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1.
Artigo em Inglês | MEDLINE | ID: mdl-32233193

RESUMO

A number of treatment options have been explored for peri-implantitis. Seven rough-surfaced implants that failed from peri-implantitis were retrieved. Surfaces were treated by different methods: saline, chlorhexidine, citric acid, 35% phosphoric acid etch gel, hydrogen peroxide, implantoplasty, airborne-particle abrasion, laser, and titanium brush. Implants were observed under scanning electron microscopy. Chemical agents failed to remove any biologic debris. Airborne-particle abrasion, laser, and titanium brush removed part of the biologic debris, and implantoplasty showed complete biologic debris removal. In ex vivo failed implants, implantoplasty showed complete disturbance and removal of bacterial biofilm.


Assuntos
Implantes Dentários , Peri-Implantite , Descontaminação , Humanos , Microscopia Eletrônica de Varredura , Propriedades de Superfície , Titânio
2.
Minerva Stomatol ; 69(1): 37-54, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32214066

RESUMO

INTRODUCTION: The aim of this study was to review the histologic evidence of reosseointegration and related influencing factors in experimental induced peri-implantitis. EVIDENCE ACQUISITION: An electronic search was performed on Medline for animal studies that included a histometric evaluation of the amount of regenerated bone in contact with an implant surface. Questions raised in the study focused on the role of implant surfaces, bone regeneration and decontamination treatments in achieving reosseointegration. A detailed electronic search was then conducted on MEDLINE (PubMed) up to July 2017. EVIDENCE SYNTHESIS: One hundred and one articles were selected as abstract, thirty-seven articles assessed as full-text and sixteen finally included in the study. Reported measurements of reosseointegration varied significantly in the study, from 0 to 3.37 mm. There is histological evidence that reosseointegration can occur after treatment of ligature-induced peri-implantitis. However regenerated bone in contact with bone is generally restricted to the most apical portion of the peri-implant defect. CONCLUSIONS: Animal studies of induced peri-implantitis seem to indicate that rough surfaces can enhance reosseointegration as compared to smooth surfaces. With regard to bone regeneration techniques and materials, submerged healing and barrier membranes have shown a positive effect on reosseointegration. No evidence exists, however, about the specific role of different bone substitutes and their ability to improve bone formation. Growth factors have been shown to improve reosseointegration in animal models, though additional study is required to confirm the data. Several decontamination treatments have been shown to promote reosseointegration compared to control; however no specific procedure has proven superior to others in achieving reosseointegration.


Assuntos
Substitutos Ósseos , Implantes Dentários , Peri-Implantite , Animais , Regeneração Óssea , Humanos , Osteogênese
3.
Dent Clin North Am ; 64(2): 305-313, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32111270

RESUMO

With a very large number of endosseous dental implants placed by generalists and specialists, complications are to be expected. Among them are problems with the soft tissue interface and the hard tissue attachment. Peri-implant mucositis and peri-implantitis are not uncommon, but their prevalence and impact may be reduced with diagnosis and appropriate management, as can the likelihood of progression from mucositis to peri-implantitis. Successful implant dentistry does not end with integration and restoration, and both patient and professionally administered modalities are important for long-term implant maintenance.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Estomatite , Humanos , Fatores de Risco
4.
Artigo em Inglês | MEDLINE | ID: mdl-32186288

