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Hussain B, Grytten JI, Rongen G, Sanz M, Haugen HJ. Surface Topography Has Less Influence on Peri-Implantitis than Patient Factors: A Comparative Clinical Study of Two Dental Implant Systems. ACS Biomater Sci Eng 2024; 10:4562-4574. [PMID: 38916970 PMCID: PMC11234333 DOI: 10.1021/acsbiomaterials.3c01809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 06/15/2024] [Accepted: 06/17/2024] [Indexed: 06/27/2024]
Abstract
OBJECTIVES This study aims to assess the risk of peri-implantitis (PI) onset among different implant systems and evaluate the severity of the disease from a population of patients treated in a university clinic. Furthermore, this study intends to thoroughly examine the surface properties of the implant systems that have been identified and investigated. MATERIAL AND METHODS Data from a total of six hundred and 14 patients were extracted from the Institute of Clinical Dentistry, Dental Faculty, University of Oslo. Subject- and implant-based variables were collected, including the type of implant, date of implant installation, medical records, recall appointments up to 2022, periodontal measurements, information on diabetes, smoking status, sex, and age. The outcome of interest was the diagnosis of PI, defined as the occurrence of bleeding on probing (BoP), peri-implant probing depth (PD) ≥ 5 mm, and bone loss (BL). Data were analyzed using multivariate linear and logistic regression. Scanning electron microscopy, light laser profilometer, and X-ray photoelectron spectroscopy were utilized for surface and chemical analyses. RESULTS Among the patients evaluated, 6.8% were diagnosed with PI. A comparison was made between two different implant systems: Dentsply Sirona, OsseospeedTM and Straumann SLActive, with mean follow-up times of 3.84 years (SE: 0.15) and 3.34 years (SE: 0.15), respectively. The surfaces have different topographies and surface chemistry. However, no significant association was found between PI and implant surface/system, including no difference in the onset or severity of the disease. Nonetheless, plaque control was associated with an increased risk of developing PI, along with the gender of the patient. Furthermore, patients suffering from PI exhibited increased BL in the anterior region. CONCLUSION No differences were observed among the evaluated implant systems, although the surfaces have different topography and chemistry. Factors that affected the risk of developing PI were plaque index and male gender. The severity of BL in patients with PI was more pronounced in the anterior region. Consequently, our findings show that success in implantology is less contingent on selecting implant systems and more on a better understanding of patient-specific risk factors, as well as on implementing biomaterials that can more effectively debride dental implants.
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Affiliation(s)
- Badra Hussain
- Department
of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo 0316, Norway
| | | | - Gunnar Rongen
- Institute
of Community Dentistry, University of Oslo, Oslo 0316, Norway
| | - Mariano Sanz
- Section
of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid 28040, Spain
- ETEP
(Etiology and Therapy of Periodiontal and Peri-Implant Diseases) Research
Group, Complutense University, Madrid 28040, Spain
| | - Håvard Jostein Haugen
- Department
of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo 0316, Norway
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Song YW, Park JY, Na JY, Kwon YH, Cha JK, Jung UW, Thoma DS, Jung RE. Does an untreated peri-implant dehiscence defect affect the progression of peri-implantitis?: A preclinical in vivo experimental study. Clin Oral Implants Res 2024. [PMID: 38949573 DOI: 10.1111/clr.14324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 05/18/2024] [Accepted: 06/18/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE To investigate the early impact of plaque accumulation in a buccal dehiscence defect on peri-implant marginal bone resorption. MATERIALS AND METHODS In six male Mongrel dogs, four dental implants were placed in the posterior maxilla on both sides (two implants per side). Based on the group allocation, each implant was randomly assigned to one of the following four groups to decide whether buccal dehiscence defect was prepared and whether silk ligation was applied at 8 weeks post-implant placement for peri-implantitis induction: UC (no defect without ligation); UD (defect without ligation); LC (no defect with ligation); and LD (defect with ligation) groups. Eight weeks after disease induction, the outcomes from radiographic and histologic analyses were statistically analyzed (p < .05). RESULTS Based on radiographs, the exposed area of implant threads was smallest in group UC (p < .0083). Based on histology, both the distances from the implant platform to the first bone-to-implant contact point and to the bone crest were significantly longer in the LD group (p < .0083). In the UD group, some spontaneous bone fill occurred from the base of the defect at 8 weeks after implant placement. The apical extension of inflammatory cell infiltrate was significantly more prominent in the LD and LC groups compared to the UC group (p < .0083). CONCLUSION Plaque accumulated on the exposed implant surface had a negative impact on maintaining the peri-implant marginal bone level, especially when there was a dehiscence defect around the implant.
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Affiliation(s)
- Young Woo Song
- Department of Periodontology, Dental Hospital, Veterans Health Service Medical Center, Seoul, South Korea
| | - Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ji-Yeong Na
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Yoon-Hee Kwon
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Daniel S Thoma
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Rajasekar A, Varghese SS. Comparison of Malondialdehyde Levels among Patients with Sandblasted Acid-Etched and Anodized Surface Dental Implants: A Prospective Clinical Study. J Long Term Eff Med Implants 2024; 34:1-7. [PMID: 38505886 DOI: 10.1615/jlongtermeffmedimplants.2023047545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Inflammation that occur as a part of body's response to implant-tissue contact can result in oxidative stress. Therefore, exploring the oxidative stress around different surface treated dental implants is essential to improve the performance of implants. The purpose of this study was to detect and measure the level of malondialdehyde (MDA), oxidative stress marker among patients with sandblasted acid-etched and anodized surface dental implants. In this prospective clinical study, 78 patients who had undergone implant placement for missing single posterior tooth in mandible using sandblasted acid-etched and anodized surface dental implants during August 2019 - December 2019 were enrolled according to strict inclusion and exclusion criteria and were categorized into Group 1: SLA (n = 27), Group 2: SLActive (n = 26), Group 3: TiUnite (n = 25) based on the surface modification of the implants. Peri-implant crevicular fluid (PICF) was collected and MDA was quantified using ELISA kit at 3 months and 1 year. Statistical analysis was performed using one-way ANOVA, followed by Tukey's HSD post hoc. For intragroup comparison, paired t-test was used. MDA levels in group 3 implants was significantly higher than groups 1 and 2 (P ≤ 0.05). On pairwise comparison, there was a statistically significant difference between the groups at baseline (P ≤ 0.05) and 1-year follow-up (P ≤ 0.05). Intragroup comparison showed that there was a statistically significant difference from baseline in all the three groups (P ≤ 0.05). MDA level in peri-implant crevicular fluid was high around TiUnite dental implant as compared to SLA and SLActive implants.
