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1.
J Oral Sci ; 63(2): 152-156, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33597334

RESUMO

PURPOSE: To determine the impact of experimentally preformed peri-implant crater-shaped bone defects on the evolution of in situ microbiota and development of bone defects compared to those induced over time by ligature placement only. METHODS: Implants were installed in the mandibles of eight dogs. Standardized bone defects were preformed in four test animals but not in the other four control animals, prior to implant (3.3 mm × 8 mm) installation. After 2 months of healing, peri-implantitis was induced with silk ligatures in both groups for 2 months. Microbial samples were obtained from implants and teeth for analysis at three time points (qPCR), and the average depths of the bone defects were measured. RESULTS: At the baseline, the total marker load of periodontal-pathogenic bacteria (TML) for teeth accounted for 5.2% (0-17.4%). After implant healing, TMLs for implants and teeth were comparable (7.1% [0.3-17.4%]). The TML of both groups was 3.5%, 2 months after ligature placement. Bone defects had a mean depth of 1.84 mm at preformed defects and 1.64 mm at control sites (P > 0.05). CONCLUSION: Preformed defects in the test group showed comparable results to the control group in terms of TML, the incidence of periodontal-pathogenic bacteria, and bone defect depth.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Perda do Osso Alveolar/etiologia , Animais , Implantes Dentários/efeitos adversos , Ligadura , Mandíbula
2.
PLoS One ; 15(12): e0244020, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33320905

RESUMO

AIM: To assess the distribution and deposition of aerosols during simulated periodontal therapy. METHODS: A manikin with simulated fluorescein salivation was treated by four experienced dentists applying two different periodontal treatment options, i.e. air-polishing with an airflow device or ultrasonic scaling in the upper and lower anterior front for 5 minutes, respectively. Aerosol deposition was quantitatively measured on 21 pre-defined locations with varying distances to the manikins mouth in triplicates using absorbent filter papers. RESULTS: The selected periodontal interventions resulted in different contamination levels around the patient's mouth. The highest contamination could be measured on probes on the patient's chest and forehead but also on the practitioner's glove. With increasing distance to the working site contamination of the probes decreased with both devices. Air-polishing led to greater contamination than ultrasonic. CONCLUSION: Both devices showed contamination of the nearby structures, less contamination was detected when using the ultrasonic. Affirming the value of wearing protective equipment we support the need for universal barrier precautions and effective routine infection control in dental practice.


Assuntos
Aerossóis/química , Polimento Dentário/instrumentação , Controle de Infecções Dentárias/métodos , Periodontia/instrumentação , Terapia por Ultrassom/instrumentação , Humanos , Manequins , Segurança do Paciente , Equipamento de Proteção Individual/normas , Saliva/química
3.
Clin Oral Investig ; 2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32914269

RESUMO

OBJECTIVES: To evaluate the effectiveness of mechanical debridement and/or air polishing on the healing of ligature-induced buccal periimplantitis dehiscence defects in dogs. MATERIAL AND METHODS: Forty-eight implants were placed in the mandibles of twelve beagle dogs, and periimplantitis was induced for 2 months using ligatures. The resulting buccal dehiscence-type defects were surgically cleaned and augmented (xenogenic filler and resorbable membrane) according to one of the following treatments: (1) Cleaning with carbon curette (debridement - D) and guided bone regeneration (GBR/G): DG, (2) air polishing cleaning (A) and GBR: AG, (3) a combination of D/A/G: DAG, and (4) D/A without GBR: DA. After 2 months, histomorphometric and inflammatory evaluations were conducted. RESULTS: The median bone gain after therapy ranged between 1.2 mm (DG) and 2.7 mm (AG). Relative bone gain was between 39% (DG) and 59% (AG). The lowest inflammation scores were obtained in DA without GBR (5.84), whereas significantly higher values between 8.2 and 9.4 were found in the groups with augmentation. At lingual sites without defects, scores ranged from 4.1 to 5.9. According to ISO, differences above 2.9 were considered representative for irritative properties. CONCLUSIONS: All treatments resulted in partial regeneration of the defects. No treatment group showed a significantly (p < 0.05) better outcome. However, pretreatment with air polishing showed a tendency for less inflammation. Noteworthy, inflammation assessment showed an overall irritative potential after GBR in the evaluated early healing phase. CLINICAL RELEVANCE: Periimplantitis treatment still represents a big issue in daily practice and requires additional preclinical research in order to improve treatment concepts.

