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Giok KC, Veettil SK, Menon RK. Risk factors for Peri-implantitis: An umbrella review of meta-analyses of observational studies and assessment of biases. J Dent 2024; 146:105065. [PMID: 38762079 DOI: 10.1016/j.jdent.2024.105065] [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: 04/19/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/20/2024] Open
Abstract
OBJECTIVES To perform a comprehensive quantitative and qualitative analysis of the findings from previously published meta-analyses and to assess existing biases. DATA/SOURCES A search was conducted for meta-analyses of observational studies investigating the association between any risk factor and peri‑implantitis in PubMed, Scopus, Cochrane Database of Systematic Reviews, and Epistemonikos, from inception until October 2023 (PROSPERO: CRD42024512408). STUDY SELECTION From a total of 5002 publications, 51 full-text articles were evaluated for eligibility, and 12 articles that described 41 unique meta-analyses evaluating the association between risk factors and periimplantitis were selected. Among 41 associations, 24 associations were significant. None of the associations were graded as convincing evidence. Two associations, presence of periodontitis (OR = 3.84 [95 % CI 2.58,5.72]) and cigarette smoking (RR=2.07 [95 % CI 1.41,3.04]) were graded as highly suggestive. Eight associations, diabetes mellitus, hyperglycaemia, lack of prophylaxis, history of chronic periodontal disease, ongoing or history of periodontal disease, implants located in the anterior region of the jaw (maxillary and mandibular), osteoprotegerin (OPG) gene polymorphisms, and lack of keratinized mucosal width were graded as suggestive evidence. CONCLUSIONS Periodontitis and cigarette smoking are highly suggestive risk factors for peri‑implantitis. The remaining risk factors which are suggestive require more high-quality studies to be performed to upgrade the level of evidence. CLINICAL SIGNIFICANCE The highly suggestive and suggestive risk factors for peri‑implantitis summarized in this umbrella review should be rigorously assessed, monitored and managed by clinicians to reduce the risk peri‑implantitis, as well as to form part of the preoperative consent process.
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Affiliation(s)
- Koay Chun Giok
- School of Dentistry, International Medical University, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Sajesh K Veettil
- School of Pharmacy, Department of Pharmacy Practice, College of pharmacy, International Medical University, Kuala Lumpur, Wilayah Persekutuan, Malaysia; School of Medicine, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Rohit Kunnath Menon
- Prosthodontics, College of Dentistry, Ajman University, Ajman, United Arab Emirates.
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Bencze B, Cavalcante BGN, Romandini M, Róna V, Váncsa S, Varga G, Kivovics M, Szabó B, Agócs G, Géczi Z, Hermann P, Hegyi P, Végh D. Prediabetes and poorly controlled type-2 diabetes as risk indicators for peri-implant diseases:A systematic review and meta-analysis. J Dent 2024; 146:105094. [PMID: 38788918 DOI: 10.1016/j.jdent.2024.105094] [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: 02/14/2024] [Revised: 05/18/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024] Open
Abstract
OBJECTIVE The study answers the PECO question: "In adults with dental implants (P), do subjects suffering from type-2 diabetes or prediabetes (E) have worse peri-implant conditions (O) than subjects without type-2 diabetes and prediabetes (C)?". Prediabetes (5.7-6.4 % HbA1c), and the different qualities of glycemic control in type-2 diabetes; well-controlled (>8 % HbA1c), and poorly controlled (>8 % HbA1c) individuals; were classified according to the recommendations of the American Diabetes Association. DATA Predefined search keys were used with search terms including: Dental implant, diabetes mellitus, glycemic control and HbA1c. SOURCES An electronic search in the MEDLINE, Embase, and Cochrane libraries were conducted without any filters or language restrictions. Additionally, manual search of the reference lists were carried out to identify all relevant articles. STUDY SELECTION Eligibility criteria were cohort, case-control and cross-sectional studies that answerd our PECO question with at least 1 year of follow-up. From a total of 2660 records, 35 articles (1761 individuals) were included in the analysis. Meta-analytic difference in means for crestal bone loss was 1.2 mm [95 % CI=0.4; 2.1] in patients with prediabetes, 1.8 mm [CI=1.0; 2.7] in poorly controlled patients, whereas 0.4 mm [CI=-0.3; 1.1] in well-controlled individuals. Meta-regression showed that 1 % increase in HbA1c increased crestal bone loss by 0.24 mm. CONCLUSIONS Within the limitations of the study, patients with poorly controlled type-2 diabetes or prediabetes may have worse peri-implant conditions compared to patients without diabetes and well-controlled type-2 diabetes. Well-controlled type-2 diabetes is not a risk indicator for peri-implant diseases. CLINICAL SIGNIFICANCE Clinicians should measure blood HbA1c levels when planning implant-supported restorations, thus patients with undiagnosed or poorly controlled type-2 diabetes can be identified, that allows for glycemic level adjustment prior to dental implant surgery, ensuring peri-implant health. PROTOCOL REGISTRATION NUMBER: (CRD42022375263).
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Affiliation(s)
- Bulcsú Bencze
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | | | - Mario Romandini
- Department of Periodontology, University of Oslo, Oslo, Norway
| | - Virág Róna
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Szilárd Váncsa
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Márton Kivovics
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Community Dentistry, Semmelweis University, Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Gergely Agócs
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - Zoltán Géczi
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary; Medical School, Institute for Translational Medicine, University of Pécs, Hungary
| | - Dániel Végh
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
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Al-Bakri SMR, Magan-Fernandez A, Galindo-Moreno P, O'Valle F, Martin-Morales N, Padial-Molina M, Mesa F. Detection and comparison of neutrophil extracellular traps in tissue samples of peri-implantitis, periodontitis, and healthy patients: A pilot study. Clin Implant Dent Relat Res 2024; 26:631-641. [PMID: 38556724 DOI: 10.1111/cid.13325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 02/07/2024] [Accepted: 03/18/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVE The aim of this study was to detect and compare the tissular expression of neutrophil extracellular traps (NETs) in peri-implant and periodontal samples of patients with peri-implantitis, periodontitis, and controls. MATERIALS AND METHODS An observational study was performed on patients with peri-implantitis, periodontitis, and controls. Peri-implant and/or periodontal clinical examinations were performed on each participant. Tissue samples were collected during tooth/implant extraction for clinical reasons. Electron microscopy analysis, Picro-Sirius red staining, immunohistochemical (CD15), and immunofluorescence (citrullinated H3 and myeloperoxidase) techniques were performed to detect NET-related structures and the degree of connective tissue destruction, between the study groups. RESULTS Sixty-four patients were included in the study: 28 peri-implantitis, 26 periodontitis, and 10 controls, with a total of 51 implants, 26 periodontal teeth, and 10 control teeth. Neutrophil release of nuclear content was observed in transmission electron microscopy. Immunohistochemical analysis showed a greater CD15 expression in both peri-implantitis and periodontitis compared to controls (p < 0.001), and peri-implantitis presented lower levels of connective tissue and collagen compared to both periodontitis (p = 0.044; p < 0.001) and controls (p < 0.001). Immunofluorescence showed greater citH3 expression in peri-implantitis than the one found in both periodontitis (p = 0.003) and controls (p = 0.048). CONCLUSIONS A greater presence and involvement of neutrophils, as well as a greater connective tissue destruction were observed in cases of peri-implantitis. A higher expression of NET-related markers was found in mucosal samples of peri-implantitis compared to periodontitis and controls.
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Affiliation(s)
- Sarmad Muayad Rasheed Al-Bakri
- Department of Periodontics, School of Dentistry, University of Granada, Granada, Spain
- PhD Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain
| | | | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- ibs.GRANADA - Instituto de Investigación Biosanitaria, Granada, Spain
| | - Francisco O'Valle
- ibs.GRANADA - Instituto de Investigación Biosanitaria, Granada, Spain
- Department of Pathology, School of Medicine and IBIMER, University of Granada, Granada, Spain
| | - Natividad Martin-Morales
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- ibs.GRANADA - Instituto de Investigación Biosanitaria, Granada, Spain
- Department of Pathology, School of Medicine and IBIMER, University of Granada, Granada, Spain
- PhD Program in Biomedicine, University of Granada, Granada, Spain
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- ibs.GRANADA - Instituto de Investigación Biosanitaria, Granada, Spain
| | - Francisco Mesa
- Department of Periodontics, School of Dentistry, University of Granada, Granada, Spain
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Monje A, Nart J. Disease recurrence during supportive therapy following peri-implantitis treatment: A retrospective study. J Periodontal Res 2024. [PMID: 38693780 DOI: 10.1111/jre.13281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 05/03/2024]
Abstract
AIM Supportive therapy is key to prevent disease recurrence after peri-implantitis treatment. The primary objective was to quantify disease recurrence during supportive peri-implant therapy (SPIT) after peri-implantitis treatment. A secondary objective was to assess the success/failure of cumulative interceptive supportive therapy (CIST) after peri-implantitis treatment. METHODS Compliers (whether regular or erratic) with SPIT after peri-implantitis treatment during ≥12 months were retrospectively evaluated. CIST was prescribed whenever residual pockets ≥6 mm concomitant with profuse bleeding on probing (disease recurrence) were identified. Patient- and implant-related factors were analyzed to explore their associations with disease recurrence and the need for CIST. RESULTS Disease recurrence was considered in 28 patients (40 implants). Of these, 14 patients (23 implants) further demonstrated radiographic evidence of progressive bone loss (≥1 mm). This represented an overall disease recurrence following peri-implantitis treatment of ~20% and ~ 10% at patient and implant levels, respectively. Smokers, patients diagnosed at baseline with periodontitis grade C, and males were significantly more prone to exhibit recurrence. Patients undergoing CIST due to instability were not likely to respond favorably (~70% continued to exhibit residual pockets). CONCLUSION Disease recurrence during SPIT following peri-implantitis treatment on selected cases is ~20%. Patients undergoing CIST due to instability are not likely to respond favorably.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
- Division of Periodontics, CICOM-MONJE, Badajoz, Spain
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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5
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Zhu Y, Xu Y, Ling Z, Zhao C, Xu A, He F. The biofilm removal effect and osteogenic potential on the titanium surface by electrolytic cleaning: An in vitro comparison of electrolytic parameters and five techniques. Clin Oral Implants Res 2024; 35:454-466. [PMID: 38345170 DOI: 10.1111/clr.14245] [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: 06/01/2023] [Revised: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES To determine the optimal current and time of electrolytic cleaning (EC), compare its biofilm removal effect with generic treatments and evaluate the influence of EC to surface characteristics and osteogenic potential of SLA titanium (Ti) discs. MATERIALS AND METHODS The six-species biofilm-covered Ti discs were placed as cathodes in physiologic saline and subjected to various current and time treatments. The residual biofilms were evaluated to determine the optimal parameters. The contaminated Ti discs were randomized and treated by rotating Ti brush; ultrasonic-scaling with metal tips; ultrasonic-scaling with PEEK tips; air-polishing and EC. The residual biofilms were compared using a lipopolysaccharide kit (LPS), scanning electron microscope (SEM), confocal laser scanning microscopy and colony-forming unit counting. Non-contaminated Ti discs were treated and characterized. The bone marrow mesenchymal stem cells (BMSCs) were cultured on treated non-contaminated Ti discs. The adhesion, proliferation, alkaline phosphatase (ALP) activity and osteocalcin level of BMSCs were assessed. RESULTS The parameters at 0.6A5min were considered optimal. For LPS and SEM, EC promoted a significantly greater biofilm removal than the other groups. There were no changes in the Ti discs' colour, topography, roughness and chemical elements after EC, and the electrolysis-treated Ti discs obtained a super-hydrophilic surface. EC positively impacted the proliferation and ALP activity of BMSCs, surpassing the efficacy of alternative treatments. CONCLUSIONS EC achieves a near-complete eradication of contaminants on the SLA surface, causes no surface damage with improved hydrophilicity, and promotes the early osteogenic response of BMSCs, which makes it a promising treatment for peri-implantitis.
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Affiliation(s)
- Yun Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Oral Disease, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yangbo Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Oral Disease, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Zhaoting Ling
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Oral Disease, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Congrui Zhao
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Oral Disease, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Antian Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Oral Disease, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Fuming He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Oral Disease, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
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Nicola D, Isabella DR, Carolina C, Baldini N, Raffaele M. Treatment of peri-implant mucositis: Adjunctive effect of glycine powder air polishing to professional mechanical biofilm removal. 12 months randomized clinical study. Clin Implant Dent Relat Res 2024; 26:415-426. [PMID: 38317375 DOI: 10.1111/cid.13304] [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: 11/05/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 02/07/2024]
Abstract
INTRODUCTION To evaluate the adjunctive effect of glycine-powder air-polishing (GPAP) to full-mouth ultrasonic debridement (Fm-UD) in the treatment of peri-implant mucositis, and to determine the impact of implant and patient-level variables for disease resolution. METHODS Individuals with a diagnosis of peri-implant mucositis were consecutively included in this randomized parallel arm clinical study. All the participants received a session of Fm-UD. Only implants allocated to the test group were additionally treated with GPAP. Clinical assessments were recorded at baseline, at 3 and at 12 months following intervention. The primary outcomes were complete disease resolution (DR1), defined as absence of bleeding sites at probing per implants, and partial disease resolution (DR2), measured as the presence of less than two bleeding sites at probing per implant. A final logistic multivariate regression model was built to evaluate the predictive role of implant and patient-level variables on DR. RESULTS Fifty two patients and 157 implants were included. Both groups displayed significant reduction in the extent of bleeding on probing and plaque levels. At 12 months, DR1 was achieved in 16% and 27% of participants for the test and the control group respectively. IDR1 was best predicted by the number of bleeding sites (OR = 2.7, p = 0.04) and the greatest PPD value (OR = 2.7, p = 0.05), while IDR2 by the prosthetic connection (OR = 2.59, p = 0.02), the mean PPD (OR = 2.23, p = 0.04), the FMBS (OR = 4.09, p = 0.04), and number of implants (OR = 4.59, p = 0.02). CONCLUSIONS Despite significant improvements of clinical signs of peri-implant inflammation, the use of GPAP appears to have no adjunctive effect as compared with Fm-UD alone in the achievement of DR. Elevated initial levels of bleeding and PD predicted inferior likelihood of reaching disease resolution. The present randomized parallel arm clinical study was registered on Clinicaltrials.gov and received the following registration number: NCT05801315. This clinical trial was not registered prior to participant recruitment and randomization (https://register. CLINICALTRIALS gov/prs/app/action/SelectProtocol?sid=S0009965&selectaction=Edit&uid=U0004FXM&ts=2&cx=fje7l8).
