Peri-implantitis: Summary and consensus statements of group 3. The 6th EAO Consensus Conference 2021.

OBJECTIVE: To evaluate the influence of implant and prosthetic components on peri-implant tissue health. A further aim was to evaluate peri-implant soft-tissue changes following surgical peri-implantitis treatment. MATERIALS AND METHODS: Group discussions based on two systematic reviews (SR) and one critical review (CR) addressed (i) the influence of implant material and surface characteristics on the incidence and progression of peri-implantitis, (ii) implant and restorative design elements and the associated risk for peri-implant diseases, and (iii) peri-implant soft-tissue level changes and patient-reported outcomes following peri-implantitis treatment. Consensus statements, clinical recommendations, and implications for future research were discussed within the group and approved during plenary sessions. RESULTS: Data from preclinical in vivo studies demonstrated significantly greater radiographic bone loss and increased area of inflammatory infiltrate at modified compared to non-modified surface implants. Limited clinical data did not show differences between modified and non-modified implant surfaces in incidence or progression of peri-implantitis (SR). There is some evidence that restricted accessibility for oral hygiene and an emergence angle of >30 combined with a convex emergence profile of the abutment/prosthesis are associated with an increased risk for peri-implantitis (CR). Reconstructive therapy for peri-implantitis resulted in significantly less soft-tissue recession, when compared with access flap. Implantoplasty or the adjunctive use of a barrier membrane had no influence on the extent of peri-implant mucosal recession following peri-implantitis treatment (SR). CONCLUSIONS: Prosthesis overcontouring and impaired access to oral hygiene procedures increases risk for peri-implantitis. When indicated, reconstructive peri-implantitis treatment may facilitate the maintenance of post-operative peri-implant soft-tissue levels.

[Periodontal optimization of the smile: choosing the right moment to achieve a maximum esthetic result]. / Optimisation parodontale du sourire : adresser au bon moment pour un réel bénéfice esthétique.

INTRODUCTION: Today, esthetic enhancement is one of the main reasons why patients seek orthodontic treatment. Governed by the canons of beauty dictated by our society, the smile is a key component in this quest for perfect beauty. Hence, the orthodontist is often the first specialist to be consulted by adolescents, but also, more and more, by adults as well. Using simple tools, the practitioner must be able to make a precise analysis of the patient combining both orthodontic and periodontal examinations with an esthetic periodontal diagnosis. OBJECTIVES: Using this analysis, the orthodontist must be able to identify his/her patient's periodontal morphotype and assess whether there is a risk of complications during treatment. One of the main complications that may arise is periodontal recession, which can both impact the esthetic result and give rise to patient anxiety, very soon leaving the orthodontist at a loss. If in doubt, it is essential to refer one's patient to the general dentist or to the periodontist. MATERIALS AND METHODS: In this paper, the authors will describe a didactic decision-making tree, which will assist practitioners in learning how to manage their patients. DISCUSSION: A synergistic approach to global patient management will ensure an optimal outcome by providing the patient with an appropriate and individualized treatment procedure.

Assessing a multiplex-targeted proteomics approach for the clinical diagnosis of periodontitis using saliva samples.

AIM: The present study focused on the research of new biomarkers based on the liquid chromatography-multiple-reaction monitoring (MRM) proteomic profile in whole saliva of patients with periodontitis compared with periodontal healthy patients. METHODS: A 30-min multiplexed liquid chromatography-MRM method was used for absolute quantification of 35 plasma biomarkers in saliva from control patients and patients with periodontitis. RESULTS: Three proteins namely hemopexin, plasminogen and α-fibrinogen were shown to be clearly related to the presence of periodontitis compared with healthy patients. Apolipoprotein H was found to discriminate for the first time chronic and aggressive periodontitis. CONCLUSION: Our results indicate that this innovative MRM method could be used to screen for periodontitis in clinical environment. Furthermore, apolipoprotein H was found to be a discriminant biomarker of aggressive periodontitis.