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Affiliation(s)
- Arvina Rajasekar
- Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Sheeja S Varghese
- Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai-600077, India
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Xia X, Chiang CC, Gopalakrishnan SK, Kulkarni AV, Ren F, Ziegler KJ, Esquivel-Upshaw JF. Properties of SiCN Films Relevant to Dental Implant Applications. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5318. [PMID: 37570022 PMCID: PMC10420248 DOI: 10.3390/ma16155318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/17/2023] [Accepted: 07/14/2023] [Indexed: 08/13/2023]
Abstract
The application of surface coatings is a popular technique to improve the performance of materials used for medical and dental implants. Ternary silicon carbon nitride (SiCN), obtained by introducing nitrogen into SiC, has attracted significant interest due to its potential advantages. This study investigated the properties of SiCN films deposited via PECVD for dental implant coatings. Chemical composition, optical, and tribological properties were analyzed by adjusting the gas flow rates of NH3, CH4, and SiH4. The results indicated that an increase in the NH3 flow rate led to higher deposition rates, scaling from 5.7 nm/min at an NH3 flow rate of 2 sccm to 7 nm/min at an NH3 flow rate of 8 sccm. Concurrently, the formation of N-Si bonds was observed. The films with a higher nitrogen content exhibited lower refractive indices, diminishing from 2.5 to 2.3 as the NH3 flow rate increased from 2 sccm to 8 sccm. The contact angle of SiCN films had minimal differences, while the corrosion rate was dependent on the pH of the environment. These findings contribute to a better understanding of the properties and potential applications of SiCN films for use in dental implants.
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Affiliation(s)
- Xinyi Xia
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (X.X.)
| | - Chao-Ching Chiang
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (X.X.)
| | - Sarathy K. Gopalakrishnan
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (X.X.)
| | - Aniruddha V. Kulkarni
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (X.X.)
| | - Fan Ren
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (X.X.)
| | - Kirk J. Ziegler
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (X.X.)
| | - Josephine F. Esquivel-Upshaw
- Department of Restorative Dental Sciences, Division of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
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Clinical outcomes of different implant types in mandibular bar-retained overdentures: a retrospective analysis with up to 20 years follow-up. Int J Implant Dent 2022; 8:38. [PMID: 36149544 PMCID: PMC9508294 DOI: 10.1186/s40729-022-00439-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To determine the clinical and radiological outcomes of hybrid-design- (HD) and bone-level (BL) implants for bar-retained mandibular implant-overdentures (IODs). METHODS For this retrospective study, edentulous patients who had received maxillary complete dentures and mandibular bar-retained IODs were invited for a follow-up assessment. Implant survival, implant success and health of peri-implant tissues were assessed on an implant level-based analysis. Patient-based parameters served to identify risk factors for peri-implant bone loss, presence of peri-implantitis and success. RESULTS Eighty patients (median age 72.72 [67.03; 78.81] years, 46 females) with 180 implants (median follow-up 12.01 [10.82; 21.04] years) were assessed. There was no difference concerning the rate of implant failure (p = 0.26), or peri-implantitis (p = 0.97) between HD and BL implants. Solely in one study group, there was the presence of peri-implant pus. Implant success was higher in BL implants with one group being notably higher than the comparing groups (p = 0.045). For bone loss, a width of keratinized mucosa (KM) ≤ 1 mm (p = 0.0006) and the presence of xerostomia (p = 0.09) were identified as risk factors. Smoking (p = 0.013) and a higher body mass index (BMI) (p = 0.03) were a risk factor for peri-implantitis. As risk factors for reduced implant success, a small width of KM (p = 0.003) and the presence of xerostomia (p = 0.007) were identified. CONCLUSIONS For mandibular bar-retained IODs, both BL and HD implants are mostly successful. A minimum of 1 mm KM around implants and normal salivary flow are relevant factors for implant success and stable peri-implant bone levels. Smoking and a high BMI are potential risk factors for peri-implantitis.
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Osman MA, Alamoush RA, Kushnerev E, Seymour KG, Watts DC, Yates JM. Biological response of epithelial and connective tissue cells to titanium surfaces with different ranges of roughness: An in-vitro study. Dent Mater 2022; 38:1777-1788. [DOI: 10.1016/j.dental.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/22/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022]
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In-Vitro Phenotypic Response of Human Osteoblasts to Different Degrees of Titanium Surface Roughness. Dent J (Basel) 2022; 10:dj10080140. [PMID: 36005238 PMCID: PMC9406766 DOI: 10.3390/dj10080140] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/14/2022] [Accepted: 07/27/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives: This study aimed to investigate human osteoblast (HOB) responses towards different degrees of titanium (Ti) implant surface roughness. Methods: Four degrees of Ti surface roughness were investigated on a micrometer roughness scale: smooth (S: 0.08−0.1 µm), minimally rough (MM: 0.3−0.5 µm), moderately rough (MR: 1.2−1.4 µm), and rough (R: 3.3−3.7 µm). HOB cells were cultured, expanded, and maintained according to the supplier’s protocol. Cell proliferation and cytotoxicity were assessed at day 1, 3, 5, and 10 using alamarBlue and lactate dehydrogenase colorimetric assays. Data were analyzed with one-way ANOVA, two-way ANOVA, and Tukey’s post hoc test (p = 0.05 for all tests). Results: There was no significant difference in the cell proliferation or cytotoxicity of the HOB cells in contact with the different degrees of Ti surface roughness. There was, however, a significant time effect on cell proliferation (p < 0.0001) with different exposure durations for each roughness degree. Furthermore, a positive correlation (non-significant) between proliferation and cytotoxicity was observed for all investigated degrees of surface roughness. Conclusion: All investigated roughness degrees showed comparable HOB proliferation, with the MR surface presenting the highest percentage, followed by the R, MM, ad S, surfaces, respectively. The S surface showed the highest cytotoxic effect on HOBs; however, it did not reach the cytotoxic level suggested by the ISO for any medical device to be considered cytotoxic.
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Sayardoust S, Johansson A, Jönsson D. Do Probiotics Cause a Shift in the Microbiota of Dental Implants—A Systematic Review and Meta-Analysis. Front Cell Infect Microbiol 2022; 12:823985. [PMID: 35372118 PMCID: PMC8966653 DOI: 10.3389/fcimb.2022.823985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe primary aim of this current systematic review and meta-analysis was to evaluate the potential microbiological effect of probiotics on the implant microbiota. The secondary aim was to evaluate if probiotics have any effect as an adjunct to non-surgical peri-implant treatment in reducing peri-implant mucositis and peri-implantitis clinical parameters—bleeding on probing, modified Gingival Index, and pocket depth.MethodsThe research focus questions were constructed in accordance with the Participants, Intervention, Comparison, and Outcomes (PICO) criteria, and a PROSPERO protocol was registered. A comprehensive systematic search in MEDLINE via the PubMed, Scopus, and Web of Science Core Collection databases was conducted. Two independent reviewers screened the reports based on the PICO criteria—inclusion and exclusion criteria.ResultsIn total, 467 records were identified, and ultimately, 7 papers were included: 3 papers in the qualitative synthesis of microbiological effect and 4 in the meta-analysis synthesis on pocket depth. The data synthesis showed that probiotics had no detectable effect on the implant microflora, and in the following data synthesis, no clinical peri-implantitis variable showed a significantly beneficial effect from probiotics in the test group compared to the control group.ConclusionWithin the limitations of this review, the oral implant microflora is not affected by probiotics nor do probiotics add any effect to the conventional non-surgical treatment of peri-implant mucositis and peri-implantitis.
