Peri-implantitis: etiology, diagnosis and treatment: an update.

Peri-implant mucositis is described as the presence of inflammation in the mucosa around implants without any bone loss. By contrast, in peri-implantitis, besides the inflammation in the peri-implant mucosa, loss of supporting bone is also seen. The probing depth, the presence of bleeding on probing, suppuration and radiographs should be assessed regularly for the diagnosis of peri-implant diseases. Poor oral hygiene, smoking and previous history of periodontitis are known risk factors for the disease. The occlusion and longevity of fixed partial dentures around implants, whether connected to the natural teeth or not, is still an area of investigaton, but studies show that long-term results are acceptable for both. Various treatment modalities are discussed in relation to the management of periimplantitis. The predictable outcome of peri-implantitis management is not yet known.

Multiple sclerosis and oral health: an update.

Multiple sclerosis is a chronic, neurodegenerative disease seen in 69.1 per 100,000 person-years in the world. As multiple sclerosis and periodontal disease both have an inflammatory origin, dental professionals should be aware of the link between these two diseases. In patients unable to carry out effective oral hygiene, dental treatment should be done by dental hygienists and/or dentists to prevent dental caries and periodontal disease. It is hoped that by identifying multiple sclerosis patients in dental clinics, the required support and treatment could be provided to these patients to improve their quality of life and that dental professionals would feel comfortable treating patients with multiple sclerosis.

Multiple sclerosis and oral health--an update.

Multiple sclerosis is a chronic, neurodegenerative disease seen in 69.1 per 100,000 person-years in the world. As multiple sclerosis and periodontal disease both have an inflammatory origin, dental professionals should be aware of the link between these two diseases. In patients unable to carry out effective oral hygiene, dental treatment should be done by dental hygienists and/or dentists to prevent dental caries and periodontal disease. It is hoped that by identifying multiple sclerosis patients in dental clinics, the required support and treatment could be provided to these patients to improve their quality of life and that dental professionals would feel comfortable treating patients with multiple sclerosis.

Serum and saliva sialic acid in periodontitis patients with and without cardiovascular disease.

Serum total sialic acid (sTSA) has recently been shown to be a cardiovascular risk factor. However, there is little information about the role of sTSA and TSA in saliva in periodontitis, a chronic and inflammatory disease known to be a risk factor for cardiovascular disease (CVD). We aimed to investigate the changes in sTSA and TSA levels in saliva in patients having both periodontitis and CVD versus periodontitis patients without diagnosed CVD. The study group consisted of 26 patients with proven periodontitis and 26 controls with no diagnosed systemic disease but periodontitis. sTSA and saliva TSA levels were determined by the thiobarbituric acid method, and C-reactive protein (CRP) was evaluated by the nephelometric method. The severity of periodontitis has been determined by the community periodontal index of treatment needs (CPITN). TSA in blood and saliva and CRP levels in blood were significantly increased in CVD patients compared with the control group. CPITN ranged from 2 to 4 in both groups. Significant and positive correlations were found between sTSA and saliva SA levels in patients and controls and between tooth loss and TSA both in blood and saliva. Therefore, TSA in saliva may be a useful marker similar to sTSA in CVD patients.

Levels of C-reactive protein and protein C in periodontitis patients with and without cardiovascular disease.

Since periodontitis is a chronic and inflammatory disease, a number of hypotheses have proposed that it has an etiological or modulating role in cardiovascular disease (CVD). This study aimed to ascertain the changes in the plasma levels of C-reactive protein (CRP) and protein C (PC), a natural anticoagulant also having an anti-inflammatory effect, in patients who have mild-to-severe periodontitis with or without CVD. The test group consisted of 26 patients with CVD and chronic periodontitis and the control group consisted of 26 patients with chronic periodontitis and no systemic disease. In both groups Community Periodontal Index of Treatment Needs scores were recorded and blood samples were collected. CRP levels were significantly high and PC activity was significantly low in the test group compared to the control group (p < 0.001). There was a negative correlation between tooth loss and PC and between CRP and PC. How PC is affected by the inflammatory events and its association with CRP is an active area of investigation.