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Affiliation(s)
- Discepoli Nicola
- Department of Medical Biotechnologies, Unit of Periodontics, Università degli Studi di Siena, Siena, Italy
| | - De Rubertis Isabella
- Department of Medical Biotechnologies, Unit of Periodontics, Università degli Studi di Siena, Siena, Italy
| | - Ciocci Carolina
- Department of Medical Biotechnologies, Unit of Periodontics, Università degli Studi di Siena, Siena, Italy
| | - Nicola Baldini
- Department of Medical Biotechnologies, Unit of Oral Surgery, Università degli Studi di Siena, Siena, Italy
| | - Mirra Raffaele
- Department of Medical Biotechnologies, Unit of Periodontics, Università degli Studi di Siena, Siena, Italy
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Sinjab K, Sawant S, Ou A, Fenno JC, Wang HL, Kumar P. Impact of surface characteristics on the peri-implant microbiome in health and disease. J Periodontol 2024; 95:244-255. [PMID: 37665015 PMCID: PMC10909931 DOI: 10.1002/jper.23-0205] [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: 03/26/2023] [Revised: 07/18/2023] [Accepted: 07/26/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Because little is known about the impact of implant surface modifications on the peri-implant microbiome, we aimed to examine peri-implant communities in various surface types in order to better understand the impact of these surfaces on the development of peri-implantitis (PI). METHODS One hundred and six systemically healthy individuals with anodized (AN), hydroxyapatite-coated (HA), or sandblasted acid-etched (SLA) implants that were >6 months in function were recruited and categorized into health (H) or PI. Peri-implant biofilm was analyzed using 16S rRNA gene sequencing and compared between health/disease and HA/SLA/AN using community-level and taxa-level metrics. RESULTS Healthy implants did not demonstrate significant differences in clustering, alpha- or beta-diversity based on surface modification. AN and HA surfaces displayed significant differences between health and PI (p < 0.05); however, such a clustering was not evident with SLA (p > 0.05). AN and HA surfaces also differed in the magnitude and diversity of differences between health and PI. Six species belonging to the genera Shuttleworthia, Scardovia, and Prevotella demonstrated lower abundances in AN implants with PI, and 18 species belonging to the genera Fretibacterium, Tannerella, Treponema, and Fusobacterium were elevated, while in HA implants with PI, 20 species belonging to the genera Streptococcus, Lactobacillus, Veillonella, Rothia, and family Ruminococcaceae were depleted and Peptostreptococcaceae, Atopobiaceae, Veillonellaceae, Porphyromonadaceae, Desulfobulbaceae, and order Synergistales were enriched. CONCLUSIONS Within the limitations of this study, we demonstrate that implant surface can differentially modify the disease-associated microbiome, suggesting that surface topography must be considered in the multi-factorial etiology of peri-implant diseases.
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Affiliation(s)
- Khaled Sinjab
- Department of Periodontics and Oral Medicine, School of Dentistry University of Michigan 1011 N University Ave Ann Arbor, Michigan 48109
| | - Shriya Sawant
- Department of Periodontics and Oral Medicine, School of Dentistry University of Michigan 1011 N University Ave Ann Arbor, Michigan 48109
| | - Alice Ou
- Department of Periodontics and Oral Medicine, School of Dentistry University of Michigan 1011 N University Ave Ann Arbor, Michigan 48109
| | - J. Christopher Fenno
- Department of Biological and Material Sciences and Prosthodontics, School of Dentistry University of Michigan 1011 N University Ave Ann Arbor, Michigan 48109
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry University of Michigan 1011 N University Ave Ann Arbor, Michigan 48109
| | - Purnima Kumar
- Department of Periodontics and Oral Medicine, School of Dentistry University of Michigan 1011 N University Ave Ann Arbor, Michigan 48109
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Monje A, Pons R, Nart J, Miron RJ, Schwarz F, Sculean A. Selecting biomaterials in the reconstructive therapy of peri-implantitis. Periodontol 2000 2024; 94:192-212. [PMID: 37728141 DOI: 10.1111/prd.12523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/28/2023] [Accepted: 08/21/2023] [Indexed: 09/21/2023]
Abstract
Peri-implantitis is a pathogenic inflammatory condition characterized by progressive bone loss and clinical inflammation that may compromise the stability of dental implants. Therapeutic modalities have been advocated to arrest the disorder and to establish peri-implant health. Reconstructive therapy is indicated for bone defects exhibiting contained/angular components. This therapeutic modality is based upon the application of the biological and technical principles of periodontal regeneration. Nonetheless, the comparative efficacy of reconstructive therapy and nonreconstructive modalities remains unclear. Therefore, the aim of this narrative review is to address major clinical concerns regarding the efficacy, effectiveness, and feasibility of using biomaterials in peri-implantitis therapy. In particular, the use of bone grafting materials, barrier membranes, and biologics is comprehensively explored.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Ramón Pons
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt, Germany
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
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Toia M, Parpaiola A, Stevanello N, Tattan M, Saleh MHA, Ravidà A. Clinical outcomes of implant- versus abutment-level connection in screw-retained fixed dental prostheses: A 5-year randomized controlled trial. Clin Oral Implants Res 2024; 35:230-241. [PMID: 38012845 DOI: 10.1111/clr.14217] [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: 02/28/2023] [Revised: 09/26/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
AIM The aim of the study was to evaluate the 5 years clinical outcomes associated with implant-level connection (IL) versus abutment-level connection (AL) for implants with an internal conical connection (ICC) supporting a screw-retained fixed partial denture. MATERIALS AND METHODS Fifty patients with 119 implants were randomly allocated to either the AL or IL group. Radiographic (Marginal bone loss) and clinical outcomes (Bleeding on Probing, probing pocket depth, plaque accumulation, incidence of peri-implantitis and peri-implant mucositis as well as prosthetic complications) were collected and compared at 1, 2, 3, and 5 years. A linear mixed model was used to evaluate the differences between groups. RESULTS Five years after treatment, the MBL change was not significantly different between the groups at any point. The MBL was 0.23 ± 0.64 mm (AL) and 0.23 ± 0.29 mm (IL). The bleeding on Probing was 44% (AL) and 45% (IL) (p = .89). The mean probing depth was 2.91 ± 1.01 mm (AL) and 3.51 ± 0.67 mm (IL). This difference between the groups was statistically significant but clinical insignificant. Presence of plaque was slightly higher (p = .06) in the IL group (34.4%) compared with the AL group (26.3%). The overall technical, biological, and prosthetic complication rates were similar between groups. None of the implants developed peri-implantitis during the entire follow-up period. CONCLUSION The results of this clinical trial indicated that all clinical and radiographical parameters were clinically comparable between the study groups.
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Affiliation(s)
- Marco Toia
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Andrea Parpaiola
- Department Clinic-Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | | | - Mustafa Tattan
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Andrea Ravidà
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
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Khan SN, Koldsland OC, Tiainen H, Hjortsjö C. Anatomical three-dimensional model with peri-implant defect for in vitro assessment of dental implant decontamination. Clin Exp Dent Res 2024; 10:e841. [PMID: 38345509 PMCID: PMC10829417 DOI: 10.1002/cre2.841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/23/2023] [Accepted: 12/30/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES Access to the implant surface plays a significant role in effective mechanical biofilm removal in peri-implantitis treatment. Mechanical decontamination may also alter the surface topography of the implant, potentially increasing susceptibility to bacterial recolonization. This in vitro study aimed to evaluate a newly developed, anatomically realistic, and adaptable three-dimensional (3D)printed model with a peri-implant bone defect to evaluate the accessibility and changes of dental implant surfaces after mechanical decontamination treatment. MATERIAL AND METHODS A split model of an advanced peri-implant bone defect was prepared using 3D printing. The function of the model was tested by mechanical decontamination of the exposed surface of dental implants (Standard Implant Straumann AG) coated with a thin layer of colored occlusion spray. Two different instruments for mechanical decontamination were used. Following decontamination, the implants were removed from the split model and photographed. Image analysis and fluorescence spectroscopy were used to quantify the remaining occlusion spray both in terms of area and total amount, while scanning electron microscopy and optical profilometry were used to analyze alteration in the implant surface morphology. RESULTS The 3D model allowed easy placement and removal of the dental implants without disturbing the implant surfaces. Qualitative and quantitative assessment of removal of the occlusion spray revealed differences in the mechanism of action and access to the implant surface between tested instruments. The model permitted surface topography analysis following the decontamination procedure. CONCLUSION The developed 3D model allowed a realistic simulation of decontamination of implant surfaces with colored occlusion spray in an advanced peri-implant defect. 3D printing allows easy adaptation of the model in terms of the shape and location of the defect. The model presents a valuable tool for in vitro investigation of the accessibility and changes of the implant surface after mechanical and chemical decontamination.
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Affiliation(s)
- Sadia Nazir Khan
- Department of Prosthetics and Oral Function, Faculty of DentistryUniversity of OsloOsloNorway
| | | | - Hanna Tiainen
- Department of Biomaterials, Faculty of DentistryUniversity of OsloOsloNorway
| | - Carl Hjortsjö
- Department of Prosthetics and Oral Function, Faculty of DentistryUniversity of OsloOsloNorway
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11
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Maquera-Huacho PM, de Carvalho GG, Jafelicci M, Marcantonio E, Spolidorio DMP. Physical-chemical influences and cell behavior of natural compounds on titanium dental surfaces. Braz Dent J 2023; 34:53-62. [PMID: 38133473 PMCID: PMC10759949 DOI: 10.1590/0103-6440202305582] [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: 05/11/2023] [Accepted: 10/30/2023] [Indexed: 12/23/2023] Open
Abstract
The present study evaluated the influence of carvacrol, terpinene-4-ol, and chlorhexidine on the physical-chemical properties of titanium surfaces, cell viability, proliferation, adhesion, and spreading of fibroblasts and osteoblasts in vitro. Titanium surfaces (Ti) were treated with Carvacrol (Cvc), Terpinen-4-ol (T4ol), Chlorhexidine (CHX), DMSO, and ultrapure water (Control group). Physical-chemical modifications were evaluated by surface wettability, the surface free energy (SFE) calculated from the contact angle values using the Owens-Wendt-Rabel-Kaeble (OWRK) equation, scanning electron microscopy (SEM) and energy dispersive spectrometry probe (EDS) system. Cells were seeded onto Ti-treated surfaces and incubated for 24 h and 72 h, then evaluated by Alamar blue assay and fluorescence microscopy. Surfaces treated with Cvc and T4ol showed the presence of Na, O, and Cl. All surfaces showed hydrophilic characteristics and SFE values between 5.5 mN/m and 3.4 mN/m. On the other hand, EDS peaks demonstrated the presence of O and Cl after CHX treatment. A reduction of cell viability and adhesion was noted on titanium surfaces treated with CHX after 24 and 72h. In conclusion, the results indicate that the decontamination with Cvc and T4ol on Ti surfaces does not alter the surface proprieties and allows an adequate interaction with cells involved in the re-osseointegration process such as fibroblasts and osteoblasts.
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Affiliation(s)
- Patricia Milagros Maquera-Huacho
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University(Unesp), Araraquara, SP, Brazil
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University(Unesp), Araraquara, São Paulo, Brazil
| | - Gabriel Garcia de Carvalho
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University(Unesp), Araraquara, SP, Brazil
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University(Unesp), Araraquara, São Paulo, Brazil
| | - Miguel Jafelicci
- Institute of Chemistry, Laboratory of Magnetic Materials and Colloids, São Paulo State University(Unesp), Araraquara, SP, Brazil
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University(Unesp), Araraquara, São Paulo, Brazil
| | - Denise Madalena Palomari Spolidorio
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University(Unesp), Araraquara, SP, Brazil
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University(Unesp), Araraquara, São Paulo, Brazil
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12
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Lim HC, Kim CH, Yoon H, Lee S, Chung JH, Shin SY. Keratinized tissue augmentation using collagen-based soft tissue substitute with/without epidermal growth factor on buccally positioned implants: a pilot preclinical study. Clin Oral Investig 2023; 27:7899-7908. [PMID: 37989966 DOI: 10.1007/s00784-023-05382-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 11/11/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES To investigate the effect of epithelial growth factor (EGF) with collagen matrix (CM) on the gain of KT for buccally positioned implants in dogs. MATERIALS AND METHODS In five dogs, four implants were placed buccally with the whole part of KT excision on the buccal side (two implants per each hemi-mandible). After one month, KT augmentation was performed: 1) free gingival grafts (FGG), 2) collagen matrix (CM) only, 3) CM soaked with 1 μg/g of EGF, and 4) CM soaked with 10 μg/g of EGF (n = 5 in each group). The experimental animals were sacrificed three months post-KT augmentation. Clinical, histologic, and histomorphometric analyses were performed. RESULTS The clinical KT zone was the highest in group FGG (5.16 ± 1.63 mm). Histologically, all groups presented buccal bony dehiscence. Regarding newly formed KT, no specific difference was found among the groups, but robust rete pegs formation in some specimens in group FGG. Histomorphometric KT height (4.66 ± 1.81 mm) and length (5.56 ± 2.25 mm) were the highest in group FGG, whereas similar increases were noted in the rest. The buccal soft tissue thickness at the coronal part of the implant did not exceed 2 mm in all groups. CONCLUSION All groups presented increased KT zone, but FGG treatment was more favored. The addition of EGF to CM appeared not to enhance KT formation. CLINICAL RELEVANCE FGG treatment was more favorable to re-establish the KT zone than other treatment modalities.