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Affiliation(s)
- Shariel Sayardoust
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- *Correspondence: Shariel Sayardoust,
| | - Anders Johansson
- Division of Molecular Periodontology, Department of Odontology, Umeå University, Umeå, Sweden
| | - Daniel Jönsson
- Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Odontology and Oral Health, Public Dental Care of Skåne, Lund, Sweden
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Namour M, Nammour S, Rompen E. Laser-Assisted Periodontitis and Peri-Implantitis Treatments: Update and the State of the Art. Photobiomodul Photomed Laser Surg 2022; 40:157-158. [DOI: 10.1089/photob.2021.0164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Melanie Namour
- Department of Periodontology, University Hospital Sart Tilman, Faculty of Medicine, University of Liège, Liege, Belgium
| | - Samir Nammour
- Department of Dentistry, Faculty of Medicine, University of Liege, Liege, Belgium
| | - Eric Rompen
- Department of Periodontology, University Hospital Sart Tilman, Faculty of Medicine, University of Liège, Liege, Belgium
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Efficiency of cold atmospheric plasma, cleaning powders and their combination for biofilm removal on two different titanium implant surfaces. Clin Oral Investig 2022; 26:3179-3187. [PMID: 34988694 PMCID: PMC8898218 DOI: 10.1007/s00784-021-04300-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/16/2021] [Indexed: 01/06/2023]
Abstract
Objectives Biofilm removal is the decisive factor for the control of peri-implantitis. Cold atmospheric pressure plasma (CAP) can become an effective aid due to its ability to destroy and to inactivate bacterial biofilm residues. This study evaluated the cleaning efficiency of CAP, and air-polishing with glycine (APG) or erythritol (APE) containing powders alone or in combination with CAP (APG + CAP, APE + CAP) on sandblasted/acid etched, and anodised titanium implant surface. Materials and methods On respective titanium discs, a 7-day ex vivo human biofilm was grown. Afterwards, the samples were treated with CAP, APG, APE, APG + CAP, and APE + CAP. Sterile and untreated biofilm discs were used for verification. Directly after treatment and after 5 days of incubation in medium at 37 °C, samples were prepared for examination by fluorescence microscopy. The relative biofilm fluorescence was measured for quantitative analyses. Results Air-polishing with or without CAP removed biofilms effectively. The combination of air-polishing with CAP showed the best cleaning results compared to single treatments, even on day 5. Immediately after treatment, APE + CAP showed insignificant higher cleansing efficiency than APG + CAP. Conclusions CAP supports mechanical cleansing and disinfection to remove and inactivate microbial biofilm on implant surfaces significantly. Here, the type of the powder was not important. The highest cleansing results were obtained on sandblasted/etched surfaces. Clinical relevance. Microbial residuals impede wound healing and re-osseointegration after peri-implantitis treatment. Air-polishing treatment removes biofilms very effectively, but not completely. In combination with CAP, microbial free surfaces can be achieved. The tested treatment regime offers an advantage during treatment of peri-implantitis.
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Stavropoulos A, Bertl K, Winning L, Polyzois I. What is the influence of implant surface characteristics and/or implant material on the incidence and progression of peri-implantitis? A systematic literature review. Clin Oral Implants Res 2021; 32 Suppl 21:203-229. [PMID: 34642989 DOI: 10.1111/clr.13859] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/06/2021] [Accepted: 04/27/2021] [Indexed: 12/09/2022]
Abstract
OBJECTIVES To answer the focused question, 'In animals or patients with dental implants, does implant surface characteristics and/or implant material have an effect on incidence and progression of peri-implantitis?' MATERIAL AND METHODS Pre-clinical in vivo experiments on experimental peri-implantitis and clinical trials with any aim and design, and ≥5 years follow-up, where the effect of ≥2 different type of implant material and/or surface characteristics on peri-implantitis incidence or severity, and/or progression, implant survival or losses due to peri-implantitis, and/or marginal bone levels/loss was assessed. RESULTS Meta-analyses based on data of pre-clinical experiments, using the ligature induced peri-implantitis model in the dog, indicated that after the spontaneous progression phase implants with a modified surface showed significantly greater radiographic bone loss (effect size 0.44 mm; 95%CI 0.10-0.79; p = .012; 8 publications) and area of infiltrated connective tissue (effect size 0.75 mm2 ; 95%CI 0.15-1.34; p = .014; 5 publications) compared to non-modified surfaces. However, in 9 out of the 18 included experiments, reported in 25 publications, no significant differences were shown among the different implant surface types assessed. Clinical and/or radiographic data from 7605 patients with 26,188 implants, reported in 31 publications (20 RCTs, 3 CTs, 4 prospective cohort, and 4 retrospective studies; 12 with follow-up ≥10 years), overall did not show significant differences in the incidence of peri-implantitis, when this was reported or could be inferred, among the various implant surfaces. In general, high survival rates (90-100%) up to 30 years and no clinically relevant differences in marginal bone loss/levels, merely compatible with crestal remodelling, were presented for the various implant types. CONCLUSION Pre-clinical in vivo experiments indicate that surface characteristics of modified implants may have a significant negative impact on peri-implantitis progression, while clinical studies do not support the notion that there is a difference in peri-implantitis incidence among the various types of implant surfaces. No assumptions can be made regarding the possible impact of implant material on incidence and/or peri-implantitis progression due to limited information.
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Affiliation(s)
- Andreas Stavropoulos
- Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland.,Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Lewis Winning
- Department of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Ioannis Polyzois
- Department of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
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12
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Di Raimondo R, Sanz-Esporrin J, Martin IS, Vignoletti F, Nuñez J, Muñoz F, Haugen HJ, Sanz M. Hard tissue volumetric and soft tissue contour linear changes at implants with different surface characteristics after experimentally induced peri-implantitis: an experimental in vivo investigation. Clin Oral Investig 2021; 25:3905-3918. [PMID: 33415377 DOI: 10.1007/s00784-020-03720-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 11/27/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the hard tissue volumetric and soft tissue contour linear changes in implants with two different implant surface characteristics after a ligature-induced peri-implantitis. MATERIAL AND METHODS In eight beagle dogs, implants with the same size and diameter but distinct surface characteristics were placed in the healed mandibular sites. Test implants had an external monolayer of multi-phosphonate molecules (B+), while control implants were identical but without the phosphonate-rich surface. Once the implants were osseointegrated, oral hygiene was interrupted and peri-implantitis was induced by placing subgingival ligatures. After 16 weeks, the ligatures were removed and peri-implantitis progressed spontaneously. Bone to implant contact (BIC) and bone loss (BL) were assessed three-dimensionally with Micro-Ct (μCT). Dental casts were optically scanned and the obtained digitalized standard tessellation language (STL) images were used to assess the soft tissue vertical and horizontal contour linear changes. RESULTS Reduction of the three-dimensional BIC percentage during the induction and progression phases of the experimental peri-implantitis was similar for both the experimental and control implants, without statistically significant differences between them. Soft tissue analysis revealed for both implant groups an increase in horizontal dimension after the induction of peri-implantitis, followed by a decrease after the spontaneous progression period. In the vertical dimension, a soft tissue dehiscence was observed in both groups, being more pronounced at the buccal aspect. CONCLUSIONS The added phosphonate-rich surface did not provide a more resistant environment against experimental peri-implantitis, when assessed by the changes in bone volume and soft tissue contours. CLINICAL RELEVANCE Ligature-induced peri-implantitis is a validated model to study the tissue changes occurring during peri-implantitis. It was hypothesized that a stronger osseointegration mediated by the chemical bond of a phosphonate-rich implant surface would develop an environment more resistant to the inflammatory changes occurring after experimental peri-implantitis. These results, however, indicate that the hard and soft tissue destructive changes occurring at both the induction and progression phases of experimental peri-implantitis were not influenced by the quality of osseointegration.
