Radiographic bone level around particular laser-treated dental implants: 1 to 6 years multicenter retrospective study.

PURPOSE: The aim of the present retrospective study was to evaluate clinical and radiological outcomes, in terms of implant survival rate, marginal bone loss, and peri-implantitis incidence, of a titanium implants with an innovative laser-treated surface. MATERIALS AND METHODS: A total of 502 dental implants were inserted in four dental practices (Udine, Arezzo, Frascati, Roma) between 2008 and 2013. All inserted implants had laser-modified surface characterized by a series of 20-µm-diameter holes (7-10 µm deep) every 10 µm (Synthegra®, Geass srl, Italy). The minimum follow-up period was set at 1 year after the final restoration. Radiographs were taken after implant insertion (T0), at time of loading (T1), and during the follow-up period (last recall, T2). Marginal bone loss and peri-implant disease incidence were recorded. RESULTS: A total of 502 implants with a maximum follow-up period of 6 years were monitored. The mean differential between T0 and T2 was 0.05 ± 1.08 mm at the mesial aspect and 0.08 ± 1.11 mm at the distal with a mean follow-up period of 35.76 ± 18.05 months. After being in function for 1 to 6 years, implants reported varying behavior: 8.8% of sites did not show any radiographic changes and 38.5% of sites showed bone resorption. The bone appeared to have been growing coronally in 50.7% of the sites measured. CONCLUSION: Implants showed a maintenance of marginal bone levels over time, and in many cases, it seems that laser-modified implant surface could promote a bone growth. The low peri-implant disease incidence recorded could be attributed to the laser titanium surface features that seem to prevent bacterial colonization. Future randomized and controlled studies are needed to confirm the results of the present multi-centrical retrospective analysis.

Clinical outcomes of experimental gingivitis and peri-implant mucositis treatment with professionally administered plaque removal and photodynamic therapy.

AIM: To comparatively evaluate the outcomes of professionally administered plaque removal (PAPR) and photodynamic therapy (PDT) in the treatment for experimentally induced gingivitis (G) and peri-implant mucositis (p-iM). MATERIALS AND METHODS: Twenty systemically healthy patients, each contributing a single implant-supported unit in a posterior sextant and a tooth within the same quadrant, were selected. Patients underwent an experimental G and p-iM trial consisting of a 2-week period of undisturbed plaque accumulation and a 6-week resolution phase following treatment administration. Supragingival plaque levels, probing depth (PD) and bleeding on probing (BoP) were recorded at experimental tooth and implant either before or 2 and 6 weeks after administration of PAPR+PDT. RESULTS: The results of the study indicate that (i) treatment with PAPR and PDT resulted in a significant reduction in the median number of BoP+ sites from 1 to 0 around teeth (P=.01) and from 3.5 to 2.0 around implants (P=.03), with the treatment effect being affected by initial PD; (ii) implants showed a significantly higher number of residual BoP+ sites following treatment, and the difference between implants and teeth was particularly pronounced (implants: 42%; teeth: 22%) at shallow (1-2 mm) sulci as observed at 6 weeks following treatment. CONCLUSIONS: G and p-iM can be effectively treated with PAPR+PDT. At shallow (1-2 mm) sulci, implants may show a higher number of residual bleeding sites when compared to teeth, and the number of residual bleeding sites following PAPR+PDT increases with increasing PD around either teeth or implants.

A novel non-surgical method for mild peri-implantitis- a multicenter consecutive case series.

