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1.
Monogr Oral Sci ; 29: 98-104, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33427228

RESUMEN

The present narrative review provides a summary of the temporal and spatial reactions of the oral microbiome to the placement of a dental implant into the oral cavity, depicting the most important interactions between the oral microbiota and the host response involved in the development of peri-implant infections in humans (i.e., peri-implant mucositis and peri-implantitis). Starting with the formation of a pellicle to acute and rampant peri-implant inflammation, a number of steps, including biofilm formation, aggressive bacterial invasion, and host defense mechanisms, are involved. Better understanding of the factors related to the host response and changes in the composition of microbiota has led to the development of novel treatment modalities. Finally, a short outlook into the future is provided.


Asunto(s)
Implantes Dentales , Microbiota , Periimplantitis , Estomatitis , Bacterias , Implantes Dentales/efectos adversos , Humanos , Periimplantitis/etiología , Estomatitis/etiología
2.
J Biol Regul Homeost Agents ; 35(1 Suppl. 1): 11-18, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33463139

RESUMEN

Implant dentistry has emerged as a first line of treatment to replace missing teeth for both the edentulous and partially dentate patients. Implant dentistry is accompanied by the onset of peri-implantitis (PIM). PIM is characterized by the inflammatory destruction of the implant-supporting tissues, because of biofilm formation on the implant surface. A history of periodontitis, poor oral hygiene, and smoking are considered as risk factors for PIM. Occasionally PIM is associated with iatrogenic factors, that, only recently, have been acknowledged as direct cause of PIM, i.e.: non-parallel adjacent implants or the presence of a gap, between fixture and prosthetic components. The use both of traditional protocols of nonsurgical periodontal therapy and the laser seems to be an effective alternative treatment modality for PMI. By the application of laser-assisted non-surgical peri-implant therapy the periodontal pocket depth was reduced. The present article illustrates the nonsurgical management of one case, where failure to remove residual cement, from an implant-supported dental prosthesis, seemed to cause PMI.


Asunto(s)
Implantes Dentales , Periimplantitis , Implantes Dentales/efectos adversos , Odontología , Humanos , Rayos Láser , Periimplantitis/etiología , Periimplantitis/terapia , Bolsa Periodontal , Periodontitis/etiología , Periodontitis/terapia
3.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 814-818, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171552

RESUMEN

Due to the highly predictable long-term clinical outcomes, modern implant dentistry has become one of the most preferred treatment modalities for restoring missing teeth. However, the complications of implant therapy compromise the long-term implant success and remain a great challenge to clinicians. Hardware complications include the mechanical complications which are related to the manufacturer-fabricated components of the prosthesis, such as abutment/screw loosening, fracture and implant fracture; and the technical complication which are related to laboratory-fabricated components of the prosthesis, such as veneer chipping. The biological complications mainly include peri-implant mucositis and peri-implantitis. It is crucial to figure out how to effectively avoid and manage the complications of implant therapy. This article reported the definitions, incidences, risk factors, prevention and treatment of both mechanical and biological complications of implant therapy.


Asunto(s)
Implantes Dentales , Periimplantitis , Estomatitis , Pérdida de Diente , Implantes Dentales/efectos adversos , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Humanos , Periimplantitis/etiología , Periimplantitis/prevención & control
4.
Int J Periodontics Restorative Dent ; 40(6): e229-e233, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33151189

RESUMEN

A link between periodontitis and cardiovascular disease has been reported in the literature. For this systematic review, the keywords "cardiovascular disease" (CVD) were combined with "periodontitis" and "peri-implantitis" and were used to search for literature published on MEDLINE and PubMed between 1990 and 2020. Hand searching was also performed. A total of 206 articles were identified, 51 of which were reviewed. A link between periodontal disease and CVD can be explained by both the infection and inflammatory pathways. Interventional studies on the treatment of periodontal disease related to CVD have shown conflicting results. Therefore, based on published studies, CVD should presently be considered a comorbidity of periodontitis (with an association but no direct cause and effect documented). The association of CVD with peri-implantitis has too few studies to draw any conclusions. More studies are necessary before any conclusions can be made between CVD and periodontitis and CVD and peri-implantitis regarding possible links and the extent of association.


