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1.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 47(4): 521-528, 2022 Apr 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-35545348

RESUMO

Peri-implantitis, characterized by inflammation of tissues around implants and gradual loss of supporting bone tissue, has become one of the main causes for implant failure. Thoroughly removing the plaque biofilm on the implant surface is the first principle in the treatment of peri-implantitis. For this reason, various decontamination methods have been proposed, which can be divided into 2 categories: Removing biofilm and killing microorganisms according to the effect of plaque biofilm on the implant surface. However, at present, there is no decontamination method that can completely remove the plaque biofilm on the implant surface, and it lacks of clinical recommended guidelines. To understand the advantages and disadvantages, effectiveness and safety for different implant surface decontamination methods is of great significance to guide the clinical selection for peri-implantitis treatment.


Assuntos
Implantes Dentários , Peri-Implantite , Osso e Ossos , Descontaminação , Humanos , Inflamação , Peri-Implantite/terapia , Próteses e Implantes
2.
Int J Oral Maxillofac Implants ; 37(2): 235-249, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35476853

RESUMO

PURPOSE: This systematic review aimed to assess the clinical efficacy of antibiotics when used as an adjunct in treating peri-implant diseases. MATERIALS AND METHODS: A systematic search of papers published between January 1980 and March 2020 was conducted. Randomized clinical trials with at least 10 patients who had peri-implant diseases, treated with or without adjunctive antibiotics in combination with surgical or nonsurgical therapies, and with a minimum of at least 3 months of follow-up were included. Meta-analyses were conducted to analyze weighted mean differences in probing depth reduction, radiographic bone level gain, and odds ratio of treatment success. RESULTS: From the 856 articles identified, 10 articles met the inclusion criteria and were selected. Of these, 7 articles were used for the meta-analysis. The adjunctive use of antibiotics in the treatment of peri-implant diseases yielded significantly greater probing depth reduction (weighted mean differences = 0.56 mm at 3 months, P = .001; 0.77 mm at 6 months, P < .00001; 0.92 mm at 12 months, P < .00001), radiographic bone level gain (weighted mean differences = 0.64 mm, P = .03), and treatment success (odds ratio = 1.74, P = .04) compared to the same treatment without antibiotics. CONCLUSION: Based on the existing evidence, the use of adjunctive antibiotics to treat peri-implant diseases, especially peri-implantitis, provided potential benefits in clinical outcomes for up to 12 months posttherapy.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Estomatite , Antibacterianos/uso terapêutico , Implantes Dentários/efeitos adversos , Humanos , Mucosite/induzido quimicamente , Mucosite/tratamento farmacológico , Peri-Implantite/terapia
3.
Int J Oral Maxillofac Implants ; 37(2): 270-282, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35476855

RESUMO

PURPOSE: This systematic review and Bayesian network meta-analysis (NMA) were performed to compare the clinical effects of nonaugmentative adjunctive approaches in the surgical treatment of peri-implantitis. MATERIALS AND METHODS: A systematic search of six electronic databases was performed up to June 20, 2020. Additional relevant literature was identified through gray literature and hand searches. Randomized controlled trials (RCTs) of surgical treatment of periimplantitis with nonaugmentative adjunctive approaches were included. Probing depth (PD) changes, marginal bone level (MBL) changes, and treatment success rates were extracted and assessed. Pairwise meta-analysis and Bayesian NMA were performed. This review was registered at PROSPERO (CRD42020191113). RESULTS: The search yielded 7,419 articles, of which 10 studies with 11 articles were included in the quantitative analysis. In the NMA of mechanical approaches and photodynamic therapy (PDT), compared with hand curettes, implantoplasty provided significant additional PD improvement at the 6-month follow-up evaluation (mean difference [MD]: 1.29; 95% confidence interval [CI]: 0.17, 2.38) and 12-month follow-up evaluation (MD: 1.39; 95% CI: 0.91, 1.74). In the NMA of antiseptics and systemic antibiotics, adjunctive use of antiseptics and/or systemic antibiotics did not provide significant improvement in PD or MBL. In the NMA of all adjunctive approaches, no significant differences were found in PD improvements. CONCLUSION: Within the limitations of this systematic review and NMA, implantoplasty is more effective than hand curettes in improving PD in the surgical treatment of peri-implantitis. Chemical antiseptics or systemic antibiotics have a limited effect on improving PD and MBL.