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Affiliation(s)
- R Di Raimondo
- Graduate Clinic of Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Javier Sanz-Esporrin
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain.
- Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n (Ciudad Universitaria), 28040, Madrid, Spain.
| | - I Sanz Martin
- Graduate Clinic of Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - F Vignoletti
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - J Nuñez
- Graduate Clinic of Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - F Muñoz
- Department of Veterinary Clinical Sciences, University of Santiago de Compostela, Lugo, Spain
| | - H J Haugen
- Department of Biomaterials, Institute for Clinical Dentistry, University of Oslo, Oslo, Norway
| | - M Sanz
- Graduate Clinic of Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
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Huang H, Chen D, Lippuner K, Hunziker EB. Induced Experimental Periimplantitis and Periodontitis: What are the Differences in the Inflammatory Response ? J ORAL IMPLANTOL 2020; 47:359-369. [PMID: 33259586 DOI: 10.1563/aaid-joi-d-19-00362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This preliminary study investigates the differences between experimental periodontitis and periimplantitis in a dog model, with a focus on the histopathology, the inflammatory responses and specific immunoregulatory activities, driven by Th1/Th2 positive cells. Twelve dental implants were inserted into the edentulated posterior mandibles of six Beagle dogs and were given twelve weeks time for osseointegration. Experimental periimplantitis and periodontitis (first mandible molar) was then induced using cotton-floss ligatures. Twelve weeks later, alveolar bones were quantitated by cone beam-computer tomography. Histopathological analysis of the inflamed gingiva and of the periodontal tissues was performed by light microscopy, and the Th1/ Th2 cell populations were investigated by flow cytometry. Periimplantitis as well as periodontitis were both found to be associated with pronounced bone resorption effects, both to a similar degree vertically, but with a differential bone resorption pattern mesio-distally, and with a significantly higher and consistent bone resorption result in periimplantitis; however, with a higher variance of bone resorption in periodontitis. The histological appearances of the inflammatory tissues were identical. The percentages of Th1/ Th2 cells in the inflamed gingival tissues of both experimental periimplantitis and periodontitis were also found to be similar. Experimental periodontitis and periimplantitis in the dog model show essentially the same cellular pathology of inflammation. However, bone resorption was found to be significantly higher in periimplantitis; the histopathological changes in the periodontal tissues were similar in both groups, but showed a higher inter-individual variation in periodontitis, and appeared more uniform in periimplantitis. This preliminary study indicates that more focused experimental in-vivo inflammation models need to be developed to better simulate the human pathology in the two different diseases, and in order to have a valuable tool to investigate more specifically how novel treatments/prevention approaches may heal the differential adverse effects on bone tissue and on periodontium in periodontitis and in periimplantitis.
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Affiliation(s)
- Hairong Huang
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Gustav Mahlerlaan 3004, 1081LA Amsterdam, Nord-Holland, the Netherlands
| | - Dong Chen
- State Key Laboratory of Basic Science of Stomatology, Laboratory of Oral Biomedicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Kurt Lippuner
- Department of Osteoporosis, Inselspital Bern University Hospital, Freiburgstrasse 3, CH-3010 Bern, Switzerland
| | - Ernst Bruno Hunziker
- Inselspital Universitatsspital Bern Research Head Osteoporosis and Othopaedic Research Freiburgstrasse 3 SWITZERLAND Bern Bern 3010 +41860794446551 +41794446551 Departments of Osteoporosis and Orthopaedic Surgery, Inselspital Bern University Hospital, Freiburgstrasse 3, CH-3010 Bern, Switzerland
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Efficacy of Local Minocycline Agents in Treating Peri-Implantitis: An Experimental In Vivo Study in Beagle Dogs. Pharmaceutics 2020; 12:pharmaceutics12111016. [PMID: 33114168 PMCID: PMC7690844 DOI: 10.3390/pharmaceutics12111016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/17/2020] [Accepted: 10/22/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Local delivery agents (LDA) have the advantage of delivering the antibiotics at high concentrations to the targeted sites. However, the constant flow of gingival crevicular fluids and saliva may restrict their efficacy. Therefore, the drug sustainability and pharmacodynamic properties of any proposed LDA should be evaluated. METHODS Four dental implants were placed unilaterally in the edentulous mandible of six beagle dogs. Peri-implantitis were experimentally induced using silk-ligatures. Each implant was randomly allocated to receive one of the following four treatments: (i) MC (Chitosan-alginate (CA) minocycline), (ii) MP (CA-without minocycline), (iii) PG (Polyacrylate-glycerin minocycline), and (iv) Control (mechanical debridement only). Mechanical therapies and LDAs were administered into the gingival sulcus two times at a 4-week interval. Drug sustainability as well as clinical, radiographical, and immunohistochemical (IHC) analyses were conducted to evaluate the efficacies of treatments. RESULTS Reduced mean probing depth was observed in all of the test groups after the second delivery. A minimal marginal bone level change was observed during the treatment period (MP (-0.06 ± 0.53 mm) to PG (-0.25 ± 0.42 mm)). The distribution of IHC cell marker analysis of all targeted antibodies ranged from 6.34% to 11.33%. All treatment outcomes between the test groups were comparable. A prolonged retention of LDA was observed from CA microspheres (MC and MP) at both administrations (p < 0.017) and prolonged sustainability of bacteriostatic effect was observed from MC compared to PG after the second administration (p < 0.05). CONCLUSIONS Prolonged retention of CA microspheres was observed and the longer bacteriostatic effect was observed from the MC group. Mechanical debridement with adjunct LDA therapy may impede peri-implantitis progression, however, prolonged drug action did not lead to improved treatment outcome.