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Affiliation(s)
- Hyun-Chang Lim
- Department of Periodontology, Periodontal Implant Clinical Research Institute, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center, Seoul, Korea.
| | - Chang-Hoon Kim
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | - Heejun Yoon
- Department of Periodontology, Periodontal Implant Clinical Research Institute, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center, Seoul, Korea
| | - Sunmin Lee
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jong-Hyuk Chung
- Department of Periodontology, Periodontal Implant Clinical Research Institute, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center, Seoul, Korea
| | - Seung-Yun Shin
- Department of Periodontology, Periodontal Implant Clinical Research Institute, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center, Seoul, Korea
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13
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Htay PEE, Leesungbok R, Lee SW, Jee YJ, Kang KL, Hong SO. Reliability of a chairside CAD-CAM surgical guide for dental implant surgery on the anterior maxilla: An in vitro study. J Adv Prosthodont 2023; 15:259-270. [PMID: 37936833 PMCID: PMC10625886 DOI: 10.4047/jap.2023.15.5.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 11/09/2023] Open
Abstract
PURPOSE This study evaluated the reliability of the chair-side CAD-CAM surgical guide (CSG) in the anterior maxilla by comparing its accuracy with the laboratory 3D-printed surgical guide (3DSG) and manual surgical guide (MSG) concerning different levels of dentists' surgical experience. MATERIALS AND METHODS Ten surgical guides of each type (MSG, 3DSG, and CSG) were fabricated on a control study model with missing right and left central incisors. Sixty implants were placed in 30 study models by two dentists (one inexperienced and one experienced) using three different types of surgical guides. Horizontal deviations at shoulder and at apex, vertical, and angular deviations were measured after superimposing the planned and placed implant positions in the software. Kruskal-Wallis and Mann-Whitney U tests were used to compare the accuracy of three types of surgical guides in each dentist group and the accuracy of each surgical guide between two dentists (α = .05). RESULTS There were no significant differences in any deviations between CSG and 3DSG, apart from angular deviation, for both dentists' groups. Moreover, both CSG and 3DSG showed no significant differences in accuracy between the two dentists (P > .05). In contrast, MSG demonstrated significant differences from CSG and 3DSG and a significant difference in accuracy between the two dentists (P < .05). CONCLUSION CSG provides superior accuracy to MSG in implant placement in the maxillary anterior region and is comparable to 3DSG at different levels of surgical experience, while offering the benefits of shorter manufacturing time and reduced patient visits.
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Affiliation(s)
- Phyo Ei Ei Htay
- Department of Prosthodontics, College of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Richard Leesungbok
- Department of Biomaterials and Prosthodontics, Kyung Hee University College of Dentistry, Kyung Hee University Dental Hospital at Gangdong, Seoul, Republic of Korea
| | - Suk Won Lee
- Department of Biomaterials and Prosthodontics, Kyung Hee University College of Dentistry, Kyung Hee University Dental Hospital at Gangdong, Seoul, Republic of Korea
| | - Yu-Jin Jee
- Department of Oral and Maxillofacial Surgery, Kyung Hee University College of Dentistry, Kyung Hee University Dental Hospital at Gangdong, Seoul, Republic of Korea
| | - Kyung Lhi Kang
- Department of Periodontics, Kyung Hee University College of Dentistry, Kyung Hee University Dental Hospital at Gangdong, Seoul, Republic of Korea
| | - Sung Ok Hong
- Department of Oral and Maxillofacial Surgery, Kyung Hee University College of Dentistry, Kyung Hee University Dental Hospital at Gangdong, Seoul, Republic of Korea
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14
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Chan H, Rodriguez Betancourt A, Liu CC, Chiang Y, Schmidlin PR. A conceptual review on reconstructive peri-implantitis therapy: Challenges and opportunities. Clin Exp Dent Res 2023; 9:735-745. [PMID: 37735844 PMCID: PMC10582225 DOI: 10.1002/cre2.788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/24/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVES The current strategies to reconstruct lost peri-implant tissues due to the disease have been largely unpredictable. The aim of this conceptual review is to discuss relevant biological and biomechanical challenges of applying reconstructive means to treat peri-implantitis. Additionally, opportunities to improve treatment predictability are presented. MATERIAL AND METHODS A narrative review was conducted to fulfill the aim. RESULTS The four interrelated negative conditions hampering effective reconstruction are: inferior tissue perfusion, unfavorable bone topography, ineffective surface treatment, and unstable wound. First, peri-implant tissues resemble scars with reduced cellularity and vascularity, coupled with the absence of the periodontal ligament plexuses and the avascular implant and biomaterials, maintaining primary closure is a challenge, which is critical for regeneration. Second, defect morphology and bone topography surrounding implants determine the reconstructive potential. Unfortunately, noncontained defects are frequently encountered, with a combination of suprabony (horizontal bone loss) and infrabony (vertical usually involving circumferential bone loss) defects. Third, current attempts for implant surface decontamination are insufficient due to inaccessible macrostructure and rough surfaces in the micro-scale. Histologic evaluation has shown bacteria aggregation and calcified deposits around implants. Lastly, wound stability is difficult to achieve due to inherent soft tissue biomechanical quality and quantity deficiencies and mobile bone particulates. Opportunities to tackle the abovementioned challenges include the use of novel imaging technologies, such as high-frequency dental ultrasound and laser speckle imaging to evaluate tissue perfusion, soft tissue quality/quantity, and bone topography pre-surgically. The use of the operating microscope could allow better visualization and removal of etiologic factors. Strategies to improve soft tissue quality may include preoperative control of soft tissue inflammation and the potential use of biologics. Methods such as fixation to stabilize the biomaterials could be beneficial. CONCLUSIONS A more nuanced understanding of the current challenges and opportunities can lead to more effective preoperative and postoperative care protocols, ultimately improving the success rate of reconstructive procedures.
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Affiliation(s)
- Hsun‐Liang Chan
- Department of Periodontics and Oral MedicineThe University of Michigan School of DentistryAnn ArborMichiganUSA
| | - Amanda Rodriguez Betancourt
- Department of Periodontics and Oral MedicineThe University of Michigan School of DentistryAnn ArborMichiganUSA
| | - Chun Ching Liu
- Center of Dental Medicine, Division of Periodontology and Peri‐implant diseases, Clinic of Conservative and Preventive DentistryUniversity of ZurichZurichSwitzerland
| | - Yi‐Chen Chiang
- Department of Periodontics and Oral MedicineThe University of Michigan School of DentistryAnn ArborMichiganUSA
| | - Patrick R. Schmidlin
- Center of Dental Medicine, Division of Periodontology and Peri‐implant diseases, Clinic of Conservative and Preventive DentistryUniversity of ZurichZurichSwitzerland
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15
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Vilarrasa J, Àlvarez G, Soler-Ollé A, Gil J, Nart J, Blanc V. Bacterial Adhesion of TESPSA and Citric Acid on Different Titanium Surfaces Substrate Roughness: An In Vitro Study with a Multispecies Oral Biofilm Model. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4592. [PMID: 37444905 DOI: 10.3390/ma16134592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/11/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023]
Abstract
This in vitro study analyzed the influence of substrate roughness on biofilm adhesion and cellular viability over triethoxysilylpropyl succinic anhydride silane (TESPSA)- and citric acid (CA)-coated surfaces at 12 and 24 h, respectively. A multispecies biofilm composed of S. oralis, A. naslundii, V. parvula, F. nucleatum, P. intermedia, P. gingivalis, P. endodontalis and F. alocis was developed over titanium discs grouped depending on their roughness (low, medium, high) and antibacterial coating (low-TESPSA, medium-TESPSA, high-TESPSA, and CA). The biofilm was quantified by means of quantitative polymerase chain reaction (PCR) and viability PCR and assessed through confocal laser scanning microscope (CLSM). Quantitative PCR revealed no significant differences in bacterial adhesion and biofilm mortality. CA was the surface with the lowest bacterial counts and highest mortality at 12 and 24 h, respectively, while high harbored the highest amount of biofilm at 24 h. By CLSM, CA presented significant amounts of dead cells compared to medium-TESPSA and high-TESPSA. A significantly greater volume of dead cells was found at 12 h in low-TESPSA compared to medium-TESPSA, while CA also presented significant amounts of dead cells compared to medium-TESPSA and high-TESPSA. With regard to the live/dead ratio, low-TESPSA presented a significantly higher ratio at 12 h compared to medium-TESPSA and high-TESPSA. Similarly, CA exhibited a significantly higher live/dead ratio compared to medium-TESPSA and high-TESPSA at 12 h. This multispecies in vitro biofilm did not evidence clear antiadhesive and bactericidal differences between surfaces, although a tendency to reduce adhesion and increase antibacterial effect was observed in the low-TESPSA and CA.
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Affiliation(s)
- Javi Vilarrasa
- Department of Periodontology, Universitat Internacional de Catalunya, 08195 Barcelona, Spain
| | - Gerard Àlvarez
- Department of Microbiology, DENTAID Research Center, 08290 Cerdanyola del Vallès, Spain
| | - Agnès Soler-Ollé
- Department of Microbiology, DENTAID Research Center, 08290 Cerdanyola del Vallès, Spain
| | - Javier Gil
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallés, Spain
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, 08195 Barcelona, Spain
| | - Vanessa Blanc
- Department of Microbiology, DENTAID Research Center, 08290 Cerdanyola del Vallès, Spain
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16
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Lee W, Park JB. The clinical effect of sodium hypochlorite oral rinse on peri-implantitis lesion: A pilot study. Heliyon 2023; 9:e15859. [PMID: 37305462 PMCID: PMC10256906 DOI: 10.1016/j.heliyon.2023.e15859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 04/11/2023] [Accepted: 04/25/2023] [Indexed: 06/13/2023] Open
Abstract
Peri-implantitis poses an imminent challenge to the field of implant dentistry. Considering the promising findings of sodium hypochlorite and periodontal lesions, the aim of the present study was to evaluate the clinical effects of sodium hypochlorite oral rinse on peri-implantitis lesions. Twelve peri-implantitis patients were instructed to rinse with 15 mL of a fresh solution of 0.25% sodium hypochlorite for 30 s twice a week for 3 months. At baseline and 3-month visits, probing depth and modified sulcular bleeding index were recorded at 6 points per lesion (mesiobuccal, buccal, distobuccal, mesiolingual, lingual, and distolingual). Individual and total bacterial loads of 18 pre-designated species of microorganisms were analyzed by real-time PCR methods. Probing depth decreased after the experiment, with an average difference of 1.1 mm and a standard deviation of 1.7 mm. The modified sulcular bleeding index decreased by a mean value of 0.8 with a standard deviation of 1.1. This study demonstrated the clinical effects of sodium hypochlorite oral rinse on peri-implantitis lesions and the reduction of periodontal probing depth and gingival bleeding index. This study suggested that the concentration of 0.25% be used for treatment of peri-implantitis.
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Affiliation(s)
- Wonsup Lee
- Department of Prosthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
- Dental Implantology, Graduate School of Clinical Dental Science, The Catholic University of Korea, Seoul, Republic of Korea
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17
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Mahardawi B, Jiaranuchart S, Damrongsirirat N, Arunjaroensuk S, Mattheos N, Somboonsavatdee A, Pimkhaokham A. The lack of keratinized mucosa as a risk factor for peri-implantitis: a systematic review and meta-analysis. Sci Rep 2023; 13:3778. [PMID: 36882495 PMCID: PMC9992510 DOI: 10.1038/s41598-023-30890-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
This study aimed to investigate the effect of the lack of keratinized mucosa on the risk of peri-implantitis, while also accounting for possible confounding factors. A literature search was conducted in PubMed and Scopus, including human studies that assessed the presence and width of keratinized mucosa in relation to the occurrence of peri-implantitis. Twenty-two articles were included, and 16 cross-sectional studies we meta-analyzed. The prevalence of peri-implantitis was 6.68-62.3% on patient-level and 4.5-58.1% on implant-level. The overall analysis indicated that the lack of keratinized mucosa was associated with a higher prevalence of peri-implantitis (OR = 2.78, 95% CI 2.07-3.74, p < 0.00001). Similar results were shown when subgroup analyses were performed, including studies with a similar case definition of peri-implantitis (Marginal Bone Loss, MBL ≥ 2 mm) (OR = 1.96, 95% CI 1.41-2.73, p < 0.0001), fixed prostheses only (OR = 2.82, 95% CI 1.85-4.28, p < 0.00001), patients under regular implant maintenance (OR = 2.08, 95% CI 1.41-3.08, p = 0.0002), and studies adjusting for other variables (OR = 3.68, 95% CI 2.32-5.82, p = 0.007). Thus, the lack of keratinized mucosa is a risk factor that increases the prevalence of peri-implantitis and should be accounted for when placing dental implants.
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Affiliation(s)
- Basel Mahardawi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Sirimanas Jiaranuchart
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Napat Damrongsirirat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Sirida Arunjaroensuk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anupap Somboonsavatdee
- Department of Statistics, Chulalongkorn Business School, Chulalongkorn University, Bangkok, Thailand
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand.
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Hamilton A, Putra A, Nakapaksin P, Kamolroongwarakul P, Gallucci GO. Implant prosthodontic design as a predisposing or precipitating factor for peri-implant disease: A review. Clin Implant Dent Relat Res 2023. [PMID: 36691784 DOI: 10.1111/cid.13183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/20/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023]
Abstract
Over the past decade, emerging evidence indicates a strong relationship between prosthetic design and peri-implant tissue health. The objective of this narrative review was to evaluate the evidence for the corresponding implant prosthodontic design factors on the risk to peri-implant tissue health. One of the most important factors to achieve an acceptable implant restorative design is the ideal implant position. Malpositioned implants often result in a restorative emergence profile at the implant-abutment junction that can restrict the access for patients to perform adequate oral hygiene. Inadequate cleansability and poor oral hygiene has been reported as a precipitating factors to induce the peri-implant mucositis and peri-implantitis and are influenced by restorative contours. The implant-abutment connection, restorative material selection and restoration design are also reported in the literature as having the potential to influence peri-implant sort tissue health.