Asunto(s)
Enfermedades Cardiovasculares , Implantes Dentales , Periimplantitis , Enfermedades Periodontales , Periodontitis , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Implantes Dentales/efectos adversos , Humanos , Periimplantitis/epidemiología , Periimplantitis/etiología , Enfermedades Periodontales/complicaciones , Enfermedades Periodontales/epidemiología , Periodontitis/complicaciones , Periodontitis/epidemiología
5.
J Oral Implantol ; 46(4): 423-429, 2020 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-33031546

RESUMEN

The aim of this case report was to report the course of treatment for advanced paranasal sinus infection triggered by peri-implantitis, managed using functional endoscopic sinus surgery (FESS), with outcomes. A nonsmoking male patient received sinus augmentation with implant placement on his left posterior maxilla 15 years ago. Possibly due to noncompliance to maintenance, peri-implantitis developed and progressed into the augmented bone area in the maxilla. Eventually, maxillary sinusitis occurred concomitantly with a spread of the infection to the other paranasal sinuses. Implant removal and intraoral debridement of inflammatory tissue were performed, but there was no resolution. Subsequently, FESS was performed, with removal of nasal polyp and sequestrum. After FESS, the patient's sinusitis resolved. Histologically, the sequestrum was composed of bone substitute particles, necrotic bone, stromal fibrosis, and a very limited cellular component. Two implants were placed on the present site, and no adverse event occurred for up to 1 year after the insertion of the final prosthesis. Peri-implantitis in the posterior maxilla can trigger maxillary sinusitis with concomitant infection to the neighboring paranasal sinuses. FESS should be considered to treat this condition.


Asunto(s)
Implantes Dentales , Sinusitis Maxilar , Periimplantitis , Implantes Dentales/efectos adversos , Humanos , Masculino , Maxilar , Seno Maxilar , Sinusitis Maxilar/diagnóstico por imagen , Sinusitis Maxilar/etiología , Sinusitis Maxilar/cirugía , Periimplantitis/diagnóstico por imagen , Periimplantitis/etiología , Periimplantitis/cirugía
6.
Periodontol 2000 ; 84(1): 145-160, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32844418

RESUMEN

Peri-implant diseases are prevalent with a weighted mean prevalence rate of 43% across Europe and 22% across South and North America. Although the main etiologic agent is bacterial biofilm, a myriad of factors influence the initiation and progression of the disease. Unfortunately, the treatment of peri-implant diseases is at best favorable in the short term with a high rate of persistent inflammation and recurrence. Therefore, it is sensible to consider and control all potential factors that may predispose an implant to peri-implant tissue inflammation in an attempt to avoid the disease. This paper reviews recent evidence on factors that may predispose implants to peri-implantitis and measures that can be taken to prevent it.


Asunto(s)
Implantes Dentales , Periimplantitis/epidemiología , Periimplantitis/etiología , Humanos , Inflamación
7.
Clin Oral Implants Res ; 31(10): 1002-1009, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32794289

RESUMEN

OBJECTIVES: The aim was to evaluate the overall occurrence and potential clustering of biological and technical complications in implant dentistry. MATERIAL AND METHODS: 596 patients provided with implant-supported reconstructions were evaluated for the occurrence of (a) technical complications, (b) peri-implantitis and (c) implant loss during a period of 9 years. Time and type of event were scored, and potential risk factors were explored through parametric modelling of survival and hazards. Clustering of complications was assessed at the patient level, and patient satisfaction was evaluated by questionnaire completed at the 9-year examination. RESULTS: 42% of patients were affected by technical and/or biological complications during the 9-year observation period. Extent of therapy (Hazard Ratio 2.5: patients with partial jaw restorations; HR 3.9: patients with full jaw restorations) and a history of periodontitis (HR 1.6) were identified as risk factors. While technical complications occurred mostly as isolated events, 41% of subjects identified with peri-implantitis and 52% of subjects with implant loss also presented with other complications. The hazard for technical complications and implant loss peaked at 0.7 years and 0.2 years, respectively, while the hazard for peri-implantitis was consistent throughout the observation period. The overall proportion of satisfied patients at 9 years was high (95%), and only minor differences between individuals with and without complications were noted. CONCLUSIONS: Complications following implant-supported restorative therapy were common findings. Extent of therapy and periodontitis were identified as risk factors. While technical complications occurred in an isolated pattern, peri-implantitis and implant loss demonstrated clustering with other types of complications.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales/efectos adversos , Periimplantitis/epidemiología , Periimplantitis/etiología , Periodontitis , Análisis por Conglomerados , Prótesis Dental de Soporte Implantado/efectos adversos , Humanos
8.
J Biol Regul Homeost Agents ; 34(3 Suppl. 1): 147-153, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32618172

