Critical appraisal of YouTube videos regarding peri-implant diseases and conditions: A cross-sectional analysis

PURPOSE

To critically appraise the quality and reliability of YouTube videos regarding peri-implant diseases and conditions as a source of information for patients, students, and young clinicians.

MATERIALS AND METHODS

In March 2023, electronic searches were performed on YouTube website to identify videos related to peri-implant diseases and conditions. We considered only the relevant 250 English-language videos with durations between 3 and 30 min for final analyses. Following the eligibility criteria videos were evaluated for their demographic data, including number of views; number of likes, dislikes, and comments; days since upload; duration; and number of subscribers. Moreover, two assessors independently evaluated the quality and reliability of the included videos using the DISCERN and Video Information and Quality Index (VIQI) tools. Statistical analyses were performed using the Kruskal-Wallis test and Spearman correlation analysis (∝ = 0.05).

RESULTS

A total of 69 videos were included for profound analyses. The average DISCERN and VIQI scores were 35.04 ± 6.3 and 14.18 ± 2.46, with 53 videos categorized as "poor" quality using the DISCERN tool. A Spearman rank correlation analysis presented a strong agreement between the DISCERN and VIQI scores (r = .753; p < .001). Nevertheless, based on different sources of upload, no statistically significant differences were reported for video demographics, interaction index, and DISCERN and VIQI scores.

CONCLUSIONS

Although YouTube videos on peri-implant diseases and conditions present accurate preliminary information, their reliability still remains uncertain. Hence, we urge respective policymakers to recognize, endorse and produce high-quality videos for accurate information dissemination.

Prevalence of Peri-Implant Disease in Patients with Stage III or IV Periodontitis: Results of a Long-Term Follow-Up from a Specialized Periodontal Practice

The aim of this study was to examine the conditions of implants that had been in function for 5-17 years in stage III/IV periodontitis patients of a specialized periodontal practice. There were 83 patients (43 female/40 male, mean age 64.4 (9.69) years), with a total of 213 implants, who participated in the study. Assessments included periodontal and peri-implant probing depths, bleeding and plaque scores, and a radiographic examination. Smoking habits, participation in a supportive care program (SCP), and the Implant Disease Risk Assessment (IDRA) scores were recorded. A total of 44 patients presented with stage III periodontitis, and 39 with stage IV. In all, 85% of patients had adhered to regular SCP. On an implant/patient level, peri-implant health was found in 37.1.7% (79 implants)/24.1% (20 patients), peri-implant mucositis in 58.7% (125 implants)/66.3% (55 patients), and peri-implantitis in 4.2% (9 implants)/9.6% (8 patients). IDRA scores showed 30.5% of implants at moderate and 69.5% at high risk. The present long-term analysis shows a high prevalence of peri-implant disease in patients treated for advanced periodontitis. These findings underline the challenges involved in the long-term maintenance of oral health in stage III/IV periodontitis patients restored with dental implants.

Correlation between Accuracy in Computer-Guided Implantology and Peri-Implant Tissue Stability: A Prospective Clinical and Radiological Pilot Study

The present pilot study was designed by hypothesizing a possible correlation between lack of accuracy in implant placement and peri-implant hard and soft tissue health. A total of five patients underwent computer-guided implant surgery and full-arch immediate loading between 2013 and 2014. They subsequently underwent postoperative cone-beam computed tomography (CBCT). After a follow-up of 5 years, all patients were recalled for a clinical-radiographic evaluation of peri-implant health status. The mean linear deviation was 0.5 ± 0.2 mm at the implant's head and 0.6 ± 0.2 mm at the implant's apex, while the mean angular deviation of the long axis was 2.8° ± 1.2°. A mean marginal bone loss (MBL) of 1.16 ± 0.94 mm and 2.01 ± 1.76 mm was observed after 1 and 5 years of follow-up, respectively. At 5 years, the mean peri-implant probing depth (PPD) was 4.09 ± 1.44 mm, 66.6% of the evaluated implants showed peri-implant bleeding on probing (BOP), keratinized mucosa (KM) was <2 mm in 48.4% of cases, and mucosal recession (REC) ≥ 1 mm was assessed in 45.4% of the included implants. A negative correlation was observed between bucco-palatal/lingual linear inaccuracy and MBL, PPD, BOP, and KM.

Active MMP-8 as a Biomarker of Peri-implant Health or Disease

OBJECTIVES

 This study investigated the potential of testing for active matrix metalloproteinase-8 (aMMP-8) by a quantitative point-of-care (PoC), chairside, lateral flow immunotest as a biomarker for the presence or absence of peri-implant diseases.