AIM: The aim of the present study was to evaluate the effect on peri-implant mucosal inflammation from the use of a novel instrument made of chitosan in the non-surgical treatment of mild peri-implantitis across several clinical centers. MATERIALS AND METHODS: In this 6-month multicenter prospective consecutive case series performed in six different periodontal specialist clinics, 63 implants in 63 patients were finally included. The subjects had mild peri-implantitis defined as radiographic bone loss of 1-2 mm, pocket probing depth (PPD) ≥4 mm and a positive bleeding on probing (mBoP) score. The patients were clinically examined at baseline and after 2, 4, 12 and 24 weeks, and radiographs were taken at baseline and at 3 and 6 months. Treatment of the implants with the chitosan brush seated in an oscillating dental drill piece was performed at baseline and at 3 months. Reductions in the clinical parameters (PPD and mBoP) were compared between baseline and the later examination time points. RESULTS: Significant reductions in both PPD and mBoP were observed at all time points compared with the baseline clinical measurements (p < 0.001). The mean PPD and mBoP at baseline were 5.15 mm (4.97; 5.32) and 1.86 (1.78; 1.93), respectively, whereas the mean PPD and mBoP at 6 months were 4.0 mm (3.91; 4.19) and 0.64 (0.54; 0.75), respectively. Stable reductions in PPD and mBoP were evident up to 6 months after the initial treatment and 3 months after the second treatment. All 63 implants were reported to have stable radiographic levels of osseous support. CONCLUSIONS: This case series demonstrated that an oscillating chitosan brush is safe to use and seems to have merits in the non-surgical treatment of dental implants with mild peri-implantitis. To measure the effectiveness of the method, a multicenter randomized clinical trial needs to be undertaken.

Reconstruction of Peri-implant Osseous Defects: A Multicenter Randomized Trial.

There is a paucity of data for the effectiveness of reconstructive procedures in the treatment of peri-implantitis. The objective of this study was to compare reconstruction of peri-implant osseous defects with open flap debridement (OFD) plus porous titanium granules (PTGs) compared with OFD alone. Sixty-three patients (36 female, 27 male; mean age 58.4 y [SD 12.3]), contributing one circumferential peri-implant intraosseous defect, were included in a multinational, multicenter randomized trial using a parallel-group design. After OFD and surface decontamination using titanium brushes and hydrogen peroxide, 33 defects received PTGs. The implants were not submerged. All patients received adjunctive perioperative systemic antibiotics. The primary outcome variable (defect fill) was assessed on digitalized radiographs. Clinical measurements of probing depth (PPD), bleeding on probing (BoP), suppuration, and plaque were taken by blinded examiners. After 12 mo, the test group (OFD plus PTG) showed a mean radiographic defect fill (mesial/distal) of 3.6/3.6 mm compared with 1.1/1.0 in the control group (OFD). Differences were statistically significant in favor of the test group (P < 0.0001). The OFD plus PTG group showed a mean reduction in PPD of 2.8 mm compared with 2.6 mm in the OFD group. BoP was reduced from 89.4% to 33.3% and from 85.8% to 40.4% for the test and control groups, respectively. There was no significant difference in complete resolution of peri-implantitis (PPD ≤4 mm and no BoP at six implant sites and no further bone loss), because this finding was accomplished at 30% of implants in the test group and 23% of implants in the control group. Reconstructive surgery using PTGs resulted in significantly enhanced radiographic defect fill compared with OFD. However, limitations in the lack of ability to discern biomaterial from osseous tissue could not be verified to determine new bone formation. Similar improvements according to clinical measures were obtained after both surgical treatment modalities (ClinicalTrials.gov NCT02406001).

A preliminary comparison of the effect of 0.3% versus 0.2% chlorhexidine mouth rinse on de novo plaque formation: a monocentre randomized double-blind crossover trial.

OBJECTIVE: Chlorhexidine (CHX) is considered the gold standard against gram-negative microorganisms. Little has been written about the simultaneous influence that both time and concentration could have on antiplaque formation effectiveness of CHX. The aim of this study is to compare the clinical and microbiological effectiveness of two different CHX concentrations and time applications in a 4-day plaque regrowth study model. MATERIAL AND METHODS: Twenty volunteers were enrolled in a randomized double-blind crossover study comparing the effectiveness of CHX 0.3% and CHX 0.2% mouth rinses applied for 15 and 30 s, respectively. Plaque index (PII), total bacterial counts and the detection of specific periopathogens were measured at the 5th day of each mouth rinse application. Taste acceptance was evaluated using a questionnaire. RESULTS: Chlorhexidine 0.3% resulted in a statistically greater reductions (10%) in PIl and periopathogens compared to CHX 0.2%. Furthermore, patients reported comparable taste acceptance in both groups. CONCLUSION: Chlorhexidine is an effective oral antiseptic. The CHX 0.3% mouth rinse formulation used for 15 s resulted in superior clinical and microbiological outcomes compared to the CHX 0.2% formulation, used for 30 s.