RESUMEN

Matrix metalloproteases (MMPs) are a family of zinc-dependent endopeptidases, produced by numerous cell types including fibroblasts, endothelial cells, osteoblasts, macrophages, lymphocytes and neutrophils, and capable of degrading different components of the extracellular matrix (ECM), but also cytokines, receptors and factors that regulate cell motility (1). MMPs represent the main proteolytic enzymes involved in the remodeling and degradation of the components of the extracellular matrix, in the modifications of interactions between cells, and those between cells and the ECM that regulate, for example, the processes of cell migration (2, 3). Due to these characteristics, the MMPs are involved in numerous physiological processes (angiogenesis, apoptosis, bone remodeling, wound repair, morphogenesis, inflammation, immune response) response to incongruous conservative and endodontic treatments (29-37, 46, 47) and pathological (periodontitis, arthritis, cancer, cardiovascular diseases, neurological diseases, osteoporosis etc.) (5). Metalloproteinase-8 (MMP-8) is an important indicator of tissue decomposition and is present in case of periodontitis in the gingiva and in the sulcular fluid. The concentration of MMP-8 in the sulcular fluid of patients with chronic or aggressive periodontitis is higher than that found in healthy patients (4, 6). MMP-8 was also significantly correlated with gingivitis index, plaque index, probing and clinical attack level. For this reason, the concentration of MMP-8 in the sulcular fluid could constitute a useful index to monitor periodontitis activity and be used to predict disease progression, also because of orthodontic treatments (38-45). Patients with periodontitis had elevated concentrations of MMP-8 salivary compared to patients with gingivitis and healthy tissues. Through this experimentation we wanted to demonstrate the real effectiveness of using this test as a means of preventing peri-implant pathology.


Asunto(s)
Gingivitis , Periimplantitis , Periodontitis , Células Endoteliales , Humanos , Metaloproteinasa 8 de la Matriz , Periimplantitis/etiología
9.
Quintessence Int ; 51(10): 810-820, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32577710

RESUMEN

Biologic complications around dental implants may be categorized into peri-implant mucositis and peri-implantitis. Peri-implant mucositis is defined as reversible inflammation in the peri-implant mucosa without any apparent bone destruction. Peri-implantitis refers to inflammatory process that resulted in destruction of alveolar bone and attachment. Potential etiologic and contributing factors to both diseases are discussed in this review. By targeting and eliminating the etiologic factors nonsurgically as well as surgically, dental implants presenting with peri-implant diseases may be rescued, and then maintained with proper long-term peri-implant supportive therapy. Furthermore, clinical cases and their management are presented to demonstrate the available treatment options. Implant therapy should be carefully planned and executed with consideration of potential etiologic and contributing factors to developing biologic complications. During the initial consideration, patients should be informed of the potential biologic complications in dental implant therapy. Clinicians should monitor implants for any development or recurrence of peri-implant disease to ensure timely therapeutic intervention.


Asunto(s)
Pérdida de Hueso Alveolar , Productos Biológicos , Implantes Dentales , Mucositis , Periimplantitis , Implantes Dentales/efectos adversos , Humanos , Mucositis/etiología , Periimplantitis/etiología , Periimplantitis/terapia
10.
BMC Oral Health ; 20(1): 92, 2020 03 30.
Artículo en Inglés | MEDLINE | ID: mdl-32228667

