent 2022; 43:206-214. [PMID: 35380854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
While many clinicians are cognizant of the high survival rate of dental implants, the elevated prevalences of peri-implant mucositis and peri-implantitis post implant insertions may not be as well known. This underscores the need for greater awareness of the importance of continuous personal and professional peri-implant maintenance to facilitate implant success. The occurrence of peri-implant mucositis and peri-implantitis post implant insertions among patients ranges in studies from 46% to 63% and 19% to 23%, respectively. Individuals who undertake regular personal and professional maintenance therapy compared to patients who have irregular supportive therapy manifest reduced occurrences of peri-implant mucositis and peri-implantitis. The frequency of professional maintenance intervals usually ranges from 3 to 6 months, and its specific periodicity should be based on a patient's risk profile. Supportive care visits provide the clinician an opportunity to monitor peri-implant status. No long-term controlled clinical trials have evaluated the timing of maintenance intervals, but substantial evidence shows that professional supportive care enhances peri-implant health and the success rate of dental implants. A patient's informed consent form should include the responsibility to be compliant with personal and professional peri-implant supportive therapy.
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Affiliation(s)
- Gary Greenstein
- Former Clinical Professor, Division of Periodontics, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York; Private Practice, limited to Periodontics and Dental Implantology, Freehold, New Jersey
| | - Robert Eskow
- Clinical Professor, Division of Periodontics, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York; Private Practice limited to Periodontics, Dental Implantology, and Oral Medicine, Livingston and Clark, New Jersey
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35
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Zipprich H, Weigl P, Di Gianfilippo R, Steigmann L, Henrich D, Wang HL, Schlee M, Ratka C. Comparison of decontamination efficacy of two electrolyte cleaning methods to diode laser, plasma, and air-abrasive devices. Clin Oral Investig 2022; 26:4549-4558. [PMID: 35322316 DOI: 10.1007/s00784-022-04421-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/17/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To compare the in vitro decontamination efficacy of two electrolytic cleaning methods to diode laser, plasma, and air-abrasive devices. MATERIAL AND METHODS Sixty sandblasted large-grit acid-etched (SLA) implants were incubated with 2 ml of human saliva and Tryptic Soy Broth solution under continuous shaking for 14 days. Implants were then randomly assigned to one untreated control group (n = 10) and 5 different decontamination modalities: air-abrasive powder (n = 10), diode laser (n = 10), plasma cleaning (n = 10), and two electrolytic test protocols using either potassium iodide (KI) (n = 10) or sodium formate (CHNaO2) (n = 10) solution. Implants were stained for dead and alive bacteria in two standardized measurement areas, observed at fluorescent microscope, and analyzed for color intensity. RESULTS All disinfecting treatment modalities significantly reduced the stained area compared to the untreated control group for both measurement areas (p < 0.001). Among test interventions, electrolytic KI and CHNaO2 treatments were equally effective, and each one significantly reduced the stained area compared to any other treatment modality (p < 0.001). Efficacy of electrolytic protocols was not affected by the angulation of examined surfaces [surface angulation 0° vs. 60° (staining %): electrolytic cleaning-KI 0.03 ± 0.04 vs. 0.09 ± 0.10; electrolytic cleaning-CHNaO2 0.01 ± 0.01 vs. 0.06 ± 0.08; (p > 0.05)], while air abrasion [surface angulation 0° vs. 60° (staining %): 2.66 ± 0.83 vs. 42.12 ± 3.46 (p < 0.001)] and plasma cleaning [surface angulation 0° vs. 60° (staining %): 33.25 ± 3.01 vs. 39.16 ± 3.15 (p < 0.001)] were. CONCLUSIONS Within the limitations of the present in vitro study, electrolytic decontamination with KI and CHNaO2 was significantly more effective in reducing bacterial stained surface of rough titanium implants than air-abrasive powder, diode laser, and plasma cleaning, regardless of the accessibility of the contaminated implant location. CLINICAL RELEVANCE Complete bacterial elimination (residual bacteria < 1%) was achieved only for the electrolytic cleaning approaches, irrespectively of the favorable or unfavorable access to implant surface.
