A Cross-Sectional Analysis on Factors Associated With Peri-Implant Pathologies at the Implant Level.

Pathologies in peri-implant tissues are common and may disturb long-term implant supported rehabilitation. We aimed to evaluate the occurrence of such peri-implant diseases and their associated factors in this study. Peri-implantitis and mucositis were diagnosed based on clinical and radiological findings. Statistical analysis was performed with the X2 and logistic regression. Peri-implant mucositis and peri-implantitis were observed in 43.4% and 13.8% of patients with implants evaluated, respectively. Univariate analysis found associations with systemic changes (P = .016; yes), medication use (P = .010; yes), implant location (P < .0001; upper jaw), implant region (P = .008; posterior), previous augmentation procedure (P = .023; yes), time of prostheses use (P < .0001; >2 years), keratinized mucosa (P < .0001; absence); and gingival bleeding index (P = .005; >30%). In the multiple analysis, independent predictors were: >2 years of prostheses use (P < .0001; PR = 1.720), upper jaw location (P < .0001; PR = 1.421), gingival bleeding index >30% (P = .001; PR = 1.496), and use of medication (P < .0001; PR = 1.261). The frequency of peri-implant pathologies is high (approximately 57.2%) with several aspects of the occurrence being related to the patients' prosthesis. Prostheses type and the complexity of rehabilitation are worth highlighting. Factors include the location of the dental implant, gingival bleeding index, patient's use of medication(s), and the time of prostheses use.

Do patients with aggressive and chronic periodontitis exhibit specific differences in the subgingival microbial composition? A systematic review.

BACKGROUND: The 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions grouped the diseases previously recognized as chronic (CP) or aggressive (AgP) periodontitis under a single category named periodontitis. The rationale for this decision was the lack of specific patterns of immune-inflammatory response or microbial profiles associated with CP or AgP. However, no previous studies have compiled the results of all studies comparing subgingival microbial data between these clinical conditions. Thus, this systematic review aimed to answer the following focused question: "Do patients with AgP periodontitis present differences in the subgingival microbiota when compared with patients with CP?" METHODS: A systematic review was conducted according to the PRISMA statement. The MEDLINE, EMBASE, and Cochrane databases were searched up to June 2019 for studies of any design (except case reports, case series, and reviews) comparing subgingival microbial data from patients with CP and AgP. RESULTS: A total of 488 articles were identified and 56 were included. Thirteen studies found Aggregatibacter actinomycetemcomitans elevated in AgP in comparison with CP, while Fusobacterium nucleatum, Parvimonas micra, and Campylobacter rectus were elevated in AgP in a few studies. None of these species were elevated in CP. However, the number of studies not showing statistically significant differences between CP and AgP was always higher than that of studies showing differences. CONCLUSION: These results suggested an association of A. actinomycetemcomitans with AgP, but neither this species nor the other species studied to date were unique to or could differentiate between CP and AgP (PROSPERO #CRD42016039385).

Different antibiotic protocols in the treatment of severe chronic periodontitis: A 1-year randomized trial.

AIM: To evaluate the clinical effects of different dosages of metronidazole (MTZ) and durations of MTZ + amoxicillin (AMX) in the treatment of generalized chronic periodontitis (GChP). MATERIAL AND METHODS: Subjects with severe GChP were randomly assigned to receive scaling and root planing (SRP)-only, or combined with 250 or 400 mg of MTZ + AMX (500 mg) thrice a day (TID), for 7 or 14 days. Subjects were monitored for 1 year. RESULTS: One hundred and nine subjects were enrolled. At 1 year, 61.9% and 63.6% of the subjects receiving AMX + 250 or 400 mg of MTZ for 14 days, respectively, reached the clinical endpoint for treatment (≤4 sites with probing depth ≥5 mm), against 31.8% of those taking 250 or 400 mg of MTZ for 7 days (p < .05) and 13.6% of those receiving SRP-only (p < .05). Fourteen days of MTZ + AMX was the only significant predictor of subjects reaching the clinical endpoint at 1 year (OR, 5.26; 95% CI, 2.3-12.1, p = .0000). The frequency of adverse events did not differ among treatment groups (p > .05). CONCLUSION: The adjunctive use of 400 or 250 mg of MTZ plus 500 mg of AMX/TID/14 days offers statistically significant and clinically relevant benefits over those achieved with SRP alone in the treatment of severe GChP. The added benefits of the 7-days regimen in this population were less evident. (ClinicalTrials.gov NCT02735395).