RESUMEN

BACKGROUND: To assess long-term results of implants (XiVE/Frialit-2 Synchro) in a private periodontal practice according to survival and success rates (biological and technical complications) and to detect possible influencing factors, retrospectively. METHODS: Implant placement of at least one implant took place 10 years ±6 months before clinical and radiographic re-examination. Incidence of implant loss as main and incidence of mucositis/ peri-implantitis as secondary outcome were detected. Also, patient-related and implant-related influencing factors were determined by regression analyses. RESULTS: 100 patients (59.0% female) with 242 implants were included into analysis. Survival rate was 94.0% (XiVE: 97.7%; Frialit-2-Synchro: 66.7%). Mucositis was found in 77.6% of all patients, moderate/severe peri-implantitis in 16.3%. In logistic regression analyses statistically significant influencing factors for implant loss was implant type (p < 0.001), for mucositis a wider implant diameter (p = 0.0438) and a high modified Plaque Index (p = 0.0253), for peri-implantits number of implants per patient (p = 0.0075) and a wider implant diameter (p = 0.0079). Technical complications were found in 47 implants (19.4%). CONCLUSIONS: XiVE implants showed a high survival rate over a 10-year follow-up, on the other hand Frialit-2 Synchro implants had worse survival rates. Success rates regarding biological complications are in line with other implant systems.


Asunto(s)
Implantes Dentales/efectos adversos , Fracaso de la Restauración Dental/estadística & datos numéricos , Mucositis/epidemiología , Mucositis/cirugía , Periimplantitis/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Pérdida de Hueso Alveolar/epidemiología , Placa Dental/microbiología , Índice de Placa Dental , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Mucositis/etiología , Periimplantitis/etiología , Estudios Retrospectivos , Análisis de Supervivencia
11.
Curr Pharm Biotechnol ; 21(9): 862-871, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32081107

RESUMEN

BACKGROUND AND OBJECTIVE: Dental peri-implantitis, which can be caused by several different microbial factors, is characterized by inflammatory lesions of the surrounding hard and soft tissues of an oral implant. Matrix Metalloproteinase 9 (MMP9) is thought to be involved in the pathogenesis of peri-implantitis. However, the regulatory mechanism of MMP9 in peri-implantitis has not been fully elucidated. In this study, we tried to evaluate the regulatory mechanism of MMP9 in peri-implantitis. METHODS: We collected Peri-Implant Crevicular Fluid (PICF) from ten healthy implants and ten periimplantitis patients and compared their expression level of MMP9. We also cultured macrophages from the peripheral blood of healthy volunteers infected by Porphyromonas gingivalis to reveal the regulatory mechanism of MMP9 in peri-implantitis. Western blot, immunofluorescence staining and quantitative Polymerase Chain Reaction (RT-PCR) were used to better characterize the mechanism of MMP9. RESULTS: The expression of MMP9 was up-regulated in peri-implantitis patient PICF and P. gingivalis infected human macrophages. LOX-1, not dectin-1, was found to mediate MMP9 expression in human macrophages with P. gingivalis infection. Expression of Erk1/2 was responsible for infection-induced MMP9 expression. Finally, use of a broad-spectrum metalloproteinase inhibitor impaired LOX-1 expression in infected macrophages. CONCLUSION: Our results demonstrate that MMP9 is involved in dental peri-implantitis and is regulated by LOX-1 and Erk1/2. This LOX-1/MMP9 signaling pathway may represent a potential drug target for peri-implantitis.


Asunto(s)
Implantes Dentales , Sistema de Señalización de MAP Quinasas/genética , Macrófagos/metabolismo , Metaloproteinasa 9 de la Matriz/genética , Periimplantitis/metabolismo , Receptores Depuradores de Clase E/metabolismo , Humanos , Macrófagos/microbiología , Masculino , Periimplantitis/etiología , Porphyromonas gingivalis/crecimiento & desarrollo , Regulación hacia Arriba
12.
J Endod ; 46(3): 444-448, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31959483