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Affiliation(s)
| | - Paul Weigl
- Department of Postgraduate Education, Faculty of Oral and Dental Medicine, J. W. Goethe University, 60596, Frankfurt am Main, Germany
| | - Riccardo Di Gianfilippo
- Department of Periodontics and Oral Medicine, The University of Michigan - School of Dentistry, 1011 North university Avenue, Ann Arbor, MI, 48109, USA.
| | - Larissa Steigmann
- Department of Periodontics and Oral Medicine, The University of Michigan - School of Dentistry, 1011 North university Avenue, Ann Arbor, MI, 48109, USA
| | - Dirk Henrich
- Department of Trauma, Hand & Reconstructive Surgery, Goethe University, 60596, Frankfurt am Main, Germany
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, The University of Michigan - School of Dentistry, 1011 North university Avenue, Ann Arbor, MI, 48109, USA
| | - Markus Schlee
- Department of Maxillofacial Surgery, Goethe University, 60596, Frankfurt am Main, Germany
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Wang Y, Chen CY, Stathopoulou PG, Graham LK, Korostoff J, Chen YW. Efficacy of Antibiotics Used as an Adjunct in the Treatment of Peri-implant Mucositis and Peri-implantitis: A Systematic Review and Meta-analysis. Int J Oral Maxillofac Implants 2022; 37:235-249. [PMID: 35476853 DOI: 10.11607/jomi.9220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This systematic review aimed to assess the clinical efficacy of antibiotics when used as an adjunct in treating peri-implant diseases. MATERIALS AND METHODS A systematic search of papers published between January 1980 and March 2020 was conducted. Randomized clinical trials with at least 10 patients who had peri-implant diseases, treated with or without adjunctive antibiotics in combination with surgical or nonsurgical therapies, and with a minimum of at least 3 months of follow-up were included. Meta-analyses were conducted to analyze weighted mean differences in probing depth reduction, radiographic bone level gain, and odds ratio of treatment success. RESULTS From the 856 articles identified, 10 articles met the inclusion criteria and were selected. Of these, 7 articles were used for the meta-analysis. The adjunctive use of antibiotics in the treatment of peri-implant diseases yielded significantly greater probing depth reduction (weighted mean differences = 0.56 mm at 3 months, P = .001; 0.77 mm at 6 months, P < .00001; 0.92 mm at 12 months, P < .00001), radiographic bone level gain (weighted mean differences = 0.64 mm, P = .03), and treatment success (odds ratio = 1.74, P = .04) compared to the same treatment without antibiotics. CONCLUSION Based on the existing evidence, the use of adjunctive antibiotics to treat peri-implant diseases, especially peri-implantitis, provided potential benefits in clinical outcomes for up to 12 months posttherapy.
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Li ZB, Li K, Ding T, Yang HQ, Du M, Yu Y. The Effect of Nonaugmentative Approaches in the Surgical Treatment of Peri-implantitis: A Systematic Review and Network Meta-analysis. Int J Oral Maxillofac Implants 2022; 37:270-282. [PMID: 35476855 DOI: 10.11607/jomi.9211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This systematic review and Bayesian network meta-analysis (NMA) were performed to compare the clinical effects of nonaugmentative adjunctive approaches in the surgical treatment of peri-implantitis. MATERIALS AND METHODS A systematic search of six electronic databases was performed up to June 20, 2020. Additional relevant literature was identified through gray literature and hand searches. Randomized controlled trials (RCTs) of surgical treatment of periimplantitis with nonaugmentative adjunctive approaches were included. Probing depth (PD) changes, marginal bone level (MBL) changes, and treatment success rates were extracted and assessed. Pairwise meta-analysis and Bayesian NMA were performed. This review was registered at PROSPERO (CRD42020191113). RESULTS The search yielded 7,419 articles, of which 10 studies with 11 articles were included in the quantitative analysis. In the NMA of mechanical approaches and photodynamic therapy (PDT), compared with hand curettes, implantoplasty provided significant additional PD improvement at the 6-month follow-up evaluation (mean difference [MD]: 1.29; 95% confidence interval [CI]: 0.17, 2.38) and 12-month follow-up evaluation (MD: 1.39; 95% CI: 0.91, 1.74). In the NMA of antiseptics and systemic antibiotics, adjunctive use of antiseptics and/or systemic antibiotics did not provide significant improvement in PD or MBL. In the NMA of all adjunctive approaches, no significant differences were found in PD improvements. CONCLUSION Within the limitations of this systematic review and NMA, implantoplasty is more effective than hand curettes in improving PD in the surgical treatment of peri-implantitis. Chemical antiseptics or systemic antibiotics have a limited effect on improving PD and MBL.
