Implant survival in the anterior mandible: A retrospective cohort study.

OBJECTIVE: This study aims to report the implant survival rate of dental implants of partially dentate patients in the anterior mandible and the potential risk indicators for implant failure. MATERIALS AND METHODS: Patients with implant-supported restorations of single or multiple teeth in the anterior mandible restored with fixed partial implant-supported restorations were evaluated. Patient demographic data, implant placement timing, and loading protocol, biological and/or technical complications at the time of the last clinical and radiographic follow-up visit were registered. Survival rate, success rate, and potential risk indicators for implant failure were calculated. RESULTS: A total of 108 patients and 186 implants with a mean follow-up period of 5.48 years (0.1-11.34 years) were included. The 11.3-year cumulative survival rate was 90.9%. Immediate implant placement (OR = 2.75) (p = .08) and immediate implant loading (OR = 8.8) (p = .02*) indicated a higher risk of failure than late implant placement or loading. When combining both categories (type 1A), an OR = 10.59 (p = .04*) for implant failure was found compared to category 4C. Implants placed following static-computer-assisted implant surgery (S-CAIS) showed less risk of failure compared to freehand implant placement (OR = 0.18; 95% CI: 0.02-1.37) (p = .09). CONCLUSIONS: The survival rate of implants placed in the anterior mandible was considerably low (90.9%). S-CAIS, late placement, and conventional loading are protective factor against implant failure in the anterior mandible.

Biofilm formation on dental implants with different surface micro-topography: An in vitro study.

OBJECTIVES: To compare biofilm formation on whole dental titanium implants with different surface micro-topography. METHODS: A multispecies in vitro biofilm model consisting of initial (Streptococcus oralis and Actinomyces naeslundii), early (Veillonella parvula), secondary (Fusobacterium nucleatum) and late colonizers (Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans) was grown for 96 hr on sterile titanium dental implants with either minimal (Sa : 0.5-1.0 mm) or moderate-roughness titanium surfaces (Sa : 1.1-2.0 mm). The resulting biofilms were studied with Confocal Laser Scanning Microscopy (CLSM) and Scanning Electron Microscope. Concentrations (colony-forming units per mL [CFU/ml]) of each bacterium were measured by quantitative Polymerase Chain Reaction (qPCR) and compared by Student t tests. RESULTS: A biofilm, located mainly at the peak and lateral areas of the implant threads, was observed on both implant surfaces, with a greater biomass and a greater live/dead ratio in moderate- compared to minimal-roughness surface implants. Statistically significant higher values of total bacteria (mean difference = 2.61 × 107  CFU/ml; 95% confidence interval - CI [1.91 × 106 ; 5.02 × 107 ]; p = 0.036), F. Nucleatum (mean difference = 4.43 × 106  CFU/ml; 95% CI [1.06 × 106 ; 7.80 × 106 ]; p = 0.013) and A. actinomycetemcomitans (mean difference = 2.55 × 107  CFU/ml; 95% CI [1.07 × 107 ; 4.04 × 107 ]; p = 0.002), were found in the moderate- compared to minimal-roughness surface dental implants. CONCLUSIONS: Implants with moderate-roughness surfaces accumulated more bacterial biomass and significant higher number of pathogenic bacteria (F. nucleatum and A. actinomycetemcomitans), when compared to implants with minimal-roughness surfaces, within a similar biofilm structure.

Effect of implantoplasty on fracture resistance and surface roughness of standard diameter dental implants.