RESUMEN

Peri-implantitis is becoming a frequent complication observed around dental implants. An endodontic infection of a nearby tooth or an immediate implant placement in an inflamed bone socket from failing endodontic therapy has been associated with retrograde peri-implantitis (RPI), a condition that presents with radiographic lucency at the "apex" of an implant. However, current classification schemes do not capture endodontic lesions that may manifest as coronal or intrabony lesions associated with dental implants. As a result, such cases may be mistreated. Here we present for the first time 2 cases in which peri-implant bone loss occurred in the coronal half of the implant adjacent to a tooth with an endodontic-periodontic lesion and was resolved via endodontic therapy or tooth extraction as indicated. This proof of concept report aimed to introduce endodontic peri-implant ("endo-implant") defects and increase vigilance, which may help prevent overtreatment or mistreatment of such cases.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Periimplantitis , Atención Odontológica , Implantes Dentales/efectos adversos , Humanos , Periimplantitis/etiología , Periimplantitis/terapia , Periodoncia , Extracción Dental
13.
J Clin Periodontol ; 47(3): 392-403, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31912511

RESUMEN

OBJECTIVE: To identify the influence of prosthetic features through a comprehensive analysis with other known risk factors. MATERIALS AND METHODS: A total of 169 patients (n = implants: 349) was retrospectively included in the present study. Peri-implantitis was diagnosed based on peri-implant bone loss and probing depth. Using radiographs taken 1 and 5 years following prosthesis insertion, the following features were determined: peri-implant marginal bone loss (MBL), emergence angle (EA), emergence profile (EP) and crown/implant ratio (CIR). The splinted position of prosthesis was also recorded. Multivariable generalized estimating equation was used to analyse the influence of each feature on the prevalence of peri-implantitis. The final prediction model was constructed by Cox proportional hazard regression analysis. RESULTS: The EA showed a significant correlation with MBL. A statistically greater prevalence of peri-implantitis was observed if EA ≥ 30 degrees, when EP is convex and in middle implant splinted with both mesial and distal adjacent implants in bone-level implant. A similar correlation was not observed in tissue-level implants. CIR had no significant effect on the prevalence of peri-implantitis. CONCLUSION: Over-contoured implant prosthesis is a critical local confounder for peri-implantitis. The implant splinted to both mesial and distal adjacent implant has a higher risk of peri-implantitis.


Asunto(s)
Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/epidemiología , Pérdida de Hueso Alveolar/etiología , Implantes Dentales/efectos adversos , Periimplantitis/diagnóstico por imagen , Periimplantitis/epidemiología , Periimplantitis/etiología , Estudios Transversales , Humanos , Estudios Retrospectivos
14.
Braz Oral Res ; 33(suppl 1): e063, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31576947

RESUMEN

The objective of this paper was to evaluate the current evidence reporting on the prevalence of peri-implantitis and to determine the influencing factors. An electronic search for articles published until February 2019 reporting on the prevalence of peri-implantitis was performed in MEDLINE. Included criteria were published in international peer-reviewed journals, written in English language, reported on the prevalence of peri-implantitis, included implants with a minimum follow-up of one year after functional loading and used a clear definition for peri-implantitis and/or peri-implant mucositis with a clear cutoff for bone level changes according to the case definitions of Sanz and Chapple and Berglundh et al. 2018. Included papers were anaylized for factors affecting the reported prevalences for peri-implantitis. Twenty-five papers were included in the present review and a wide range for the reported prevalence of peri-implantitis was seen. Case definitions for peri-implantitis with various thresholds for bone loss together with the type of reporting on patient- or implant-level were the most significant factors that lead to a large variety of the occurrence of the disease. Additionally, follow-up time and the evaluation in a certain "convenience" population may have influenced the prevalence values. In conclusion, it can be stated that a wide range for reporting the prevalence of peri-implantitis can be found and no real estimation of the global burden of the disease can be made. Applying accurate case definitions for peri-implantitis is the most important factor for reporting the prevalence and should be strictly followed in future reports.


Asunto(s)
Periimplantitis/epidemiología , Estomatitis/epidemiología , Humanos , Periimplantitis/etiología , Prevalencia , Factores de Riesgo , Estomatitis/etiología
15.
Braz Oral Res ; 33(suppl 1): e067, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31576951

RESUMEN

Peri-implantitis is currently a topic of major interest in implantology. Considered one of the main reasons of late implant failure, there is an emerged concern whether implant characteristics could trigger inflammatory lesion and loss of supporting bone. The purpose of this narrative review is to provide an evidence based overview on the influence of implant-based factors in the occurrence of peri-implantitis. A literature review was conducted addressing the following topics: implant surface topography; implant location; occlusal overload; time in function; prosthesis-associated factors (rehabilitation extension, excess of cement and implant-abutment connection); and metal particle release. Although existing data suggests that some implant-based factors may increase the risk of peri-implantitis, the evidence is still limited to consider them a true risk factor for peri-implantitis. In conclusion, further evidences are required to a better understanding of the influence of implant-based factors in the occurrence of peri-implantitis. Large population-based studies including concomitant analyses of implant- and patient-based factors are required to provide strong evidence of a possible association with peri-implantitis in a higher probability. The identification of these factors is essential for the establishment of strategies to prevent peri-implantitis.