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Dell'Olmo F, Blasi G, Monje A, Mariotti A, Valles C, Pascual A, Nart J. Periodontists' Trends in the Management of Peri-implant Diseases. Int J Oral Maxillofac Implants 2022; 37:329-338. [PMID: 35476862 DOI: 10.11607/jomi.9374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The scarce standard therapeutic protocols for the management of peri-implant diseases results in the empirical application of therapeutic modalities. The objective of this study was to carry out a survey to analyze the therapeutic trends of professionals with different academic backgrounds and levels of expertise. MATERIALS AND METHODS An exploratory cross-sectional internet-based study survey of board-certified members of the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) was conducted. To assess the therapeutic trends, four clinical vignettes representing different scenarios of peri-implant biologic complications were provided to the participants. Differences in practice patterns were determined using chi-square test and Student t test or analysis of variance (ANOVA) test for qualitative variables. RESULTS A total of 268 members of the AAP and EFP completed the survey. A significant difference in preferred treatment plan was found between EFP and AAP periodontists, resective therapy being the treatment of choice by the majority of the former (41.2%) and regenerative therapy by the latter (48.9%; P < .001). Overall, 48.1% of experts did not consider any intervention for the management of mucositis. Antibiotic prescriptions differed among groups, with statistical significance in each clinical case, and the explantation criteria were inconsistent and differed significantly among groups. CONCLUSION Substantial variations exist concerning the decision-making to manage peri-implant diseases and conditions.
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孙 菲, 李 思, 危 伊, 钟 金, 王 翠, 胡 文. [Efficacy of combined application of glycine powder air-polishing in non-surgical treatment of peri-implant diseases]. Beijing Da Xue Xue Bao Yi Xue Ban 2022; 54:119-125. [PMID: 35165478 PMCID: PMC8860663 DOI: 10.19723/j.issn.1671-167x.2022.01.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To compare the clinical efficacy of combined application of glycine powder air-polishing and mechanical submucosal debridement in non-surgical treatment of peri-implant diseases. METHODS A randomized controlled clinical study was carried out on patients diagnosed with peri-implant diseases in the Department of Periodontology, Peking University School and Hospital of Stomatology, between May of 2020 and June of 2021.Twenty-eight patients with totally sixty-two implants were enrolled.The patients were randomly divided into the test group and control group. The patients in the test group (13 subjects/32 implants) received mechanical submucosal debridement using titanium curettes combined with application of glycine powder air-polishing, while the control group (15 subjects/30 implants) received mechanical submucosal debridement using titanium only. Clinical parameters, such as plaque index (PLI), pocket probing depth (PPD), bleeding index (BI) and the percentage of suppuration on probing on implants' level (SoP%) were measured at baseline and 8 weeks after non-surgical intervention. Changes and group differences of clinical parameters of the implants before and 8 weeks after non-surgical intervention were compared. RESULTS Mean PLI, PPD, BI of both the test group and control group significantly reduced 8 weeks after non-surgical intervention (P < 0.05). Compared with the control group, the test group achieved lower BI (2.7±0.8 vs. 2.2±0.7, P < 0.05), more reduction of BI (0.6±0.7 vs. 1.1±0.6, P < 0.01) and more reduction of SoP% (21.9% vs. 10%, P < 0.05) after non-surgical intervention. Both the control and test groups exhibited comparable PLI and PPD reductions (P>0.05). For the implants diagnosed with peri-implant mucositis, the test group revealed more signi-ficant reduction in BI and SoP% than the control group (1.0±0.7 vs. 0.4±0.7, P=0.02; 6.3% vs. 0, P=0.012). There was no significant difference existing in PLI and PD improvement between the control group and test group (P>0.05). For the implants diagnosed with peri-implantitis, there was no significant difference existing in PLI, PPD, BI and SoP% improvement values between the test and control groups (P>0.05). No complications or discomforts were reported during the study. CONCLUSION Both treatment procedures could relieve the inflammation of peri-implant soft tissue. Non-surgical mechanical submucosal debridement combined application of glycine powder air-polishing is associated with significant reduction of soft tissue bleeding and suppuration on probing especially in the implants diagnosed with peri-implant mucositis.