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Affiliation(s)
- Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia.,Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Armand Putra
- Private Practice, Perth, Western Australia, Australia.,Department of Graduate Prosthodontic, University of Washington, Seattle, Washington, USA
| | - Pranai Nakapaksin
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Pongrapee Kamolroongwarakul
- Dental Center, Private Hospital, Bangkok, Thailand.,Department of Graduate Prosthodontic, Mahidol University, Bangkok, Thailand
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Huang S, Zhong Y, Fu Y, Zheng X, Feng Z, Mo A. Graphene and its derivatives: "one stone, three birds" strategy for orthopedic implant-associated infections. Biomater Sci 2023; 11:380-399. [PMID: 36453143 DOI: 10.1039/d2bm01507b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Orthopedic implants provide an avascular surface for microbial attachment and biofilm formation, impeding the entry of immune cells and the diffusion of antibiotics. The above is an important cause of dental and orthopedic implant-associated infection (IAI). For the prevention and treatment of IAI, the drawbacks of antibiotic resistance and surgical treatment are increasingly apparent. Due to their outstanding biological properties such as biocompatibility, immunomodulatory effects, and antibacterial properties, graphene-based nanomaterials (GBNs) have been applied to bone tissue engineering to deal with IAI, and in particular have great potential application in drug/gene carriers, multi-functional platforms, and coating forms. Here we review the latest research progress and achievements in GBNs for the prevention and treatment of IAI, mainly including their biomedical applications for antibacterial and immunomodulation effects, and for inducing osteogenesis. Furthermore, the biosafety of graphene family materials in bone tissue regeneration and the feasibility of clinical application are critically analyzed and discussed.
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Affiliation(s)
- Si Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China. .,Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yongjin Zhong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China. .,Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yu Fu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China. .,Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xiaofei Zheng
- Stomatology Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zeru Feng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China. .,Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Anchun Mo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China. .,Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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20
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Monje A, González-Martín O, Ávila-Ortiz G. Impact of peri-implant soft tissue characteristics on health and esthetics. J ESTHET RESTOR DENT 2023; 35:183-196. [PMID: 36650691 DOI: 10.1111/jerd.13003] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To review the impact of key peri-implant soft tissue characteristics on health and esthetics. MAIN CONSIDERATIONS The keratinized mucosa width (KMW), the mucosal thickness (MT), and the supracrestal tissue height (STH) are essential components of the peri-implant soft tissue phenotype. An inadequate KMW (<2 mm) has been associated with local discomfort upon oral hygiene performance and increased risk for the onset of peri-implant diseases. A minimum buccal MT (≥2 mm) is generally required to prevent esthetic issues related to the effect of transmucosal prosthetic elements on the color of the mucosa and can also contribute to long-term mucosal stability. STH is directly related to marginal bone remodeling patterns during the early healing process that follows the connection of transmucosal prosthetic components. Short STH, generally defined as <3 mm, has been consistently associated with marginal bone loss resulting from the physiologic establishment of the mucosal seal. Insufficient STH may also derive into the fabrication of unfavorable transmucosal prosthetic contours, which frequently results in unpleasing esthetic outcomes and predisposes to submarginal biofilm accumulation. Peri-implant soft tissue dehiscences (PISTDs) are a type of peri-implant deformity that are associated with esthetic issues and often occur in sites presenting KMW, MT, and/or STH deficiencies. PISTDs should be correctly diagnosed and treated accordingly, usually by means of multidisciplinary therapy. CONCLUSION Understanding the impact of different dimensional and morphologic features of the peri-implant mucosa on health and esthetic outcomes is fundamental to make appropriate clinical decisions in the context of tooth replacement therapy with implant-supported prostheses.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Periodontology, University of Bern, Bern, Switzerland
| | - Oscar González-Martín
- Private Practice, Atelier Dental Madrid, Madrid, Spain.,Department of Periodontology, Complutense University of Madrid, Madrid, Spain
| | - Gustavo Ávila-Ortiz
- Private Practice, Atelier Dental Madrid, Madrid, Spain.,Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, USA.,Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
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Han HS, Kim PJ, Kim KT, Kim S, Ku Y, Cho YD. Dental implant proximity to adjacent teeth: A retrospective study. Clin Implant Dent Relat Res 2022; 24:733-739. [PMID: 36131203 DOI: 10.1111/cid.13132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to assess the occurrence and prognosis of dental implant proximity or direct contact with the adjacent tooth and to evaluate the symptoms and complications in both the implant and the adjacent tooth. We then elaborate on treatment modalities and discuss the prevention of this phenomenon. MATERIALS AND METHODS This retrospective study was conducted based on the dental clinical and radiographic records of 43 patients with implant-tooth proximity of <1.0 mm or direct implant-tooth contact. Multivariate Bayesian logistic regression was performed to examine the influence of individual variables on correcting major clinical variables. RESULTS In the multivariate regression analysis, the rate of occurrence of tooth symptom decreased by about 95% with every increase of 1.0 mm distance between implant and tooth (odds ratio [OR] = 0.1, 95% confidence interval [CI]: 0.004-0.680, p = 0.024). In the case of implant-tooth root proximity in the anterior area, the OR of peri-implantitis occurrence was 30.4-fold greater than in posterior sites (OR = 30.4, 95% CI: 1.189-785.914, p = 0.040). CONCLUSION Implant-tooth root proximity or direct implant-tooth contact is an iatrogenic factor that causes various complications, including devitalization of the adjacent tooth and peri-implantitis. Proactive prevention with surgical stents and intra-operative periapical radiographs is needed. If proximity or contact is found during surgery, repositioning of the fixture to the correct location is recommended in order to maintain peri-implant health and prevent complications.
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Affiliation(s)
- Hee-Seung Han
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Pil-Jong Kim
- Biomedical Knowledge Engineering Laboratory, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ki-Tae Kim
- Department of Molecular Genetics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Sungtae Kim
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Young Ku
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Young-Dan Cho
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Republic of Korea
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Guarnieri R, Reda R, Zanza A, Miccoli G, Nardo DD, Testarelli L. Can Peri-Implant Marginal Bone Loss Progression and a-MMP-8 Be Considered Indicators of the Subsequent Onset of Peri-Implantitis? A 5-Year Study. Diagnostics (Basel) 2022; 12:diagnostics12112599. [PMID: 36359443 PMCID: PMC9689086 DOI: 10.3390/diagnostics12112599] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/22/2022] [Accepted: 10/23/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this retrospective study was to investigate the relationship between the amount of early bone remodeling, the marginal bone loss (MBL) progression, and the peri-implant sulcular fluid concentration of active metalloproteinase-8 (a-MMP-8) and the incidence of peri-implantitis (P) over 5 years of implant function. It has been documented that dental implants with a high degree of early marginal bone loss (MBL) are likely to achieve additional increased MBL during function. Moreover, it has been speculated that early increased MBL might be a predictive factor for the subsequent onset of peri-implant inflammatory diseases. Clinical and radiographic data at implant placement (T0) and restoration delivery (TR) at 6 months (T1), 2 years (T2), and 5 years (T5) post-loading were retrospectively collected. MBL levels/rates (MBLr) and peri-implant sulcular fluid levels/rates of a-MMP-8 were assessed at TR, T1, T2, and T5. Implants were divided into two groups: group 1 with peri-implantitis (P+) and group 2 without peri-implantitis (P−). A multi-level simple binary logistic regression, using generalized estimation equations (GEEs), was implemented to assess the association between each independent variable and P+. A receiver operating characteristics (ROC) curve was used to evaluate an optimal cutoff point for T1 MBL degree and a-MMP-8 level to discriminate between P+ and P− implants. A total of 80 patients who had received 80 implants between them (39 implants with a laser-microtextured collar surface (LMS) and 41 implants with a machined collar surface (MS)) were included. Periapical radiographs and a software package were used to measure MBL rates. Peri-implant sulcular implant fluid samples were analyzed by a chairside mouth-rinse test (ImplantSafe®) in combination with a digital reader (ORALyzer®). Twenty-four implants (six with an LMS and eighteen with an MS) were classified as P+. No statistically significant association was found between the amount of early bone remodeling, MBL progression, and MBLr and the incidence of peri-implantitis. Implants with a-MMP-8 levels >15.3 ng/mL at T1 presented a significantly higher probability of P+. The amount of early marginal bone remodeling cannot be considered as an indicator of the subsequent onset of P, whereas high a-MMP-8 levels 6 months after loading could have a distinct ability to predict P.
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Affiliation(s)
- Renzo Guarnieri
- Private Periodontal Implant Practice, 31100 Treviso, Italy
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
- Department of Prosthodontics and Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, India
| | - Rodolfo Reda
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
- Department of Prosthodontics and Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, India
| | - Alessio Zanza
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
- Correspondence:
| | - Gabriele Miccoli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Dario Di Nardo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
- Department of Prosthodontics and Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, India
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Boldeanu LC, Boariu M, Rusu D, Vaduva A, Roman A, Surlin P, Martu I, Dragoi R, Popa-Wagner A, Stratul SI. Histomorphometrical and CBCT Evaluation of Tissue Loss Progression Induced by Consecutive, Alternate Ligatures in Experimental Peri-Implantitis in a Dog Model: A Pilot Study. J Clin Med 2022; 11:jcm11206188. [PMID: 36294510 PMCID: PMC9605274 DOI: 10.3390/jcm11206188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/29/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives: Soft and hard tissue breakdown was histologically and radiologically assessed around implants with alternate, consecutively placed ligatures on the same edentulous dog hemimandible. The influence of ligatured implants (LI) on adjacent non-ligatured implants (NLI, as a possible naturally induced peri-implantitis) was also evaluated. Material and Methods: Three months after tooth extraction, five dental implants were placed in the dog hemimandible. Two months after abutment placement, ligatures were placed subsequently two months apart on alternate implants, while both intermediate implants were left without ligatures. Ligatures were kept in place during the entire experiment, and no plaque control measures were taken. Eleven months post-implantation, the animal was sacrificed. Undecalcified ground sections were cut, stained with Masson Goldner and MOVAT Pentachrome and evaluated by light microscopy. Soft and hard tissue loss was assessed using histomorphometric and CBCT parameters. Results: All NLI presented deep false peri-implant pockets on the oral aspect and pronounced vertical bone resorption on the buccal aspect. After 2, 4 and 6 months, during the breakdown period, more than 30% of the bone was lost in LI in all directions, while, despite immediate vicinity, NLI displayed less destruction. Intense inflammation, typical for induced peri-implantitis, was present, with similar intensity in LI as NLI, but in different parts of the lesions. Morphometry confirmed intense soft tissue inflammation, more bone resorption and higher amounts of infiltrated connective tissue in LI when compared with NLI. Conclusion: Within the limits of the present pilot study, the adequacy of the experimental dog model based on ligature-induced peri-implantitis was able to be successfully challenged by non-ligature models of spontaneously occurring peri-implant inflammation, while meeting the requirements for experimental designs with a very small numbers of animals. The influence of implants with severe peri-implantitis on adjacent implants resulted in less than expected tissue loss in the latter accession numbers.
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Affiliation(s)
- Lucia-Camelia Boldeanu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marius Boariu
- Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Correspondence: (M.B.); (A.P.-W.); Tel.: +40-722701871 (M.B.); +49-15202946197 (A.P.-W.)
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Adrian Vaduva
- Department of Pathology, Faculty of Medicine, ANAPATMOL Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alexandra Roman
- Applicative Periodontal Regeneration Research Unit, Department of Peridontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj Napoca, Romania
| | - Petra Surlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Ioana Martu
- Department of Dental Technology, Faculty of Dental Medicine Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Razvan Dragoi
- Department of Balneology, Medical Rehabilitation and Rheumatology, Center for Assessment of Movement, Functionality and Disability, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Aurel Popa-Wagner
- Experimental Research Center in Normal and Pathological Aging (ARES), University of Medicine and Pharmacy, 200349 Craiova, Romania
- Correspondence: (M.B.); (A.P.-W.); Tel.: +40-722701871 (M.B.); +49-15202946197 (A.P.-W.)
| | - Stefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Rodriguez MV, Ravidà A, Saleh MH, Basma HS, Dukka H, Khurshid H, Wang H, Moreno PG. Is the degree of physiological bone remodeling a predictive factor for peri-implantitis? J Periodontol 2022; 93:1273-1282. [PMID: 35536150 PMCID: PMC9796402 DOI: 10.1002/jper.21-0723] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/19/2022] [Accepted: 04/30/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND The amount of initial physiological bone remodeling (IPBR) after implant placement varies and the ways it may play a role in peri-implantitis development remains unknown. The aim of this retrospective study was to investigate the association between the amount of IPBR during the first year of implant placement and incidence of peri-implantitis as well as the pattern of progressive bone loss. METHODS Clinical and radiographic documentation of implants at the time of implant placement (T0), 1 year ± 6 months after crown placement (T1), and at a ≥2-year follow-up from implant placement (T2) were retrospectively collected. IPBR was defined as the bone loss occurring from implant placement to the end of the bone remodeling (T1). Cases were grouped into those diagnosed with (test) or without peri-implantitis (PIm) (control). Linear regression model under generalized estimation equation approach was estimated to assess correlation between marginal bone loss (MBL) rates in both periods (T1-T0) and (T2-T1). Receiver operating characteristics curve was estimated to explore an optimal cut-off point of T1-T0 MBL to discriminate between PIm and no-PIm implants. RESULTS A total of 45 patients receiving 57 implants without PIm and 40 with PIm were included. There were no associations between PIm and IPBR (p > 0.05), nor between BML of (T2-T1) and (T1-T0). However, arch and total follow-up showed significant influence on the probability of PIm. Splinted implants showed an MBL rate of 0.60-mm/year higher than non-splinted implants (p < 0.001) from T1 to T2. CONCLUSION No statistically significant association was found between IPBR and incidence of peri-implantitis.