Assuntos
Anti-Infecciosos Locais , Peri-Implantite , Fotoquimioterapia , Antibacterianos/uso terapêutico , Anti-Infecciosos Locais/uso terapêutico , Humanos , Metanálise em Rede , Peri-Implantite/terapia
4.
Int J Oral Maxillofac Implants ; 37(2): 329-338, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35476862

RESUMO

PURPOSE: The scarce standard therapeutic protocols for the management of peri-implant diseases results in the empirical application of therapeutic modalities. The objective of this study was to carry out a survey to analyze the therapeutic trends of professionals with different academic backgrounds and levels of expertise. MATERIALS AND METHODS: An exploratory cross-sectional internet-based study survey of board-certified members of the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) was conducted. To assess the therapeutic trends, four clinical vignettes representing different scenarios of peri-implant biologic complications were provided to the participants. Differences in practice patterns were determined using chi-square test and Student t test or analysis of variance (ANOVA) test for qualitative variables. RESULTS: A total of 268 members of the AAP and EFP completed the survey. A significant difference in preferred treatment plan was found between EFP and AAP periodontists, resective therapy being the treatment of choice by the majority of the former (41.2%) and regenerative therapy by the latter (48.9%; P < .001). Overall, 48.1% of experts did not consider any intervention for the management of mucositis. Antibiotic prescriptions differed among groups, with statistical significance in each clinical case, and the explantation criteria were inconsistent and differed significantly among groups. CONCLUSION: Substantial variations exist concerning the decision-making to manage peri-implant diseases and conditions.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Estudos Transversais , Implantes Dentários/efeitos adversos , Odontólogos , Humanos , Mucosite/complicações , Peri-Implantite/etiologia , Peri-Implantite/terapia , Complicações Pós-Operatórias
5.
Compend Contin Educ Dent ; 43(4): 206-213; quiz 214, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35380854

RESUMO

While many clinicians are cognizant of the high survival rate of dental implants, the elevated prevalences of peri-implant mucositis and peri-implantitis post implant insertions may not be as well known. This underscores the need for greater awareness of the importance of continuous personal and professional peri-implant maintenance to facilitate implant success. The occurrence of peri-implant mucositis and peri-implantitis post implant insertions among patients ranges in studies from 46% to 63% and 19% to 23%, respectively. Individuals who undertake regular personal and professional maintenance therapy compared to patients who have irregular supportive therapy manifest reduced occurrences of peri-implant mucositis and peri-implantitis. The frequency of professional maintenance intervals usually ranges from 3 to 6 months, and its specific periodicity should be based on a patient's risk profile. Supportive care visits provide the clinician an opportunity to monitor peri-implant status. No long-term controlled clinical trials have evaluated the timing of maintenance intervals, but substantial evidence shows that professional supportive care enhances peri-implant health and the success rate of dental implants. A patient's informed consent form should include the responsibility to be compliant with personal and professional peri-implant supportive therapy.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Estomatite , Implantação Dentária , Implantes Dentários/efeitos adversos , Humanos , Mucosite/epidemiologia , Mucosite/etiologia , Mucosite/terapia , Peri-Implantite/epidemiologia , Peri-Implantite/etiologia , Peri-Implantite/terapia , Prevalência , Estomatite/epidemiologia , Estomatite/etiologia , Estomatite/terapia
6.
Oral Health Prev Dent ; 20(1): 219-226, 2022 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-35481346