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Affiliation(s)
- 菲 孙
- />北京大学口腔医学院·口腔医院牙周科, 国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
| | - 思琪 李
- />北京大学口腔医学院·口腔医院牙周科, 国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
| | - 伊萍 危
- />北京大学口腔医学院·口腔医院牙周科, 国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
| | - 金晟 钟
- />北京大学口腔医学院·口腔医院牙周科, 国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
| | - 翠 王
- />北京大学口腔医学院·口腔医院牙周科, 国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
| | - 文杰 胡
- />北京大学口腔医学院·口腔医院牙周科, 国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
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Francis S, Iaculli F, Perrotti V, Piattelli A, Quaranta A. Titanium Surface Decontamination: A Systematic Review of In Vitro Comparative Studies. Int J Oral Maxillofac Implants 2022; 37:76-84. [PMID: 35235623 DOI: 10.11607/jomi.8969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To achieve high plaque removal around peri-implant tissues, noninvasive cleaning methods that guarantee the long-term success and survival of titanium implants should be established. This systematic review aimed to systematically evaluate in vitro investigations assessing different treatment modalities to decontaminate titanium surfaces, with special focus on the most effective cleaning procedures. MATERIALS AND METHODS PRISMA guidelines were adopted in an electronic search conducted through MEDLINE, Scopus, and Google Scholar databases to identify studies on mechanical, chemical, or laser decontamination modalities up to November 2019. RESULTS The search resulted in 326 articles; after removing duplicates and reading titles, abstracts, and full texts, 38 articles were ultimately processed for data extraction. Mechanical decontamination provided better results in comparison to laser and chemical procedures. Among mechanical modalities, air abrasion showed the best cleaning effectiveness. Conversely, upon comparison of the chemical methods, chlorhexidine demonstrated comparable results with all tested substances and even with photodynamic therapy. Among different lasers, the results showed that the diode was more promising compared with the other tested lasers. CONCLUSION This review demonstrated that there is still no consensus on which technique performs better. However, mechanical decontamination yielded more favorable results than laser and chemical methods. This aspect would support the hypothesis that decontamination procedures adopted in a combination fashion, which includes mechanical procedures, may provide better clinical results than when used alone.
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La Monaca G, Pranno N, Annibali S, Vozza I, Cristalli MP. Subcutaneous Facial Emphysema Following Open-Flap Air-Powder Abrasive Debridement for Peri-Implantitis: A Case Report and an Overview. Int J Environ Res Public Health 2021; 18:ijerph182413286. [PMID: 34948898 PMCID: PMC8702083 DOI: 10.3390/ijerph182413286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022]
Abstract
Subcutaneous facial emphysema related to dental treatments is a well-known clinical complication due to incidental or iatrogenic air or gas penetration into the subcutaneous tissues and fascial planes, leading to distension of the overlying skin. To the best of our knowledge, from 1960 to the current date, only six cases have been reported arising from peri-implant cleaning or non-surgical peri-implantitis treatment. Therefore, the present case of subcutaneous facial emphysema following open-flap air-powder abrasive debridement was the first report during surgical peri-implantitis therapy. Swelling on the left cheek and periorbital space suddenly arose in a 65-year-old woman during open-flap debridement with sodium bicarbonate air-powder abrasion (PROPHYflex™ 3 with periotip, KaVo, Biberach, Germany) of the infected implant surface. The etiology, clinical manifestations, diagnosis, potential complications, and management of subcutaneous emphysema are also briefly reviewed. The present case report draws the attention of dental practitioners, periodontists, oral surgeons, and dental hygienists to the potential iatrogenic risk of subcutaneous emphysema in using air-powder devices in implant surface debridement.
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Affiliation(s)
- Gerardo La Monaca
- Department of Oral and Maxillofacial Sciences, University of Rome, 00173 Rome, Italy; (G.L.M.); (S.A.); (I.V.)
| | - Nicola Pranno
- Department of Oral and Maxillofacial Sciences, University of Rome, 00173 Rome, Italy; (G.L.M.); (S.A.); (I.V.)