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Affiliation(s)
- Maria Vera Rodriguez
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Andrea Ravidà
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Muhammad H.A. Saleh
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA,Department of PeriodonticsUniversity of Louisville School of DentistryLouisvilleKentuckyUSA
| | - Hussein S. Basma
- Department of PeriodontologySchool of DentistryUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Himabindu Dukka
- Department of PeriodonticsUniversity of Louisville School of DentistryLouisvilleKentuckyUSA
| | - Hadiya Khurshid
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Hom‐Lay Wang
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Pablo Galindo Moreno
- Oral Surgery and Implant Dentistry DepartmentSchool of DentistryUniversity of GranadaGranadaSpain
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Platelet-Rich Fibrin Reduces IL-1β Release from Macrophages Undergoing Pyroptosis. Int J Mol Sci 2022; 23:ijms23158306. [PMID: 35955441 PMCID: PMC9368224 DOI: 10.3390/ijms23158306] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/20/2022] [Accepted: 07/24/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Pyroptosis is a catabolic process relevant to periodontal disorders for which interleukin-1β (IL-1β) inflammation is central to the pathophysiology of the disease. Despite platelet-rich fibrin (PRF) anti-inflammatory properties and its application to support periodontal regeneration, the capacity of PRF to modulate pyroptosis, specifically the production and release of IL-1β, remains unknown. The question arises whether PRF could regulate IL-1β release from macrophages in vitro. Methods: To answer this question, RAW 264.7 macrophages and primary macrophages obtained from murine bone marrow were primed with PRF before being challenged by lipopolysaccharide (LPS). Cells were then analysed for the pyroptosis signalling components by gene expression analyses and IL-1β secretion at the protein level. The release of mitochondrial reactive oxygen species (ROS) was also detected. Results: PRF lowered the LPS-induced expression of IL-1β and NLRP3 inflammasome, caspase-11 and IL-18 in primary macrophages, and IL-1β and caspase-11 in RAW 264.7 cells. Additionally, PRF diminished the secretion of IL-1β at the protein level in LPS-induced RAW 264.7 cells. This was shown through immunoassays performed with the supernatant and further confirmed by analysing the lysates of permeabilised cells. Furthermore, PRF reduced the ROS release provoked by LPS in RAW 264.7 cells. Finally, to enhance IL-1β release from the LPS-primed macrophages, we introduced a second signal with adenosine triphosphate (ATP). In this setting, PRF significantly reduced IL-1β release in RAW 264.7 cells and a trend to diminish IL-1β release in primary macrophages. Conclusion: These findings suggest that PRF can reduce IL-1β release and, at least in part, inhibit pyroptosis-related factors in LPS-challenged macrophages.
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Radaic A, Brody H, Contreras F, Hajfathalian M, Lucido L, Kamarajan P, Kapila YL. Nisin and Nisin Probiotic Disrupt Oral Pathogenic Biofilms and Restore Their Microbiome Composition towards Healthy Control Levels in a Peri-Implantitis Setting. Microorganisms 2022; 10:1336. [PMID: 35889055 PMCID: PMC9324437 DOI: 10.3390/microorganisms10071336] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/24/2022] [Accepted: 06/29/2022] [Indexed: 02/06/2023] Open
Abstract
Peri-implantitis is characterized by chronic inflammation of the peri-implant supporting tissues that progressively and irreversibly leads to bone loss and, consequently, implant loss. Similar to periodontal disease, oral dysbiosis is thought to be a driver of peri-implantitis. However, managing peri-implantitis with traditional treatment methods, such as nonsurgical debridement or surgery, is not always successful. Thus, novel strategies have been proposed to address these shortcomings. One strategy is the use of probiotics as antimicrobial agents since they are considered safe for humans and the environment. Specifically, the probiotic Lactococcus lactis produces nisin, which has been used worldwide for food preservation. The objective of this study was to determine whether nisin and the wild-type (WT) nisin-producing L. lactis probiotic can disrupt oral pathogenic biofilms and promote a healthier oral microbiome within these oral biofilms on titanium discs. Using confocal imaging and 16S rRNA sequencing, this study revealed that nisin and WT L. lactis probiotic disrupt oral pathogenic biofilms in a peri-implantitis setting in vitro. More specifically, nisin decreased the viability of the pathogen-spiked biofilms dose-dependently from 62.53 ± 3.69% to 54.26 ± 3.35% and 44.88 ± 2.98%, respectively. Similarly, 105 CFU/mL of WT L. lactis significantly decreased biofilm viability to 52.45 ± 3.41%. Further, both treatments shift the composition, relative abundance, and diversity levels of these biofilms towards healthy control levels. A total of 1 µg/mL of nisin and 103 CFU/mL of WT L. lactis were able to revert the pathogen-mediated changes in the Proteobacteria (from 80.5 ± 2.9% to 75.6 ± 2.0%, 78.0 ± 2.8%, and 75.1 ± 5.3%, respectively) and Firmicutes (from 11.6 ± 1.6% to 15.4 ± 1.3%, 13.8 ± 1.8%, and 13.7 ± 2.6%, respectively) phyla back towards control levels. Thus, nisin and its nisin-producing L. lactis probiotic may be useful in treating peri-implantitis by promoting healthier oral biofilms, which may be useful for improving patient oral health.
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Affiliation(s)
- Allan Radaic
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94143, USA; (A.R.); (H.B.); (F.C.); (M.H.); (L.L.); (P.K.)
| | - Hanna Brody
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94143, USA; (A.R.); (H.B.); (F.C.); (M.H.); (L.L.); (P.K.)
| | - Fernando Contreras
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94143, USA; (A.R.); (H.B.); (F.C.); (M.H.); (L.L.); (P.K.)
| | - Maryam Hajfathalian
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94143, USA; (A.R.); (H.B.); (F.C.); (M.H.); (L.L.); (P.K.)
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Luke Lucido
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94143, USA; (A.R.); (H.B.); (F.C.); (M.H.); (L.L.); (P.K.)
| | - Pachiyappan Kamarajan
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94143, USA; (A.R.); (H.B.); (F.C.); (M.H.); (L.L.); (P.K.)
| | - Yvonne L. Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94143, USA; (A.R.); (H.B.); (F.C.); (M.H.); (L.L.); (P.K.)
- Division of Oral and Systemic Health Sciences, Sections of Biosystems and Function and Periodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
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Dab SS. Iatrogenic peri-implantitis - Factors interplaying the implant suprastructure design. Clin Adv Periodontics 2022; 12:210-217. [PMID: 35523429 DOI: 10.1002/cap.10199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/10/2022] [Indexed: 11/11/2022]
Abstract
FOCUSSED CLINICAL QUESTION What is the key clinically controllable preventive measure that may help reduce the incidence of biological complications? SUMMARY Implant complications are common, ineffective care and delay in diagnosis can lead to expensive time-consuming surgical and non-surgical interventions. Careful selection and placement of implant allows development of adequate emergence design of the implant suprastructure. This helps achieve effective plaque control, adequate maintenance at hygiene visits, accurate follow up assessments of the peri-implant tissues addressing the key underlying factor impacting biological complications. This clinically controllable preventative measure may be considered a vital strategy in averting peri-implant disease. CONCLUSION Surge in biological complications have led to increased patient dissatisfaction in terms of time, cost, esthetics, and maintenance. One of the factors identified in causing biological complications is the iatrogenic prosthesis related factor. Minimizing the impact of this factor is crucial to the overall implant success. Selection and placement of implant following meticulous planning, using careful surgical protocols allows development of adequate suprastructure design that improves overall patient outcomes by reducing biological complications. Further research is essential to comprehensively assess the impact of these strategies in thwarting development of biological complications. This article is protected by copyright. All rights reserved Poor design of implant suprastructure leads to ineffective plaque control, inadequate maintenance, inaccurate follow up assessments predisposing to peri-implant disease. Selection and placement of implant based on available edentulous space and adjusting the running room can allow for better emergence of the suprastructure thus allowing proper oral hygiene. This clinically controllable preventative measure may be considered a vital strategy in averting peri-implant disease. Over-contoured suprastructure predisposes to peri-implantitis. Adjusting the running room during implant placement allows better emergence and effective plaque control.
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Affiliation(s)
- Sandeep Singh Dab
- Instructor, University of Toronto Faculty of Dentistry, Davisville Periodontics, 1849, Yonge Street, Suite 116, Toronto, ON, M4S 1Y2, USA
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Discepoli N, Mirra R, Vesentin C, Marruganti C, Ferrari M. Artificial biofilm removal in a peri-implant mucositis model: Efficacy of air polishing technology as adjunct to ultrasonic debridement alone and impact of the site and the depth of mucosal tunnel-An in vitro study. Clin Implant Dent Relat Res 2022; 24:242-250. [PMID: 35324063 DOI: 10.1111/cid.13077] [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: 12/08/2021] [Revised: 02/10/2022] [Accepted: 02/19/2022] [Indexed: 11/29/2022]
Abstract
AIM The current in vitro model aims to evaluate the adjunctive effect on artificial biofilm removal determined by the use of a glycine-powder air-polishing procedure (GPAP) over the ultrasonic debridement (USD) alone when the removal of artificial biofilm on abutment surface is performed. The procedures were carried out also evaluating the impact of the site (mesial, distal, vestibular, and oral) and three different mucosal tunnel depths (2 mm, 4 mm, and 6 mm). MATERIALS AND METHODS Single tooth implant replacement was simulated. Three different abutment heights together with a prosthetic contour were investigated (2 mm, 4 mm, and 6 mm); custom-made gingival masks were created to mimic peri-implant soft tissue. Biofilm was simulated with an indelible ink. The protocol consisted in two intervention stages for each abutment: (a) USD with PEEK tip plus (b) GPAP. At the end of each intervention, abutments were unscrewed, and standardized photographs were taken. Statistical analysis was carried out to compare residual stain percentage between the two intervention stages and among different sites and mucosal tunnels. RESULTS A total of 30 abutments were instrumented. A significant reduction of the percentage of residual staining (PRS) after the combination of GPAP + USD over USD alone was demonstrated (16% vs. 32%; p < 0.05). Moreover, the better performance of the GPAP + USD protocol was observed regardless of the different mucosal tunnel heights and the sites analyzed. Intragroup analysis unveils that the smaller PRS was observed for shallow mucosal tunnels (2 mm) and vestibular sites for both protocols. CONCLUSION GPAP + USD provided adjunctive effect on artificial biofilm removal in comparison to the USD alone. Furthermore, proximal surfaces and deeper mucosal tunnels (4 and 6 mm) showed a reduced instrumentation efficacy for both protocols.
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Affiliation(s)
- Nicola Discepoli
- Department of Medical Biotechnologies, Unit of Periodontics, Università degli Studi di Siena, Siena, Italy
| | - Raffaele Mirra
- Department of Medical Biotechnologies, Unit of Periodontics, Università degli Studi di Siena, Siena, Italy
| | - Cecilia Vesentin
- Department of Medical Biotechnologies, Unit of Periodontics, Università degli Studi di Siena, Siena, Italy
| | - Crystal Marruganti
- Department of Medical Biotechnologies, Unit of Periodontics, Università degli Studi di Siena, Siena, Italy
| | - Marco Ferrari
- Department of Medical Biotechnologies, Unit of Dental Material and Fixed Prosthodontics, Università degli Studi di Siena, Siena, Italy
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Polymeri A, van der Horst J, Anssari Moin D, Wismeijer D, Loos BG, Laine ML. Non-surgical peri-implantitis treatment with or without systemic antibiotics; a randomized controlled clinical trial. Clin Oral Implants Res 2022; 33:548-557. [PMID: 35238084 PMCID: PMC9314590 DOI: 10.1111/clr.13914] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 11/29/2022]
Abstract
Objectives To assess the adjunctive effect of systemic amoxicillin (AMX) and metronidazole (MTZ) in patients receiving non‐surgical treatment (NST) for peri‐implantitis (PI). Materials and methods Thirty‐seven patients were randomized into an experimental group treated with NST plus AMX + MTZ (N = 18) and a control group treated with NST alone (N = 19). Clinical parameters were evaluated at 12 weeks post‐treatment. The primary outcome was the change in peri‐implant pocket depth (PIPD) from baseline to 12 weeks, while secondary outcomes included bleeding on probing (BoP), suppuration on probing (SoP), and plaque. Data analysis was performed at patient level (one target site per patient). Results All 37 patients completed the study. Both groups showed a significant PIPD reduction after NST. The antibiotics group showed a higher mean reduction in PIPD at 12 weeks, compared with the control group (2.28 ± 1.49 mm vs. 1.47 ± 1.95 mm), however, this difference did not reach statistical significance. There was no significant effect of various potential confounders on PIPD reduction. Neither treatment resulted in significant improvements in BoP at follow‐up; 30 of 37 (81%) target sites still had BoP after treatment. Only two implants, one in each group, exhibited a successful outcome defined as PIPD < 5 mm, and absence of BoP and SoP. Conclusions Non‐surgical treatment was able to reduce PIPD at implants with PI. The adjunctive use of systemic AMX and MTZ did not show statistically significant better results compared to NST alone. NST with or without antibiotics was ineffective to completely resolve inflammation around dental implants.
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Affiliation(s)
- A Polymeri
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
| | - J van der Horst
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
| | - D Anssari Moin
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
| | - D Wismeijer
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands.,TPE, Private practice, Ellecom, the Netherlands
| | - B G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
| | - M L Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands
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Evaluation of the Effects of Mouthwash on the Morphology and Cell Viability of Osteoblast-Like Cells. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5884974. [PMID: 35155676 PMCID: PMC8837424 DOI: 10.1155/2022/5884974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/16/2022] [Accepted: 01/26/2022] [Indexed: 11/18/2022]
Abstract
This study evaluated the effects of multiple mouthwashes on the cellular viability or the morphology of preosteoblasts. Mouse calvarial osteoblast-like cells were cultured and treated with mouthwashes of (1) benzydamine hydrochloride; (2) cetylpyridinium chloride and benzalkonium chloride; (3) methyl salicylate, menthol, eucalyptol, and thymol; and (4) sodium fluoride, xylitol, and chitosan. The treatment times were 30 seconds, 90 seconds, and 270 seconds. Cell morphology was evaluated with a microscope, and the viability of the treated cells was analyzed quantitatively using a commercially available kit. The untreated control group exhibited well-stretched fibroblast-like morphology. Treatment with mouthwash resulted in morphological changes in all groups. Treatment with sodium fluoride resulted in more noticeable changes. Treatment with mouthwash for 30 seconds produced a significant decrease in cell viability. An increase in time to 90 and 270 seconds did not produce additional noticeable changes. To conclude, commercially available mouthwashes created changes in cell morphology and decreased the cell viability of osteoblast-like cells irrespective of ingredients and treatment time.