MATERIALS AND METHODS

 Eighty healthy patients with implants were recruited. The samples were collected from peri-implant sulcular fluid and quantitatively analyzed for aMMP-8. Clinical indices, which included probing depth, clinical attachment loss, bleeding on probing, and plaque, were recorded and radiographic assessments were performed.

STATISTICAL ANALYSIS

 Comparisons of aMMP-8 levels and clinical parameters were analyzed by the Kruskal-Wallis test and the pairwise post hoc Dunn-Bonferroni test. A receiver operating curve analysis was used to analyze the diagnostic ability of aMMP-8 and the correlation between aMMP-8 and probing depth of the sampled site was sought by Spearman's rho and the coefficient of determination (R 2).

RESULTS

 Statistical analysis revealed statistically significant differences of aMMP-8 levels between the healthy and the mucositis and peri-implantitis groups, and between the mucositis and the peri-implantitis groups. Increasing probing depths of the sampled site and aMMP-8 levels were significantly correlated.

CONCLUSIONS

 These data suggest that the aMMP-8 PoC test can be a beneficial adjunctive tool for early identification and screening of the risk of peri-implant diseases and progression.

Surface Coatings of Dental Implants: A Review

Replacement of missing teeth is possible using biocompatible devices such as endosseous implants. This study aims to analyze and recognize the best characteristics of different implant surfaces that ensure good peri-implant tissue healing and thus clinical success over time. The present review was performed on the recent literature concerning endosseous implants made of titanium, a material most frequently used because of its mechanical, physical, and chemical characteristics. Thanks to its low bioactivity, titanium exhibits slow osseointegration. Implant surfaces are treated so that cells do not reject the surface as a foreign material and accept it as fully biocompatible. Analysis of different types of implant surface coatings was performed in order to identify ideal surfaces that improve osseointegration, epithelial attachment to the implant site, and overall peri-implant health. This study shows that the implant surface, with different adhesion, proliferation, and spreading capabilities of osteoblastic and epithelial cells, influences the cells involved in anchorage. Implant surfaces must have antibacterial capabilities to prevent peri-implant disease. Research still needs to improve implant material to minimize clinical failure.

Current Status of Peri-Implant Diseases: A Clinical Review for Evidence-Based Decision Making

BACKGROUND

the prevalence of peri-implant diseases is constantly growing, particularly with the increasing use of dental implants. As such, achieving healthy peri-implant tissues has become a key challenge in implant dentistry since it considers the optimal success paradigm. This narrative review aims to highlight the current concepts regarding the disease and summarize the available evidence on treatment approaches clarifying their indications for usage following the World Workshop on the Classification of Periodontal and Peri-implant Diseases (2017).

METHODS

we reviewed the recent literature and conducted a narrative synthesis of the available evidence on peri-implant diseases.

RESULTS

scientific evidence on case definitions, epidemiology, risk factors, microbiological profile, prevention, and treatment approaches for peri-implant diseases were summarized and reported.

CONCLUSIONS

although there are numerous protocols for managing peri-implant diseases, they are diverse and nonstandardized, with no consensus on the most effective, leading to treatment confusion.

Soft tissue contour changes at implant sites with or without soft tissue grafting in the esthetic zone: A retrospective case-control study with a 12-year follow-up

OBJECTIVES

To evaluate the volumetric changes and peri-implant health at implant sites with and without previous soft tissue grafting over a 12-year observation period.

MATERIALS AND METHODS

Eighteen patients received dental implants and simultaneously guided bone regeneration in the esthetic zone (15-25) for dental rehabilitation. Three months following implant placement, 8 patients (test) received an additional subepithelial connective tissue graft, whereas 10 patients (control) did not receive any additional treatment. One week after prothesis delivery and at the 5 and 12 years follow-up examination, impressions were taken. Obtained casts were processed for profilometric and linear analyses. The mean distance (MD) in the mid-buccal area between the two surfaces was considered the primary outcome. Peri-implant health was assessed based on clinical and radiographic data.

RESULTS

Nine female and 7 male patients were re-assessed after a median follow-up time of 144.5 months (Min: 114.8; Max: 213.0). The median reduction of MD amounted to -0.81 mm (Min: -1.39; Max: 0.52) in the test group and -0.56 mm (Min: -0.93; Max: 0.11) in the control group, (intergroup comparison p = .607, CI 95%: -0.760/0.530). None of the implants was diagnosed with peri-implantitis. Six tests and two control implants were diagnosed with peri-implant mucositis (p = .103).