RESUMO

PURPOSE: To explore risk indicators potentially associated with early apical peri-implantitis (EAP). MATERIALS AND METHODS: A retrospective survey was performed in 2017 with recorded information from patients receiving dental implants between 1996 and 2016. Reporting follows the STROBE (strengthening the reporting of observational studies in epidemiology) guidelines. Data were collected from the medical histories and radiographs: diagnosis of EAP (health/disease), gender, age, type of surgery (immediate/delayed placement), implants placed (position, width, length, location, mesial and distal tooth-implant distance measured at the apex, state of the adjacent tooth and tooth being replaced, and surgical complications. Once the EAP had developed, data were collected regarding days of evolution, symptoms, signs and radiological findings. RESULTS: A total of 2548 patients (57.1% females and 42.9% males) with 8110 implants were enrolled in the study. 46 patients with 58 implants were diagnosed with EAP - 23 in the maxilla (39.6%) and 35 in the mandible (60.4%) - between 6 and 50 days after implant placement, with a mean period of 21.7 days (SD 10.1). The frequency of EAP was 1.81% in patients and 0.71% in implants. Immediate placement multiplied the odds of developing EAP 21-fold (95% CI 6.74 to 65.7; P < 0.001) versus delayed placement. The existence of an apical lesion in the tooth being replaced multiplied the odds of developing EAP 26.3-fold (95% CI 4.24 to 162.8; P < 0.001). Replacing a tooth endodontically treated increased the odds 3.48 times (95% CI 0.99 to 12.3; P = 0.052). The presence of an adjacent endodontically treated tooth increased the odds 0.97-fold (95% CI 0.26 to 3.60; P = 0.963). An apical mesial distance of ≤ 1.5 mm increased the odds up to 5.12-fold (95% CI 2.12 to 12.4; P < 0.001). CONCLUSIONS: The presence of endodontic periapical lesions or endodontic treatment in the tooth being replaced, immediate implant placement or mesial tooth-implant distance measured at the apex were significantly associated with increased odds of EAP.


Assuntos
Implantes Dentários , Peri-Implantite , Feminino , Humanos , Masculino , Mandíbula , Maxila , Estudos Retrospectivos
5.
Prim Dent J ; 8(4): 54-61, 2020 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-32127095

RESUMO

This article provides a narrative review of the use of dental implants in patients with periodontitis. using clinical examples where possible, consideration is given to the survival and success of implants, peri-implantitis, comparison of periodontally compromised teeth to implants and to treatment planning to help achieve favourable outcomes.
The challenges associated with restoring an edentulous arch or partially dentate dentition with implants where significant alveolar atrophy has occurred can be considerable. Compromised outcomes may be commonplace.
Dental implant treatment is more likely to be successful for those patients who attain and maintain excellent plaque control. Professional support should focus on managing underlying periodontitis prior to commencing implant therapy and providing long term, regular supportive periodontal care upon completion of treatment.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Arcada Parcialmente Edêntula , Peri-Implantite , Periodontite , Falha de Restauração Dentária , Humanos , Estudos Prospectivos
6.
Braz Dent J ; 31(1): 63-68, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32159708

RESUMO

The present study evaluated polymorphisms in RANK, RANKL and OPG-encoding genes to assess whether they are associated with mucositis and peri-implantitis in a population from the Brazilian Amazon region. One hundred and fourteen patients with dental implants were included in the study. After clinical and radiographic examination, the sample was categorized into 4 groups, according to the peri-implant status: Healthy (n=71), Mucositis (n=30), Peri-implantitis (n=13) and Diseased (Mucositis + Peri-implantitis, n=43). Genomic DNA was extracted from buccal cells from saliva, and the genetic polymorphism in osteoprotegerin (OPG), Kappa nuclear factor activator receptor (RANKL) and nuclear kappa factor activator receptor (RANK) were genotyped by the real time PCR. Univariate and multivariate statistical analyses were performed to compare clinical variables among groups and to evaluate genotypes and alleles distributions and the established alpha was 5%. Age, peri-implant biotype, diabetes and presence of peri-implant biofilm were associated with mucositis (p<0.05) and peri-implantitis (p<0.05). Smoking, alcoholism, and periodontal biofilms were also associated with the presence of peri-implantitis (p<0.05). Univariate and multivariate analysis did not demonstrate an association of peri-implantitis or mucositis with any genetic polymorphism in RANK (rs3826620), RANKL (rs9594738) and OPG (rs2073618) (p>0.05). The studied genetic polymorphism in RANK, RANKL and OPG were not associated with mucositis and peri-implantitis in a Brazilian population from the Amazon region.