- Correspondence:
| | - Susanna Annibali
- Department of Oral and Maxillofacial Sciences, University of Rome, 00173 Rome, Italy; (G.L.M.); (S.A.); (I.V.)
| | - Iole Vozza
- Department of Oral and Maxillofacial Sciences, University of Rome, 00173 Rome, Italy; (G.L.M.); (S.A.); (I.V.)
| | - Maria Paola Cristalli
- Department of Biotechnologies and Medical Surgical Sciences, University of Rome, 00173 Rome, Italy;
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Hui WL, Perrotti V, Piattelli A, Ostrikov KK, Fang Z, Quaranta A. Cold atmospheric plasma coupled with air abrasion in liquid medium for the treatment of peri-implantitis model grown with a complex human biofilm: an in vitro study. Clin Oral Investig 2021; 25:6633-6642. [PMID: 33893556 PMCID: PMC8602208 DOI: 10.1007/s00784-021-03949-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/13/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Treatment of implants with peri-implantitis is often unsuccessful due to residual microbial biofilm hindering re-osseointegration. The aim of this study was to treat biofilm-grown titanium (Ti) implants with different modalities involving air abrasion (AA) and cold atmospheric plasma (CAP) to compare the effectiveness in surface decontamination and the alteration/preservation of surface topography. MATERIALS AND METHODS Saliva collected from a peri-implantitis patient was used to in vitro develop human biofilm over 35 implants with moderately rough surface. The implants were then mounted onto standardized acrylic blocks simulating peri-implantitis defects and treated with AA (erythritol powder), CAP in a liquid medium, or a combination (COM) of both modalities. The remaining biofilm was measured by crystal violet (CV). Surface features and roughness before and after treatment were assessed by scanning electron microscope (SEM). The data were statistically analyzed using Kruskal-Wallis followed by Tukey's multiple comparison test. RESULTS In the present peri-implantitis model, the human complex biofilm growth was successful as indicated by the statistical significance between the negative and positive controls. All the treatment groups resulted in a remarkable implant surface decontamination, with values very close to the negative control for AA and COM. Indeed, statistically significant differences in the comparison between the positive control vs. all the treatment groups were found. SEM analysis showed no post-treatment alterations on the implant surface in all the groups. CONCLUSIONS Decontamination with AA delivering erythritol with or without CAP in liquid medium demonstrated compelling efficacy in the removal of biofilm from implants. All the tested treatments did not cause qualitative alterations to the Ti surface features. No specific effects of the CAP were observed, although further studies are necessary to assess its potential as monotherapy with different settings or in combination with other decontamination procedures. CLINICAL RELEVANCE CAP is a promising option in the treatment of peri-implantitis because it has potential to improve the elimination of bacterial plaque from implant surfaces, in inaccessible pockets or during open-flap debridement, and should stimulate the process of the re-osseointegration of affected dental implants by not altering surface features and roughness.
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Affiliation(s)
- Wang Lai Hui
- Smile Specialists Suite, Newcastle, NSW, Australia
- Formerly, School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
| | - Vittoria Perrotti
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), University of Chieti-Pescara, Via dei vestini, 31, 66100, Chieti, Italy.
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), University of Chieti-Pescara, Via dei vestini, 31, 66100, Chieti, Italy
| | - Kostya Ken Ostrikov
- School of Chemistry and Physics, Queensland University of Technology, Brisbane, Queensland, 4000, Australia
| | - Zhi Fang
- College of Electrical Engineering and Control Science, Nanjing Tech University, Nanjing, 210009, China
| | - Alessandro Quaranta
- Smile Specialists Suite, Newcastle, NSW, Australia
- Formerly, School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
- Sydney Dental Hospital, Sydney, NSW, Australia
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Verardi S, Valente NA. Peri-Implantitis: Application of a Protocol for the Regeneration of Deep Osseous Defects. A Retrospective Case Series. Int J Environ Res Public Health 2021; 18:ijerph182312658. [PMID: 34886384 PMCID: PMC8656633 DOI: 10.3390/ijerph182312658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/19/2021] [Accepted: 11/29/2021] [Indexed: 11/26/2022]
Abstract
Background and aims: Peri-implantitis is a complex pathology, both in its diagnosis and in the identification of etiological causes. Although we have been studying more and more over the years to try to answer the many questions that remain regarding everything that circulates around this disease which affects implants, nothing has yet been taken as an official consensus regarding its surgical treatment. There are still many proposed protocols, each of which has been shown to have comforting results and promising prospects, but no total predictability. The aim of this case series is to assess the clinical outcomes of a mixed protocol for the regeneration of deep osseous defects. Materials and methods: The data and clinical records of 23 patients, with 29 implants affected by peri-implantitis treated surgically in private practice, were analyzed retrospectively. The method used for the surgical treatment was a mixed protocol of mechanical–chemical decontamination and bone regeneration with bovine xenograft. Results: All patients were followed for at least 2 years, averaging 28.9 months (a range of 24–38 months) with a reduction in the probing depth (PD) at one year from the initial 8.14 ± 1.156 mm to 3.72 ± 0.649 mm, and to 4.14 ± 1.093 mm at the final assessment. The differences between assessment time points were always statistically significant. The data regarding bleeding on probing (BoP) and suppuration also showed a statistically significant reduction at the final time point compared to the baseline. Only one patient, at 24 months, still showed BoP, suppuration, and a PD deeper than 5 mm, indicating a recurrence of the disease compared to the initial improvement of the PD (5 mm) at one year. Conclusions: In conclusion, within the limits of this retrospective analysis, it can be affirmed that this combined mechanical–chemical and regenerative decontamination therapy is effective in the treatment of peri-implantitis.