CONCLUSIONS

Despite the limited number of included patients, similar results in terms of volumetric, linear changes, and peri-implant conditions could be detected at implant sites with or without soft tissue grafting over a period of 12 years.

Impact of Metformin on Periodontal and Peri-Implant Soft and Hard Tissue

Periodontal and peri-implant soft and hard tissue in diabetic patients have always been a topic of interest for researchers and clinicians alike. Among which, a subtopic that has attracted more attention is the beneficial effect of metformin (MF) on periodontal and peri-implant soft and hard tissue. This review aimed to assess the impact of MF on the periodontal and peri-implant soft- and hard-tissue healing among diabetic patients. Research was conducted using the keywords 'metformin', 'diabetes', 'periodontitis', 'implant', and 'peri-implantitis' via the Medline (PubMed) and Google Scholar databases. Selected articles were reviewed. A total of 21 articles, discussing the impact on periodontal health (six animal studies, seven clinical studies, and three systematic reviews) and five studies on peri-implant health (four animal studies and one clinical study) were included. All have reported a positive impact of MF on decreasing the inflammatory response, oxidative stress, and ultimate bone loss. Similarly, human studies reported a positive effect of MF on clinical and radiographic parameters compared with controls. Despite systematic reviews reporting heterogeneity among the included studies, MF has shown a positive impact on periodontal health. In animal, clinical studies, and systematic reviews, MF showed a protective impact on periodontal and peri-implant health.

Incidence of Peri-Implantitis and Relationship with Different Conditions: A Retrospective Study

Articles on the prevalence of peri-implant diseases showed that 90% of peri-implant tissues had some form of inflammatory response and a prevalence of peri-implantitis from 28% to 51% according to various publications. Objective: To provide an overview of how risk factors can be related with peri-implantitis. Methods: A retrospective longitudinal study including 555 implants placed in 132 patients was evaluated based on the presence of peri-implantitis following the criteria of Renvert et al. 2018. Results: In total, 21 patients (15.9%) suffered peri-implantitis (PPG) and 111 patients (84.1%) did not suffer peri-implantitis (NPG). The results reveal that smokers have a high incidence of peri-implantitis (72.7%) compared to non-smokers (27.3%) (p < 0.0005). Another variable with significant results (p < 0.01) was periodontitis: 50% PPG and 23.9% NPG suffered advanced periodontitis. Systemic diseases such as arterial hypertension, diabetes mellitus, osteoporosis, and cardiovascular diseases do not show a statistically significant influence on the incidence of peri-implantitis. Patients who did not attend their maintenance therapy appointment had an incidence of peri-implantitis of 61.4%, compared to 27.3% in those who attend (p < 0.0001). From the results obtained, we can conclude that relevant factors affect peri-implantitis, such as tobacco habits, moderate and severe periodontitis, and attendance in maintenance therapy.

It is all about peri-implant tissue health

Healthy peri-implant tissues have become synonymous with implant success and a major challenge in contemporary implant dentistry. Numerous local and systemic factors, as well as iatrogenic and other hitherto underappreciated factors of potential clinical relevance may influence the outcome of implant therapy. In this volume of Periodontology 2000, a group of outstanding experts has elaborated on the latest insights on the prevention and management of major surgical, biological and technical complications, to facilitate the establishment and maintenance of peri-implant health. This volume focusses on factors affecting early and late implant loss and the potential role of systemic diseases and local conditions. It comprehensively discusses the implementation of guided implant surgery to facilitate the cleansibility of implant-supported restorations, as well as iatrogenic factors related to bone augmentation/sinus grafting procedures. The challenges associated with soft-tissue grafting and the prevention of esthetic complications are also reviewed as the paradigm of success in implant dentistry shifts from implant survival towards a greater focus on patient-reported outcomes. Prosthetic failures remain a significant challenge and are discussed in light of new evidence, as is the relevance of the structural dimensions of the peri-implant mucosa. The volume closes with detailed and well-illustrated appraisals of the surgical management of peri-implantitis, the management and sequelae of dental implant removal, and the latest evidence for the oral health related quality of life in patients treated with dental implants.

Novel method to obtain human non-separated histological samples for the assessment of peri-implant soft tissue response: A feasibility study

OBJECTIVES

To introduce a standardized and less invasive clinical model that provides histological information on the abutment-mucosa interface in humans.