Patient satisfaction concerning implant-supported prostheses: an observational study.

The aim of this observational study was to assess the degree of patient satisfaction toward implant-supported prostheses. A questionnaire was used with two scales (one consisting of detailed adjectival and the other of numerical responses) regarding chewing, esthetics, speaking, comfort and overall satisfaction. The scales were administered to a sample of 147 patients treated with implants and prostheses. The data were submitted to the Kappa statistic and the Chi-square test to analyze the association between dependent and independent variables. High degrees of satisfaction (greater than 91%) were found for all categories evaluated, regardless of gender, age, number of implants or type of prosthesis. "Comfort" was associated significantly with the number of implants (p = 0.038), and "speaking" was associated significantly with the type of prosthesis (p = 0.029). Positive agreement was found between the scales for all categories evaluated, without statistically significant differences regarding respondent preference (p = 0.735). Patients treated with implant-supported prostheses were highly satisfied with the treatment.

Patient satisfaction concerning implant-supported prostheses: an observational study

The aim of this observational study was to assess the degree of patient satisfaction toward implant-supported prostheses. A questionnaire was used with two scales (one consisting of detailed adjectival and the other of numerical responses) regarding chewing, esthetics, speaking, comfort and overall satisfaction. The scales were administered to a sample of 147 patients treated with implants and prostheses. The data were submitted to the Kappa statistic and the Chi-square test to analyze the association between dependent and independent variables. High degrees of satisfaction (greater than 91%) were found for all categories evaluated, regardless of gender, age, number of implants or type of prosthesis. “Comfort” was associated significantly with the number of implants (p = 0.038), and “speaking” was associated significantly with the type of prosthesis (p = 0.029). Positive agreement was found between the scales for all categories evaluated, without statistically significant differences regarding respondent preference (p = 0.735). Patients treated with implant-supported prostheses were highly satisfied with the treatment.

Long-term periodontal tissue outcome in regenerated infrabony and furcation defects: a systematic review.

OBJECTIVES: This study aimed to systematically evaluate the long-term results of periodontal tissues in regenerated infrabony and furcation defects. MATERIAL AND METHODS: A search of the Medline database was performed (1960 to 2012), complimented by an additional hand search. For inclusion in the review, clinical trials had to include the long-term evaluation of infrabony and furcation defects submitted to periodontal regeneration for up to 3 years of follow-up. Changes in clinical attachment level (CAL) from pre-surgery, at the first post-surgical, and final evaluations were used to analyze the effects of regenerative treatments over time. RESULTS: A total of 866 articles were found using the descriptors employed. Of these, 216 papers were selected for abstract reading by two evaluators. One hundred and eighty-nine were excluded for not fulfilling the eligibility criteria. Twenty-seven papers were selected for the analysis of the full texts, and 13 were excluded. Two studies were included after a manual search. Finally, 16 papers were selected for the present review. CONCLUSIONS: Regenerative techniques for the treatment of infrabony and furcation defects resulted in improved CAL during long-term follow-up periods, even when attachment losses occurred during this period. This improvement should be carefully evaluated with regard to its clinical relevance for dental longevity. CLINICAL RELEVANCE: The improvement in clinical attachment level achieved by regenerative techniques with biomaterials demonstrated satisfactory results over the long-term. However, regenerative techniques still present different success rates with regard to gain in clinical attachment level.

Condição peri-implantar e fatores associados à s doenças peri-implantares em pacientes reabilitados no serviço odontológico da Faculdade de Odontologia da UFRN / Condition peri-implant s and factors associated with peri-implant diseases in patients rehabilitated in dental service of the Faculty of Dentistry UFRN

