An evaluation of 910 premolars transplanted in the anterior region-A retrospective analysis of survival, success, and complications.

AIM: The aim this retrospective analysis was to evaluate the survival, success and possible complications of transplanted premolars to the anterior region subdivided in development stage and patient's age. MATERIALS AND METHODS: The material comprised patients that underwent a tooth transplantation between April 2004 and December 2021. A total of 910 premolars were transplanted in 707 patients. Tooth mobility, oral hygiene, and periodontal parameters were clinically evaluated. Standardized radiographs were used to evaluate pulpal and periodontal healing and root formation. The cumulative survival rate was calculated using the Kaplan-Meier method. RESULTS: The data were subdivided in three groups based on the stage of root development and patient's age. The average age at surgery was 16 years. The main indication for transplantation was trauma, followed by agenesis and other indications. Two premolars were lost during the whole observation period. The overall survival and success in the immature premolars group after an observation period of 10 years was 99.8%. The 10-year survival and success rate when fully developed premolars were transplanted in the anterior region in adolescents were 100% and 96.3%, respectively. In adults, the 10-year survival and success rate were 87.5%. CONCLUSION: Transplantation of premolars with developing and fully developed roots to the anterior region in children, adolescents, and adults is a predictable treatment modality.

An evaluation of 1654 premolars transplanted in the posterior region-A retrospective analysis of survival, success and complications.

AIM: The aim of this retrospective analysis was to evaluate the survival, success and possible complications of transplanted premolars in the posterior region subdivided by developmental stage and patient age. MATERIALS AND METHODS: This study included patients who underwent tooth transplantation between April 2004 and December 2021. A total of 1654 premolars were transplanted into 1243 patients. Tooth mobility, oral hygiene and periodontal parameters were clinically evaluated. Intraoral radiographs were used to evaluate pulpal and periodontal healing, and root formation. The cumulative survival rate was calculated using the Kaplan-Meier method. RESULTS: Data were subdivided into three groups based on the stage of root development and patient age. The mean age at surgery was 14.5 years. The main indication for transplantation was agenesis, followed by trauma and other indications, such as impacted or malformed teeth. A total of 11 premolars were lost during the study period. The overall survival and success rates in the immature premolar group after an observation period of 10 years were 99.7% and 99.4%, respectively. High survival and success rates (95.7% and 95.5%, respectively) were also observed when fully developed premolars were transplanted into the posterior region of adolescents. In adults, the success rate after 10-year follow-up is 83.3%. CONCLUSIONS: Transplantation of premolars with developing and fully developed roots is a predictable treatment modality.

Influence of various air-abrasive powders on the viability and density of periodontal cells: An in vitro study.

Remnants of air-abrasive powders on treated surfaces and tissues may affect tissue healing. The purpose of this in vitro study was to investigate the possible effect of five commercially available air-abrasive powders on the viability and cell density of three types of periodontal cells. A sodium bicarbonate powder, two amino acid glycine powders, an amino acid glycine and tricalcium phosphate powder and an erythritol powder were tested. Suspensions of these powders in three different concentrations were prepared and incubated with gingival epithelial cells, gingival fibroblasts, and periodontal ligament (PDL) fibroblasts for 6 hours. Mitochondrial activity, as a measure for cell viability, was evaluated by means of fluorescence activity of a redox indicator. Amount of DNA was measured as indication of cell density. All powders affected in different degrees cell viability and/or density. The most pronounced adverse effect was observed with the sodium bicarbonate followed by the erythritol-containing powder and at the highest concentration. A fivefold reduction or more in the number of cells was observed. The tricalcium phosphate containing powder had the least effect on all types of cells. Even, increased numbers of epithelial cells (twofold) were observed. Within the limits of the present study, it was concluded that careful selection of the powder is important to improve the clinical outcomes of air powder abrasive treatment. A tricalcium phosphate containing powder may improve the biologic responses. A sodium bicarbonate powder should be used with caution. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1955-1963, 2018.

Recommendations on the clinical application of air polishing for the management of peri-implant mucositis and peri-implantitis.

Air polishing was introduced as an alternative approach for the supra- and submucosal biofilm management at dental implants. An international expert meeting involving competent clinicians and researchers took place during the EUROPERIO 8 conference in London, UK, on 4 June 2015. Prior to this meeting a comprehensive systematic review dealing with the efficacy of air polishing in the treatment of peri-implant mucositis and peri-implantitis was prepared and served as a basis for the group discussions. This paper summarizes the consensus statements and practical recommendations on the clinical application of air polishing for the management of peri-implant mucositis and peri-implantitis.

Primary prevention of periodontitis: managing gingivitis.

