A review of the influence of periodontal treatment in systemic diseases.

The effects and consequences of periodontal diseases might not be confined to the oral cavity. A great body of evidence has arisen supporting the claim demonstrating an association with several systemic conditions and diseases. With different levels of evidence, an association between periodontal disease and cardiovascular disease, diabetes, psoriasis, rheumatoid arthritis, pregnancy outcomes and respiratory diseases has been established. However, the true nature of this association, if it is causal, still remains elusive. For a better understanding of the complex relationships linking different conditions, interventional studies now begin to focus on the possible outcomes of periodontal treatment in relation to the events, symptoms and biomarkers of several systemic disorders, assessing if periodontal treatment has any impact on them, hopefully reducing their severity or prevalence. Therefore, we proceeded to review the recent literature on the subject, attempting to present a brief explanation of the systemic condition or disease, what proposed mechanisms might give biological plausibility to its association with periodontal disease, and finally and more importantly, what data are currently available pertaining to the effects periodontal treatment may have. Raising awareness and discussing the possible benefits of periodontal treatment on overall systemic health is important, in order to change the perception that periodontal diseases are only limited to the oral cavity, and ultimately providing better and comprehensive care to patients.

Relevant Aspects of the Dental Implant Design on the Insertion Torque, Resonance Frequency Analysis (RFA) and Micromobility: An In Vitro Study.

The major problems for the osseointegration of dental implants are the loosening of the screw that fixes the dental implant to the abutment and the micromovements that are generated when mechanical loads are applied. In this work, torque differences in the tightening and loosening of the connection screws after 1 cycle, 10 cycles and 1000 cycles for 4 dental implants with 2 external and 2 internal connections were analyzed. The loosening of 240 implants (60 for each system) was determined using high-precision torsimeters and an electromechanical testing machine. A total of 60 dental implants for each of the 4 systems were inserted into fresh bovine bone to determine the micromovements. The implant stability values (ISQ) were determined by RFA. The mechanical loads were performed at 30° from 20 N to 200 N. By means of the Q-star technique, the micromovements were determined. It was observed that, for a few cycles, the loosening of the screw did not exceed a loss of tightening of 10% for both connections. However, for 1000 cycles, the loss for the external connection was around 20% and for the internal connection it was 13%. The micromovements showed a lineal increase with the applied load for the implant systems studied. An external connection presented greater micromotions for each level of applied load and lower ISQ values than internal ones. An excellent lineal correlation between the ISQ and micromobility was observed. These results may be very useful for clinicians in the selection of the type of dental implant, depending on the masticatory load of the patient as well as the consequences of the insertion torque of the dental implant and its revisions.

Is It Possible to Monitor Implant Stability on a Prosthetic Abutment? An In Vitro Resonance Frequency Analysis.

In order to apply the "one-abutment-one-time" concept, we evaluated the possibility of measuring resonance frequency analysis (RFA) on the abutment. This trial aimed to compare the Implant Stability Quotient (ISQ) values obtained by the PenguinRFA when screwing the transducer onto the implant or onto abutments with different heights and angulations. Eighty implants (VEGA®, Klockner Implant System, SOADCO, Les Escaldes, Andorra) were inserted into fresh bovine ribs. The groups were composed of 20 implants, 12 mm in length, with two diameters (3.5 and 4 mm). Five different abutments for screwed retained restorations (Permanent®) were placed as follows: straight with 1, 2, and 3 mm heights, and angulated at 18° with 2 and 3 mm heights. The mean value of the ISQ measured directly on the implant was 75.72 ± 4.37. The mean value of the ISQ registered over straight abutments was 79.5 ± 8.50, 76.12 ± 6.63, and 71.42 ± 6.86 for 1, 2, and 3 mm height abutments. The mean ISQ over angled abutments of 2 and 3 mm heights were 68.74 ± 4.68 and 64.51 ± 4.53 respectively. The present study demonstrates that, when the ISQ is registered over the straight abutments of 2 and 3 mm heights, the values decrease, and values are lower for angled, 3 mm height abutments.

In vitro comparative analysis of two resonance frequency measurement devices: Osstell implant stability coefficient and Penguin resonance frequency analysis.

Adequate implant stability is an essential requirement. The introduction of the Penguin resonance frequency analysis raises some questions regarding its reliability, reproducibility, and repeatability as well as how it compares to the older Osstell device. PURPOSE: To assess the newer Penguin implant stability coefficient (ISQ) device (vs the Osstell device). MATERIALS AND METHODS: A total of 120 implants were used, divided into four groups (A, B, C, and D) (according to design) and placed in fresh bovine bone. Consecutive measurements were made with both devices (Penguin/Osstell) with their respective transducers. Then, the ISQ values were measured with the Penguin device using the Osstell transducer, and vice-versa. RESULTS: The mean insertion torque (N/cm) values for the implants were as follows: Group A = 24.7 ± 9.4; Group B = 25.6 ± 9.7; Group C = 28.7 ± 7.9; Group D = 19.1 ± 5.5. The mean ISQ values for the entire sample were as follows: Penguin 67.7 ± 6.1 and Osstell 68.5 ± 9.6. The ISQ value measured with the Penguin device using a SmartPeg transducer was 67.0 ± 8.0, and that for the Osstell device using a MultiPeg transducer was 68.3 ± 7.5. The intraclass correlation coefficient (ICC) was calculated for the ISQ values obtained from both devices and was >0.90 for all transducers. When the ICC transducers were interchanged, the values were <0.77. CONCLUSIONS: Both ISQ devices allow for reliable and repeatable measurement of implant stability; however, the use of each device-specific transducer is recommended.