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Affiliation(s)
- Simone Verardi
- Department of Periodontics, University of Washington, Seattle, WA 98195, USA;
| | - Nicola Alberto Valente
- Department of Periodontology, School of Dental Medicine, University of Cagliari, 09124 Cagliari, Italy
- Department of Periodontics and Endodontics, State University of New York at Buffalo, New York, NY 14214, USA
- Correspondence:
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Roncati M. Impact of Home and Professional Care on Laser-Assisted Management of Peri-implant Complications: A Case Report. INT J PERIODONT REST 2021; 41:819-825. [PMID: 34818384 DOI: 10.11607/prd.5009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This case report emphasizes how home and professional care can impact clinical outcomes following nonsurgical mechanical therapy with the adjunctive use of a diode laser to treat failing implants. Localized severe peri-implant disease was diagnosed in a patient who was susceptible to periodontal disease, not compliant, and did not accept the surgical approach. A cause-related, diode laser-assisted, nonsurgical treatment was therefore implemented, according to a dedicated protocol, in four closely scheduled appointments. The patient's oral hygiene skills became extremely effective. She then adhered to a bimonthly maintenance protocol in the first follow-up year and quarterly in the subsequent year. Bone remineralization was detected on comparative periapical radiographs 2 years after the diagnosis of peri-implantitis. At the 2-year observation, the patient's high standard of home care and dedicated maintenance arrested the progression of peri-implantitis and yielded clinical and radiographic improvements following nonsurgical mechanical therapy with adjunctive repeated application of a diode laser.
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Garaicoa-Pazmino C, Lin GH, Alkandery A, Parra-Carrasquer C, Suárez-López Del Amo F. Influence of implant surface characteristics on the initiation, progression and treatment outcomes of peri-implantitis: A systematic review and meta-analysis based on animal model studies. Int J Oral Implantol (Berl) 2021; 14:367-382. [PMID: 34726847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE To evaluate the impact of implant surface characteristics on the initiation, progression and treatment outcomes of peri-implantitis based exclusively on in vivo investigations. MATERIALS AND METHODS A literature search was conducted by two independent reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify animal studies comparing at least two different implant surfaces affected by experimental peri-implantitis, with distinct characteristics and with or without subsequent surgical treatment that aims to arrest disease progression. The parameters evaluated included both radiographic (e.g., marginal bone level) and clinical (e.g., probing depth, bleeding on probing) aspects to determine changes in disease progression and treatment outcomes. RESULTS No statistically significant differences were found among the different implant surfaces during the initiation of peri-implantitis. On the other hand, the progression and treatment outcomes of peri-implantitis displayed statistically significant differences among the different implant systems, with turned surfaces reporting less bone loss during the progression period and greater bone gain after treatment. CONCLUSIONS Implant surface characteristics play a critical role in the progression and treatment outcomes of peri-implantitis. Turned implant surfaces demonstrated the least amount of bone loss after ligature removal and recorded the most favourable treatment outcomes.