Assuntos
Implantes Dentários , Peri-Implantite , Brasil , Humanos , Mucosa Bucal , Osteoprotegerina , Polimorfismo Genético
7.
Quintessence Int ; 51(3): 212-218, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32020131

RESUMO

OBJECTIVE: The aim was to investigate the presence of Entamoeba gingivalis and Trichomonas tenax in peri-implantitis lesions. METHOD AND MATERIALS: A total of 141 individuals were included in this study, of which 40 had clinically healthy implants (group H); the remaining were associated with peri-implantitis (group P). Gingival crevicular fluid was collected using absorbent paper, followed by a dental plaque sample from the peri-implant sulcus/pocket using a titanium curette. The samples were transferred into an Eppendorf tube. Each specimen was divided into two parts. One part was examined under a light microscope at a 10 × and 40 × magnification to detect parasites. The other part was spread on a microscope slide, stained with Giemsa stain, and examined under a microscope at 100 × magnification. Pearson chi-square test was used in the statistical analysis of data, with a significance level of P < .05. RESULTS: Although there was no presence of parasite around the healthy implants, two parasites were detected in peri-implantitis lesions. Out of 101 lesions, 31 (30.7%) showed E gingivalis, and 34 (33.6%) presented with T tenax. There was a statistically significant difference between the presence of E gingivalis and demographic data including gender, education status, frequency of dental visits, and brushing frequency. Presence of T tenax in lesions was correlated with frequency of dental visits (P < .05). It was observed that E gingivalis and T tenax were mostly detected in the mandible (P = .004 and .014, respectively) in comparison with the maxilla. CONCLUSION: This study showed that peri-implantitis lesions were involved with E gingivalis and T tenax, in contrast to the healthy areas.


Assuntos
Implantes Dentários , Entamoeba , Peri-Implantite , Trichomonas , Líquido do Sulco Gengival , Humanos
8.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(1): 58-63, 2020 Feb 18.
Artigo em Chinês | MEDLINE | ID: mdl-32071464

RESUMO

OBJECTIVE: To evaluate the short-term outcome of regenerative surgery for peri-implantitis therapy. METHODS: From March 2018 to January 2019, 9 patients with 10 implants who suffered from peri-implantitis were included in the present research. Vertical bone defect at least 3mm in depth with 2 or more residual bone walls was confirmed around each implant by radiographic examination. Restorations were replaced by healing abutments on 3 implants with the consent of the patients. Guided bone regeneration surgery was performed after a hygienic phase. During surgery, full thickness flaps were elevated on both buccal and lingual aspects. Titanium curette was used for inflammatory granulation tissue removal and implant surface cleaning. The implant surface was decontaminated by chemical rinsing with 3% hydrogen peroxide solution. After being thoroughly rinsed with saline, the bone substitutes were placed in bone defects which were covered by collagen membranes. 6 months after non-submerged healing, the clinical parameters including peri-implant probing depth (PD, distance between pocket bottom and peri-implant soft tissue margin) and radiographic bone level (BL, distance form implant shoulder to the first bone-to-implant contact) were used to evaluate the regenerative outcome. PD was measured at six sites (mesial, middle and distal sites at both buccal and lingual aspects) around each implant, and BL was measured at the mesial and distal surfaces of each implant on a periapical radiograph. RESULTS: The deepest PD and largest BL of each implant ranged from 6-10 mm and 3.2-8.3 mm respectively. All the implants healed uneventfully after surgery. The mean peri-implant PD at baseline and 6 months after surgery were (6.2±1.4) mm and (3.1±0.6) mm respectively, and a mean (3.0±1.5) mm radiographic bone gain was observed, P<0.01. Treatment success was defined as: no sites with residual PD≥6 mm, no bleeding on probing, and BL elevation of at least 1 mm. Nine implants from 8 patients fulfilled the success criteria. Residual pockets with 6 mm in depth and bleeding on probing could be detected in only one implant. CONCLUSION: Within the limitation of the present research, guided bone regeneration surgery can be used for the treatment of bone defect that resulted from peri-implantitis. Significant PD reduction and radiographic bone gain can be obtained after 6 months observation.