A introdução dos implantes dentários osseointegrados como uma ferramenta na reabilitação oral de pacientes edêntulos e parcialmente edêntulos é uma realidade no cotidiano do cirurgião-dentista. Estudos reportam uma alta taxa de sucesso da utilização de implantes no tratamento reabilitador. Entretanto, outras investigações têm mostrado a perda desses implantes devido a infecções peri-implantares, como a mucosite e a peri-implantite. O objetivo deste trabalho foi avaliar a frequência das doenças peri-implantares e seus fatores associados em pacientes com implantes dentais em função reabilitados no serviço odontológico da Faculdade de Odontologia da UFRN. Foram examinados 155 indivíduos portadores de 523 implantes e 2718 dentes. Dentes e implantes foram avaliados por meio de sondagem periodontal, observando-se a profundidade de sondagem, retração gengival, bem como foram avaliados índices de placa visível (IPV) e sangramento gengival (ISG) e presença de supuração. Os dados foram armazenados em fichas clínicas e avaliados estatisticamente por meio da estatística descritiva e inferencial. A idade média dos pacientes foi de 54,05 (± 12,61) anos, sendo 79,4% do sexo feminino. As frequências da mucosite, peri-implantite e periodontite em indivíduos foram 54%, 28% e 50%, respectivamente. Dos 523 implantes avaliados, 43% tinham mucosite, 14% peri-implantite e 43% saúde. Os testes Qui-quadrado de Pearson e Exato de Fisher mostraram que as doenças peri-implantares estão associadas as doenças periodontais, uso de medicação, alterações sistêmicas número de implantes, IPV, ISG, ao tempo de função das próteses, região do implante, número de roscas expostas e faixa de mucosa queratinizada (p<0,05). A análise de regressão múltipla, através da regressão binária logística, constatou que indivíduos que faziam uso de medicação (OR = 1,784), com um ISG > 10% (OR = 1,742), com implantes instalados na maxila (OR = 2,654), onde a prótese sobre o implante tinham mais de 2 anos em função (OR = 3,144) e que radiograficamente apresentavam uma perda óssea atingindo a terceira rosca do implante (OR = 4,701) mostram uma associação positiva com as doenças peri-implantares de maneira que esses indivíduos têm mais chances de ter essas doenças. Os resultados sugerem que a frequência das doenças peri-implantares na população em estudo foi de 82% dos pacientes e que estas doenças estão associadas a fatores relacionados aos indivíduos como: a presença da doença periodontal, piores IPV e IS, alterações sistêmicas, uso de medicação e maior número de implantes; e a fatores locais relacionados aos implantes como: ausência ou faixa de mucosa menor que 2mm, implantes na maxila e na região anterior, perda óssea atingindo a terceira rosca do implante e a um tempo de reabilitação prótetica maior que 2 anos. (AU)

The introduction of osseointegrated dental implants as a tool in oral and maxillo-facial rehabilitation is an everyday dentist reality. Several studies have reported a high rate of successful use of osseointegrated implants in the rehabilitation treatment. However, other investigations have shown some loss of these implants due to peri-implant infections, such periimplantitis. Thus, the aim of this study was to evaluate the frequency of peri-implant mucositis and periimplantitis in osseointegrated implants in function as well as the frequency of periodontal disease in patients with dental implants. It was examined 155 individuals and 523 implants and 2718 teeth. The teeth and implants were evaluated by periodontal probing, observing the probing pocket depth, gingival recession and clinical attachment level, visible plaque index and gingival bleeding index, mobility and the presence of suppuration. The data were stored and evaluated in a descriptive statistical analysis. The average patient age was 54,05 (±12,61) years and 79,4% were female. The frequency of mucositis, periimplantitis and periodontitis in patients were 54%, 28% and 50%, respectively. From 523 implants evaluated, 43% had mucositis, 14% had periimplantitis and 43% heath. The Chi-square test and Fisher's Exact test showed that patients with peri-implant diseases were associated with periodontal diseases, medication use, number of implants, Visible Plaque Index (VPI), Gingival Bleeding Index (GBI) and the time when the prosthesis is in function (p <0.05). Multivariate analysis using binary logistic regression found that subjects who were taking medication (OR = 1.784), with an ISG >10% (OR = 1.742), with implants placed in the jaw (OR = 2.654) where the prosthesis on the implant had over 2 years in function (OR = 3.144) and had a radiographic bone loss reaching the third implant thread (OR = 4.701) showed a positive association with peri-implant disease so that these individuals are more chance to have these peri-implant diseases. The results suggest that the frequency of peri-implant disease in the study population was 82% of patients and these diseases are associated with factors related to subjects such as: the presence of periodontal disease, and worse VPI and GBI, systemic changes, use of medication and more implants, and the local factors related to implants such as absence or mucosa range smaller than 2 mm, the jaw implant and the anterior bone loss reaching the third screw implant and a prosthetic rehabilitation time greater than 2 years. (AU)