RESUMO

PURPOSE: Cortisol levels (CL) in peri-implant sulcular fluid (PISF) samples in relation to type-2 diabetes mellitus (T2DM) and peri-implantitis remain unaddressed. It is hypothesi?sed that PISF CL are higher in patients with type-2 diabetes and peri-implantitis than in healthy patients without and with peri-implantitis. The aim was to assess the PISF CL of peri-implantitis patients without and with T2DM. MATERIALS AND METHODS: Peri-implantitis patients with T2DM (group 1), T2DM patients without peri-implantitis (group 2), non-diabetic patients with peri-implantitis (group 3) and non-diabetic patients without peri-implantitis (group 4) were included. Demographics were recorded; and patients' medical and dental records were assessed. Peri-implant modified plaque-index (mPI), modified gingival index (mGI), and probing depth (PD) and crestal bone loss (CBL) were recorded. The PISF was collected and CL were determined. p < 0.01 was considered statistically significant. RESULTS: Each of the four groups included 16 subjects (n = 64) with no difference in mean age. In groups 1 and 2, the mean duration of T2DM was 10.5 ± 0.8 and 10.6 ± 0.4 years, respectively. Mean HbA1c levels (p < 0.01) were higher and clinicoradiographic parameters (p < 0.001) were worse in group 1 than in the other groups. The median PISF volume and mean CL were higher in groups 1 (p < 0.01) and 3 (p < 0.01) than groups 2 and 4. There was a statistically significant correlation between PD and CL in group 3 (p < 0.001). CONCLUSION: Cortisol levels in the PISF are higher in T2DM and non-diabetic patients with peri-implantitis than in healthy individuals with and without peri-implantitis. Hyperglycemia did not influence peri-implant clinicoradiographic parameters and CL in the present patient population.


Assuntos
Implantes Dentários , Diabetes Mellitus Tipo 2 , Peri-Implantite , Diabetes Mellitus Tipo 2/complicações , Humanos , Hidrocortisona , Peri-Implantite/epidemiologia , Peri-Implantite/etiologia , Índice Periodontal
7.
Front Cell Infect Microbiol ; 12: 823985, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35372118

RESUMO

Objective: The primary aim of this current systematic review and meta-analysis was to evaluate the potential microbiological effect of probiotics on the implant microbiota. The secondary aim was to evaluate if probiotics have any effect as an adjunct to non-surgical peri-implant treatment in reducing peri-implant mucositis and peri-implantitis clinical parameters-bleeding on probing, modified Gingival Index, and pocket depth. Methods: The research focus questions were constructed in accordance with the Participants, Intervention, Comparison, and Outcomes (PICO) criteria, and a PROSPERO protocol was registered. A comprehensive systematic search in MEDLINE via the PubMed, Scopus, and Web of Science Core Collection databases was conducted. Two independent reviewers screened the reports based on the PICO criteria-inclusion and exclusion criteria. Results: In total, 467 records were identified, and ultimately, 7 papers were included: 3 papers in the qualitative synthesis of microbiological effect and 4 in the meta-analysis synthesis on pocket depth. The data synthesis showed that probiotics had no detectable effect on the implant microflora, and in the following data synthesis, no clinical peri-implantitis variable showed a significantly beneficial effect from probiotics in the test group compared to the control group. Conclusion: Within the limitations of this review, the oral implant microflora is not affected by probiotics nor do probiotics add any effect to the conventional non-surgical treatment of peri-implant mucositis and peri-implantitis.


Assuntos
Implantes Dentários , Microbiota , Peri-Implantite , Probióticos , Estomatite , Implantes Dentários/efeitos adversos , Humanos , Peri-Implantite/etiologia , Peri-Implantite/microbiologia , Probióticos/uso terapêutico , Estomatite/complicações , Estomatite/terapia
8.
J Long Term Eff Med Implants ; 32(1): 19-23, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35377990

RESUMO

PURPOSE: Chlorhexidine is the most favored and widely used antimicrobial agent for the treatment of peri-implantitis. But, not many clinicians are aware of its side effects on dental implants and its cytotoxic effects on osteoblasts. The objectives of this review are to study the effect of chlorhexidine on osteoblasts as well as on the surface topography of dental implants. MATERIALS AND METHODS: MEDLINE-PubMed (The National Library of Medicine, Washington DC) was used as a search engine. Databases were searched from 2010 to 2020 were explored using the following terms: "dental implant surface," "chlorhexidine mouthwash," "osteoblast cells," "osseointegration." From the total hits obtained, each article along with its cross-reference was manually read and filtered based on the focused question. The inclusion criteria included articles published only in English language involving human studies, randomized control trials, in vitro studies, and review articles. Exclusion criteria included studies published in languages other than English, orthodontic mini-implants, and pilot studies. The final process involved scrutinizing for any duplicate content of the hand searched articles. Following this, data was extracted from the compiled hand searched articles to obtain relevant information for the review. RESULTS: Chlorhexidine alters the surface topography of dental implants and causes cell cytotoxicity. This, in turn, can hinder the re-osseointegration potential and hence cause dental implant failure. It is, therefore, recommended to discourage the use of chlorhexidine as a surface decontaminant for peri-implantitis cases and practice implementing other antimicrobial agents.