Assuntos
Perda do Osso Alveolar , Substitutos Ósseos , Implantes Dentários , Peri-Implantite , Colágeno , Humanos , Retalhos Cirúrgicos , Resultado do Tratamento
9.
Int J Oral Maxillofac Implants ; 35(35): 197-206, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923303

RESUMO

PURPOSE: Numerous approaches have been proposed for the treatment of peri-implantitis, but to date, none has been identified as the most effective. This study compared the efficacy of implantoplasty and glycine air polishing for the surgical treatment of peri-implantitis. MATERIALS AND METHODS: This prospective, randomized, parallel-group trial included 31 patients presenting with 42 implants with peri-implantitis. Patients underwent surgical treatment by implantoplasty (test group, n = 22) or glycine air polishing (control group, n = 20). Clinical parameters (Plaque Index), bleeding on probing (BOP), suppuration on probing (SOP), probing pocket depth (PPD), relative attachment level (RAL), and mucosal recession were assessed before surgery (baseline), and at 3 months and 6 months after surgery. Bone loss was recorded at baseline and 6 months. Two composite outcomes were also evaluated, according to the following definitions: (1) mean PPD reduction ≥ 0.5 mm + no further loss of bone; (2) PPD ≤ 5 mm, absence of BOP/SOP, and no additional mean bone loss ≥ 0.5 mm. RESULTS: Plaque Index remained low (< 0.5) in both groups for the duration of the study. Mean BOP, SOP, PPD, and RAL were greatly reduced at 3 months in both groups, and remained low between 3 months and 6 months. Bone loss was stable in the implantoplasty group, and slight bone gain (0.5 mm) was observed in the glycine air-polishing group. There were no significant differences between the two groups in any parameter, and composite treatment outcomes were similar in both groups, irrespective of the definition. CONCLUSION: Within the limitations of this 6-month follow-up study, implantoplasty is as effective as glycine air polishing for the surgical treatment of peri-implantitis.


Assuntos
Abrasão Dental por Ar , Glicina , Peri-Implantite , Seguimentos , Glicina/administração & dosagem , Humanos , Peri-Implantite/cirurgia , Índice Periodontal , Estudos Prospectivos , Resultado do Tratamento
10.
J Endod ; 46(3): 444-448, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31959483

RESUMO

Peri-implantitis is becoming a frequent complication observed around dental implants. An endodontic infection of a nearby tooth or an immediate implant placement in an inflamed bone socket from failing endodontic therapy has been associated with retrograde peri-implantitis (RPI), a condition that presents with radiographic lucency at the "apex" of an implant. However, current classification schemes do not capture endodontic lesions that may manifest as coronal or intrabony lesions associated with dental implants. As a result, such cases may be mistreated. Here we present for the first time 2 cases in which peri-implant bone loss occurred in the coronal half of the implant adjacent to a tooth with an endodontic-periodontic lesion and was resolved via endodontic therapy or tooth extraction as indicated. This proof of concept report aimed to introduce endodontic peri-implant ("endo-implant") defects and increase vigilance, which may help prevent overtreatment or mistreatment of such cases.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Assistência Odontológica , Implantes Dentários/efeitos adversos , Humanos , Peri-Implantite/etiologia , Peri-Implantite/terapia , Periodontia , Extração Dentária
11.
Arch Oral Biol ; 111: 104650, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31931278

RESUMO

OBJECTIVE: The aim of the present study was to review original clinical studies published in indexed databases, which assessed the role of oral yeasts in the etiopathogenesis of peri-implantitis. DESIGN: The focused question was "Do oral yeasts play a role in the etiopathogenesis of peri-implantitis?". Indexed databases were searched up to and including November 2019 using different combinations of the following key indexing terms: alveolar bone loss; candida, dental implant, oral; probing depth, peri-implant mucositis; peri-implantitis; and yeast. Original clinical studies were included. Studies performed on animal models, letters to the Editor, in-vivo/in-vitro/ex-vivo studies, commentaries, case-reports/series and historic reviews were excluded. The pattern of the present review article was customized to summarize the pertinent information. RESULTS: The initial search yielded 69 studies. Sixty-two studies, which did not fit the eligibility criteria were excluded. Seven studies were included and processed for data extraction. In all studies, oral yeasts were identified in conjunction with pathogenic bacteria in the oral biofilm samples collected from patients with peri-implantitis. In 1 study on type-2 diabetic and non-diabetic patients with peri-implantitis, the counts of oral yeasts were significantly higher in type-2 diabetic and systemically healthy patients with peri-implantitis than individuals without peri-implantitis. A prior sample-size estimation was performed in 3 of the 7 included studies. CONCLUSION: There is no direct evidence to confirm that oral yeasts contribute towards the etiopathogenesis of peri-implantitis.


