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Shiba T, Komatsu K, Watanabe T, Takeuchi Y, Nemoto T, Ohsugi Y, Katagiri S, Shimogishi M, Marukawa E, Iwata T. Peri-implantitis management by resective surgery combined with implantoplasty and Er:YAG laser irradiation, accompanied by free gingival graft: a case report. Ther Adv Chronic Dis 2023; 14:20406223231174816. [PMID: 37324409 PMCID: PMC10265339 DOI: 10.1177/20406223231174816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 04/24/2023] [Indexed: 06/17/2023] Open
Abstract
The optimal method for decontamination of implant surfaces for peri-implantitis treatment remains controversial. In recent years, erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiation and implantoplasty (IP) (i.e. mechanical modification of the implant) have been reported to be effective in decontaminating implant surfaces during the surgical treatment. Also, a lack of adequate keratinized mucosa (KM) around the implant is known to be associated with more plaque accumulation, tissue inflammation, attachment loss, and mucosal recession, increasing the risk of peri-implantitis. Therefore, free gingival graft (FGG) has been recommended for gaining adequate KM around the implant. However, the necessity of acquiring KM for the treatment of peri-implantitis using FGG remains unclear. In this report, we applied the apically positioned flap (APF) as resective surgery for peri-implantitis treatment in conjunction with IP and Er:YAG laser irradiation to polish/clean the implant surface. Furthermore, FGG was conducted simultaneously to create additional KM, which increased the tissue stability and contributed to the positive results. The two patients were 64 and 63 years old with a history of periodontitis. The removal of granulation tissue and debridement of contaminated implant surfaces were performed with Er:YAG laser irradiation post flap elevation and then modified smooth surfaces mechanically using IP. Er:YAG laser irradiation was also utilized to remove the titanium particles. In addition, we performed FGG to increase the width of KM as a vestibuloplasty. Peri-implant tissue inflammation and progressive bone resorption were not observed, and both patients maintained good oral hygiene conditions until the 1-year follow-up appointment. Bacterial analysis via high-throughput sequencing revealed proportional decreases in bacteria associated with periodontitis (Porphyromonas, Treponema, and Fusobacterium). To the best of our knowledge, this study is the first to describe peri-implantitis management and bacterial change before and after procedures by resective surgery combined with IP and Er:YAG laser irradiation for peri-implantitis treatment, accompanied by FGG for increasing KM around the implants.
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Affiliation(s)
- Takahiko Shiba
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku 1138510, Tokyo, Japan
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Keiji Komatsu
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Takayasu Watanabe
- Department of Chemistry, Nihon University School of Dentistry, Chiyoda-ku, Japan
| | - Yasuo Takeuchi
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Bunkyo-ku 1138510, Tokyo, Japan
| | - Takashi Nemoto
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Masahiro Shimogishi
- Department of Regenerative and Reconstructive Dentistry, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Eriko Marukawa
- Department of Regenerative and Reconstructive Dentistry, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
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Balázs Á, Winkler B, Kristóf K, Harsányi L, Bokor L. [Relationship of consequences of anastomotic insufficiency and bacterial flora of oral cavity in patients with esophageal and cardia cancer]. Orv Hetil 2017; 158:25-30. [PMID: 28067081 DOI: 10.1556/650.2017.30632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION In the course of anastomotic insufficiency following resection of esophageal cancers the bacterial compound of the esophageal substance has a remarkable, presumable role in the outcome of complications. AIM The purpose of this study is to compare the consequences of the anastomotic leak with the bacterial flora of patients' oral cavity. METHOD In this prospective study a total of 131 patients were investigated directly before the surgical intervention taking a bacterial sample. Bacterial flora of patients' oral cavity was analysed; and the correlation between the consequences of the anastomotic leak and the content of the bacterial flora was examined. RESULTS Pathogenic bacteria in the oral microflora in 50 cases (38.2%) was found. Statistically significant, moderate correlation was found between the severity of the complication and the incidence of pathogenic bacteria (rs = 0.553; p≤0.05). CONCLUSIONS Pathogenic agent in the microbial flora might induce higher risk and more severe outcome in case of anastomotic leakage and it might be evaluated as a determinative factor. Consideration of the bacterial flora of the oral cavity requires more attention in the preoperative preparation than before and it demands the change of the current practice. Orv. Hetil., 2017, 158(1), 25-30.