Assuntos
Implantes Dentários , Procedimentos de Ancoragem Ortodôntica , Peri-Implantite , Clorexidina/uso terapêutico , Implantes Dentários/efeitos adversos , Humanos , Osseointegração , Peri-Implantite/tratamento farmacológico , Peri-Implantite/etiologia , Estados Unidos
9.
J Long Term Eff Med Implants ; 32(1): 85-91, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35377998

RESUMO

Peri-implant mucositis is a reversible inflammatory process of the soft tissue surrounding a dental implant. If left untreated, peri-implant mucositis can evolve into peri-implantitis, which leads to the loss of the supporting bone around the implant. The treatment of peri-implantitis is of special importance, since peri-implantitis can be very expensive and troublesome for both the patient and the dentist and a lack of complete resolution can lead to a low probability of implant success. This study aims to evaluate the effects of probiotic tablets on the condition of patients with peri-implant mucositis after scaling. In this double-blind randomized intervention trial, packages containing 14 probiotic capsules or a single-dose placebo were provided to 25 volunteer patients after scaling among those called to a private clinic in Mashhad. During the research process, we used the probing depth (PD) index and the bleeding on probing (BOP) index to diagnose peri-implant mucositis before and after the 28-day period. According to the study findings, on the day of scaling and 4 weeks after scaling and mouthwash use, there was a statistically significant difference in BOP index values between the probiotic group and the placebo group (P < 0.001). There was no difference in PD index values between these two groups. In conclusion, probiotic treatment can be used in interventions, prevention, and dentists' recommendations to alleviate or eradicate peri-implant mucositis.


Assuntos
Mucosite , Peri-Implantite , Probióticos , Humanos , Antissépticos Bucais/uso terapêutico , Mucosite/tratamento farmacológico , Mucosite/etiologia , Mucosite/prevenção & controle , Peri-Implantite/terapia , Probióticos/uso terapêutico
10.
Artigo em Inglês | MEDLINE | ID: mdl-35472104

RESUMO

Historically, diagnosing peri-implantitis is done based on whether the disease is present, evaluated using the arbitrary thresholds of probing depths and bone loss. Using this approach as a tool to ascertain meaningful information regarding prevalence and treatment is limited. Efforts have been made to improve upon this, but to date, only one of these classifications has provided a simple method to communicate disease severity based on the amount of bone loss. A modified version of this simplified classification is proposed here, including information regarding the implant position, as emerging information suggests that this is a crucial factor in the etiology and prognosis of peri-implantitis. This enhancement to the classification better serves both researchers and clinicians in their discussion about peri-implantitis and helps to determine and recommend the most effective methods of management.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Perda do Osso Alveolar/terapia , Humanos , Peri-Implantite/diagnóstico , Peri-Implantite/terapia , Prognóstico
11.
Artigo em Inglês | MEDLINE | ID: mdl-35472107

RESUMO

Peri-implantitis is an increasingly prevalent condition that, if left untreated, can lead to implant failure and loss. Numerous regenerative treatment modalities have been reported in the literature with varying degrees of success. Unfortunately, there is little consensus regarding optimal methods for predictable regeneration of the peri-implant bone lost due to the disease. This case report presents a 68-year-old healthy, nonsmoking man with peri-implantitis affecting the endosseous implant that replaced the maxillary left first molar. After unsuccessful nonsurgical debridement, regenerative surgical therapy was recommended. Guided bone regeneration (GBR) was performed using natural bovine bone mineral covered with a dehydrated human deepithelialized human amnion-chorion membrane (ddACM). Implant surface decontamination was achieved using a titanium brush. Posttreatment clinical assessment suggested that the patient responded well to surgical regenerative therapy. This response was characterized by the reestablishment of healthy peri-implant soft tissues. From a radiographic perspective, complete bone fill of the peri-implant bony defect was seen. These outcomes were maintained over 2 years. This case demonstrates that it is possible to treat peri-implantitis successfully and obtain stable long-term results with a GBR approach utilizing a xenogeneic bone substitute with ddACM.


