Patient
M. salivarium
V. parvula
S. aureus
P. gingivalis
P. micra
T. forsythia
Fungal organisms
1
7.05E + 01
7.00E + 01
-
...
Patient
M. salivarium
V. parvula
S. aureus
P. gingivalis
P. micra
T. forsythia
Fungal organisms
1
-
2.26E + 03
-
1...
Patient
Severity
M. salivarium
V. parvula
S. aureus
P. gingivalis
P. micra
T. forsythia
Fungal organisms
1
i-m
-
7.96E + 04
...
Species
Gene
Primer/probe
Sequences (5′-3′)
Aspergillus spp. plus
ITS2
aspe-F
CTG TCC GAG CGT CAT TG
Penicillium spp.
pen1-F
...
Species
Gene
Primer/probe
Sequences (5′-3′)
Mycoplasma salivarium
rpoB
msali-F
CCG TCA AAT GAT TTC GAT TGC
msali-R
GAA CTG CTT GAC GTT GCA TGT T
...
Schwarz, F., Becker, K., Rahn, S. et al. Real-time PCR analysis of fungal organisms and bacterial species at peri-implantitis sites. Int J Implant Dent 1, 9 (2015). https://doi.org/10.1186/s40729-015-0010-6
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Received: 16 January 2015
Accepted: 11 March 2015
Published: 21 April 2015
DOI: https://doi.org/10.1186/s40729-015-0010-6
Frank Schwarz, Kathrin Becker, Sebastian Rahn, Andrea Hegewald, Klaus Pfeffer, and Birgit Henrich declare that they have no competing interests.
FS, BH, and KP have made substantial contributions to study conception and design, analysis, and interpretation of data as well as manuscript preparation. KB performed the statistical analysis. AH and SR were involved in data acquisition. All authors rea...
Department of Oral Surgery, Westdeutsche Kieferklinik, Heinrich Heine University, Moorenstraße 5, D-40225, Düsseldorf, Germany
Frank Schwarz & Andrea Hegewald
Department of Orthodontics, Westdeutsche Kieferklinik, Heinrich Heine University, Moorenstraße 5, D-40225, Düsseldorf, Germany
Kathrin Becker
Institute of Medical Microbiology and Hospital Hygiene, Heinrich Heine University, Univer...
We kindly appreciate the skills and commitment of Ms. Dana Belick (Institute of Medical Microbiology and Hospital Hygiene, Heinrich Heine University, Düsseldorf) in the DNA preparation and bacterial analysis and the Jürgen Manchot Foundation for financial support.
Hultin M, Gustafsson A, Hallstrom H, Johansson LA, Ekfeldt A, Klinge B. Microbiological findings and host response in patients with peri-implantitis. Clin Oral Implants Res. 2002;13:349–58.
Engel LD, Kenny GE. Mycoplasma salivarium in human gingival sulci. J Periodontal Res. 1970;5:163–71.
Jarvensivu A, Hietanen J, Rautemaa R, Sorsa T, Richardson M. Candida yeasts in chronic periodontitis ti...
McDonald RR, Antonishyn NA, Hansen T, Snook LA, Nagle E, Mulvey MR, et al. Development of a triplex real-time PCR assay for detection of Panton-Valentine leukocidin toxin genes in clinical isolates of methicillin-resistant Staphylococcus aureus. J Clin Microbiol. 2005;43:6147–9.
Morillo JM, Lau L, Sanz M, Herrera D, Martin C, Silva A. Quantitative real-time polymerase chain reaction based on si...
Lindhe J, Meyle J, Group DoEWoP. Peri-implant diseases: consensus report of the sixth European workshop on periodontology. J Clin Periodontol. 2008;35:282–5.
Mombelli A, Decaillet F. The characteristics of biofilms in peri-implant disease. J Clin Periodontol. 2011;38 Suppl 11:203–13.
Heitz-Mayfield LJ. Peri-implant diseases: diagnosis and risk indicators. J Clin Periodontol. 2008;35:292–30...
Bleeding on probing
Mycoplasma salivarium
Porphyromonas gingivalis
Parvimonas micra
Probing pocket depth
Staphylococcus aureus
Tannerella forsythia
Veillonella parvula
Within the limitations of the present analysis, it was concluded that Candida spp. and other fungal organisms were frequently identified at peri-implantitis as well as healthy implant sites and co-colonized with P. micra and T. forsythia.