[Collaboration between periodontics and orthodontics: interest of alveolar corticotomies and piezocision. Review of literature]. / Collaboration parodontie et orthodontie : intérêts des corticotomies alvéolaires et de la piézocision. Revue de la littérature.

INTRODUCTION: Orthodontics in adults must adapt to certain particularities especially related to the decrease or absence of growth and the prevalence of periodontal damage in this population. This review of the literature aims to assess the effects of alveolar corticotomies on accelerating or facilitating tooth movements in different types of orthodontic movements, to compare results obtained by classical technique with those obtained by piezocision and analyze their impact on periodontal tissues in the long term. MATERIAL AND METHODS: Research was performed with Medline, Embase and Cochrane databases, beginning in January 2000. Every study, selected through its title and abstract, was then evaluated through its full content. A total of 65 studies were included. RESULTS: All studies showed that corticotomies temporarily facilitate accelerated orthodontic tooth movement, with minimal complications. No periodontal lesion, loss of pulpal vitality or severe root resorption were reported. DISCUSSION: Only a few studies have examined control groups treated with conventional orthodontics. Corticotomy allows temporary acceleration of orthodontic tooth movement. Piezocision is less invasive and performed in certain indications; it also lightens the postoperative complications. However, the fact that using alveolar corticotomies significantly decreases the treatment time remains uncertain, due to the lack of significant data. Further prospective randomized clinical studies are necessary to analyze more precisely the decrease in the overall treatment time, improved periodontal support and stability of orthodontic treatment results in the long term following the alveolar corticotomies.

Benefits of mineralized bone cortical allograft for immediate implant placement in extraction sites: an in vivo study in dogs.

PURPOSE: The aim of the present study was to evaluate the effectiveness of using a mineralized bone cortical allograft (MBCA), with or without a resorbable collagenous membrane derived from bovine pericardium, on alveolar bone remodeling after immediate implant placement in a dog model. METHODS: Six mongrel dogs were included. The test and control sites were randomly selected. Four biradicular premolars were extracted from the mandible. In control sites, implants without an allograft or membrane were placed immediately in the fresh extraction sockets. In the test sites, an MBCA was placed to fill the gap between the bone socket wall and implant, with or without a resorbable collagenous membrane. Specimens were collected after 1 and 3 months. The amount of residual particles and new bone quality were evaluated by histomorphometry. RESULTS: Few residual graft particles were observed to be closely embedded in the new bone without any contact with the implant surface. The allograft combined with a resorbable collagen membrane limited the resorption of the buccal wall in height and width. The histological quality of the new bone was equivalent to that of the original bone. The MBCA improved the quality of new bone formation, with few residual particles observed at 3 months. CONCLUSIONS: The preliminary results of this animal study indicate a real benefit in obtaining new bone as well as in enhancing osseointegration due to the high resorbability of cortical allograft particles, in comparison to the results of xenografts or other biomaterials (mineralized or demineralized cancellous allografts) that have been presented in the literature. Furthermore, the use of an MBCA combined with a collagen membrane in extraction and immediate implant placement limited the extent of post-extraction resorption.

Long-term follow up of post-surgical tooth autotransplantation: a retrospective study.

AIM: The aim of the present retrospective study was to evaluate the long-term results of tooth autotransplantation using the survival and success rates of transplanted teeth as outcome variables. METHODS: Thirty patients received a total of 44 transplants of immature teeth from 1987 to 1997. Seventeen of those patients with 25 transplants were recalled 10-20 years after tooth transplantation for complete clinical and radiographic examinations, followed by questionnaires that examined the patients' degrees of satisfaction. The incidence of all types of complications was carefully analyzed. Success was defined as being free of all complications over the entire observation period. RESULTS: The long-term survival rate for transplants that were observed after at least 10 years was 96%. The cumulative complication rate (pulpal, periodontal, and operative complication rates) after an observation period of 10-20 years was 38.9%. Therefore, the success rate at 10 years was 61.1%. CONCLUSION: The present study confirms that transplanted teeth have a high long-term survival rate and a lower long-term success rate. This procedure should be recommended and carried out in appropriate patients when necessary because it is the most biological approach, even though it is highly sensitive to technique.