Assuntos
Implantes Dentários , Peri-Implantite , Idoso , Âmnio , Animais , Regeneração Óssea , Bovinos , Córion , Seguimentos , Humanos , Masculino , Peri-Implantite/diagnóstico por imagem , Peri-Implantite/cirurgia
13.
Artigo em Inglês | MEDLINE | ID: mdl-35409826

RESUMO

Articles on the prevalence of peri-implant diseases showed that 90% of peri-implant tissues had some form of inflammatory response and a prevalence of peri-implantitis from 28% to 51% according to various publications. OBJECTIVE: To provide an overview of how risk factors can be related with peri-implantitis. METHODS: A retrospective longitudinal study including 555 implants placed in 132 patients was evaluated based on the presence of peri-implantitis following the criteria of Renvert et al. 2018. RESULTS: In total, 21 patients (15.9%) suffered peri-implantitis (PPG) and 111 patients (84.1%) did not suffer peri-implantitis (NPG). The results reveal that smokers have a high incidence of peri-implantitis (72.7%) compared to non-smokers (27.3%) (p < 0.0005). Another variable with significant results (p < 0.01) was periodontitis: 50% PPG and 23.9% NPG suffered advanced periodontitis. Systemic diseases such as arterial hypertension, diabetes mellitus, osteoporosis, and cardiovascular diseases do not show a statistically significant influence on the incidence of peri-implantitis. Patients who did not attend their maintenance therapy appointment had an incidence of peri-implantitis of 61.4%, compared to 27.3% in those who attend (p < 0.0001). From the results obtained, we can conclude that relevant factors affect peri-implantitis, such as tobacco habits, moderate and severe periodontitis, and attendance in maintenance therapy.


Assuntos
Peri-Implantite , Periodontite , Humanos , Incidência , Estudos Longitudinais , Peri-Implantite/epidemiologia , Peri-Implantite/etiologia , Periodontite/complicações , Periodontite/epidemiologia , Estudos Retrospectivos , Fatores de Risco
14.
Stomatologiia (Mosk) ; 101(2): 42-46, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35362702

RESUMO

THE AIM OF THE STUDY: Was to assess the effectiveness of the use of hydroxyapatite (HAP) and tricalcium phosphate (TCF) modified with hyaluronic acid in the treatment of patients with periimplantitis. MATERIALS AND METHODS: Clinical studies were conducted in 128 patients (44% male and 56% female) aged up to 55 years, who sought dental care with the main diagnosis of periimplant mucositis and periimplantitis. To compare the features of osseointegration of dental implants under bone remodeling three groups of patients were formed: one control and 2 main ones. In the control group the wound was managed under a blood clot, in the first main group HAP and TCF and in the second main group HAP and TCF modified with hyaluronic acid were used. X-ray examination was performed in various modes. Clinical assessment of implant stability in the operated area was carried out using subjective (percussion and palpation method) and objective method of frequency resonance analysis using the Osstell ISQ device calculating the stability coefficient of the dental implant (SCDI). RESULTS: 12 months after the periimplant zone remodeling procedure the bone resorption rates surrounding the implant were statistically significantly the lowest in the second main group (0.682±0.006 mm, p<0.001) compared with the values in the control and first main groups (1.626±0.022 and 1.025±0.034 mm, respectively). In the former groups bone resorption continued to progress during the observation period. In patients of the second main group, the average values of the SCDI for all study periods were 68.97±1.09 units which turned out to be the highest indicator and significantly differed from the values of other observation groups (p<0.05), which may be due to a tighter fit of the implants to the surface of the newly formed bone tissue. CONCLUSION: The results of the study 12 months after the periimplant zone remodeling operation procedure prove the efficacy of HAP and TCF modified with hyaluronic acid for the treatment of patients with periimplantitis.