Asunto(s)
Implantes Dentales/efectos adversos , Periimplantitis/etiología , Medición de Riesgo , Prótesis Anclada al Hueso/efectos adversos , Humanos , Periimplantitis/prevención & control , Factores de Riesgo , Propiedades de Superficie , Factores de Tiempo , Insuficiencia del Tratamiento
16.
Braz Oral Res ; 33(suppl 1): e069, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31576953

RESUMEN

Observational studies have indicated that crestal bone level changes at implants are typically associated with clinical signs of inflammation, but still mechanical overload has been described as possible factor leading to hard-tissue deficiencies at implant sites without mucosal inflammation. The aim of this paper was systematically review the literature regarding the possible effect of traumatic occlusal forces on the peri-implant bone levels. Literature search was conducted using PubMed, Scielo and Lilacs, including the following terms: oral OR dental AND implant$ AND (load OR overload OR excessive load OR force$ OR bruxism) AND (bone loss OR bone resorption OR implant failure$). Databases were searched for the past 10 years of publications, including: clinical human studies, either randomized or not, cohort studies, case control studies, case series and animal research. Exclusion criteria were review articles, guidelines and in vitro and in silico (finite element analysis) research, as well as retrospective studies. The PICO questions formulated was: "does traumatic occlusal forces lead to peri-implant bone loss?" The database searches as well as additional hand searching, resulted in 807 potentially relevant titles. After inclusion/exclusion criteria assessment 2 clinical and 4 animal studies were considered relevant to the topic. The included animal studies did not reveal an association between overload and peri-implant bone loss when lower overloads were applied, whereas in the presence of excessive overload it seemed to generate peri-implant bone loss, even in the absence of inflammation. The effect of traumatic occlusal forces in peri-implant bone loss is poorly reported and provides little evidence to support a cause-and-effect relationship in humans, considering the strength of a clinically relevant traumatic occlusal force.


Asunto(s)
Pérdida de Hueso Alveolar/etiología , Fuerza de la Mordida , Bruxismo/complicaciones , Oclusión Dental Traumática/complicaciones , Resorción Ósea/etiología , Humanos , Periimplantitis/etiología , Factores de Tiempo , Insuficiencia del Tratamiento
17.
Braz Oral Res ; 33(suppl 1): e070, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31576954

RESUMEN

The aim of this review is to summarize the evidence on associations between diabetes mellitus (DM) and complications around dental implants. Electronic database searches of MEDLINE, EMBASE, JBI Database of Systematic Reviews and Implementation Reports, Cochrane Database of Systematic Reviews and the PROSPERO register were performed from 1990 up to and including May 2018, using MeSH terms and other keywords. Systematic reviews and meta-analyses investigating the associations of DM and implant complications (failure, survival, bone loss, peri-implant diseases, and post-surgery infection) were eligible. The quality of the included reviews was determined using the Assessment of Multiple Systematic Reviews Tool 2 (AMSTAR 2). Twelve systematic reviews were included. Implant survival rates ranged from 83.5% to 100%, while implant failure rates varied from 0% to 14.3% for subjects with DM. The three meta-analyses performed for event "implant failure" reported no statistically significant differences between diabetic and non-diabetic subjects. An apparently increased risk of peri-implantitis is reported in patients with DM. According to the AMSTAR 2 classification, 50% of the reviews were classified as being of "critically low", 25% as of "low" and 25% as of "moderate" quality. Evidence indicates high levels of survival and low levels of failure of implants inserted in patients with DM. However, DM was assessed as a whole in the majority of studies and, the actual influence of hyperglycemia on implant survival/failure is still uncertain. DM/hyperglycemia seems to be associated with a high risk of peri-implantitis. However, this conclusion is based on a limited number of systematic reviews.


