RESUMO
Dental implants sometimes need bone augmentation to recreate an adequate bone height and volume. Numerous bone augmentation techniques have been described, and, currently, the most commonly used bone graft procedure is xenografts with deproteinized bovine bone mineral (DBBM). The addition of platelet-rich fibrin (PRF) to DBBM has already shown better performance than DBBM alone in restoring intrabony periodontal defects, but the role of PRF in preimplantation bone grafts is still not clear. The objective of this systematic review was to evaluate the efficacy of the adjunction of PRF or L-PRF to DBBM in bone ridge augmentation procedures. Clinical randomized controlled studies using PRF associated with DBBM were included. In April 2023, three electronic databases (PubMed, Cochrane, and Web of Science) were searched. The search strategy was performed according to PRISMA guidelines. The risk of bias assessments were performed using the Cochrane Collaboration tool. A total of seven articles were included and analyzed. The results show no statistically significant effect of PRF added to DBBM compared to DBBM alone in the sinus lift procedure but do show an effect in the reduction in bone graft resorption in one study of mandibular guided bone regeneration.
RESUMO
The 5- and 10-year implant success rates in dentistry are nearly 90%. Prevalence of peri-implant diseases is 10% for peri-implantitis and 50% for peri-implant mucositis. To better understand these inflammatory pathologies of infectious origin, it is important to know if the composition of the peri-implant microbiota is comparable with the periodontal microbiota in healthy and pathological conditions. New generation sequencing (NGS) is a recent metagenomic method that analyzes the overall microorganisms present in an ecological niche by exploiting their genome. These methods are of two types: 16S rRNA sequencing and the shotgun technique. For several years, they have been used to explore the oral, periodontal, and, more specifically, peri-implant microbiota. The aim of this systematic review is to analyze the recent results of these new explorations by comparing the periodontal and peri-implant microbiota in patients with healthy and diseased sites and to explore the microbiological characteristics of peri-implantitis. A better knowledge of the composition of the peri-implant microbiota would enable us to optimize our therapeutic strategies. An electronic systematic search was performed using the medical databases PubMed/Medline, Cochrane Library, and ScienceDirect, and Periodontology 2000. The selected articles were published between January 2015 and March 2021. Inclusion criteria included clinical studies comparing healthy and pathological periodontal and peri-implant microbiota exclusively using 16S rRNA sequencing or shotgun sequencing, with enrolled populations free of systemic pathology, and studies without substantial bias. Eight articles were selected and reviewed. All of them used 16S rRNA sequencing exclusively. The assessment of these articles demonstrates the specific character of the peri-implant microbiota in comparison with the periodontal microbiota in healthy and pathological conditions. Indeed, peri-implant diseases are defined by dysbiotic bacterial communities that vary from one individual to another, including known periodontopathogens such as Porphyromonas gingivalis (P.g.) and genera less mentioned in the periodontal disease pattern such as Filifactor alocis. Examination of peri-implant microbiota with 16S rRNA sequencing reveals differences between the periodontal and peri-implant microbiota under healthy and pathological conditions in terms of diversity and composition. The pattern of dysbiotic drift is preserved in periodontal and peri-implant diseases, but when comparing the different types of pathological sites, the peri-implant microbiota has a specificity in the presence of bacteria proper to peri-implantitis and different relative proportions of the microorganisms present.