Assuntos
Implantes Dentários , Peri-Implantite , Idoso , Fosfatos de Cálcio , Implantes Dentários/efeitos adversos , Durapatita/uso terapêutico , Feminino , Humanos , Ácido Hialurônico/uso terapêutico , Masculino , Peri-Implantite/diagnóstico por imagem , Peri-Implantite/tratamento farmacológico , Resultado do Tratamento
15.
Clin Oral Investig ; 26(4): 3735-3746, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35244779

RESUMO

OBJECTIVE: To evaluate re-osseointegration after electrolytic cleaning and regenerative therapy of dental implants with peri-implantitis in humans. MATERIAL AND METHODS: Four dental implants that developed peri-implantitis underwent electrolytic cleaning followed by regenerative therapy with guided bone regeneration. All four implants developed recurrent peri-implantitis and were therefore explanted 6 to 13 months later. Radiographic bone level, probing depth, and bleeding on probing were determined at the time of surgery, 6 months later, and before implant retrieval. The peri-implant tissues were histologically and histomorphometrically analyzed. RESULTS: All four implants demonstrated radiographic and histological bone gain, reduced probing depth, and bleeding on probing. Radiographic bone gain was 5.8 mm mesially and 4.8 mm distally for implant #1, 3.3 mm and 2.3 mm for implant #2, 3.1 mm and 0.5 mm for implant #3, and 3.5 mm and 2.8 mm for implant #4. The histometric mean and maximum vertical bone gain for implant #1 to #4 was 1.65 mm and 2.54 mm, 3.04 mm and 3.47 mm, 0.43 mm and 1.27 mm, and 4.16 mm and 5.22 mm, respectively. The percentage of re-osseointegration for implant #1 to #4 was 21.0%, 36.9%, 5.7%, and 39.0%, respectively. In one implant, the newly formed bone was deposited directly onto calculus on the implant surface. CONCLUSIONS: We found that (1) re-osseointegration is possible on a formerly contaminated implant surface and (2) the electrolytic cleaning process seems to be effective enough at sites with calculus residues. CLINICAL RELEVANCE: Since re-osseointegration can be achieved by electrolytic cleaning, this decontamination technique may be considered as a future treatment concept.


Assuntos
Implantes Dentários , Peri-Implantite , Regeneração Óssea , Humanos , Osseointegração , Peri-Implantite/cirurgia
16.
Clin Implant Dent Relat Res ; 24(2): 166-175, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35349773

RESUMO

AIMS: The objective of the present case series is to report on the rationale, surgical technique and outcome of a protocol for peri-implant mucosal phenotype modification therapy, referred to as "fibrin immobilization vestibular extension (FIVE)". MATERIAL AND METHODS: The protocol utilized entailed apical positioning and stabilization of peri-implant flap with modular screws. The screws were also used for the immobilization of solid matrix platelet-rich fibrin to fill the gap created between apically positioned flap and the crestal margin of the flap. RESULTS: A total of 30 patients (12 male, 18 females) with 93 implants were treated with FIVE protocol for various indications, including for vestibular extension following alveolar ridge augmentation (N = 6), preprosthetic (N = 9), postprosthetic (N = 2), and peri-implantitis (N = 13). The keratinized mucosal width preoperatively was 1.67 mm with 95% confidence interval [CI] (1.46, 1.88). Immediately following FIVE surgery, the vestibule was extended to 9.10 with 95% CI (8.44, 9.76). At 3 months, 4.9 mm (95% CI: 4.5-5.2 mm) of peri-implant keratinized mucosal width was present. The keratinized mucosal width remained relatively stable thereafter and was 4.0 mm (95% CI: 3.5-4.5 mm) at 3 years post-FIVE surgery. When overall group means across all time points were analyzed, maxilla had mean of 6.1 mm (95% CI: 5.8-6.5) versus mandible exhibited mean of 5.1 mm (95% CI: 4.6-5.6 mm). The mean of maxilla was significantly higher than that of the mandible (p < 0.0001) across all time points. Treatment of peri-implantitis with FIVE lead to significant pocket reduction and wide band of keratinized mucosa. Seven of 38 implants in 3 of 13 peri-implantitis patients were removed due to advanced peri-implantitis. DISCUSSION: The present case series provides proof-of-principle data for efficacy of FIVE for peri-implant phenotype modification therapy that generated attached keratinized mucosa in a variety of applications. This protocol provides an alternative to procedures involving harvesting of autogenous mucosal graft.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Peri-Implantite , Feminino , Fibrina/uso terapêutico , Humanos , Masculino , Mandíbula/cirurgia , Peri-Implantite/cirurgia
17.
Clin Implant Dent Relat Res ; 24(2): 151-165, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35313069