Assuntos
Peri-Implantite , Perda do Osso Alveolar , Implantes Dentários , Humanos , Índice Periodontal , Estomatite
12.
J Oral Sci ; 62(1): 57-61, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31996524

RESUMO

Porphyromonas gingivalis (P. gingivalis) is one of the major pathogenic bacteria of periodontitis or peri-implantitis. P. gingivalis tends to attach to the implant's neck with the formation of biofilm, leading to peri-implantitis. d-arginine has been shown to have a potential antimicrobial role. In this study, P. gingivalis was cultured in Brain Heart Infusion broth together with d-arginine. After 3 days (inhibition) or 6 days (dissociation), these were characterized using crystal violet (CV) staining for the biofilm, extracellular polysaccharide (EPS) production from the biofilm, and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay for biofilm activation. Furthermore, the P. gingivalis biofilm was observed by scanning electron microscopy (SEM). d-arginine effectively reduced biomass accumulation and promoted dissociation at concentrations of ≥50 mM and 100 mM, respectively. Through CV staining, d-arginine concentrations of EPS production from the biofilm for inhibition and dissociation effects was ≥50 mM and 100 mM, respectively. In addition, d-arginine affected biofilm activation for the corresponding concentrations: ≥60 mM for inhibition and ≥90 mM for dispersal. Under SEM observation, d-arginine changed the P. gingivalis biofilm structure in relatively high concentrations for inhibition or dissociation, respectively. The authors concluded that d-arginine could inhibit the formation of P. gingivalis biofilm and promote the dissociation of P. gingivalis biofilm.


Assuntos
Peri-Implantite , Porphyromonas gingivalis , Arginina , Biofilmes , Humanos , Microscopia Eletrônica de Varredura
13.
Gene ; 727: 144258, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31759984

RESUMO

Peri-implantitis is similar to periodontitis in both symptoms and treatment; however, their level of similarity remains controversial. Here, we compared multiple cases of periodontitis and peri-implantitis through transcriptome and methylome profiling, and analyzed the effects of smoking as a typical risk factor. Human gingival tissues were obtained from 20 patients with periodontitis or peri-implantitis via periodontal surgical procedures. Total RNA and genomic DNA were isolated, and transcriptome and methylome datasets were generated. Comprehensive analysis of differential gene expression, DNA methylation, and protein-protein interactions indicated that periodontitis and peri-implantitis share biological similarities; however, hierarchical clustering between the two disease groups revealed distinct molecular characteristics. These differences might be related to structural differences in natural tooth-bone and implant-bone. Additionally, smoking differentially affected periodontitis and peri-implantitis in terms of host-defense mechanism impairment. Within the limitations of this study, the results provide evidence that peri-implantitis is distinct from periodontitis and that smoking potentially affects disease progression. Our study provides a foundation for the rational design of a large-scale study in the future for a more comprehensive analysis that includes microbiome and clinical data.


Assuntos
Peri-Implantite/genética , Periodontite/genética , /genética , Feminino , Perfilação da Expressão Gênica/métodos , Gengiva/microbiologia , Humanos , Masculino , Microbiota/genética , Pessoa de Meia-Idade , Peri-Implantite/metabolismo , Fatores de Risco , Fumar , Uso de Tabaco/efeitos adversos , Uso de Tabaco/genética , Transcriptoma/genética
14.
Clin Oral Investig ; 24(1): 309-315, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31102043