UNLABELLED: Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic inflammatory consequences. Periodontitis is preventable and treatment leads to reduced rates of tooth loss and improved quality of life. However, successful treatment necessitates behaviour change in patients to address lifestyle risk factors (e.g. smoking) and, most importantly, to attain and sustain high standards of daily plaque removal, lifelong. While mechanical plaque removal remains the bedrock of successful periodontal disease management, in high-risk patients it appears that the critical threshold for plaque accumulation to trigger periodontitis is low, and such patients may benefit from adjunctive agents for primary prevention of periodontitis. AIM: The aims of this working group were to systematically review the evidence for primary prevention of periodontitis by preventing gingivitis via four approaches: 1) the efficacy of mechanical self-administered plaque control regimes; 2) the efficacy of self-administered inter-dental mechanical plaque control; 3) the efficacy of adjunctive chemical plaque control; and 4) anti-inflammatory (sole or adjunctive) approaches. METHODS: Two meta-reviews (mechanical plaque removal) and two traditional systematic reviews (chemical plaque control/anti-inflammatory agents) formed the basis of this consensus. RESULTS: Data support the belief that professionally administered plaque control significantly improves gingival inflammation and lowers plaque scores, with some evidence that reinforcement of oral hygiene provides further benefit. Re-chargeable power toothbrushes provide small but statistically significant additional reductions in gingival inflammation and plaque levels. Flossing cannot be recommended other than for sites of gingival and periodontal health, where inter-dental brushes (IDBs) will not pass through the interproximal area without trauma. Otherwise, IDBs are the device of choice for interproximal plaque removal. Use of local or systemic anti-inflammatory agents in the management of gingivitis has no robust evidence base. We support the almost universal recommendations that all people should brush their teeth twice a day for at least 2 min. with fluoridated dentifrice. Expert opinion is that for periodontitis patients 2 min. is likely to be insufficient, especially when considering the need for additional use of inter-dental cleaning devices. In patients with gingivitis once daily inter-dental cleaning is recommended and the adjunctive use of chemical plaque control agents offers advantages in this group.

Influence of mechanical instruments on the biocompatibility of titanium dental implants surfaces: a systematic review.

OBJECTIVE: The objective of this systematic review was to evaluate the effect of mechanical instruments on the biocompatibility of titanium dental implant surfaces. MATERIALS AND METHODS: MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched up to December 2013, to identify controlled studies on the ability of cells to adhere and colonize non-contaminated and contaminated, smooth and rough, titanium surfaces after instrumentation with different mechanical instruments. RESULTS: A comprehensive search identified 1893 unique potential papers. Eleven studies met the inclusion criteria and were selected for this review. All studies were in vitro studies. Most studies used titanium discs, strips and cylinders. The air abrasive was the treatment mostly evaluated. The available studies had a high heterogeneity which precluded any statistical analysis of the data. Therefore, the conclusions are not based on quantitative data. Instrumentation seems to have a selective influence on the attachment of different cells. In the presence of contamination, plastic curettes, metal curettes, rotating titanium brushes and an ultrasonic scaling system with a carbon tip and polishing fluid seem to fail to restore the biocompatibility of rough titanium surfaces. The air-powder abrasive system with sodium bicarbonate powder does not seem to affect the fibroblast-titanium surface interaction after treatment of smooth or rough surfaces, even in the presence of contamination. CONCLUSION: The available data suggest that treatment with an air-powder abrasive system with sodium bicarbonate powder does not seem to adversely affect the biocompatibility of titanium dental implant surfaces. However, the clinical impact of these findings requires further clarification.

Mechanical self-performed oral hygiene of implant supported restorations: a systematic review.

UNLABELLED: A systematic review of self-performed oral hygiene practices for optimal maintenance of dental implant-supported restorations reveals a lack of evidence to support best practices. BACKGROUND: The standard of the patients' home care is a key factor for long term stability of dental implants and the prevention of biological complications. The objective of this systematic review is to evaluate and summarize the literature with respect to various mechanical oral hygiene modalities around implant-supported restorations. METHODS: MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched up to October 2013 to identify eligible studies. Five studies that met the inclusion criteria were included. Two cohort studies about powered toothbrushes and three (randomized) controlled trials comparing powered to manual toothbrushes were reviewed. All studies showed an improvement in the clinical parameters over time. Powered toothbrushes were found to perform better than manual toothbrushes but no firm conclusions can be made between treatment modalities. CONCLUSIONS: There is a lack of evidence with respect to effective and optimal self-performed oral hygiene around dental implants. At present, home care recommendations are based on the knowledge that is available with respect to cleaning of natural teeth. It becomes evident that there is an urgent need for academic institutions and industry to initiate and support high quality randomized controlled clinical trials on this topic in the near future.

The effects of mechanical instruments on contaminated titanium dental implant surfaces: a systematic review.