RESUMO

BACKGROUND: Studies around natural dentition demonstrated that smoking can reduce the tendency of inflamed tissue to bleed upon probing after controlling for possible confounders. In addition, previous research suggested that smokers may present alterations of the peri-implant microbiome. AIM: This study aimed at investigating the impact of smoking on: (1) peri-implant bleeding on probing (BOP; primary objective); (2) the association between BOP/bone loss and BOP/visible gingival inflammation; (3) peri-implant microbiome. METHODS: Partially edentulous patients with implants restored with a single crowns were included in this study. Subjects were either smokers (≥1 cigarettes per day) or nonsmokers (never smokers). The primary outcome of this cross-sectional study was BOP and secondary outcomes included: Probing pocket depth (PPD), Modified gingival Index (mGI) and Progressive Marginal Bone Loss. In addition, microbial profiles of the subjects were assessed through sequencing of the 16S rRNA gene. Univariate and multilevel multivariate analyses by means of Generalized Estimating Equations were conducted to analyze the association between smoking and peri-implant BOP. RESULTS: Overall, 27 nonsmokers and 27 smokers were included and 96.3% and 77.78% of patients presented peri-implant BOP in the nonsmoker and smoker group, respectively (p = 0.046). Smoking was inversely associated with BOP in the multivariate multilevel analysis (OR = 0.356; 95% CI: 0.193-0.660; p = 0.001) whereas a positive correlation was demonstrated for mGI > 0 (OR = 3.289; 95% CI: 2.014-5.371; p < 0.001); PPD (OR = 1.692; 95% CI: 0.263-0.883; p = 0.039) and gender (OR = 2.323; 95% CI: 1.310-4.120 p = 0.004). A decrease of BOP sensitivity in detecting visible gingival inflammation (mGI > 0) was observed in smokers. Besides, taxonomic and changes in diversity regarding the peri-implant microbiota were detected comparing the two groups. Significantly higher richness of the microbiota was demonstrated in the smoker group when implants affected by peri-implantitis were compared to either healthy implants or implants presenting mucositis. CONCLUSIONS: Smoking is a potential modifier of BOP and peri-implant microbiota.


Assuntos
Implantes Dentários , Peri-Implantite , Estudos Transversais , Implantes Dentários/efeitos adversos , Humanos , Inflamação , Peri-Implantite/etiologia , RNA Ribossômico 16S , Fumar/efeitos adversos , Tuberculina
18.
Clin Implant Dent Relat Res ; 24(2): 222-232, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35320880

RESUMO

BACKGROUND: The treatment of the peri-implantitis remains complex and challenging with no consensus on which is the best treatment approach. PURPOSE: To examine the key local and systemic factors associated with implant loss, disease progression, or favorable outcomes after surgical peri-implantitis therapy. MATERIALS AND METHODS: Records of patients treated for peri-implantitis were screened. Patient-, implant- and surgery-related variables on and prior to the day of the surgery were collected (T0: time of peri-implantitis treatment). If the treated implant was still in function when the data was collected, the patient invited to participate for a recall study visit (T1, longest follow-up after treatment). Impacts of the variables on the implant survival, success, and peri-implant bone change after treatment were investigated. RESULTS: Eighty patients with 121 implants with a mean follow-up of 42.6 ± 26.3 months were included. A total of 22 implants (18.2%) were removed during the follow-up period. When relative bone loss (%) was in range 25%-50%, risk for implant removal increased 15 times compared to lower bone loss <25% (OR = 15.2; CI: 2.06-112.7; p = 0.008). Similarly, relative bone loss of >50% increased 20 times the risk of implant failure compared to the <25% (OR = 20.2; CI: 2.42-169.6; p = 0.006). For post-treatment success rate, history of periodontitis significantly increased the risk of unsuccess treatment (OR = 3.07; p = 0.04) after resective surgery). CONCLUSION: Severe bone loss (>50%) poses significantly higher risk of treatment failure.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Periodontite , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Perda do Osso Alveolar/cirurgia , Implantes Dentários/efeitos adversos , Progressão da Doença , Humanos , Peri-Implantite/etiologia , Peri-Implantite/cirurgia , Periodontite/cirurgia , Prognóstico
19.
Clin Implant Dent Relat Res ; 24(2): 242-250, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35324063