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Alpaslan Yayli NZ, Talmac AC, Keskin Tunc S, Akbal D, Altindal D, Ertugrul AS. Erbium, chromium-doped: yttrium, scandium, gallium, garnet and diode lasers in the treatment of peri-implantitis: clinical and biochemical outcomes in a randomized-controlled clinical trial. Lasers Med Sci 2021; 37:665-674. [PMID: 34637055 DOI: 10.1007/s10103-021-03436-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/01/2021] [Indexed: 11/25/2022]
Abstract
This study aims to evaluate the effects of 940 nm diode laser and 2780 nm erbium, chromium-doped: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) laser used in addition to mechanical therapy in the non-surgical treatment of peri-implantitis on clinical parameters and matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) levels in the peri-implant crevicular fluid. A total of 50 patients with peri-implantitis were randomized into three groups to receive peri-implant treatment. The control group (n = 17) only received conventional non-surgical mechanical therapy. The trial groups [(diode group (n = 16) and Er,Cr:YSGG group (n = 17)] received dental laser in addition to mechanical therapy. Gingival index (GI), plaque index (PI), bleeding on probing, probing depth (PD), MMP-9, and TIMP-1 levels were assessed at baseline (T0) and at 6 months after treatment (T1). The GI, PI, and PD significantly decreased in all groups at T1, compared to T0 (p < 0.05). The decrease in the PD was similar between the control and diode groups with Er,Cr:YSGG providing more reduction (1.16 ± 0.64 mm) than either method (p = 0.032). A significant intra-group decrease in MMP-9 level was only observed in the Er,Cr:YSGG group (p = 0.009). The decrease in TIMP-1 level from T0 to T1 was similar between the control and the diode groups (p > 0.05) and it was significantly lower than the decrease in the Er,Cr:YSGG group (p < 0.05). Addition of diode laser to non-surgical mechanical therapy does not provide any additional benefit for treatment outcomes. The Er,Cr:YSGG laser seems to be more efficient both at clinical and molecular levels. ClinicalTrials, ID: NCT04730687. Registered 13 April 2021. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04730687.
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Affiliation(s)
| | - Ahmet Cemil Talmac
- Faculty of Dentistry, Department of Periodontology, Van Yuzuncu Yil University, Van, 65080, Turkey
| | - Serap Keskin Tunc
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Van Yuzuncu Yil University, Van, Turkey
| | - Damla Akbal
- Faculty of Dentistry, Department of Periodontology, Van Yuzuncu Yil University, Van, 65080, Turkey
| | - Dicle Altindal
- Faculty of Dentistry, Department of Periodontology, Van Yuzuncu Yil University, Van, 65080, Turkey
| | - Abdullah Seckin Ertugrul
- Faculty of Dentistry, Department of Periodontology, Izmir Katip Celebi University, Izmir, Turkey
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Wu S, Xu J, Zou L, Luo S, Yao R, Zheng B, Liang G, Wu D, Li Y. Long-lasting renewable antibacterial porous polymeric coatings enable titanium biomaterials to prevent and treat peri-implant infection. Nat Commun 2021; 12:3303. [PMID: 34083518 PMCID: PMC8175680 DOI: 10.1038/s41467-021-23069-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 03/18/2021] [Indexed: 01/14/2023] Open
Abstract
Peri-implant infection is one of the biggest threats to the success of dental implant. Existing coatings on titanium surfaces exhibit rapid decrease in antibacterial efficacy, which is difficult to promisingly prevent peri-implant infection. Herein, we report an N-halamine polymeric coating on titanium surface that simultaneously has long-lasting renewable antibacterial efficacy with good stability and biocompatibility. Our coating is powerfully biocidal against both main pathogenic bacteria of peri-implant infection and complex bacteria from peri-implantitis patients. More importantly, its antibacterial efficacy can persist for a long term (e.g., 12~16 weeks) in vitro, in animal model, and even in human oral cavity, which generally covers the whole formation process of osseointegrated interface. Furthermore, after consumption, it can regain its antibacterial ability by facile rechlorination, highlighting a valuable concept of renewable antibacterial coating in dental implant. These findings indicate an appealing application prospect for prevention and treatment of peri-implant infection.
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Affiliation(s)
- Shuyi Wu
- Department of Prosthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510055, P. R. China
| | - Jianmeng Xu
- Department of Prosthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510055, P. R. China
| | - Leiyan Zou
- Department of Prosthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510055, P. R. China
| | - Shulu Luo
- Department of Prosthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510055, P. R. China
| | - Run Yao
- Department of Prosthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510055, P. R. China
| | - Bingna Zheng
- Materials Science Institute, PCFM Lab and GDHPRC Lab, School of Chemistry, Sun Yat-sen University, Guangzhou, 510275, P. R. China
| | - Guobin Liang
- Department of Prosthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510055, P. R. China
| | - Dingcai Wu
- Materials Science Institute, PCFM Lab and GDHPRC Lab, School of Chemistry, Sun Yat-sen University, Guangzhou, 510275, P. R. China.
| | - Yan Li
- Department of Prosthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510055, P. R. China.