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Qiao S, Wu D, Wang M, Qian S, Zhu Y, Shi J, Wei Y, Lai H. Oral microbial profile variation during canine ligature-induced peri-implantitis development. BMC Microbiol 2020; 20:293. [PMID: 32993514 PMCID: PMC7526148 DOI: 10.1186/s12866-020-01982-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/18/2020] [Indexed: 12/16/2022] Open
Abstract
Background Dental implants have become well-established in oral rehabilitation for fully or partially edentulous patients. However, peri-implantitis often leads to the failure of dental implants. The aim of this study was to understand the core microbiome associated with peri-implantitis and evaluate potential peri-implantitis pathogens based on canine peri-implantitis model. Results In this study, three beagle dogs were used to build peri-implantitis models with ligature-induced strategy. The peri-implant sulcular fluids were collected at four different phases based on disease severity during the peri-implantitis development. Microbial compositions during peri-implantitis development were monitored and evaluated. The microbes were presented with operational taxonomic unit (OTU) classified at 97% identity of the high-throughput 16S rRNA gene fragments. Microbial diversity and richness varied during peri-implantitis. At the phylum-level, Firmicutes decreased and Bacteroides increased during peri-implantitis development. At the genus-level, Peptostreptococcus decreased and Porphyromonas increased, suggesting peri-implantitis pathogens might be assigned to these two genera. Further species-level and co-occurrence network analyses identified several potential keystone species during peri-implantitis development, and some OTUs were potential peri-implantitis pathogens. Conclusion In summary, canine peri-implantitis models help to identify several potential keystone peri-implantitis associated species. The canine model can give insight into human peri-implantitis associated microbiota.
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Affiliation(s)
- Shichong Qiao
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, PR China
| | - Dongle Wu
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, PR China
| | - Mengge Wang
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education & School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, 450001, Henan Province, PR China
| | - Shujiao Qian
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, PR China
| | - Yu Zhu
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, PR China
| | - Junyu Shi
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, PR China
| | - Yongjun Wei
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education & School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, 450001, Henan Province, PR China.
| | - Hongchang Lai
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, PR China.
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Solderer A, Pippenger BE, Donnet M, Wiedemeier D, Ramenzoni LL, Schmidlin PR. Evaluation of air polishing with a sterile powder and mechanical debridement during regenerative surgical periimplantitis treatment: a study in dogs. Clin Oral Investig 2020; 25:2609-2618. [PMID: 32914269 PMCID: PMC8060171 DOI: 10.1007/s00784-020-03572-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 09/03/2020] [Indexed: 11/28/2022]
Abstract
Objectives To evaluate the effectiveness of mechanical debridement and/or air polishing on the healing of ligature-induced buccal periimplantitis dehiscence defects in dogs. Material and methods Forty-eight implants were placed in the mandibles of twelve beagle dogs, and periimplantitis was induced for 2 months using ligatures. The resulting buccal dehiscence-type defects were surgically cleaned and augmented (xenogenic filler and resorbable membrane) according to one of the following treatments: (1) Cleaning with carbon curette (debridement - D) and guided bone regeneration (GBR/G): DG, (2) air polishing cleaning (A) and GBR: AG, (3) a combination of D/A/G: DAG, and (4) D/A without GBR: DA. After 2 months, histomorphometric and inflammatory evaluations were conducted. Results The median bone gain after therapy ranged between 1.2 mm (DG) and 2.7 mm (AG). Relative bone gain was between 39% (DG) and 59% (AG). The lowest inflammation scores were obtained in DA without GBR (5.84), whereas significantly higher values between 8.2 and 9.4 were found in the groups with augmentation. At lingual sites without defects, scores ranged from 4.1 to 5.9. According to ISO, differences above 2.9 were considered representative for irritative properties. Conclusions All treatments resulted in partial regeneration of the defects. No treatment group showed a significantly (p < 0.05) better outcome. However, pretreatment with air polishing showed a tendency for less inflammation. Noteworthy, inflammation assessment showed an overall irritative potential after GBR in the evaluated early healing phase. Clinical relevance Periimplantitis treatment still represents a big issue in daily practice and requires additional preclinical research in order to improve treatment concepts.
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Affiliation(s)
- Alex Solderer
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-implant Diseases, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | | | | | - Daniel Wiedemeier
- Statistical Services, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Liza L Ramenzoni
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-implant Diseases, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Patrick R Schmidlin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-implant Diseases, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
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Monje A, Eick S, Buser D, Salvi GE. Microbial and host-derived biomarker changes during ligature-induced and spontaneous peri-implantitis in the Beagle dog. J Periodontal Res 2020; 56:93-100. [PMID: 32885473 DOI: 10.1111/jre.12797] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/01/2020] [Accepted: 08/07/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate microbial and host-derived biomarker changes during experimental peri-implantitis in the Beagle dog. BACKGROUND Limited data exist on the microbial and biomarker changes during progressive bone loss as result of experimental peri-implantitis. METHODS In total, 36 implants (ndogs = 6) were assessed over 3 episodes of ligature-induced peri-implantitis followed by a period of spontaneous progression. Implants with hybrid (H) and completely rough (R) surface designs were used. Clinical and radiographic parameters were recorded at 4 timepoints. Peri-implant sulcus fluid was collected from the buccal and lingual aspects of the implants. The presence of 7 bacterial species and 2 host-derived biomarkers was assessed during the study period. RESULTS Total bacterial counts were significantly correlated with marginal bone loss (MBL) (r = .21; P = .009). Further, Phorphyromonas gulae (Pg) and Tannerella forsythia (Tf) were commonly correlated with MBL, suppuration (SUP) and the sulcular bleeding index scores (mSBI) (P < .05). Other bacteria were further correlated with SUP, mSBI, and MBL. While the analyzed bacteria dropped, Prevotella intermedia (Pi) further increased during the spontaneous progressive phase (P < .05). Total bacterial load did not differ significantly between H and R implants. Host-derived IL-10 was undetected along the study period. IL-1β positively correlated with probing pocket depth (r = .18; P = .03). During spontaneous progression, H implants displayed statistically significant lower levels of IL-1β (P = .003). CONCLUSION Experimental peri-implantitis is associated with an increase in bacterial counts. While Pg and Tf are associated with ligature-induced disease progression, Pi augmented its load during the spontaneous progressive phase. IL-1β is associated with pocket probing depth and influenced by implant surface characteristics during the spontaneous progression phase.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology, Universidad Internacional de Catalunya, Barcelona, Spain.,Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sigrun Eick
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Daniel Buser
- Department of Stomatology and Oral Surgery, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, University of Bern, Bern, Switzerland
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Efficacy of growth factors for the treatment of peri-implant diseases: a systematic review and meta-analysis. Clin Oral Investig 2020; 24:2141-2161. [PMID: 32418012 DOI: 10.1007/s00784-020-03240-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 02/11/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of this study was to conduct a systematic review and meta-analysis on the efficacy of growth factors (GF) on clinical outcomes after treatment (surgical/non-surgical) of peri-implant diseases (peri-implant mucositis and peri-implantitis). MATERIALS AND METHODS A protocol was developed to answer the following focused question: Is there any difference for the use of GF for treatment of peri-implant diseases versus comparative GF treatment or without GF? Electronic database and manual searches were independently conducted to identify randomized controlled trials (RCTs). Publications were selected based on eligibility criteria and then assessed for risk-of-bias using the Cochrane Handbook. The primary outcome was probing depth (PD) and bleeding on probing (BOP) reduction along with changes in vertical defect depth (VDD). Changes in clinical attachment level, gingival recession, and plaque index, among others, were studied as secondary outcomes. Based on primary outcomes, random-effects meta-analysis was conducted. RESULTS A total of five RCTs were included. GF enhance the reduction of PD (standardized mean difference (SMD) = - 1.28; 95% confidence interval (CI) - 1.75, - 0.79; p = < 0.0001) and BOP (SMD = - 1.23; 95% CI - 1.70, - 0.76; p = < 0.0001) in the management of peri-implant mucositis. For the treatment of peri-implantitis, the use of GF yielded to significantly greater improvement in VDD (SMD = 0.68; 95% CI 0.22, 1.14; p = 0.004); however, there were no significant differences in terms of PD (SMD = 0.08; 95% CI - 1.08, 1.26; p = 0.887) and BOP (SMD = 0.211; 95% CI - 0.20, 0.63; p = 0.317). The overall risk of bias of the included studies was low to unclear. CONCLUSION The results of the present systematic review suggest that the addition of GF might enhance the outcomes in the treatment of peri-implant mucositis. However, there is a lack of evidence for supporting additional benefit of GF managing peri-implantitis. CLINICAL RELEVANCE Within the limitations of the current systematic review and based on the meta-analyses, (1) the addition of GF for the treatment peri-implant mucositis might be associated with better outcomes in terms of PD and BOP, and (2) an additional benefit of GF for the treatment peri-implantitis could not be determined on the basis of the selected evidence.