RESUMO

AIM: The current in vitro model aims to evaluate the adjunctive effect on artificial biofilm removal determined by the use of a glycine-powder air-polishing procedure (GPAP) over the ultrasonic debridement (USD) alone when the removal of artificial biofilm on abutment surface is performed. The procedures were carried out also evaluating the impact of the site (mesial, distal, vestibular, and oral) and three different mucosal tunnel depths (2 mm, 4 mm, and 6 mm). MATERIALS AND METHODS: Single tooth implant replacement was simulated. Three different abutment heights together with a prosthetic contour were investigated (2 mm, 4 mm, and 6 mm); custom-made gingival masks were created to mimic peri-implant soft tissue. Biofilm was simulated with an indelible ink. The protocol consisted in two intervention stages for each abutment: (a) USD with PEEK tip plus (b) GPAP. At the end of each intervention, abutments were unscrewed, and standardized photographs were taken. Statistical analysis was carried out to compare residual stain percentage between the two intervention stages and among different sites and mucosal tunnels. RESULTS: A total of 30 abutments were instrumented. A significant reduction of the percentage of residual staining (PRS) after the combination of GPAP + USD over USD alone was demonstrated (16% vs. 32%; p < 0.05). Moreover, the better performance of the GPAP + USD protocol was observed regardless of the different mucosal tunnel heights and the sites analyzed. Intragroup analysis unveils that the smaller PRS was observed for shallow mucosal tunnels (2 mm) and vestibular sites for both protocols. CONCLUSION: GPAP + USD provided adjunctive effect on artificial biofilm removal in comparison to the USD alone. Furthermore, proximal surfaces and deeper mucosal tunnels (4 and 6 mm) showed a reduced instrumentation efficacy for both protocols.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Biofilmes , Desbridamento , Polimento Dentário , Glicina , Humanos , Peri-Implantite/terapia , Pós , Tecnologia , Ultrassom
20.
Int J Implant Dent ; 8(1): 10, 2022 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-35235079

RESUMO

BACKGROUND: As carcinogenic risk factors, environmental factors can be classified into physical, biological, and chemical factors. Subperiosteal implants (SIs) are associated with complications, such as framework exposure, infection, and fistula formation. A current hypothesis suggests that chronic mechanical irritation could be a co-factor in carcinogenesis, while peri-implantitis might be an initiating or promoting agent in the development of oral mucosal cancer. Herein, we report a case of squamous cell carcinoma (SCC) around a maxillary SI associated with chronic mechanical irritation and peri-implantitis as physical and biological factors, respectively. CASE PRESENTATION: A 74-year-old male patient presented with severe mobility of the SI and an undermined ulcer with induration, accompanied by a palatal fistula and the exposure of the metal framework. The SI had been placed on the maxilla for the occlusal reconstruction of the molar area 20 years ago. An incisional biopsy of the ulcer revealed SCC (cT4aN2cM0). Neoadjuvant chemotherapy was initiated, followed by bilateral neck dissection and partial resection of the maxilla with SI removal. Energy-dispersive X-ray analysis suggested that the SI was fabricated using pure titanium, and titanium was absent in the specimen. Scanning electron microscopy of the SI in contact with the SCC showed a few microcracks, suggesting pitting corrosion. DISCUSSION: Chronic mechanical irritation due to the mobility of an improperly designed SI can be a physical factor, and prolonged peri-implantitis without regular maintenance can be a biological factor in carcinogenesis. Improperly designed main struts and a large masticatory force in the molar area resulted in deterioration of the retention and mobility of the SI. The screw and framework frequently moved on mastication and came in direct contact with the ulcer as chronic mechanical irritation. Bacterial invasion into the subperiosteal space expanded by the mobility of the metal framework led to peri-implantitis. The influence of chemical factors was considered relatively small in this case since the patient had no history of smoking or drinking, and titanium was absent in the specimen. Therefore, it is conceivable that SCC can arise owing to persistent inflammation caused by chronic mechanical irritation and peri-implantitis as physical and biological factors, respectively.


Assuntos
Carcinoma de Células Escamosas , Implantes Dentários , Doença Enxerto-Hospedeiro , Peri-Implantite , Idoso , Fatores Biológicos , Carcinogênese , Carcinoma de Células Escamosas/cirurgia , Implantes Dentários/efeitos adversos , Humanos , Masculino , Maxila/cirurgia , Peri-Implantite/etiologia , Titânio , Úlcera
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