OBJECTIVE: To assess the effect of implantoplasty on the fracture resistance, surface roughness, and macroscopic morphology of standard diameter (4.1 mm) external connection dental implants. MATERIALS AND METHODS: An in vitro study was conducted in 20 screw-shaped titanium dental implants with an external connection. In 10 implants, the threads and surface were removed and polished with high-speed burs (implantoplasty), while the remaining 10 implants were used as controls. The final implant dimensions were recorded. The newly polished surface quality was assessed by scanning electron microscopy (SEM) and by 3D surface roughness analysis using a confocal laser microscope. Finally, all the implants were subjected to a mechanical pressure resistance test. A descriptive analysis of the data was made. Also, Student's t tests were employed to detect differences regarding the compression tests. RESULTS: Implantoplasty was carried out for a mean time of 10 min and 48 s (standard deviation (SD) of 1 min 22 s). Macroscopically, the resulting surface had a smooth appearance, although small titanium shavings and silicon debris were present. The final surface roughness (Sa values 0.1 ± 0.02 µm) was significantly lower than that of the original (0.75 ± 0.08 µm Sa ) (p = .005). There was minimal reduction in the implant's inner body diameter (0.19 ± 0.03 mm), and no statistically significant differences were found between the test and control implants regarding the maximum resistance force (896 vs 880 N, respectively). CONCLUSIONS: Implantoplasty, although technically demanding and time-consuming, does not seem to significantly alter fracture resistance of standard diameter external connection implants. A smooth surface with Sa values below 0.1 µm can be obtained through the use of silicon polishers. A larger sample is required to confirm that implantoplasty does not significantly affect the maximum resistance force of standard diameter external connection implants.

Tratamiento periodontal no quirúrgico en pacientes con gingivitis y periodontitis moderada. Respuesta bioquímica y microbiológica / Non surgical periodontal treatment in patients with gingivitis and moderate periodontitis. Biochemical and microbiological response

Objetivo: Conocer la respuesta inflamatoria a través de la presencia de interleucina 1β e identificar microorganismos patógenos como posibles marcadores inmunológicos y microbiológicos en el diagnóstico y tratamiento periodontal no quirúrgico en sujetos con gingivitis y periodontitis crónica moderada en población mexicana. Material y métodos: En este estudio prospectivo de cohortes, se seleccionaron 18 pacientes con signos clínicos de gingivitis y 17 pacientes con periodontitis crónica moderada, se recolectaron las muestras de biopelícula subgingival y de fluido gingival crevicular. Se cuantificó la interleucina 1β durante las fases pretratamiento, postratamiento y de mantenimiento del tratamiento periodontal no quirúrgico. Resultados: Las variables de respuesta microbiológica mostraron que Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans disminuyeron significativamente en individuos con gingivitis. Así como Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans y Actinomyces sp. en periodontitis crónica moderada. Las variables de respuesta bioquímica mostraron una disminución significativa en la concentración y cuenta total de interleucina 1β en los individuos con periodontitis crónica moderada en la fase de mantenimiento del tratamiento así como de las variables de respuesta clínica. Conclusión: Hay reducción de los niveles de interleucina 1β con la disminución de la microflora. Los niveles de interleucina 1β son marcadores sensibles para el diagnóstico y severidad de la enfermedad periodontal.

Objective: To ascertain inflammatory response through interleucina 1β presence and identify pathogenic microorganisms as possible immunological and microbiological markers in diagnosis and treatment non-surgical periodontal in patients with gingivitis and moderate chronic periodontitis in a sample of Mexican population. Material and methods: In the present prospective cohort study, 18 patients with signs of gingivitis and 17 patients with moderate chronic periodontitis were selected. Samples of subgingival biofilm and of crevicular gingival fluid were collected. Interleukine 1β was quantified during the pre-treatment, post-treatment and maintenance phases of the nonsurgical periodontal treatment. Continuous variables were analyzed with the Student test, as well as categorical variables which were analyzed with the TurkeyKramer test. For independent groups the Pearson test was used. Results: Microbiological response variables showed that Porphyromonas gingivalis, Prevotella intermedia , Fusobacterium nucleatum , Aggregatibacter actinomycetemcomitans significantly decreased in subjects with gingivitis. Porphyromonas gingivalis , Tannerella forsythia , Fusobacterium nucleatum , Aggregatibacter actinomycetemcomitans and Actinomyces ssp . decreased in cases. Biochemical response variables showed significant decrease in IL-1β concentration and total count in individuals with moderate chronic periodontitis in treatment maintenance phase. The same result applied to clinical response variables. Conclusions: There is a decrease in Interleukin 1β levels with decrease in microflora. Interleukin 1β are sensitive markers for diagnosis of periodontal disease and assessment of its severity.