OBJECTIVE: The objective of this systematic review was to evaluate the ability of mechanical instruments to clean contaminated implant titanium surfaces. MATERIALS AND METHODS: MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched up to May 2013 to identify controlled studies on the cleaning efficacy of mechanical instruments on contaminated titanium surfaces. RESULTS: A comprehensive search identified 1893 unique potential papers. Fourteen studies met the inclusion criteria and were selected for this systematic review. Most of the studies were in vitro studies. Different surfaces and different contamination methods were used. Most studies used titanium discs, strips and cylinders. The air abrasive was the treatment mostly evaluated. The available studies had a high heterogeneity that precluded any statistical analysis of the data. Therefore, the conclusions are not based on quantitative data. Non-metal curettes and rubber cups were found to be ineffective. Positive results were reported for (ultra)sonic scalers with a metal tip on polished surfaces, (ultra)sonic scalers with a non-metal tip on smooth and sand-blasted and acid-etched (SLA) surfaces, metal curettes and rotating titanium brushes on SLA surfaces. The air abrasive was found to be effective in cleaning machined, SLA and titanium plasma-sprayed (TPS) surfaces. CONCLUSION: The available data suggest that the air abrasive may remove plaque effectively from machined, SLA and TPS titanium surfaces. Positive results were also observed for rotating titanium brushes on SLA surfaces and ultrasonic scalers with non-metal tip on polished and SLA surfaces. However, the clinical impact of these findings requires further clarification.

Titanium surface alterations following the use of different mechanical instruments: a systematic review.

OBJECTIVE: To systematically collect and evaluate existing evidence on the effects of different mechanical instruments on the surface characteristics of smooth and rough titanium surfaces. MATERIALS AND METHODS: PubMed-MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched up to December 2010 to identify appropriate studies. The eligible studies were controlled studies investigating titanium surface alterations following treatment with different mechanical instruments. RESULTS: In total, 3275 unique papers were identified. A screening of the titles and abstracts resulted in 34 publications that met all of the eligibility criteria. Surface roughness was evaluated using scanning electron microscopy in most studies and using a profilometer in only 10 studies. The rough surfaces evaluated were titanium plasma sprayed and sandblasted and acid-etched surfaces only. Non-metal instruments were found to cause minimal or no damage to both smooth and rough titanium surfaces. Metal instruments were found to cause major damage to smooth surfaces. Burs seemed to be the instruments of choice, if smoothening of a rough surface was required. CONCLUSION: Non-metal instruments and rubber cups seem to be the instruments of choice for the treatment of smooth surfaces. Similarly, for rough implant surfaces, non-metal instruments and air abrasives are the instruments of choice, if surface integrity needs to be maintained. Metal instruments and burs are recommended only in cases requiring the smoothening of the surface roughness. The clinical impact of these findings requires clarification.

The effect of chemotherapeutic agents on contaminated titanium surfaces: a systematic review.

OBJECTIVE: To systematically collect and evaluate the existing evidence for the abilities of different chemotherapeutic agents to decontaminate biofilm-contaminated titanium surfaces. MATERIAL AND METHODS: PubMed-MEDLINE and the Cochrane-CENTRAL databases were searched, covering research published on or before June 2010, to identify appropriate studies. The eligible studies were controlled studies on the effects of chemical treatments on biofilm-contaminated titanium surfaces. RESULTS: In total, 2425 unique papers were identified. Independent screening of the titles and abstracts resulted in only four publications that met all of the eligibility criteria. None of the in vivo studies assessed titanium surface decontamination in a controlled fashion. Three studies provided in vitro data, and one used an ex vivo protocol. Citric acid was found to be the most effective treatment in lipopolysaccharide removal as compared with an untreated control, although its effectiveness was equivalent to those of water and saline. In addition, citric acid demonstrated the greatest efficacy in cleaning the contaminated titanium surface, as evidenced by scanning electron microscopy. CONCLUSION: The data reported for the efficacy of chemotherapeutic agents in cleaning contaminated titanium surfaces are scarce, which precludes the generation of firm conclusions. Based on the lack of robust data, we cautiously conclude that citric acid is the chemotherapeutic agent with the highest potential for the removal of biofilms from contaminated titanium surfaces in vitro, although it does not achieve complete removal. To date, the killing effect of citric acid against biofilms has not been investigated on titanium surfaces.

Mannose-binding lectin gene polymorphisms in relation to periodontitis.

AIM: To investigate the correlation of six functional polymorphisms in the MBL gene with MBL plasma levels in relation to periodontitis. MATERIAL AND METHODS: A total of 92 periodontitis patients and 70 controls, all of Caucasian origin, were included. Patients and controls were genotyped for the L/H, X/Y, P/Q, A/D, A/B and A/C polymorphisms. Distributions of genotypes, rate of allele carriage and allele frequencies were compared between patients and controls. Patients and controls were subdivided in groups of genotypes. Plasma MBL levels were compared between different genotype groups. RESULTS: On the basis of genotyping, three phenotypes with regard to mannose-binding lectin (MBL) production were distinguished: high-producers, low-producers and deficient subjects. No differences in the genotype frequencies were observed between patients and controls. Within patients and controls, subjects with the high-producing genotypes had significantly higher MBL plasma levels than low-producers and deficient subjects (p<0.001). Plasma MBL was higher in low-producer patients compared with low-producer controls (p(adjusted)=0.021). CONCLUSION: No association could be observed between MBL gene polymorphisms and susceptibility to periodontitis in Caucasians. However, now that genotyping could distinguish the low producing and deficient subjects from the high-producers, it was observed, for the first time, that MBL acts as a weak acute-phase protein in periodontitis.