Clinical peri-implant outcomes, technical complications, and patient satisfaction with single vs. splinted crown supported implants in the anterior mandible region of diabetic individuals.

OBJECTIVE: To compare the clinical and radiographic peri-implant parameters around narrow diameter implants (NDI) supported single (NDISCs) and splinted crowns (NDISPs) in the anterior maxilla of non-diabetics and type 2 diabetes mellitus patients (T2DM). MATERIALS AND METHODS: The clinical and radiographic parameters of NDISC and NDISP were assessed in the anterior mandibular jaw of T2DM and non-diabetic individuals. Plaque index (PI), bleeding on probing (BoP), probing depth (PD) and crestal bone levels were recorded. Technical complications and patient satisfaction were also assessed. ANOVA (one-way analysis of variance) was used to compare the inter-group means of clinical indices and radiographic bone loss while Shapiro-Wilk was used to compute the normal distribution of dependent variables. A p-value of less than 0.05 was considered significant. RESULTS: Sixty-three patients (35 males and 28 females) were part of the study out of which 32 were non-diabetics and 31 were T2DM patients. A total of 188 implants (124 NDISCs and 64 NDISPs) having moderately roughened topography were used for the study. The mean glycated hemoglobin in the non-diabetic group was 4.3 while that in the T2DM group was 7.9 with an average diabetic history of 8.6 years. Peri-implant parameters, including PI, BoP, and PD, were comparable between the single crown and splinted crown groups. However, there was a statistically significant difference in PI, BoP, and PD when a comparison was made between the non-diabetes and T2DM groups (p<0.05). An overall 88% of the patients were satisfied with the esthetics of the crowns while 75% of the subjects were satisfied with the function of the crowns. CONCLUSIONS: Narrow diameter implants of both types had satisfactory clinical and radiographic outcomes within non-diabetic and diabetic individuals. However, clinical and radiographic parameters were worse in type 2 diabetes mellitus patients when compared to non-diabetics.

Implant abutment disinfection using plasma of argon and 0.2% and chlorhexidine gel applications immediately before prosthesis delivery: clinical and radiographic status at 5-years of follow-up.

OBJECTIVE: The purpose of this five-year follow-up study was to investigate the clinical and radiologic status of implants that had undergone abutment disinfection immediately prior to prosthetic loading (PL) using plasma of argon (PA) or 0.2% chlorhexidine (CHX) gel. PATIENTS AND METHODS: Sixty patients who had had an implant-supported prosthesis fitted at least five years previously were recruited for this study. In groups 1, 2, and 3, implant abutment disinfection was performed using PA, 0.2% CHX, and a vapor protocol, respectively. Modified plaque index (mPI), modified bleeding index (mBI), probing depth (PD), and mesial and distal crestal bone loss (CBL) were measured. A questionnaire on routine oral hygiene, smoking habits, and systemic health status was also administered. Sample size estimation was performed, and group comparisons were made. Probability values less than 0.05 were considered statistically significant. RESULTS: Group 1, 2, and 3 included 20 (20 implants) patients each. At five-year's follow-up, there was no difference in mBI, mPI, and PD in all groups. There was no significant difference in peri-implant CBL in all patients. None of the patients were immunosuppressed or had periodontal disease, and or had used nicotinic products within the past five years. Toothbrushing twice daily was reported by at least 90% of individuals in all groups. Flossing of interproximal spaces once daily was reported by at minimum 60% of individuals in all groups. CONCLUSIONS: Disinfection of implant abutments directly before PL can be performed using AP, or 0.2% CHX gel.

Efficacy of adjunct subgingival minocycline delivery for treatment of peri-implantitis in moderate cigarette smokers.

OBJECTIVE: Localized subgingival minocycline hydrochloride (MH) delivery as an adjuvant to with non-surgical mechanical debridement (NSMD) is useful for the treatment of periodontitis; however, there are no trials that have assessed the efficacy of subgingival MH delivery with NSMD for the treatment of peri-implantitis in cigarette-smokers and non-smokers. This randomized controlled trial assessed the efficacy of subgingival MH delivery with NSMD for the treatment of peri-implantitis in cigarette-smokers. PATIENTS AND METHODS: Self-reported current cigarette-smokers and non-smokers with peri-implantitis were encompassed. These individuals were subdivided into 2-subgroups. Patients in test- and control groups received NSMD with and without a single delivery of subgingival MH. Modified-gingival-index (mGI), modified-plaque-index (mPI), probing-depth (PD) and crestal-bone-loss (CBL) were measured at baseline and at 6-months' follow-up. Demographic-data was also collected. Level of significance was set at p<0.01. RESULTS: Twenty-four cigarette-smokers and 24 non-smokers with peri-implantitis were included. There was a significant reduction in mPI (p<0.01), mGI (p<0.01), PD (p<0.01) at 6-months among patients with and without type-2 DM in test- and control-groups. There was no significant difference in peri-implant mPI, PD and mGI, patients with and without type-2 diabetes in test- and control-groups at 6-months of follow-up. There was no significant difference in CBL in all patients at 6-months of follow-up. CONCLUSIONS: A single application of subgingival MH delivery is as effective as NSMD alone for the treatment of peri-implantitis in cigarette-smokers and non-smokers.