RESUMO

OBJECTIVE: Colony-stimulating factor (CSF)-1 and interleukin (IL)-34 are growth factors that regulate myeloid cell functions and support osteoclastogenesis. CSF-1 and IL-34 levels in peri-implant diseases are yet unknown. This study evaluated CSF-1, IL-34, and IL-1ß levels in saliva and peri-implant crevicular fluid (PICF) from patients having mucositis or peri-implantitis, as well as their correlation to clinical parameters of disease. MATERIAL AND METHODS: Forty-three patients were included (mean age 61.1 ± 8.4; 62.8% female), 20 having mucositis and 23 having peri-implantitis. Patients were clinically examined and unstimulated whole saliva and PICF were collected. Levels of CSF-1, IL-34, and IL-1ß were determined by enzyme-linked immunosorbent assays. RESULTS: CSF-1 levels were higher in PICF from peri-implantitis compared with mucositis patients (p = 0.028), whereas IL-34 levels showed no significant difference between the groups (p = 0.060). No significant difference was found in PICF IL-1ß levels between the groups. Salivary levels of CSF-1 and IL-34 did not differ significantly between mucositis and peri-implantitis. No significant difference was observed in the salivary levels of IL-1ß between groups (p = 0.061). CSF-1 and IL-1ß correlated significantly in both saliva and PICF. CSF-1 levels in saliva correlated with its levels in PICF. PICF CSF-1 levels showed potential to discriminate between peri-implantitis and mucositis (AUC = 0.695, 95% CI 0.53-0.85; p = 0.029). CONCLUSION: Increased levels of CSF-1 in peri-implant crevicular fluid, but not in saliva, were found in peri-implantitis patients, which might aid to discriminate the early and late stages of peri-implant diseases. CLINICAL RELEVANCE: This result suggests an increased osteoclastogenic potential in peri-implantitis patients.


Assuntos
Implantes Dentários , Interleucinas , Fator Estimulador de Colônias de Macrófagos , Peri-Implantite , Idoso , Biomarcadores/análise , Feminino , Líquido do Sulco Gengival , Humanos , Interleucinas/metabolismo , Fator Estimulador de Colônias de Macrófagos/metabolismo , Masculino , Pessoa de Meia-Idade , Peri-Implantite/diagnóstico , Peri-Implantite/metabolismo , Saliva/metabolismo
15.
Clin Oral Investig ; 24(2): 675-682, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31123873

RESUMO

OBJECTIVES: To assess the clinical and radiographic outcomes of implants treated by means of non-surgical debridement with systemic antibiotic therapy. MATERIALS AND METHODS: A prospective case series study evaluating the 12-month clinical and radiographic outcomes of peri-implantitis lesions treated with ultrasonic scaler debridement, a glycine air abrasive, and metronidazole followed by supportive maintenance. Clinical and radiographic variables and success criteria were defined a priori. RESULTS: Overall, 21 patients were included. One implant failed during the study period (implant survival rate 95.24%). Substantial changes occurred at 12 months in all the clinical and radiographic variables, reaching strong statistical significance in the majority of them. According to the success criteria applied, 40.90% of the peri-implantitis were arrested and resolved, while 59.1% presented with at least one probed site with bleeding on probing (BoP). Moreover, 95.45% exhibited peri-implant pocket depth (PPD) < 5 mm at the end of the study. None of the implants presented with progressive bone loss. CONCLUSION: Non-surgical therapy of peri-implantitis is effective to arrest progressive bone loss, reduce PPD and suppuration, and achieve radiographic bone fill in the majority of cases. Nevertheless, it failed to be completely efficacious in the achievement of successful therapeutic outcomes as BoP remained frequently present. CLINICAL RELEVANCE: Non-surgical therapy achieved significant clinical and radiological improvements.


Assuntos
Implantes Dentários , Peri-Implantite , Antibacterianos , Raspagem Dentária , Humanos , Peri-Implantite/terapia , Estudos Prospectivos , Resultado do Tratamento
16.
Clin Oral Investig ; 24(1): 47-60, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31729576