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Namour M, El Mobadder M, Magnin D, Peremans A, Verspecht T, Teughels W, Lamard L, Nammour S, Rompen E. Q-Switch Nd:YAG Laser-Assisted Decontamination of Implant Surface. Dent J (Basel) 2019; 7:dj7040099. [PMID: 31581536 PMCID: PMC6960958 DOI: 10.3390/dj7040099] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/19/2019] [Accepted: 09/24/2019] [Indexed: 01/04/2023] Open
Abstract
Peri-implantitis (PI) is an inflammatory disease of peri-implant tissues, it represents the most frequent complication of dental implants. Evidence revealed that microorganisms play the chief role in causing PI. The purpose of our study is to evaluate the cleaning of contaminated dental implant surfaces by means of the Q-switch Nd:YAG (Neodymium-doped Yttrium Aluminum Garnet) laser and an increase in temperature at lased implant surfaces during the cleaning process. Seventy-eight implants (titanium grade 4) were used (Euroteknika, Sallanches, France). Thirty-six sterile implants and forty-two contaminated implants were collected from failed clinical implants for different reasons, independent from the study. Thirty-six contaminated implants were partially irradiated by Q-switch Nd:YAG laser (1064 nm). Six other contaminated implants were used for temperature rise evaluation. All laser irradiations were calibrated by means of a powermetter in order to evaluate the effective delivered energy. The irradiation conditions delivered per pulse on the target were effectively: energy density per pulse of 0.597 J/cm2, pick powers density of 56 mW/cm2, 270 mW per pulse with a spot diameter of 2.4 mm, and with repetition rate of 10 Hz for pulse duration of 6 ns. Irradiation was performed during a total time of 2 s in a non-contact mode at a distance of 0.5 mm from implant surfaces. The parameters were chosen according to the results of a theoretical modeling calculation of the Nd:YAG laser fluency on implant surface. Evaluation of contaminants removal showed that the cleaning of the irradiated implant surfaces was statistically similar to those of sterile implants (p-value ≤ 0.05). SEM analysis confirmed that our parameters did not alter the lased surfaces. The increase in temperature generated at lased implant surfaces during cleaning was below 1 °C. According to our findings, Q-switch Nd:YAG laser with short pulse duration in nanoseconds is able to significantly clean contaminated implant surfaces. Irradiation parameters used in our study can be considered safe for periodontal tissue.
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Affiliation(s)
- Melanie Namour
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium.
| | - Marwan El Mobadder
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium.
| | - Delphine Magnin
- Bio- and Soft Matter Division, Institute of Condensed and Nanosciences, Université Catholique de Louvain (UCL), 1348-Louvain-la-Neuve, Belgium.
| | - André Peremans
- Laboratoire Physique de la Matière et du Rayonnement (P.M.R.), Université de Namur, 5000 Namur, Belgium.
| | - Tim Verspecht
- Department of Oral Health Sciences, University of Leuven (K.U. Leuven), 3000 Leuven, Belgium.
| | - Wim Teughels
- Department of Oral Health Sciences, University of Leuven (K.U. Leuven) and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium.
| | | | - Samir Nammour
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium.
| | - Eric Rompen
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium.
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Monje A, Insua A, Wang HL. Understanding Peri-Implantitis as a Plaque-Associated and Site-Specific Entity: On the Local Predisposing Factors. J Clin Med 2019; 8:E279. [PMID: 30823574 PMCID: PMC6406659 DOI: 10.3390/jcm8020279] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 12/22/2022] Open
Abstract
The prevalence of implant biological complications has grown enormously over the last decade, in concordance with the impact of biofilm and its byproducts upon disease development. Deleterious habits and systemic conditions have been regarded as risk factors for peri-implantitis. However, little is known about the influence of local confounders upon the onset and progression of the disease. The present narrative review therefore describes the emerging local predisposing factors that place dental implants/patients at risk of developing peri-implantitis. A review is also made of the triggering factors capable of inducing peri-implantitis and of the accelerating factors capable of interfering with the progression of the disease.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, 08195 Barcelona, Spain.
- Division of Periodontics, CICOM Periodoncia, 06011 Badajoz, Badajoz, Spain Santiago de Compostela, Spain.
| | - Angel Insua
- Division of Periodontics, CICOM Periodoncia, 06011 Badajoz, Badajoz, Spain Santiago de Compostela, Spain.
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA.