Furthermore, the present analysis failed to identify any significant correlation of either fungal organisms or disease severity with opportunistic bacteria, such as M. salivarium, V. parvula, and S. aureus. At tooth sites, M. salivarium was mainly isolated from the sulcus area and associated with gingivitis lesions [27]. Interestingly, S. aureus has only been identified at one single peri-implanti...
The present study aimed at analyzing and correlating fungal organisms with several periodontopathogenic and opportunistic bacterial species at peri-implantitis sites using real-time PCR. These outcomes were compared with those noted at healthy implant sites as well as teeth with a history of periodontitis.
Basically, the present analysis has pointed to a high prevalence of fungal organisms in sub...
The Kendall-Tau-b coefficients failed to reveal any significant correlations between the presence of fungal organisms and the proportions of M. salivarium (0.25), V. parvula (0.34), P. gingivalis (0.60), P. micra (0.32), T. forsythia (0.12), and S. aureus (0.66) (P > 0.05, respectively).
According to the given definition, the present analysis was based on a total of n = 13 initial to moderate and n = 6 advanced peri-implantitis lesions (n = 19 patients), 10 healthy implant sites (n = 10 patients), as well as 10 teeth with a history of periodontitis (n = 10 out of 19 patients suffering from peri-implantitis).
The analysis of fungal organisms as well as of M. sa...
The statistical analysis was performed using a commercially available software program (SPSS Statistics 22.0, IBM Corp., Ehningen, Germany). Kendall-Tau-b correlation coefficients were calculated to evaluate the dependence between fungal organisms, bacterial species as well as disease severity (i.e., initial to moderate and advanced sites). Results were considered statistically significant at P
In the peri-implantitis group, one additional subgingival plaque sample was obtained from partially edentulous patients with a history of periodontitis (n = 10) and obtained at a tooth exhibiting the highest PD but no signs of acute periodontal disease (i.e., BOP/no suppuration). None of these teeth were located adjacent to the sampled implant sites. The control samples were also prepared for ...
A total of 29 partially or fully edentulous patients were consecutively recruited from the Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany, between April 2013 and July 2014. Nineteen patients (7 men and 13 women; mean age 58.8 ± 12.6 years) suffered from initial to moderate or advanced peri-implantitis, while ten patients (6 men and 4 women; mean age 55.2 ± 1...
There is considerable evidence supporting the view that peri-implant diseases are infectious in nature and mainly linked to an uncontrolled accumulation of bacterial plaque biofilms [1]. Basically, diseased implant sites are dominated by gram-negative anaerobic bacteria and therefore feature microbiological characteristics similar to those noted for chronic periodontal infections [2]. Even though ...
The potential role of fungal organisms and their co-aggregation with either periodontopathogens or opportunistic pathogens at peri-implantitis sites is unknown. The aim of the present study was to qualitatively/quantitatively analyze and correlate fungal organisms and bacterial species at peri-implantitis sites.
In a total of 29 patients, submucosal/subgingival plaque samples were collected at pe...
Fig. 5. Box plot illustrating maximum PD reduction between the grafted and non-grafted patient groups that did not reach a significant difference (p = 0.968)
Fig. 5. Box plot illustrating maximum PD reduction between the grafted and non-grafted patient groups that did not reach a significant difference (p = 0.968)
Fig. 4. Box plot presenting mean BOP reduction between the two patient groups (grafted and non-grafted) with no significant difference (p = 0.778)
Fig. 4. Box plot presenting mean BOP reduction between the two patient groups (grafted and non-grafted) with no significant difference (p = 0.778)
Fig. 3. Dumbbell—dot plots illustrating (a) disease resolution and no resolution at non-grafted and grafted sites at the patient level analysis with no significant difference between the two groups (p = 0.579). Patents with improvement, deterioration, and no improvement following the treatment based on the max PD changes are depicted; (b) disease resolution and no resolution at the implant...