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Graphene for Antimicrobial and Coating Application. Int J Mol Sci 2022; 23:ijms23010499. [PMID: 35008923 PMCID: PMC8745297 DOI: 10.3390/ijms23010499] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/28/2021] [Accepted: 12/30/2021] [Indexed: 12/22/2022] Open
Abstract
Graphene is a versatile compound with several outstanding properties, providing a combination of impressive surface area, high strength, thermal and electrical properties, with a wide array of functionalization possibilities. This review aims to present an introduction of graphene and presents a comprehensive up-to-date review of graphene as an antimicrobial and coating application in medicine and dentistry. Available articles on graphene for biomedical applications were reviewed from January 1957 to August 2020) using MEDLINE/PubMed, Web of Science, and ScienceDirect. The selected articles were included in this study. Extensive research on graphene in several fields exists. However, the available literature on graphene-based coatings in dentistry and medical implant technology is limited. Graphene exhibits high biocompatibility, corrosion prevention, antimicrobial properties to prevent the colonization of bacteria. Graphene coatings enhance adhesion of cells, osteogenic differentiation, and promote antibacterial activity to parts of titanium unaffected by the thermal treatment. Furthermore, the graphene layer can improve the surface properties of implants which can be used for biomedical applications. Hence, graphene and its derivatives may hold the key for the next revolution in dental and medical technology.
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Tabassum A. Radiographic comparisons of crestal bone levels around implants placed with low-speed drilling and standard drilling protocols: Preliminary results. Saudi Dent J 2021; 33:965-971. [PMID: 34938039 PMCID: PMC8665170 DOI: 10.1016/j.sdentj.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 07/04/2021] [Accepted: 08/01/2021] [Indexed: 12/02/2022] Open
Abstract
Background The present study aimed to investigate the mean crestal bone loss (CBL) by placing implants using two different drilling-protocols, i.e., standard drilling with saline irrigation and low-speed drilling without saline irrigation. Material and Methods The patients were enrolled in the present study from a university teaching institute. Patients who fulfilled the inclusion criteria were randomly placed in two study groups: 1) control group: Standard drilling with saline irrigation and 2) test group: low-speed drilling without saline irrigation. The radiographic mean crestal bone loss (CBL) was evaluated at 3 months of follow-up before implant loading. Data analysis was performed using SPSS 20.0 (IBM product, Chicago, USA) and a p-value ≤ 0.05 was considered statistically significant. Results Sixteen patients (10 males and 6 females) participated in the study. Thirty Camlog®-screw-line implants were placed (15 implants per study group). After 3 months of follow-up, the means CBL of implants placed with standard drilling and low-speed drilling protocols were 1.01 ± 0.49 mm and 0.74 ± 0.62 mm, respectively. No statistically significant difference could be recorded between two groups (p = 0.206). Conclusions Dental implants placed with low-speed drilling without saline irrigation exhibited a similar CBL to implants installed with the standard drilling protocol. However, further randomised clinical trials are recommended to obtain stronger evidence and a better understanding of the effect of the low-speed drilling protocol without saline irrigation on mean CBL and long-term implant survival.
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Affiliation(s)
- Afsheen Tabassum
- Division of Periodontology, 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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Mistry A, Ucer C, Thompson JD, Khan RS, Karahmet E, Sher F. 3D Guided Dental Implant Placement: Impact on Surgical Accuracy and Collateral Damage to the Inferior Alveolar Nerve. Dent J (Basel) 2021; 9:dj9090099. [PMID: 34562973 PMCID: PMC8470513 DOI: 10.3390/dj9090099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 01/26/2023] Open
Abstract
An increase in the number of implants placed has led to a corresponding increase in the number of complications reported. The complications can vary from restorative complications due to poor placement to damage to collateral structures such as nerves and adjacent teeth. A large majority of these complications can be avoided if the implant has been placed accurately in the optimal position. Therefore, the aim of this in vitro pilot study was to investigate the effect of freehand (FH) and fully guided (FG) surgery on the accuracy of implants placed in close proximity to vital structures such as the inferior alveolar nerve (IAN). Cone-beam computed tomography (CBCT) and intraoral scans of six patients who have had previous dental implants in the posterior mandible were used in this study. The ideal implant position was planned. FG surgical guides were manufactured for each case. In this study, the three-dimensional 3D printed resin models of each of the cases were produced and the implants placed using FG and FH methods on the respective models. The outcome variables of the study, angular deviations were calculated and the distance to the IAN was measured. The mean deviations for the planned position observed were 1.10 mm coronally, 1.88 mm apically with up to 6.3 degrees’ angular deviation for FH surgery. For FG surgical technique the mean deviation was found to be at 0.35 mm coronally, 0.43 mm apically with 0.78 degrees angularly respectively. The maximum deviation from the planned position for the apex of the implant to the IAN was 2.55 mm using FH and 0.63 mm FG. This bench study, within its limitations, demonstrated surgically acceptable accuracy for both FH and FG techniques that would allow safe placement of implants to vital structures such as the IAN when a safety zone of 3 mm is allowed. Nevertheless, a better margin of error was observed for FG surgery with respect to the angular deviation and controlling the distance of the implant to the IAN using R2 Gate® system.
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Affiliation(s)
- Amit Mistry
- Amit Mistry Implants, The Whitehouse, Greenalls Avenue, Warrington WA4 6HL, UK;
| | - Cemal Ucer
- ICE Postgraduate Dental Institute and Hospital, Salford M50 3XZ, UK;
| | - John D. Thompson
- School of Health and Society, University of Salford, Salford M5 4WT, UK;
| | - Rabia Sannam Khan
- Education and Research Director, ICE Postgraduate Dental Institute and Hospital, 24 Furness Quay, Salford M50 3XZ, UK;
| | - Emina Karahmet
- Department of Medical Chemistry, Faculty of Pharmacy, University of Tuzla, 75000 Tuzla, Bosnia and Herzegovina;
| | - Farooq Sher
- Department of Engineering, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
- Correspondence: ; Tel.: +44-(0)-115-84-86679
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Polymeri A, Loos BG, Aronovich S, Steigmann L, Inglehart MR. Risk factors, diagnosis and treatment of peri-implantitis: A cross-cultural comparison of U.S. and European periodontists' considerations. J Periodontol 2021; 93:481-492. [PMID: 34390497 PMCID: PMC10138758 DOI: 10.1002/jper.21-0010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 07/14/2021] [Accepted: 08/11/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Peri-implantitis (PI) is a growing concern in the dental community worldwide. The study aimed to compare U.S. vs. European periodontists' considerations of risk factors, diagnostic criteria, and management of PI. MATERIALS AND METHODS 393 periodontists from the U.S. and 100 periodontists from Europe (Germany, Greece, Netherlands) responded to anonymous surveys electronically or by mail. RESULTS Compared to U.S. periodontists, European respondents were younger, more likely to be female and placed fewer implants per month (9.12 vs. 13.90;p = 0.003). Poor oral hygiene, history of periodontitis, and smoking were considered as very important risk factors by both groups (rated >4 on 5-point scale). European periodontists rated poor oral hygiene (4.64 vs. 4.45;p = 0.005) and history of periodontitis (4.36 vs. 4.10;p = 0.006) as more important and implant surface (2.91 vs. 3.18;p = 0.023), occlusion (2.80 vs. 3.75;p<0.001) and presence of keratinized tissue (3.27 vs. 3.77;p<0.001) as less important than did U.S. periodontists. Both groups rated clinical probing, radiographic bone loss, and presence of bleeding and suppuration as rather important diagnostic criteria. They rated implant exposure/mucosal recession as relatively less important with U.S. periodontists giving higher importance ratings than European periodontists (3.99 vs. 3.54;p = 0.001). Both groups nearly always used patient education, plaque control and mechanical debridement when treating PI. U.S. periodontists were more likely to use antibiotics (3.88 vs. 3.07;p<0.001), lasers (2.11 vs. 1.68;p = 0.005), allograft (3.39 vs. 2.14;p<0.001) and regenerative approaches (3.57 vs. 2.56;p<0.001), but less likely to use resective surgery (3.09 vs. 3.53;p<0.001) than European periodontists. CONCLUSIONS U.S. and European periodontists' considerations concerning risk factors, diagnosis and management of PI were evidence-based. Identified differences between the two groups can inform future educational efforts. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Angeliki Polymeri
- Department of Periodontology, University of Amsterdam and Vrije Universiteit, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Bruno G Loos
- Department of Periodontology, University of Amsterdam and Vrije Universiteit, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Sharon Aronovich
- Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI
| | - Larissa Steigmann
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
| | - Marita R Inglehart
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
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Wychowański P, Starzyńska A, Adamska P, Słupecka-Ziemilska M, Sobocki BK, Chmielewska A, Wysocki B, Alterio D, Marvaso G, Jereczek-Fossa BA, Kowalski J. Methods of Topical Administration of Drugs and Biological Active Substances for Dental Implants-A Narrative Review. Antibiotics (Basel) 2021; 10:919. [PMID: 34438969 PMCID: PMC8388631 DOI: 10.3390/antibiotics10080919] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 12/15/2022] Open
Abstract
Dental implants are, nowadays, established surgical devices for the restoration of lost teeth. Considered as an alternative for traditional prosthetic appliances, dental implants surpass them in reliability and patient feedback. Local drug delivery around the implants promotes osseointegration and reduces peri-implantitis. However, there are currently no methods of a multiple, precise topical administration of drugs to the implant area. Engineering coatings on the implants, drug application on carriers during implantation, or gingival pockets do not meet all requirements of dental surgeons. Therefore, there is a need to create porous implants and other medical devices that will allow a multiple drug delivery at a controlled dose and release profile without traumatic treatment. Due to the growing demand for the use of biologically active agents to support dental implant treatment at its various stages (implant placement, long-term use of dental superstructures, treatment of the peri-implant conditions) and due to the proven effectiveness of the topical application of pharmacological biologically active agents to the implant area, the authors would like to present a review and show the methods and devices that can be used by clinicians for local drug administration to facilitate dental implant treatment. Our review concludes that there is a need for research in the field of inventions such as new medical devices or implants with gradient solid-porous structures. These devices, in the future, will enable to perform repeatable, controllable, atraumatic, and repeatable injections of active factors that may affect the improvement of osteointegration and the longer survival of implants, as well as the treatment of peri-implantitis.
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Affiliation(s)
- Piotr Wychowański
- Department of Oral Surgery, Medical University of Warsaw, 6 St. Binieckiego Street, 02-097 Warsaw, Poland;
| | - Anna Starzyńska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (B.K.S.)
| | - Paulina Adamska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (B.K.S.)
| | - Monika Słupecka-Ziemilska
- Department of Human Epigenetics, Mossakowski Medical Research Center, Polish Academy of Sciences, 5 Pawińskiego Street, 02-106 Warsaw, Poland;
| | - Bartosz Kamil Sobocki
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (B.K.S.)
- International Research Agenda 3P—Medicine Laboratory, Medical University of Gdańsk, 3a Marii Skłodowskiej-Curie Street, 80-210 Gdańsk, Poland
| | - Agnieszka Chmielewska
- Faculty of Material Science and Engineering, Warsaw University of Technology, 141 Wołoska Street, 02-507 Warsaw, Poland;
- Department of Materials Science and Engineering, The Ohio State University, 140 W 19th Ave, Columbus, OH 43210, USA
| | - Bartłomiej Wysocki
- Center of Digital Science and Technology, Cardinal Stefan Wyszyński University in Warsaw, Woycickiego 1/3 Street, 01-938 Warsaw, Poland;
- Additive Manufacturing Research Center, College of Engineering, Youngstown State University, Youngstown, OH 44555, USA
| | - Daniela Alterio
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20141 Milan, Italy; (D.A.); (G.M.); (B.A.J.-F.)
| | - Giulia Marvaso
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20141 Milan, Italy; (D.A.); (G.M.); (B.A.J.-F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 7 Festa del Perdono Street, 20112 Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20141 Milan, Italy; (D.A.); (G.M.); (B.A.J.-F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 7 Festa del Perdono Street, 20112 Milan, Italy
| | - Jan Kowalski
- Department of Periodontology and Oral Medicine, Medical University of Warsaw, 6 St. Binieckiego Street, 02-097 Warsaw, Poland;
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Körtvélyessy G, Tarjányi T, Baráth ZL, Minarovits J, Tóth Z. Bioactive coatings for dental implants: A review of alternative strategies to prevent peri-implantitis induced by anaerobic bacteria. Anaerobe 2021; 70:102404. [PMID: 34146701 DOI: 10.1016/j.anaerobe.2021.102404] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 12/11/2022]
Abstract
Members of oral bacterial communities form biofilms not only on tooth surfaces but also on the surface of dental implants that replace natural teeth. Prolonged interaction of host cells with biofilm-forming anaerobes frequently elicits peri-implantitis, a destructive inflammatory disease accompanied by alveolar bone loss leading to implant failure. Here we wish to overview how the deposition of bioactive peptides to dental implant surfaces could potentially inhibit bacterial colonization and the development of peri-implantisis. One preventive strategy is based on natural antimicrobial peptides (AMPs) immobilized on titanium surfaces. AMPs are capable to destroy both Gram positive and Gram negative bacteria directly. An alternative strategy aims at coating implant surfaces - especially the transmucosal part - with peptides facilitating the attachment of gingival epithelial cells and connective tissue cells. These cells produce AMPs and may form a soft tissue seal that prevents oral bacteria from accessing the apical part of the osseointegrated implant. Because a wide variety of titanium-bound peptides were studied in vitro, we wish to concentrate on bioactive peptides of human origin and some of their derivatives. Furthermore, special attention will be given to peptides effective under in vivo test conditions.