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Suárez-López del Amo F, Garaicoa-Pazmiño C, Fretwurst T, Castilho RM, Squarize CH. Dental implants-associated release of titanium particles: A systematic review. Clin Oral Implants Res 2018; 29:1085-1100. [DOI: 10.1111/clr.13372] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 08/16/2018] [Accepted: 08/28/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Fernando Suárez-López del Amo
- Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine; University of Michigan School; Ann Arbor Michigan
- Department of Periodontics; University of Oklahoma Health Sciences Center; Oklahoma City Oklahoma
| | - Carlos Garaicoa-Pazmiño
- Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine; University of Michigan School; Ann Arbor Michigan
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
| | - Tobias Fretwurst
- Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine; University of Michigan School; Ann Arbor Michigan
- Department of Oral and Craniomaxillofacial Surgery, Center for Dental Medicine; University Medical Center Freiburg; Freiburg Germany
| | - Rogerio M. Castilho
- Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine; University of Michigan School; Ann Arbor Michigan
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
| | - Cristiane H. Squarize
- Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine; University of Michigan School; Ann Arbor Michigan
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
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Huang B, Zhang L, Xu L, Zhu W, Witek L, Tovar N, Coelho PG, Meng H. Effect of implant placement depth on the peri-implant bone defect configurations in ligature-induced peri-implantitis: An experimental study in dogs. Med Oral Patol Oral Cir Bucal 2018; 23:e30-e37. [PMID: 29274159 PMCID: PMC5822536 DOI: 10.4317/medoral.22032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Indexed: 11/24/2022] Open
Abstract
Background The subcrestal placement of implant platform has been considered a key factor in the preservation of crestal bone, but the influence of implant placement depth on bone remodeling combined with peri-implantitis is not fully understood. The aim of this study was to assess the effect of the crestal or subcrestal placement of implants on peri-implant bone defects of ligature-induced peri-implantitis in dogs. Material and Methods Eight weeks after tooth extraction in six beagle dogs, two different types of implants (A: OsseoSpeed™, Astra, Mölndal, Sweden; B: Integra-CP™, Bicon, Boston, USA) were placed at either crestal or subcrestal (-1.5 mm) positions on one side of the mandible. Ligature-induced peri-implantitis was initiated four weeks after the installation of the healing abutment connections. After 12 weeks, tissue biopsies were processed for histological analyses. Results Supra-alveolar bone loss combined with a shallow infrabony defect was observed in crestal level implants while deep and wide infrabony defects were present in subcrestal level groups. Subcrestal groups showed significantly greater ridge loss, depths and widths of infrabony defects when compared to crestal groups (P<0.001). Conclusions Within the limitations of the animal study, it can be stated that the implants at subcrestal position displayed greater infra-osseous defect than implants at crestal position under an experimental ligature-induced peri-implantitis. Key words:Subcrestal, peri-implantitis, histology.
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Affiliation(s)
- B Huang
- Department of Periodontology, Peking University, School and Hospital of Stomatology, zhongguancun nandajie No.22, Haidian District, Beijing 100081, China,
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Abstract
OBJECTIVES During the last decades, several changes of paradigm have modified our view on how biomaterials' surface characteristics influence the bioresponse. After becoming aware of the role of a certain microroughness for improved cellular contact and osseointegration of dental titanium implants, the likewise important role of surface energy and wettability was increasingly strengthened. Very recently, synergistic effects of nanoscaled topographical features and hydrophilicity at the implant/bone interface have been reported. METHODS Questions arise about which surface roughness and wetting data are capable to predict the bioresponse and, ultimately, the clinical performance. Current methods and approaches applied for topographical, wetting and surface energetic analyses are highlighted. Current knowledge of possible mechanisms explaining the influence of roughness and hydrophilicity at the biological interface is presented. RESULTS Most marketed and experimental surfaces are based on commonly available additive or subtractive surface modifying methods such as blasting, etching or anodizing. Different height, spatial, hybrid and functional roughness parameters have been identified as possible candidates able to predict the outcome at hard and soft tissue interfaces. Likewise, hydrophilic implants have been proven to improve the initial blood contact, to support the wound healing and thereby accelerating the osseointegration. SIGNIFICANCE There is clear relevance for the influence of topographical and wetting characteristics on a macromolecular and cellular level at endosseous implant/biosystem interfaces. However, we are still far away from designing sophisticated implant surfaces with the best possible, selective functionality for each specific tissue or cavity interface. Firstly, because our knowledge of the respective surface related reactions is at best fragmentary. Secondly, because manufacturing of multi-scaled complex surfaces including distinct nanotopographies, wetting properties, and stable cleanliness is still a technical challenge and far away from being reproducibly transferred to implant surfaces.
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Tzach-Nahman R, Mizraji G, Shapira L, Nussbaum G, Wilensky A. Oral infection with Porphyromonas gingivalis
induces peri-implantitis in a murine model: Evaluation of bone loss and the local inflammatory response. J Clin Periodontol 2017; 44:739-748. [DOI: 10.1111/jcpe.12735] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Rinat Tzach-Nahman
- Department of Periodontology; Faculty of Dental Medicine; The Hebrew University-Hadassah Medical Center; Jerusalem Israel
- The Institute of Dental Sciences; Faculty of Dental Medicine; The Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Gabriel Mizraji
- Department of Periodontology; Faculty of Dental Medicine; The Hebrew University-Hadassah Medical Center; Jerusalem Israel
- The Institute of Dental Sciences; Faculty of Dental Medicine; The Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Lior Shapira
- Department of Periodontology; Faculty of Dental Medicine; The Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Gabriel Nussbaum
- The Institute of Dental Sciences; Faculty of Dental Medicine; The Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Asaf Wilensky
- Department of Periodontology; Faculty of Dental Medicine; The Hebrew University-Hadassah Medical Center; Jerusalem Israel
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25
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Kournetas N, Spintzyk S, Schweizer E, Sawada T, Said F, Schmid P, Geis-Gerstorfer J, Eliades G, Rupp F. Comparative evaluation of topographical data of dental implant surfaces applying optical interferometry and scanning electron microscopy. Dent Mater 2017; 33:e317-e327. [PMID: 28587722 DOI: 10.1016/j.dental.2017.04.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 04/26/2017] [Accepted: 04/28/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Comparability of topographical data of implant surfaces in literature is low and their clinical relevance often equivocal. The aim of this study was to investigate the ability of scanning electron microscopy and optical interferometry to assess statistically similar 3-dimensional roughness parameter results and to evaluate these data based on predefined criteria regarded relevant for a favorable biological response. METHODS Four different commercial dental screw-type implants (NanoTite Certain Prevail, TiUnite Brånemark Mk III, XiVE S Plus and SLA Standard Plus) were analyzed by stereo scanning electron microscopy and white light interferometry. Surface height, spatial and hybrid roughness parameters (Sa, Sz, Ssk, Sku, Sal, Str, Sdr) were assessed from raw and filtered data (Gaussian 50μm and 5μm cut-off-filters), respectively. Data were statistically compared by one-way ANOVA and Tukey-Kramer post-hoc test. For a clinically relevant interpretation, a categorizing evaluation approach was used based on predefined threshold criteria for each roughness parameter. RESULTS The two methods exhibited predominantly statistical differences. Dependent on roughness parameters and filter settings, both methods showed variations in rankings of the implant surfaces and differed in their ability to discriminate the different topographies. Overall, the analyses revealed scale-dependent roughness data. Compared to the pure statistical approach, the categorizing evaluation resulted in much more similarities between the two methods. SIGNIFICANCE This study suggests to reconsider current approaches for the topographical evaluation of implant surfaces and to further seek after proper experimental settings. Furthermore, the specific role of different roughness parameters for the bioresponse has to be studied in detail in order to better define clinically relevant, scale-dependent and parameter-specific thresholds and ranges.