RESUMO

OBJECTIVES: This systematic review aims to evaluate current literature regarding available techniques for removal of osseointegrated implants in terms of explantation's success, complications, and bone loss. MATERIAL AND METHODS: Two reviewers conducted a systematic literature search through electronic databases (PubMed and EMBASE), complimented by manual and grey literature searches. Successful explantation was defined as the primary outcome. Complications and availability of residual bone for immediate implantation were defined as secondary outcomes. RESULTS: Eighteen articles, comprising 372 implants and 241 patients, were included. Five techniques were identified: reverse torque, trephines, burs, piezosurgery, and laser-assisted explantation. Peri-implantitis was the most common reason for explantation, followed by crestal bone loss, fracture, and malpositioning. The reverse torque was the most frequently reported technique (284 implants) with 87.7% success rate. Burs were used for explantation of 49 implants with a 100% success rate, while trephines were utilized for removal of 35 implants with 94% success. Piezosurgery (11 implants) and Er.Cr:YSGG laser (1 implant) showed 100% success. One study reported perforation of the sinus floor following trephine explantation, while another reported fracture of 3 implants following reverse torque application. Further analysis was hindered by the quality of the available studies and their lack of data. CONCLUSIONS: Reverse torque seems the most conservative, and in the authors' opinion, should be the first choice for explantation despite its inferior success rate. Additional studies with randomized controlled designs and larger sample sizes are required. CLINICAL RELEVANCE: Dental implants have become the leading choice to replace missing teeth with gradually increasing numbers of complications and failures. An effective, conservative, and economic explantation technique is necessary to allow a successive implant placement.


Assuntos
Prótese Ancorada no Osso , Implantes Dentários , Implantação Dentária Endo-Óssea , Humanos , Peri-Implantite , Levantamento do Assoalho do Seio Maxilar , Perda de Dente
17.
Clin Oral Implants Res ; 31(2): 192-200, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31838762

RESUMO

OBJECTIVE: To examine the progression of experimental peri-implantitis around different implants placed in augmented and pristine sites. MATERIALS AND METHODS: Six labrador dogs were used. Three months after tooth extraction, four implants with different surface modifications were installed on each side of the mandible. A standard osteotomy was applied on one side, while on the contralateral side the osteotomy was modified, resulting in a gap between the implant and the bone wall. The gap was filled with a bone substitute and covered by a resorbable membrane. Three months after implant installation, implants were exposed and healing abutments were connected. Two months later, oral hygiene procedures were abandoned and a cotton ligature was placed in a submarginal position around the neck of all implants and kept in place for 4 weeks. Following ligature removal, plaque formation continued for 6 months (spontaneous progression period). Radiographs were obtained throughout the experiment, and biopsies were collected and prepared for histological evaluation at the end of the spontaneous progression period. RESULTS: Differences in bone loss during the spontaneous progression period between pristine and augmented sites were small. The size and vertical dimension of the peri-implantitis lesion were larger at augmented than at pristine sites. Implants with non-modified surfaces exhibited smaller amounts of bone loss and smaller dimensions of peri-implantitis lesions than implants with modified surfaces. CONCLUSION: Small differences in spontaneous progression of peri-implantitis were detected between pristine and augmented sites. Implants with modified surfaces exhibited more bone loss and larger lesions than implants with non-modified surfaces, irrespective of the type of surrounding bone.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Animais , Planejamento de Prótese Dentária , Cães , Propriedades de Superfície
18.
Clin Oral Implants Res ; 31(1): 84-92, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31705683

RESUMO

OBJECTIVES: Examine the clinical and microbiological benefits of a dual-strain Lactobacillus reuteri probiotic on the non-surgical therapy of initial peri-implantitis. MATERIALS AND METHODS: This randomized, double-blind study targeted patients with initial peri-implantitis, that is peri-implantitis with a maximum mean probing pocket depth of 6 mm and maximum 3 mm bone loss compared with loading. A full-mouth prophylaxis was performed and the peri-implantitis sites were debrided. Subsequently, local application of the study drops was carried out at the peri-implantitis sites and the study lozenges were handed out. The patients in the probiotic group received drops and lozenges containing L. reuteri (ATCC PTA 5289 & DSM 17938), those in the control group received placebo products. At the implant level the measurements of interest were bleeding, probing pocket depth and plaque. Full-mouth bleeding and plaque scores were also recorded. Microbiological samples were taken from the tongue, saliva and subgingivally around the implants. RESULTS: All clinical parameters were significantly decreased after 12 and 24 weeks. At the implant level the only statistically significant difference was a greater decrease in plaque levels in the probiotic versus the control group (p = .002 at 24 weeks). At the full-mouth level, the only intergroup difference was the greater decrease in full-mouth bleeding on probing sites in the probiotic group compared with the control group (p < .001 at 24 weeks). Concerning the microbiological outcomes, no significant differences could be found at any time point, neither intra- nor intergroup. CONCLUSIONS: No adjunctive effects of the use of L. reuteri probiotics in the treatment of peri-implantitis were found.