4.
Dent J (Basel) ; 8(2)2020 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-32503214

RESUMO

This case report describes a rare case of a broken periodontal probe tip and its removal. A male patient presented himself in June 2019 due to a painful tooth in the upper left quadrant. The patient elected treatment in the dental school's student course. In October 2019, in preparation for full-mouth rehabilitation, a complete diagnostic status was performed, including radiographs. In this context, a metal-dense fragment was identified in the apical region of the (missing) tooth 45. It was diagnosed as the broken tip of a periodontal probe (type AE P OWB). Since a PCP-12 probe is generally used in-house, iatrogenic damage during the initial examination or student course could be excluded a priori. The patient was not able to remember any treatment that could be associated with the instrument's breaking. Since the probe fragment was palpable and a translocation could not be precluded, the patient agreed to its removal under local anesthesia, after a cone-beam CT. This article describes and discusses this particular case, with special emphasis on iatrogenic instrument fractures and their removal.

5.
Clin Oral Investig ; 24(3): 1091-1100, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31938962

RESUMO

BACKGROUND: Gingival recessions inevitably occur during healing after scaling and root planing, but synoptic data on this topic is still lacking. This review compared the recession formation with and without the administration of systemic antibiotics. OBJECTIVES: To evaluate the formation of recession with and without the administration of antibiotics during the healing after scaling and root planing. MATERIALS AND METHODS: This study re-analyzed publications that reported clinical attachment levels (CAL) and probing pocket depths (PD) up to January 2019, including the pivotal review by Zandbergen and co-workers (2013). Whereas these studies traditionally focused on PD and CAL, the present analysis compared recession formation (ΔREC) after adjunctive systemic administration of amoxicillin (amx) and metronidazole (met) during scaling and root planing (SRP) and SRP alone. The mean increase in ΔREC, if not reported, was calculated from CAL and PD values and statistically analyzed. Recession formation was compared after 3 and 6 months after therapy. Results were separately reported for chronic periodontitis (CP) as well as aggressive periodontitis (AP) cases. RESULTS: Recessions increased consistently between baseline and follow-up. In the AP group, median ΔREC was 0.20 mm after 3 months, irrespective of whether antibiotics were administered or not. After 6 months, median ΔREC increased to 0.35 mm after AB and remained stable at 0.20 mm with SRP alone. In the CP group, after 3 months with and without antibiotics, median ΔREC accounted for 0.30 mm and 0.14 mm, respectively. After 6 months, median ΔREC accounted for 0.28 mm (with AB) and 0.20 mm (without AB). The quantitative assessment by meta-analyses also yielded small values (≤ 0.25 mm) for the estimated differences in recession formation between AB and noAB; however, none of them reached statistical significance. CONCLUSIONS: Although a slight tendency towards higher recession formation after SRP in combination with AB could be observed in many studies, quantitative meta-analyses showed no clinically relevant difference in recession formation due to the administration of AB. In general, the description and discussion of recessions in the literature seems not to be a major focus so far. CLINICAL RELEVANCE: Since the preservation of gingival tissues is important by preventive and therapeutic means, e.g., when avoiding postoperative root sensitivity or performing regenerative surgery, these aspects should not be neglected. We thus suggest to report REC measurements along with PD and CAL values for more direct recession formation (ΔREC) assessments in the future.