MATERIALS AND METHODS

New experimental healing abutments were left in an open healing position on bone-level implants in the interforaminal region of the mandibles in six edentulous patients. The one-piece abutments were hollow cylinder-shaped with two lateral openings that allow for ingrowth of the peri-implant mucosa into the central abutment cavity. After three months of healing, abutments and ingrown mucosa were sampled and processed for histological analysis in a non-separated resin-embedding technique. To test the validity of the new model, the ingrown tissue was compared to the peri-implant mucosa around the same samples.

RESULTS

None of the experimental abutments exhibited signs of failure, and all samples showed mucosal ingrowth to the inner-abutment cavity. Comparison of ingrown tissue and peri-implant mucosa revealed no significant differences regarding the traits: tissue morphology, quality of collagen fibers, and adherence to the abutment. Ingrown mucosa exhibited a tendency for higher leukocyte infiltration.

CONCLUSIONS

The presented model is a promising approach to reduce invasiveness during the sampling process for human non-separated abutment biopsies.

The effect of adjuvant oral irrigation on self-administered oral care in the management of peri-implant mucositis: A randomized controlled clinical trial

OBJECTIVES

This single-blinded randomized clinical trial evaluated the effect of adjuvant oral irrigation in addition to self-administered oral care on prevalence and severity of peri-implant mucositis.

MATERIAL & METHODS

After randomization, patients suffering from peri-implant mucositis were assigned to the following: Group 1 (control) received oral hygiene instruction following a standardized protocol, including a sub- and supramucosal mechanical debridement. Group 2 and 3 additionally were instructed to use an oral irrigator with either water or 0.06% CHX solution. One implant per patient was considered for examination. Clinical examinations included Probing Depth, Bleeding on Probing (BOP-positive sites), and Modified Plaque and Gingival Index. A surrogate variable (mucositis severity score) was applied measuring severity of disease. Statistical analysis included linear regression models and sensitivity analysis.

RESULTS

Sixty periodontally healthy patients were examined for presence and severity of peri-implant mucositis. 70% of all patients reached complete resolution of disease after 12 weeks. The prevalence of peri-implant mucositis after 12 weeks was 50% in group 1, 35% in group 2, and 5% in group 3. Average BOP-positive sites were reduced in all groups after 12 weeks (mean change from baseline: group 1: -1.5; group 2: -1.8; group 3: -2.3).

CONCLUSION

Within the limits of the study, adjuvant use of an oral irrigator with 0.06% CHX in addition to mechanical biofilm removal and oral hygiene instruction can reduce the presence and severity of peri-implant mucositis after 12 weeks.

Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations

The objective of this review is to identify case definitions and clinical criteria of peri-implant healthy tissues, peri-implant mucositis, and peri-implantitis. The case definitions were constructed based on a review of the evidence applicable for diagnostic considerations. In summary, the diagnostic definition of peri-implant health is based on the following criteria: 1) absence of peri-implant signs of soft tissue inflammation (redness, swelling, profuse bleeding on probing), and 2) the absence of further additional bone loss following initial healing. The diagnostic definition of peri-implant mucositis is based on following criteria: 1) presence of peri-implant signs of inflammation (redness, swelling, line or drop of bleeding within 30 seconds following probing), combined with 2) no additional bone loss following initial healing. The clinical definition of peri-implantitis is based on following criteria: 1) presence of peri-implant signs of inflammation, 2) radiographic evidence of bone loss following initial healing, and 3) increasing probing depth as compared to probing depth values collected after placement of the prosthetic reconstruction. In the absence of previous radiographs, radiographic bone level ≥3 mm in combination with BOP and probing depths ≥6 mm is indicative of peri-implantitis.

Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations

The objective of this review is to identify case definitions and clinical criteria of peri-implant healthy tissues, peri-implant mucositis, and peri-implantitis. The case definitions were constructed based on a review of the evidence applicable for diagnostic considerations. In summary, the diagnostic definition of peri-implant health is based on the following criteria: 1) absence of peri-implant signs of soft tissue inflammation (redness, swelling, profuse bleeding on probing), and 2) the absence of further additional bone loss following initial healing. The diagnostic definition of peri-implant mucositis is based on following criteria: 1) presence of peri-implant signs of inflammation (redness, swelling, line or drop of bleeding within 30 seconds following probing), combined with 2) no additional bone loss following initial healing. The clinical definition of peri-implantitis is based on following criteria: 1) presence of peri-implant signs of inflammation, 2) radiographic evidence of bone loss following initial healing, and 3) increasing probing depth as compared to probing depth values collected after placement of the prosthetic reconstruction. In the absence of previous radiographs, radiographic bone level ≥3 mm in combination with BOP and probing depths ≥6 mm is indicative of peri-implantitis.