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Affiliation(s)
- Győző Körtvélyessy
- Department of Oral Biology and Experimental Dental Research, University of Szeged, Faculty of Dentistry, 6720, Szeged, Tisza Lajos Krt. 64, Hungary
| | - Tamás Tarjányi
- Department of Oral Biology and Experimental Dental Research, University of Szeged, Faculty of Dentistry, 6720, Szeged, Tisza Lajos Krt. 64, Hungary
| | - Zoltán L Baráth
- Department of Prosthodontics, University of Szeged, Faculty of Dentistry, 6720, Szeged, Tisza Lajos Krt. 64, Hungary
| | - Janos Minarovits
- Department of Oral Biology and Experimental Dental Research, University of Szeged, Faculty of Dentistry, 6720, Szeged, Tisza Lajos Krt. 64, Hungary
| | - Zsolt Tóth
- Department of Oral Biology and Experimental Dental Research, University of Szeged, Faculty of Dentistry, 6720, Szeged, Tisza Lajos Krt. 64, Hungary; Department of Experimental Physics, University of Szeged, Faculty of Science and Informatics, 6720, Szeged, Dóm Tér 9, Hungary.
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AlJasser RN, AlSarhan MA, Alotaibi DH, AlOraini S, Ansari AS, Habib SR, Zafar MS. Analysis of Prosthetic Factors Affecting Peri-Implant Health: An in vivo Retrospective Study. J Multidiscip Healthc 2021; 14:1183-1191. [PMID: 34079276 PMCID: PMC8164962 DOI: 10.2147/jmdh.s312926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/04/2021] [Indexed: 12/31/2022] Open
Abstract
Objective To investigate and compare the various restorative and prosthetic parameters affecting peri-implant tissues’ health following dental implant placement and functional loading. Methods A total of 484 dental implants (length>6mm, non-turned, 2–3 piece, titanium – Straumann) were evaluated for patients (male=271; female=213). Study variables such as patient’s age, gender, implant restoration/crown type, crown retention, and implant crown status were assessed against various periodontal parameters (periodontal pocket depth (PPD), plaque index (PI), bleeding on probing (BOP), gingival color, and crestal bone level). All the data were analyzed using the SPSS software. Results Out of all the investigated dental implants, 201 (42%) of the implants investigated presented with BOP > one-site of the peri-implant mucosa (peri-implant mucositis), 115 (23.76%) presented with peri-implant marginal bone loss. PPD value was significantly lower in good crown status (p<0.0001). Majority of the patients with good crown status had no plaque accumulation based on the PI scores (52.7%). Only 35% of the patients whose crown status was good were having BOP when compared with 65% who did not have any BOP recorded. Gingival color (pale pink and red) showed statistically significant association with crown type (porcelain fused to metal v/s all ceramic) (p=0.005). Most of patients with crown status good had no change in their radiographic findings (94%) compared to only 6% who had implant threads exposed (p<0.0001). Conclusion Optimal design of Implant prosthetic factors are vital for avoiding the development of peri-implant mucositis/peri-implantitis and must be considered during treatment planning while restoring dental implants.
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Affiliation(s)
- Reham N AlJasser
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed A AlSarhan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Dalal H Alotaibi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Saleh AlOraini
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdul Sadekh Ansari
- Dental University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Syed Rashid Habib
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah, 41311, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, 44000, Pakistan
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38
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Monje A, Pons R, Amerio E, Wang HL, Nart J. Resolution of peri-implantitis by means of implantoplasty as adjunct to surgical therapy: A retrospective study. J Periodontol 2021; 93:110-122. [PMID: 33904175 DOI: 10.1002/jper.21-0103] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/08/2021] [Accepted: 04/18/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is a paucity of data on the effectiveness of implantoplasty as adjunct to the surgical management of peri-implantitis. PURPOSE To evaluate the resolution of peri-implantitis by means of implantoplasty as adjunct to surgical resective (RES) and reconstructive (REC) therapies and supportive maintenance. METHODS Patients that underwent surgical therapy to manage peri-implantitis with a follow-up of ≥12 months and enrolled in a regular peri-implant supportive care were recruited. RES group consisted of two interventions that included osseous recontouring and apically position flap (APF) and soft tissue conditioning (STC). REC was performed in the infra-osseous compartment of combined defects. Implant survival rate was recorded. Clinical and radiographic parameters were evaluated to define a "dogmatic" (case definition #1) and a "flexible" (case definition #2) therapeutic success. Univariate and multivariate multilevel backward logistic regression were applied for statistical analysis. RESULTS Overall, 43 patients (nimplants = 135) were retrospectively assessed. Mean observational period was ∼24 months. Implant survival rate was 97.8%, being significantly higher for APF, STC, and APF + STC (RES) when compared with REC (P = 0.01) therapy, in particular for advanced lesions (>50% of bone loss). The overall therapeutic success rate at implant-level was 66% and 79.5% for case definition #1 and #2, respectively. APF group displayed more efficient disease resolution when considered success definition #1 (72%). Contrarily, when the data were adhered to success definition #2, STC group showed a slightly higher disease resolution rate (87%). For RES group, location, favoring anterior (P = 0.04) and defect type, favoring class II (P = 0.02) displayed statistical significance for therapeutic success. For REC group, implants exhibiting a wider band of keratinized mucosa (KM) demonstrated higher therapeutic success (P = 0.008). CONCLUSION Implantoplasty as an adjunct to surgical therapy proved effective in terms of disease resolution and implant survival rate. Implant location, defect morphology as well as the buccal width of KM are indicators of therapeutic success.
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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.,Private practice, Division of Periodontics, Centro de Implantología Cirugía Oral y Maxilofacial (CICOM), Badajoz, Spain
| | - Ramón Pons
- Department of Periodontology, Universidad Internacional de Catalunya, Barcelona, Spain
| | - Ettore Amerio
- Department of Periodontology, Universidad Internacional de Catalunya, Barcelona, Spain
| | - Hom-Lay Wang
- Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, MI
| | - José Nart
- Department of Periodontology, Universidad Internacional de Catalunya, Barcelona, Spain
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Kadkhodazadeh M, Amid R, Moscowchi A. Management of extensive peri-implant defects with titanium meshes. Oral Maxillofac Surg 2021; 25:561-568. [PMID: 33779869 DOI: 10.1007/s10006-021-00955-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/03/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Peri-implantitis is a biofilm-induced pathological condition, and different approaches have been proposed to manage this condition. This study introduces a surgical technique in accordance with the concept of guided bone regeneration for implants with extensive peri-implant defects. METHODS This pilot study was conducted on 7 patients with 11 implants (4 females and 3 males; 32 to 61 years). In this technique, we used a titanium mesh, a combination of autogenous bone, allogenic graft material, and acellular dermal matrix to reconstruct the peri-implant defects. All implants were placed submerged, and the second-stage surgery was conducted after 8 months. Soft tissue augmentation and vestibuloplasty were performed in the second-stage surgery, if required. RESULTS The mean function time of implants was 60.5 ± 29.4 months. The mean baseline probing pocket depth was 5.7 ± 1.4 mm, and soft tissue recession was observed at two sites (18%). The mean recession and keratinized tissue width (KTW) values were 0.4 ± 0.8 mm and 3 ± 1.6 mm, respectively. The mean marginal bone loss and bone gain were 4.4 ± 1.2 mm and 2.9 ± 0.9 mm, respectively, which showed a significant improvement. CONCLUSION Our preliminary evaluations showed favorable results in terms of radiographic defect fill and soft tissue condition. It appears that this technique may lead to promising outcomes in cautiously selected patients seeking to retain their failing implants. However, long-term results following functional loading are required before recommending this technique for daily practice.
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Affiliation(s)
- Mahdi Kadkhodazadeh
- Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd, Evin, Shahid Chamran Highway, 1983963113, Tehran, Iran
| | - Reza Amid
- Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd, Evin, Shahid Chamran Highway, 1983963113, Tehran, Iran
| | - Anahita Moscowchi
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd, Evin, Shahid Chamran Highway, 1983963113, Tehran, Iran.
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Vilarrasa J, Peña M, Gumbau L, Monje A, Nart J. Exploring the relationship among dental caries, nutritional habits, and peri-implantitis. J Periodontol 2021; 92:1306-1316. [PMID: 33599333 DOI: 10.1002/jper.20-0879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND A study was made of the prevalence, co-occurrence and association among caries, nutritional habits, and peri-implant disease, with an analysis of the influence of other patient and implant factors upon peri-implant disease. METHODS The included subjects underwent a clinical examination and were asked to complete a questionnaire. Demographic data and potential lifestyle/behavioral variables were collected. Clinical and radiographic assessment allowed calculation of the decayed, missing and filled teeth (DMFT) index and peri-implant diagnosis. Uni- and multivariate multinomial logistic regression analyses were applied to identify predictors of peri-implant disease. RESULTS A total of 169 patients with 311 implants were studied. At patient level, 92.2% of the subjects presented at least one carious lesion, whereas 22.5% and 56.2% were diagnosed with peri-implantitis and mucositis, respectively. Those patients with more than two caries had a higher risk of mucositis (OR = 3.33). Statistically significant associations for peri-implantitis included full mouth periodontal indexes, sugar-rich diets, keratinized mucosa width, number of missing teeth and interproximal untreated caries or fillings adjacent to implants. CONCLUSION High caries risk profiles and mucositis/peri-implantitis tended to accumulate within subjects. A sugar-enriched diet and untreated caries or fillings adjacent to implant sites may be further considered as risk indicators of peri-implantitis.
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Affiliation(s)
- Javi Vilarrasa
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Marta Peña
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Laura Gumbau
- Faculty of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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Urban IA, Ravidà A, Saleh MHA, Galli M, Lozada J, Farkasdi S, Wang HL. Long-term crestal bone changes in implants placed in augmented sinuses with minimal or moderate remaining alveolar bone: A 10-year retrospective case-series study. Clin Oral Implants Res 2020; 32:60-74. [PMID: 33222302 DOI: 10.1111/clr.13680] [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: 05/26/2020] [Revised: 09/13/2020] [Accepted: 10/20/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To evaluate long-term clinical and radiographic outcomes of dental implants placed after lateral window sinus augmentation utilizing the sagittal sandwich technique. MATERIALS AND METHODS Patients treated with sinus augmentation were included in this retrospective case-series study. The surgical procedure was performed with particulate autogenous bone- and anorganic bovine bone-derived mineral (3:7 ratio). Implants were grouped based on baseline residual alveolar ridge height: group S (residual alveolar ridge height of 0.1-3.5 mm), group M (height of 3.5-7mm), and group C (native bone). Radiographs were taken at baseline (abutment installation) and annually throughout the 10-year follow-up. RESULTS A total of 86 patients (92 sinus lifts) and 209 implants were included. Ten sinus membrane perforations were recorded (11% incidence), and graft infections occurred in 3 cases (3.2% incidence). During the 10-year follow-up, 3 implants (1.4%) failed. No significant differences in the mean implant marginal bone loss (MBL) between the three groups were found after 1-, 2-, and 5-year follow-up (p > .05). At 10 years, group C exhibited more MBL than group M with a mean difference of -0.53 mm (p = .01). After 10 years, MK III implants displayed significantly more bone loss in native bone than those in augmented bone with a mean difference of 0.48 mm (p = .02). Five patients and 7 implants developed peri-implantitis with no significant differences between the groups (p = .570). CONCLUSION Implant placement after two-stage sinus grafting utilizing the sagittal sandwich technique is a relatively safe and predictable procedure with minimal complications and MBL after 10-year follow-up.
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Affiliation(s)
- Istvan A Urban
- Graduate Implant Dentistry, Loma Linda University, Loma Linda, CA, USA.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Periodontics, University of Szeged, Szeged, Hungary.,Urban Regeneration Institute, Budapest, Hungary
| | - Andrea Ravidà
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Periodontics, University of Louisville School of Dentistry, Louisville, KY, USA
| | - Matthew Galli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Jaime Lozada
- Graduate Implant Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - Sandor Farkasdi
- Department of Oral Biology, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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Rocca JP, Fornaini C, Zhang Y, Zhen Y, Merigo E. Laser Multi-Wavelength Approach for the Treatment of Peri-Implantitis: A Case Report. J ORAL IMPLANTOL 2020; 46:614-618. [PMID: 32658974 DOI: 10.1563/aaid-joi-d-19-00231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Jean-Paul Rocca
- Micoralis Research Laboratory, UFR Odontologie, University of Nice Côte d'Azur, Nice, France.,Department of Stomatology, 2nd Hospital Shijiazhuang, Shijiazhuang, China
| | - Carlo Fornaini
- Micoralis Research Laboratory, UFR Odontologie, University of Nice Côte d'Azur, Nice, France.,Department of Stomatology, 2nd Hospital Shijiazhuang, Shijiazhuang, China.,GAEM, Group of Applied ElectroMagnetics, Department of Engineering and Architecture, University of Parma, Parma, Italy
| | - Yong Zhang
- Department of Stomatology, 2nd Hospital Shijiazhuang, Shijiazhuang, China
| | - Yinghua Zhen
- Department of Stomatology, 2nd Hospital Shijiazhuang, Shijiazhuang, China
| | - Elisabetta Merigo
- Micoralis Research Laboratory, UFR Odontologie, University of Nice Côte d'Azur, Nice, France.,Department of Stomatology, 2nd Hospital Shijiazhuang, Shijiazhuang, China
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Ustaoğlu G, Erdal E. Relationship between risk markers for cardiovascular disease and peri-implant diseases. Int J Implant Dent 2020; 6:73. [PMID: 33236168 PMCID: PMC7686405 DOI: 10.1186/s40729-020-00273-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023] Open
Abstract
Background The aim of this paper is to explore the serum biochemical parameters also known as risk markers for cardiovascular system, in individuals who have received dental implant treatment, and to reveal risk factors for peri-implant diseases. Methods The study included 58 subjects with peri-implantitis, 49 subjects with peri-implant mucositis, and 49 healthy subjects. All the subjects were assessed in terms of both peri-implant clinical parameters—probing depth (PD), bleeding on probing (BOP), the type of prosthesis, gingival index (GI), keratinized mucosa width (KMW), and plaque index (PI)—and serum biochemical parameters (e.g., LDL cholesterol, HDL cholesterol, triglyceride, total cholesterol, vitamin D, uric acid, white blood cell (WBC), neutrophil, hemoglobin (Hb), and platelet counts). Results KMW was the lowest in the peri-implantitis group. Compared with the other groups, the peri-implantitis group showed significantly higher levels of triglyceride, uric acid, and WBC. The peri-implantitis group had the lowest level of vitamin D. Triglyceride and uric acid levels had positive correlations with peri-implant clinical parameters. Conclusion High levels of triglyceride and uric acid may pose a risk for both peri-implant diseases and cardiovascular diseases. Prior to dental implant surgery, patients’ serum biochemical parameters should be checked.