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Affiliation(s)
- Ákos Balázs
- Általános Orvostudományi Kar, I. Sebészeti Klinika, Semmelweis Egyetem Budapest, Üllői út 78., 1082
| | - Beáta Winkler
- Általános Orvostudományi Kar, Tudományos Diákkör, Semmelweis Egyetem Budapest
| | - Katalin Kristóf
- Klinikai Mikrobiológiai, Diagnosztikai Laboratórium, Laboratóriumi Medicina Intézet Budapest
| | - László Harsányi
- Általános Orvostudományi Kar, I. Sebészeti Klinika, Semmelweis Egyetem Budapest, Üllői út 78., 1082
| | - Lívia Bokor
- Általános Orvostudományi Kar, I. Sebészeti Klinika, Semmelweis Egyetem Budapest, Üllői út 78., 1082
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Patyi M, Sejben I, Cserni G, Sántha B, Gaál Z, Pongrácz J, Oberna F. Retrospective health-care associated infection surveillance in oral and maxillofacial reconstructive microsurgery. Acta Microbiol Immunol Hung 2014; 61:407-16. [PMID: 25361526 DOI: 10.1556/amicr.61.2014.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
In polymorbid or anaemic patients who receive preoperative radiotherapy or undergo long duration surgery involving potentially infectious sites, perioperative antibiotic prophylaxis (PAP) that is effective against normal oral bacterial flora is mandatory and plays an important role in preventing postoperative infection. In a four-year retrospective analysis, the incidence, outcome, and the efficacy of PAP were evaluated in patients treated at the Department of Oral and Maxillofacial Surgery and Otorhinolaryngology at Kecskemét Hospital. The results were compared with data from the literature to determine if the use of PAP was adequate at the Department.During the study period (between 01/09/2007 and 31/01/2011) 108 patients were evaluated. The mean duration of prophylactic antibiotic treatment was 8.3 ± 5.2 days, with cefotaxime+metronidazole being the most commonly used combination. Surgical site infection occurred in 8 patients (7.5%) in the clean-contaminated category.Our results showed that the perioperative antibiotic prophylaxis administered at our Department was efficient and effective against the oral bacterial flora of patients. Its use is recommended in head and neck microsurgery. To avoid development of antibiotic resistance and to reduce costs, it seems that the duration of antibiotic regimen for primary surgery can be reduced from 8.3 ± 5.2 days to 3 days.
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Affiliation(s)
- Márta Patyi
- 1 Bács-Kiskun County Teaching Hospital Department of Hospital Hygiene Kecskemét Hungary
| | - István Sejben
- 2 Bács-Kiskun County Teaching Hospital Department of Pathology Kecskemét Hungary
| | - Gábor Cserni
- 2 Bács-Kiskun County Teaching Hospital Department of Pathology Kecskemét Hungary
| | - Beáta Sántha
- 3 Bács-Kiskun County Teaching Hospital Department of Oral and Maxillofacial Surgery and Otorhinolaryngology Kecskemét Hungary
| | - Zoltán Gaál
- 4 Bács-Kiskun County Teaching Hospital Central Intensive Care Unit Kecskemét Hungary
| | - Júlia Pongrácz
- 5 Semmelweis University Clinical Microbiology Diagnostic Laboratory, Institute of Laboratory Medicine Budapest Hungary
| | - Ferenc Oberna
- 3 Bács-Kiskun County Teaching Hospital Department of Oral and Maxillofacial Surgery and Otorhinolaryngology Kecskemét Hungary
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