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Affiliation(s)
- N Kournetas
- Department of Operative Dentistry, School of Dentistry, University of Athens, Greece
| | - S Spintzyk
- University Hospital Tübingen, Section Medical Materials Science & Technology, Tübingen, Germany
| | - E Schweizer
- University Hospital Tübingen, Section Medical Materials Science & Technology, Tübingen, Germany
| | - T Sawada
- University Hospital Tübingen, Section Medical Materials Science & Technology, Tübingen, Germany
| | - F Said
- University Hospital Tübingen, Center for Dentistry and Oral Medicine, Department of Prosthodontics, Tübingen, Germany
| | - P Schmid
- University Hospital Tübingen, Section Medical Materials Science & Technology, Tübingen, Germany
| | - J Geis-Gerstorfer
- University Hospital Tübingen, Section Medical Materials Science & Technology, Tübingen, Germany
| | - G Eliades
- Department of Biomaterials, School of Dentistry, University of Athens, Greece
| | - F Rupp
- University Hospital Tübingen, Section Medical Materials Science & Technology, Tübingen, Germany.
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26
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Bugueño J, Li W, Salat P, Qin L, Akintoye SO. The bone regenerative capacity of canine mesenchymal stem cells is regulated by site-specific multilineage differentiation. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 123:163-172. [PMID: 27876576 DOI: 10.1016/j.oooo.2016.09.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 08/08/2016] [Accepted: 09/14/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Mesenchymal stem cells (MSCs) offer a promising therapy in dentistry because of their multipotent properties. Selecting donor MSCs is crucial because Beagle dogs (canines) commonly used in preclinical studies have shown variable outcomes, and it is unclear whether canine MSCs (cMSCs) are skeletal site specific. This study tested whether jaw and long bone cMSCs have disparate in vitro and in vivo multilineage differentiation capabilities. STUDY DESIGN Primary cMSCs were isolated from the mandible (M-cMSCs) and femur (F-cMSCs) of four healthy Beagle dogs. The femur served as the non-oral control. Clonogenic and proliferative abilities were assessed. In vitro osteogenic, chondrogenic, adipogenic, and neural multilineage differentiation were correlated with in vivo bone regeneration and potential for clinical applications. RESULTS M-cMSCs displayed two-fold increase in clonogenic and proliferative capacities relative to F-cMSCs (P = .006). M-cMSCs in vitro osteogenesis based on alkaline phosphatase (P = .04), bone sialoprotein (P = .05), and osteocalcin (P = .03), as well as adipogenesis (P = .007) and chondrogenesis (P = .009), were relatively higher and correlated with enhanced M-cMSC bone regenerative capacity. Neural expression markers, nestin and βIII-tubulin, were not significantly different. CONCLUSIONS The enhanced differentiation and bone regenerative capacity of mandible MSCs may make them favorable donor graft materials for site-specific jaw bone regeneration.
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Affiliation(s)
- Juan Bugueño
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Weihua Li
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Pinky Salat
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ling Qin
- Department of Orthopedics School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sunday O Akintoye
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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27
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Mardegan GP, Shibli JA, Roth LA, Faveri M, Giro G, Bastos MF. Transforming growth factor-β, interleukin-17, and IL-23 gene expression profiles associated with human peri-implantitis. Clin Oral Implants Res 2016; 28:e10-e15. [PMID: 27062688 DOI: 10.1111/clr.12846] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The mRNA expression profiles of IL-23/Th17 and the Treg-associated cytokine TGF-β in peri-implantitis are currently under research. This study characterized the IL-17, IL-23, and TGF-β gene expression levels in healthy and diseased peri-implant tissues and correlated these data with radiographic bone loss. MATERIAL AND METHODS Peri-implant soft tissues from 40 subjects (20 healthy controls with mean age of 59.4 ± 6.3, and 20 with peri-implantitis with mean age of 56.6 ± 5.5) were enrolled in this study, and real-time PCR (RT-PCR) was used to define the profile of IL-17, IL-23, and TGF-β gene expression. RESULTS Higher levels of TGF-β mRNA were observed in biopsies taken from healthy controls, and the IL-23 mRNA levels were significantly increased in the peri-implantitis group (P < 0.0001). No differences in IL-17 mRNA levels were observed between the two groups (P > 0.05). CONCLUSIONS Data presented in this report demonstrated a predominant Th17 response in peri-implantitis subjects based on the higher levels of IL-23 and lower levels of TGF-β detected.
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Affiliation(s)
- Gustavo Pereira Mardegan
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Jamil Awad Shibli
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Leandro Amadeu Roth
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Marcelo Faveri
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Gabriela Giro
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Marta Ferreira Bastos
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
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28
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Huang B, Piao M, Zhang L, Wang X, Xu L, Zhu W, Meng H. Ligature-induced peri-implant infection in crestal and subcrestal implants: a clinical and radiographic study in dogs. PeerJ 2015; 3:e1139. [PMID: 26246975 PMCID: PMC4525689 DOI: 10.7717/peerj.1139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 07/07/2015] [Indexed: 11/20/2022] Open
Abstract
Objective. The aim of this study was to assess the influence of implant–abutment interface (IAI) placement depths on peri-implant tissues in the presence of ligature-induced peri-implant inflammation. Materials and Methods. Two implants with screwed-in IAIs (SI) and two implants with tapped-in IAIs (TI) were inserted in one side of the mandible in six dogs eight weeks after tooth extraction. Four experimental groups were constituted: SI placed crestally, SI placed 1.5 mm subcrestally, TI placed crestally and TI placed 1.5 mm subcrestally. After 12 weeks, the healing abutments were connected. Four weeks later, cotton floss ligatures were placed around the abutments to promote plaque accumulation. Clinical and radiographic examinations were performed at 0, 6 and 12 weeks after ligature placement. The effects of the IAI placement depths on clinical and radiographic parameters were assessed. Results. The alterations of peri-implant probing depths, clinical attachment levels, distances from the IAI to the first bone-implant contact (IAI-fBIC) and depths of infrabony defect were significant larger in the subcrestal groups compared with the crestal groups during the plaque accumulation period. The alterations of clinical attachment levels, IAI-fBIC, depth of the infrabony defect and horizontal bone loss were not significantly different between the SI and TI groups after ligature placement. Conclusion. Tissue destruction in subcrestal implants may be more serious than that in crestal implants in the presence of inflamed peri-implant mucosa.
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Affiliation(s)
- Baoxin Huang
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University , Guangzhou , China ; Guangdong Provincial Key Laboratory of Stomatology , Guangzhou , China ; Department of Periodontology, Peking University School and Hospital of Stomatology , Beijing , China
| | - Muzi Piao
- Department of Periodontology, Peking University School and Hospital of Stomatology , Beijing , China ; The Second Dental Center, Peking University School and Hospital of Stomatology , Beijing , China
| | - Li Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology , Beijing , China
| | - Xian'e Wang
- Department of Periodontology, Peking University School and Hospital of Stomatology , Beijing , China
| | - Li Xu
- Department of Periodontology, Peking University School and Hospital of Stomatology , Beijing , China
| | - Weidong Zhu
- Department of Periodontology, Peking University School and Hospital of Stomatology , Beijing , China
| | - Huanxin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology , Beijing , China
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