Peri-implantitis and Severity Level.

OBJECTIVES: Different diagnostic criteria were used for diagnosis of peri-implant diseases. The aim of this cross-sectional study was to explore prevalence of peri-implant diseases and subclassify peri-implantitis based on different levels of radiographic and clinical findings. MATERIALS AND METHODS: Two hundred patients having 655 dental implants were included in this study. In addition to clinical measurements, standard long-cone parallel technique was used to evaluate marginal bone level around implants. Following diagnosis of peri-implant diseases, peri-implantitis was further subclassified using a severity leveling in terms of marginal bone level and probing depth. RESULTS: Mean age of 200 subjects was 52.8 ± 12.2 years and 63% were females. In total, bleeding on probing was present in 93% and suppuration in 27% of implants. On subject basis, 2.5% were diagnosed as healthy, 28% with peri-implant mucositis (PM), and 69.5% with peri-implantitis, whereas on implant basis, 3.6% were healthy, 36% presented PM, and 60.4% peri-implantitis. Furthermore, when severity leveling was applied, peri-implantitis prevalence changed markedly and ranged from 14.5 to 31.0% at the subject level and from 10.0 to 22.0% at the implant level. Subgingival restoration margins were observed in 70.6% of patients for implants with PM and in 44% patients for implants with peri-implantitis. Most of the implants with peri-implantitis were with platform match (71.5%). CONCLUSIONS: Applying different thresholds to the peri-implantitis definition yielded different prevalence rates ranging from 10 to 31%. As no established diagnostic criteria are being used today, results from clinical studies may not reflect the true disease prevalence.

Does Implant-Abutment Interface affect Marginal Bone Levels around Implants?

OBJECTIVE: The use of dental implants with different types of surface roughness and implant-abutment interface has brought about a situation of marginal bone loss. Therefore, the aim of this study was to analyze and compare marginal bone levels of different types of osseointegrated dental implants with platform switch (Group A: Ankylos, Mannheim, Germany) and platform match (Group B: Dentsply Xive, Mannheim, Germany, and Group C: MIS Implant Technologies, Karmiel, Israel). MATERIALS AND METHODS: One hundred and seven patients (52 men and 55 women) with a mean age of 54.79 (standard deviation ± 12.35) years and a total of 321 dental implants (Group A, n = 198; Group B, n = 58; and Group C, n = 65) placed in a private practice between April 2006 and May 2015 were retrospectively analyzed. In addition to demographic information and implant characteristics, marginal bone levels were evaluated by Image J (Wayne Rasband, National Institute of Health, Maryland) program. RESULTS: The mean age of all patients was 54.79 ± 12.35 years, and 51.5% of them were women. Implants supporting fixed bridge were most commonly used in all groups (65%), whereas only 20% were restored with a single crown and 15% with overdentures. In total, 47.5% of all implants showed no marginal bone loss. Mean bone loss in Group A was significantly lower (0.81 ± 1.60 mm) as compared to Group B (1.58 ± 1.59 mm) and Group C (1.18 ± 1.36) (p < 0.005). CONCLUSION: Among different types of dental implants, platform switch seems to preserve marginal bone levels and increase the long-term success of dental implants.

Gingival melanin depigmentation by 810 nm diode laser.

The color of gingiva is determined by number and size of blood vessels, thickness of epithelium, keratinization degree, and melanin pigments present in epithelium. Melanocytes, located in basal and suprabasal layers of epithelium, are the cells that produce melanin pigments which play a main role for pigmentation of gingiva. In this case series, the use of 810 nm diode laser for depigmentation of gingiva is presented. Two female patients applied with a chief complaint of "darkened gums" due to heavy smoking. In intraoral examination, diffuse melanin pigmentation was observed in both the maxilla and mandible. Under the local anesthesia, 810 nm diode laser was applied for depigmentation at 1.3 W power in continuous mode. Patients were recalled at weeks 1, 4, and 12 to evaluate the healing and recurrence rate. Both the patients had no postoperative pain or edema, and complete healing was observed at week 12. This study revealed that depigmentation with 810 nm diode laser is successful in terms of esthetics and patient comfort.