Asunto(s)
Complicaciones de la Diabetes/complicaciones , Periimplantitis/etiología , Implantes Dentales/efectos adversos , Fracaso de la Restauración Dental , Humanos , Falla de Prótesis , Factores de Riesgo , Insuficiencia del Tratamiento
18.
Braz Oral Res ; 33(suppl 1): e074, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31576958

RESUMEN

Most of the literature evaluating dental implants focuses on implant survival, which is a limited proxy for the successful rehabilitation of patients with missing teeth. Success should include not only survival but also lack of mechanical, biological, and esthetics problems. A comprehensive review of local and systemic risk factors prior to implant placement will allow the tailoring of treatment planning and maintenance protocols to the patient's profile in order to achieve longitudinal success of the therapy. This review discusses the role of controlling different risk factors and prevention/treatment of peri-implant mucositis in order to avoid peri-implantitis. Although the literature addressing the topic is still scarce, the existing evidence shows that performing optimal plaque control and regular visits to the dentist seem to be adequate to prevent peri-implant lesions. Due to impossibility of defining a probing depth associate with peri-implant health, radiographic evaluations may be considered in the daily practice. So far, there is a strong evidence linking a past history of periodontal disease to peri-implant lesions, but this is not so evident for other factors including smoking and diabetes. The prevention of biological complications starts even before implant placement and include a broader analysis of the patient risk profile and tailoring the rehabilitation and maintenance protocols accordingly. It should be highlighted that the installation of implants does not modify the patient profile, since it does not modify genetics, microbiology or behavioral habits of any individual.


Asunto(s)
Interfase Hueso-Implante , Implantes Dentales/efectos adversos , Periimplantitis/prevención & control , Periodontitis/prevención & control , Estomatitis/prevención & control , Interfase Hueso-Implante/diagnóstico por imagen , Placa Dental/prevención & control , Humanos , Higiene Bucal , Periimplantitis/etiología , Índice Periodontal , Periodontitis/etiología , Radiografía Dental , Factores de Riesgo , Estomatitis/etiología
20.
Genes (Basel) ; 10(9)2019 09 14.
Artículo en Inglés | MEDLINE | ID: mdl-31540037

RESUMEN

BACKGROUND: Sometimes dental implants seem to be the only therapeutic alternative for the oral rehabilitation of patients with Down syndrome, given that they usually lose all their teeth early due to suffering aggressive periodontitis and they do not usually have the skills required to wear removable prostheses. However, the evolution of dental implants in these patients shows very adverse results. It is possible that basal genetic alterations, or at least some characteristics of these, may underlie these clinical results. The metabolic pathway of metallothioneins, molecules with an important influence on bone metabolism, could be one of the said alterations. AIMS: To determine whether the expression of metallothioneins (MTs) and their metabolic pathway may be identified and related to the periodontitis and lack of osseointegration of dental implants in Down syndrome patients. MATERIALS AND METHODS: Retrospective study of cases and controls by comparing patients with Down syndrome, periodontal disease, and implant failure (four patients, test group) with patients with Down syndrome, without periodontal disease, and without implant failure after two years of following (seven patients, control group), by extracting peripheral blood at the time of the dental examination to extract RNA and its subsequent processing in relation to gene expression of the metabolic pathway of metallothioneins. RESULTS: The results identified low expression in the group of patients with periodontal disease and implant failure of genes MT1E, MT1H, MT1X, MT1A, MT1B, MT1C, MT1L, MT2A, MT1M, and MT1G. CONCLUSIONS: The low MT1 and MT2 gene expression seems to be related to the onset of periodontal disease and implant rejection in Down syndrome patients, although more data are required to confirm whether this relationship is due to one of the two conditions, to both independently, or to the two jointly-this last option being indicated by our current study.


Asunto(s)
Implantes Dentales/efectos adversos , Síndrome de Down/complicaciones , Metalotioneína/metabolismo , Periimplantitis/metabolismo , Falla de Prótesis , Adulto , Femenino , Humanos , Masculino , Metalotioneína/genética , Oseointegración , Periimplantitis/complicaciones , Periimplantitis/etiología
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