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Affiliation(s)
- Gülbahar Ustaoğlu
- Dentistry Faculty, Department of Periodontology, Bolu Abant İzzet Baysal University, 14300, Bolu, Turkey.
| | - Emrah Erdal
- Medical Faculty, Department of Cardiology, Bolu Abant İzzet Baysal University, Bolu, Turkey
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Ghensi P, Manghi P, Zolfo M, Armanini F, Pasolli E, Bolzan M, Bertelle A, Dell'Acqua F, Dellasega E, Waldner R, Tessarolo F, Tomasi C, Segata N. Strong oral plaque microbiome signatures for dental implant diseases identified by strain-resolution metagenomics. NPJ Biofilms Microbiomes 2020; 6:47. [PMID: 33127901 PMCID: PMC7603341 DOI: 10.1038/s41522-020-00155-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 10/02/2020] [Indexed: 12/11/2022] Open
Abstract
Dental implants are installed in an increasing number of patients. Mucositis and peri-implantitis are common microbial-biofilm-associated diseases affecting the tissues that surround the dental implant and are a major medical and socioeconomic burden. By metagenomic sequencing of the plaque microbiome in different peri-implant health and disease conditions (113 samples from 72 individuals), we found microbial signatures for peri-implantitis and mucositis and defined the peri-implantitis-related complex (PiRC) composed by the 7 most discriminative bacteria. The peri-implantitis microbiome is site specific as contralateral healthy sites resembled more the microbiome of healthy implants, while mucositis was specifically enriched for Fusobacterium nucleatum acting as a keystone colonizer. Microbiome-based machine learning showed high diagnostic and prognostic power for peri-implant diseases and strain-level profiling identified a previously uncharacterized subspecies of F. nucleatum to be particularly associated with disease. Altogether, we associated the plaque microbiome with peri-implant diseases and identified microbial signatures of disease severity.
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Affiliation(s)
- Paolo Ghensi
- Department CIBIO, University of Trento, Trento, Italy
| | - Paolo Manghi
- Department CIBIO, University of Trento, Trento, Italy
| | - Moreno Zolfo
- Department CIBIO, University of Trento, Trento, Italy
| | | | | | - Mattia Bolzan
- Department CIBIO, University of Trento, Trento, Italy.,PreBiomics S.r.l., Trento, Italy
| | | | | | | | | | - Francesco Tessarolo
- Department of Industrial Engineering, University of Trento, Trento, Italy.,Healthcare Research and Innovation Program (IRCS-FBK-PAT), Bruno Kessler Foundation, Trento, Italy
| | - Cristiano Tomasi
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nicola Segata
- Department CIBIO, University of Trento, Trento, Italy.
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Gargallo-Albiol J, Tavelli L, Barootchi S, Monje A, Wang HL. Clinical sequelae and patients' perception of dental implant removal: A cross-sectional study. J Periodontol 2020; 92:823-832. [PMID: 32997346 DOI: 10.1002/jper.20-0259] [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: 05/07/2020] [Revised: 08/18/2020] [Accepted: 08/26/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND A cross-sectional study was designed to shed light on the clinical sequelae and patient satisfaction after dental implant removal (IR). METHODS Patients undergoing ≥1 IRs were eligible. The reasons for implant failure, clinical and radiological parameters before and after IR, and the surgical and prosthetic treatments offered after IR was assessed. Patient satisfaction was recorded and the Oral Health Impact Profile (OHIP)-14 was used to document patient self-reported dysfunction and discomfort attributed to IR. Lastly, patient expectations after IR were also evaluated. RESULTS Thirty-one patients with 45 implants were analyzed. Peri-implantitis was the main reason for IR (64.5%). The average implant survival time before IR was 120.3 ± 88.2 months. Signs of infection (51.7%) and bleeding on probing (37.5%) were common signs detected at the time of IR. Guided bone regeneration was the intervention most commonly applied simultaneously to IR (74.1%). The reported degree of satisfaction was high, and the overall OHIP-14 score was low. However, a certain patient reluctance to undergo future implant placement in the same clinic or with the same professional was recorded, and a statistically significant increase in adherence to the implant maintenance routine was observed after IR. CONCLUSIONS Peri-implantitis is the leading cause for IR. Guided bone regeneration is commonly applied to attenuate the clinical sequelae of IR. Nonetheless, IR does not seem to affect patients' satisfaction nor their quality of life, though a certain patient reluctance to undergo future implant placement in the same clinic or with the same professional was reported.
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Affiliation(s)
- Jordi Gargallo-Albiol
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Lorenzo Tavelli
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Alberto Monje
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.,Department of Periodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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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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Polymeri A, Anssari-Moin D, van der Horst J, Wismeijer D, Laine ML, Loos BG. Surgical treatment of peri-implantitis defects with two different xenograft granules: A randomized clinical pilot study. Clin Oral Implants Res 2020; 31:1047-1060. [PMID: 32803798 PMCID: PMC7693249 DOI: 10.1111/clr.13651] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 06/03/2020] [Accepted: 08/10/2020] [Indexed: 12/24/2022]
Abstract
Objectives To investigate whether xenograft EB (EndoBon) is non‐inferior to xenograft BO (Bio‐Oss) when used in reconstructive surgery of peri‐implant osseous defects. Materials and methods Dental patients with one implant each demonstrating peri‐implantitis were randomized to receive surgical debridement and defect fill with either BO or EB. Changes in bone level (BL) and intrabony defect depth (IDD) evaluated radiographically were the primary outcomes. The secondary outcomes included changes in probing pocket depth (PPD), bleeding on probing (BoP), and suppuration on probing (SoP). All outcomes were recorded before treatment and at 6 and 12 months post‐treatment. Results Twenty‐four patients (n = 11 BO, n = 13 EB) completed the study. Both groups demonstrated significant within‐group improvements in all clinical and radiographic parameters at 6 and 12 months (p ≤ .001). At 12 months, both groups presented with IDD reductions of 2.5–3.0 mm on average. The inter‐group differences were not statistically significant at all time points and for all the examined parameters (p > .05). While the radiographic defect fill in both groups exceeded > 1 mm and can be considered treatment success, successful treatment outcomes as defined by Consensus Reporting (no further bone loss, PPD ≤ 5 mm, no BOP, and no SoP) were identified in 2/11 (18%) BO and 0/13 (0%) EB individuals (Fisher's exact test, p = .199). Conclusions Within the limitations of this pilot study, the application of xenograft EB showed to be non‐inferior to xenograft BO when used in reconstructive surgery of peri‐implant osseous defects.
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Affiliation(s)
- Angeliki Polymeri
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - David Anssari-Moin
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Joyce van der Horst
- Department Oral Implantology and Prosthodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Daniel Wismeijer
- Department Oral Implantology and Prosthodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Marja L Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
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Rokaya D, Srimaneepong V, Wisitrasameewon W, Humagain M, Thunyakitpisal P. Peri-implantitis Update: Risk Indicators, Diagnosis, and Treatment. Eur J Dent 2020; 14:672-682. [PMID: 32882741 PMCID: PMC7536094 DOI: 10.1055/s-0040-1715779] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Despite the success rates of dental implants, peri-implantitis presents as the most common complication in implant dentistry. This review discusses various factors associated with peri-implantitis and various available treatments, highlighting their advantages and disadvantages. Relevant articles on peri-implantitis published in English were reviewed from August 2010 to April 2020 in MEDLINE/PubMed, Scopus, and ScienceDirect. The identified risk indicators of peri-implant diseases are plaque, smoking, history of periodontitis, surface roughness, residual cement, emergence angle >30 degrees, radiation therapy, keratinized tissue width, and function time of the implant, sex, and diabetes. Peri-implantitis treatments can be divided into nonsurgical (mechanical, antiseptic, and antibiotics), surface decontamination (chemical and laser), and surgical (air powder abrasive, resective, and regenerative). However, mechanical debridement alone may fail to eliminate the causative bacteria, and this treatment should be combined with other treatments (antiseptics and surgical treatment). Surface decontamination using chemical agents may be used as an adjuvant treatment; however, the definitive clinical benefit is yet not proven. Laser treatment may result in a short-term decrease in periodontal pocket depth, while air powder abrasive is effective in cleaning a previously contaminated implant surface. Surgical elimination of a pocket, bone recontouring and plaque control are also effective for treating peri-implantitis. The current evidence indicates that regenerative approaches to treat peri-implant defects are unpredictable.
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Affiliation(s)
- Dinesh Rokaya
- International College of Dentistry, Walailak University, Bangkok, Thailand.,Research Unit of Herbal Medicine, Biomaterials and Materials for Dental Treatment, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Viritpon Srimaneepong
- Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Wichaya Wisitrasameewon
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Manoj Humagain
- Department of Periodontics, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Pasutha Thunyakitpisal
- Research Unit of Herbal Medicine, Biomaterials and Materials for Dental Treatment, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Monje A, Vera M, Muñoz-Sanz A, Wang HL, Nart J. Suppuration as diagnostic criterium of peri-implantitis. J Periodontol 2020; 92:216-224. [PMID: 32729628 DOI: 10.1002/jper.20-0159] [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: 03/16/2020] [Revised: 05/17/2020] [Accepted: 05/19/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Suppuration (SUP) as a diagnostic parameter for monitoring dental implants is not yet well understood. The retrospective clinical and radiographic study was therefore performed to investigate the patient, implant, and site characteristics among individuals exhibiting SUP. METHODS Demographic characteristics and clinical parameters were recorded. Radiographic features were analyzed using cone-beam computed tomography. Peri-implantitis was defined based on the consensus report of Workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions: probing depth (PD) ≥6 mm, presence of bleeding and/or SUP on gentle probing, and radiographic marginal bone loss (MBL) ≥3 mm. SUP was graded according to profuseness (dot versus line/drop) and time after probing (≥15 seconds versus <15 seconds after probing versus spontaneous). Simple binary logistic regression models were estimated using generalized estimation equations to explain the probability of SUP based on demographic, clinical, and radiographic variables. RESULTS A total of 111 eligible patients (nimplants = 501) were assessed. Of them, 57 (nimplants = 334) were diagnosed with peri-implantitis according to the established case definition, and of these individuals, 31 (nimplants = 96) presented SUP. Therefore, the prevalence of SUP was 27.92% in the total sample size and 54.38% in peri-implantitis patients. Overall, 28.74% implants displayed SUP within patients with peri-implantitis. SUP was more frequently found at buccal sites (51%) and proved less prevalent at mesio-lingual sites (16.7%). Defect morphology (OR = 6.59; P = 0.004), PD (OR = 1.63; P = 0.024), and MBL (OR = 1.35; P = 0.010) were significantly associated with the presence of SUP. Likewise, defect morphology (P = 0.02), PD (P = 0.003), and MBL (P = 0.01) were significantly correlated with the grade of SUP. CONCLUSION The presence and grade of SUP are associated with peri-implant bone loss, probing depth, and defect morphology in patients with peri-implantitis.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Maria Vera
- Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Agustín Muñoz-Sanz
- Division of Infectious Diseases, Department of Biomedical Sciences, Universidad de Extremadura, Badajoz, Spain
| | - Hom-Lay Wang
- Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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Wang X, Jiang M, He X, Zhang B, Peng W, Guo L. N‑acetyl cysteine inhibits the lipopolysaccharide‑induced inflammatory response in bone marrow mesenchymal stem cells by suppressing the TXNIP/NLRP3/IL‑1β signaling pathway. Mol Med Rep 2020; 22:3299-3306. [PMID: 32945495 PMCID: PMC7453581 DOI: 10.3892/mmr.2020.11433] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 07/22/2020] [Indexed: 12/14/2022] Open
Abstract
N-acetyl cysteine (NAC) has been used to inhibit lipopolysaccharide (LPS)-induced inflammation. However, the molecular mechanism underlying its anti-inflammatory effects remains to be elucidated. The present study aimed to determine the effect of NAC on the LPS-induced inflammatory response in bone marrow mesenchymal stem cells (BMSCs) and elucidate the underlying molecular mechanism. First, BMSCs were stimulated by LPS following pretreatment with NAC (0, 0.1, 0.5, 1 or 2 mM). A Cell Counting Kit 8 assay was used to determine the number of viable cells and 1 mM NAC was selected as the experimental concentration. Then, the secretion of inflammatory factors, including interleukin (IL)-1β, IL-6 and tumor necrosis factor-α was evaluated by enzyme-linked immunosorbent assay. Finally, the expression levels of mRNA and proteins, including apoptosis-associated speck-like protein containing a CARD (ASC), nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3), caspase-1, thioredoxin-interacting protein (TXNIP), and thioredoxin (TRX), were evaluated by reverse transcription-quantitative PCR and western blot analysis, respectively. The results demonstrated that the secretion of inflammatory factors, which was increased by the administration of LPS, was reduced by pretreatment with NAC. Furthermore, NAC reduced the expression of ASC, NLRP3, caspase-1 and TXNIP, but enhanced that of TRX. To conclude, NAC had anti-inflammatory effects on LPS-stimulated BMSCs, which was closely associated with the TXNIP/NLRP3/IL-1β signaling pathway. Thus, NAC may be a promising treatment to attenuate the inflammatory response in LPS-induced BMSCs.
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Affiliation(s)
- Xuemei Wang
- Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Mengyi Jiang
- Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Xiaoping He
- Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Bo Zhang
- Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Wei Peng
- Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Ling Guo
- Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
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