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Iatrou P, Chamilos C, Nickles K, Ratka C, Eickholz P, Petsos H. In Vitro Efficacy of Three Different Nonsurgical Implant Surface Decontamination Methods in Three Different Defect Configurations. Int J Oral Maxillofac Implants 2021; 36:271-280. [PMID: 33909716 DOI: 10.11607/jomi.8864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Assessment of in vitro efficacy of three different nonsurgical implant surface decontamination methods in three peri-implant bone defect simulation models. MATERIALS AND METHODS A total of 180 implants were allocated to differently angulated (30, 60, and 90 degrees) peri-implant bone defect resin models, each covered by a mucosa mask. All implants were stained with indelible red color and assigned to one of the three defect models. In each simulated bone defect group, 20 implants were decontaminated for 2 minutes with a curette (CUR), sonic scaler (SOSC), or air-powder abrasion device (APA) with glycine powder. Photos were taken from both sides of each implant to measure the percentage of uncleaned implant surface area. Scanning electron microscopy (SEM) was used to assess the implant surface for morphologic damage. RESULTS Among the three defect angulations, a significantly different cleaning efficacy (P < .001) for each treatment method was found (30 degrees: CUR [67.33%], SOSC [62.70%], APA [39.33%]; 60 degrees: CUR [61.59%], SOSC [54.31%], APA [23.91%]; 90 degrees: CUR [66.82%], SOSC [55.77%], APA [28.03%]). SEM did not show any considerable surface damage after APA treatment in comparison with after CUR or SOSC. CONCLUSION Air-powder abrasion proved to be the most efficient nonsurgical treatment device for each type of defect in this in vitro model with the least noticeable surface change. No decontamination method resulted in complete cleaning of the color remnants on the implant surface.
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Wiedemann TG. A Clinical Approach to Treatment of Retrograde Peri-Implantitis. Compend Contin Educ Dent 2021; 42:170-176. [PMID: 33960800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Retrograde peri-implantitis (RPI) is a primary microbial inflammatory condition that affects only the apical portion of an osseointegrated implant, which retains normal bone-to-implant contact in its coronal portion. Currently, no uniformly accepted definition or classification exists for RPI. This article reviews the etiopathological mechanisms, diagnostic pattern, and current treatment modalities for this type of periapical implant bone loss. The prevalence of RPI is reported to be relatively low, and along with a lack of an accepted classification system there is no widely accepted treatment algorithm. Therapeutic options include antibiotics, open-flap implant debridement, and apical resection eventually including apicoectomy of endodontically affected adjacent teeth, with or without bone grafting or removal of the affected implant. Implants with RPI usually remain osseointegrated. A diagnostic approach is proposed.
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Affiliation(s)
- Thomas G Wiedemann
- Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, New York University College of Dentistry, New York, New York
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Wiedemann TG. A Clinical Approach to Treatment of Retrograde Peri-Implantitis. Compend Contin Educ Dent 2021; 42:e5-e9. [PMID: 33891431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Retrograde peri-implantitis (RPI) is a primary microbial inflammatory condition that affects only the apical portion of an osseointegrated implant, which retains normal bone-to-implant contact in its coronal portion. Currently, no uniformly accepted definition or classification exists for RPI. This article reviews the etiopathological mechanisms, diagnostic pattern, and current treatment modalities for this type of periapical implant bone loss. The prevalence of RPI is reported to be relatively low, and along with a lack of an accepted classification system there is no widely accepted treatment algorithm. Therapeutic options include antibiotics, open-flap implant debridement, and apical resection eventually including apicoectomy of endodontically affected adjacent teeth, with or without bone grafting or removal of the affected implant. Implants with RPI usually remain osseointegrated. A diagnostic approach is proposed to establish the staging of the lesion and determine the best treatment option accordingly. When there is no loss of implant stability the most adequate treatment in the acute and chronic stage is apical resection of the implant with regeneration of the bone defect. If there is implant mobility, extraction of the implant is necessary.
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Affiliation(s)
- Thomas G Wiedemann
- Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, New York University College of Dentistry, New York, New York
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