Risk indicators of long-term outcome of implant therapy in patients with a history of severe periodontitis or no history of periodontitis: A retrospective cohort study.

OBJECTIVE: The aim of this retrospective cohort study was to assess factors associated with peri-implant disease in partially edentulous patients with a history of severe periodontitis or no history of periodontitis. METHODS: Partially edentulous patients with a history of severe periodontitis/without history of periodontitis who received implant surgery within the past 6 to 8 years were recalled. Clinical and radiographic examinations were recorded. Periodontal probing depth, marginal bone loss (MBL) and peri-implantitis were considered as the primary outcome and peri-implant bleeding on probing (BOP) was considered as the secondary outcome. The following criteria were considered as the predictors, as well: history of severe periodontitis, gender, age, smoking, brushing frequency, recall interval, full-mouth plaque score, full-mouth bleeding score, splinted prosthesis, open/tight interproximal contact, width of keratinized mucosa, mucosal thickness, implants placed in the grafted bone and implant type. Univariate and multivariate regression analyses were utilized. RESULTS: A total of 88 patients (186 implants) fulfilled the study. Forty-seven patients (108 implants) had a history of severe periodontitis and 41 patients (78 implants) had no history of periodontitis. There was a higher chance of peri-implantitis in patients with a history of severe periodontitis (OR = 11.13; p = 0.045), implants with lack of peri-implant KM (<2 mm) and implants placed in the grafted bone (OR = 14.94, p < 0.001; OR = 4.93, p = 0.047). The risk of peri-implant MBL ≥3 mm was higher in patients with greater FMBS (OR = 1.20; p < 0.001). The chance of peri-implant BOP was independently higher in patients who brushed their teeth at most once per day (OR = 3.20; p = 0.04), higher FMBS (OR = 1.16; p < 0.001) and irregular recall visits (OR = 15.34; p = 0.001). CONCLUSIONS: Partially edentulous patients with the history of severe periodontitis, lack of peri-implant KM and implants placed in bone-grafted sites expressed higher probability of peri-implantitis. In addition, inadequate frequency of brushing (at most once daily) and irregular recall visits were associated with greater chance of peri-implant BOP.

The effects of topical erythropoietin on non-surgical treatment of periodontitis: a preliminary study.

BACKGROUND: The purpose of periodontal treatments is to reduce inflammation, restore gingival health and clinical attachment level gain by controlling microbial plaque formation and other etiological factors. One of the drugs that has been tested in many areas and shown good anti-inflammatory properties is erythropoietin (EPO). We evaluated the effect of this drug on the improvement of periodontitis after the phase I treatment. METHODS: This study was conducted on 30 patients with stage III periodontitis who had at least two bilateral teeth with CAL of ≥ 5 mm and PPD ≥ 6 mm at ≥ 2 non-adjacent teeth and bleeding on probing. After oral hygiene instruction and scaling and root planning (SRP), EPO gel containing a solution of 4000 units was applied deeply in the test group and placebo gel was deeply administered in the control pockets (5 times, every other day). The clinical parameters of the plaque index (PI), gingival index (GI), clinical attachment level (CAL), probing depth (PD) and bleeding index (BI) were measured at baseline and after three months of follow up. The P-value was set at 0.05. RESULTS: All clinical variables improved after treatment in both groups. The BI and GI scores (which reflects the degree of gingival inflammation) showed statistically more reduction in test group. The CAL decreased from 5.1 ± 4.1 to 3.40 ± 2.71 mm; and 5.67 ± 4.32 to 4.33 ± 3.19 mm in test and control group, respectively (P < 0.00). After the treatment, there was a significant greater reduction in CAL and also PD values in test group (P < 0.01). CONCLUSION: Local application of EPO gel in adjunct to SRP can improve clinical inflammation and CAL gain in periodontitis. TRIAL REGISTRATION: This study was registered at 2017-11-06 in IRCT. All procedures performed in this study were approved with ID number of IR.TUMS.DENTISTRY.REC.1396.3139 in Tehran University of medical science.

Effect of systemic administration of omeprazole on osseointegration around titanium dental implants: A histomorphometric study in dogs.

BACKGROUND: Dental implants are widely accepted substitutes for replacing missing teeth. Many factors, including the use of specific drugs such as proton-pump inhibitors (PPIs) (omeprazole), can affect the success of dental implantations. The aim of this study was to investigate the relationship between the use of omeprazole and osseointegration of dental implants. MATERIALS AND METHODS: This experimental animal study was performed on eight native male dogs weighted 11-13 kg and aged 16-20 months. The dogs were divided into two groups (receivers and nonreceivers of omeprazole). After extraction of mandibular teeth, treatment was started randomly with the administration of omeprazole and saline. After a 2-month recovery period, six titanium implants were placed in the jaws of all dogs and the administration of omeprazole was continued for 2 weeks. After 4 and 12 weeks, the dogs were anesthetized and dental implants with their bone marrow were removed. The samples were examined histomorphometrically to determine osseointegration. Data were analyzed with two-way ANOVA test for 95% confidence interval. The P value was set at 0.05. RESULTS: In the microscopic examination of the samples in week 4, the levels of bone-implant contact (BIC) in the study group were significantly lower than the control group (46.37 vs. 64.37%). In 12 weeks, BIC was significantly lower than that of the control group (67.33 vs. 82.00%). The type of bone formed in week 4 in both the groups was more woven, and in the 12th week, it was mostly lamellar. CONCLUSION: Systemic administration of PPIs may interfere with osseointegration of dental implants.