Assuntos
Lactobacillus , Peri-Implantite , Probióticos , Método Duplo-Cego , Humanos , Projetos Piloto
19.
Clin Oral Investig ; 24(2): 693-699, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31127430

RESUMO

OBJECTIVES: The purpose of this study was to investigate whether the genetic variations which could regulate inflammatory responses were associated with the risk of peri-implantitis. MATERIALS AND METHODS: We evaluated three genetic variants including tumor necrosis factor-alpha (TNF-α) - 308G/A, interleukin-1 alpha (IL-1A) - 889C/T, and IL-1 beta (IL-1B) + 3954C/T, as risk factors for peri-implantitis, in a total of 144 patients with peri-implantitis and 174 healthy controls in a Chinese non-smoking population. RESULTS: Logistic regression analyses revealed that subjects carrying the T allele of IL-1A - 889C/T and IL-1B + 3954C/T had a significant 2.27-2.47-fold (CT, OR [95% CI] = 2.27 [1.12-4.58], p = 0.021; TT, OR [95% CI] = 2.47 [1.32-4.69], p = 0.006) and 1.9-1.99-fold (CT, OR [95% CI] = 1.99 [1-3.93], p = 0.041; TT, OR [95% CI] = 1.9 [1.08-3.43], p = 0.03) increased risk of peri-implantitis, respectively, when using the CC genotype as a reference point. And subjects carrying the TT genotype of IL-1A - 889C/T or IL-1B + 3954C/T also had significantly higher periodontal variables including peri-implant pocket depth (PPD), bleeding on probing (BOP), gingival index (GI), plaque index (PI), calculus index (CI), and clinical attachment level (CAL) (p < 0.05). However, no associations were found between the TNF-α - 308G/A polymorphism and the risk of peri-implantitis. CONCLUSIONS: Our results suggest that the IL-1A - 889C/T or IL-1B + 3954C/T genetic polymorphisms were associated with the risk of peri-implantitis and periodontal status. CLINICAL RELEVANCE: Genetic polymorphisms are constant and can be measured before disease onset, thus it could be of great benefit for treatment planning and prognosis in an early stage.


Assuntos
Implantes Dentários , Interleucina-1alfa/genética , Interleucina-1beta/genética , Peri-Implantite , Fator de Necrose Tumoral alfa/genética , Humanos , Peri-Implantite/genética , Polimorfismo Genético
20.
Int J Prosthodont ; 33(1): 111-115, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31860921

RESUMO

The primary concern in carrying out dental implant treatment in patients with chronic myelogenous leukemia is the development of peri-implantitis. However, currently, the advent of molecular-targeted drugs such as nilotinib markedly improves the survival rates in such patients, and it is reported that remission status can be maintained for a long time without abnormalities such as a decrease in white blood cell count. This case history report discusses an 8-year follow-up of implant treatment administered during the remission phase of chronic myelogenous leukemia maintained using nilotinib. A 56-year-old male patient who was undergoing treatment for chronic myelogenous leukemia at the Department of Hematology requested a dental consultation for the treatment of a mastication disorder due to loss of mandibular left molars. After confirming via oral and radiographic examination that there were no abnormalities such as periodontal disease, temporomandibular joint symptoms, or metal allergy, two Brånemark System Mk III implants with diameters of 3.75 and 5 mm and lengths of 10 and 8.5 mm, respectively, were embedded in the defect. Following this, no problems were observed in the general condition, esthetics, or oral function around the implant. Further, symptoms such as mobility of the implant body or inflammation of the surrounding tissue have not appeared to this day, as the molecular-targeted drug decreases the occurrence of immunosuppression, which could not be achieved conventionally. Although this is only one instance, the possibility of implant treatment for chronic myelogenous leukemia patients in the remission phase has been presented in this case.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Leucemia Mielogênica Crônica BCR-ABL Positiva , Peri-Implantite , Implantação Dentária Endo-Óssea , Estética Dentária , Humanos , Masculino , Pessoa de Meia-Idade
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