Assuntos
Amoxicilina/administração & dosagem , Raspagem Dentária , Retração Gengival , Metronidazol/administração & dosagem , Aplainamento Radicular , Antibacterianos/administração & dosagem , Humanos
6.
Clin Exp Dent Res ; 5(6): 712-724, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31890309

RESUMO

Objectives: This narrative review is aiming on showing reasons for implant failure, removal techniques, and respective clinical considerations; further, the survival rate of implants in previous failed sites is examined. Materials and methods: Questions have been formulated, answered, and discussed through a literature search including studies assessing implant failure and removal up to 2018. Results: Studies describing reasons for implant failure, implant removal techniques, and the reinsertion of implants in a previous failed site (n = 12) were included. To date, peri-implantitis is the main reason for late implant failure (81.9%). Trephine burs seem to be the best-known method for implant removal. Nevertheless, the counter-torque-ratchet-technique, because of the low invasiveness, should be the first choice for the clinician. Regarding zirconia implant removal, only scarce data are available. Implantation in previously failed sites irrespective of an early or late failure results in 71% to 100% survival over 5 years. Conclusion: If removal is required, interventions should be based on considerations regarding minimally invasive access and management as well as predictable healing. (Post)Operative considerations should primarily depend on the defect type and the consecutive implantation plans.


Assuntos
Implantação Dentária/efeitos adversos , Implantes Dentários/efeitos adversos , Falha de Restauração Dentária , Remoção de Dispositivo/normas , Guias de Prática Clínica como Assunto , Implantação Dentária/instrumentação , Humanos , Fatores de Risco
7.
Clin Oral Investig ; 23(1): 21-32, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30535817

RESUMO

BACKGROUND: Biofilm management and infection control are essential after periodontal and implant surgery. In this context, chlorhexidine (CHX) mouth-rinses are frequently recommended post-surgically. Despite its common use and many studies in this field, a systematic evaluation of the benefits after periodontal or implant surgery is-surprisingly-still missing. OBJECTIVES: To evaluate the benefits of chlorhexidine rinsing after periodontal or implant surgery in terms of plaque and inflammation reduction potential. Furthermore, to screen whether the concentration changes or additives in CHX solutions reduce side effects associated with its use. MATERIALS AND METHODS: A systematic literature search was performed for clinical trials, which compared CHX rinsing after periodontal or implant surgery with rinsing using placebo, non-staining formulations, or solutions with reduced concentrations of the active compound. Four databases (Medline, PubMed, Embase, Cochrane) were searched up to June 2018. Two reviewers independently identified and screened the literature. RESULTS: From 691 titles identified, only eleven publications met the inclusion criteria and were finally included. Mainly early publications assessed the benefits of CHX over placebo rinsing, whereas more recent publications focused more on the evaluation of new formulations with regard to effectiveness and side effects. The use of CHX after surgery showed in general significant reduction in plaque (means of 29-86% after 1 week) and bleeding (up to 73%) as compared to placebo. No consensus, however, was found regarding the most beneficial CHX formulation avoiding side effects. CONCLUSION: Chlorhexidine rinsing helps to reduce biofilm formation and gingival inflammation after surgery. However, no additional reduction of periodontal probing depth over any given placebo or control solution could be found irrespective of whether CHX was used or not. The use of additives such as antidiscoloration systems (ADS) or herbal extracts may reduce side effects while retaining efficacy. CLINICAL RELEVANCE: Within the limitations of this review, it can be concluded that CHX may represent a valuable chemo-preventive tool immediately after surgery, during the time period in which oral hygiene capacity is compromised. To reduce the side effects of CHX and maintain comparable clinical effects, rinsing with less concentrated formulations (e.g., 0.12%) showed the most promising results so far.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Biofilmes/efeitos dos fármacos , Clorexidina/uso terapêutico , Implantação Dentária , Gengivite/prevenção & controle , Antissépticos Bucais/uso terapêutico , Doenças Periodontais/cirurgia , Infecção da Ferida Cirúrgica/prevenção & controle , Humanos
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