Fig. 2. Box plot depicting no significant differences of the baseline maximum PD values between the grafted and non-grafted patient groups (p = 0.353)
Fig. 2. Box plot depicting no significant differences of the baseline maximum PD values between the grafted and non-grafted patient groups (p = 0.353)
Fig. 1. Combined surgical therapy of peri-implantitis at respective defect sites: class I: intrabony component showing either a buccal dehiscency with a semicircular component (Ib) or a buccal dehiscency with a cicumferential component (Ic). Class II: supracrestal component. The red rectangles indicate the surface areas undergoing an implantoplasty, while the green areas indicate the defect area...
Group
Patient level
Implant level
Mean
SD
Median
...
Group
Patient level
Implant level
mean
SD
median
...
Non-grafted sites
Grafted sites
Total
Patient level
7/29 (24.1%)
4/10 (40%)
...
Non-grafted sites
Grafted sites
Implant number
41
16
Maxilla/mandible
...
Ramanauskaite, A., Becker, K., Juodzbalys, G. et al. Clinical outcomes following surgical treatment of peri-implantitis at grafted and non-grafted implant sites: a retrospective analysis.
Int J Implant Dent 4, 27 (2018). https://doi.org/10.1186/s40729-018-0135-5
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Received: 28 November 2017
Accepted: 21 May 2018
Published: 09 August 2018
DOI: https://doi.o...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
The study protocol was approved by the Heinrich-Heine University (Düsseldorf, Germany) ethics committee.
Ausra Ramanauskaite, Kathrin Becker, Gintaras Juodzbalys, and Frank Schwarz declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Department of Oral Surgery, Westdeutsche Kieferklinik, Universitätsklinikum Düsseldorf, D-40225, Düsseldorf, Germany
Ausra Ramanauskaite
Clinic of Dental and Oral Pathology, Lithuanian University of Health Sciences, Kaunas, Lithuania
Ausra Ramanauskaite
Department of Orthodontics, Westdeutsche Kieferklinik, Universitätsklinikum Düsseldorf, D-40225, Düsseldorf, Germany
Kathrin Becker
De...
The study was self-funded by the authors’ own departments.
Carcuac O, Derks J, Abrahamsson I, Wennström JL, Petzold M, Berglundh T. Surgical treatment of peri-implantitis. 3-year results from a randomized controlled clinical trial. J Clin Periodontol. 2017;44(12):1294–303.
Canullo L, Peñarrocha-Oltra D, Covani U, Botticelli D, Serino G, Penarrocha M. Clinical and microbiological findings in patients with peri-implantitis: a cross-sectional study. Cli...
Lindhe J, Meyle J, Working Group D of European Workshop on Periodontology. Peri-implant diseases: Consensus Report of the Sixth European Workshop on Periodontology. J Clin Periodontol. 2008;35(Suppl 8):282–5.
Lang NP, Berglundh T, Working Group 4 of Seventh European Workshop on Periodontology. Periimplant diseases: where are we now?--Consensus of the Seventh European Workshop on Periodontology....
Within the limitations of the current study, it was concluded that the effectiveness of combined surgical therapy of peri-implantitis was comparable at both grafted and non-grafted implant sites and was not influenced by the initial bone-grafting procedures.
The further evaluation of maximum PD reduction did not indicate a significant difference between the two groups (i.e., grafted vs. non-grafted), with the range of 1.57 to 2.20 mm at the patient level analysis and 1.31 to 2.10 mm at the implant level. These results are in concurrence with data from the previous studies, where mean PD reduction amounted from 0.74 to 2.55 mm [16], up to 3 [18], an...
According to the eighth European Workshop of Periodontology (EFP), evaluation of the effectiveness of different peri-implantitis therapies should be based on a composite outcome of disease resolution, including resolutions of mucosal inflammation, reductions in probing pocket depths, and no further bone loss [3].
The current retrospective clinical investigation evaluated treatment outcomes follow...
At the implant level, BOP reduction was noted to be 74.96% (minimum 0%; maximum 100%) at grafted implant sites and 54.88% (minimum 0%; maximum 100%) at non-grafted implant sites. According to the results of the chi-square test, the mean BOP reduction did not differ significantly between the groups at either the patient (p = 0.778, df = 1, χ2 = 0.079) or the implant (p = 0.515, df...
The present analysis was based on 39 patients diagnosed with peri-implantitis in 57 implants. The patients were divided into 2 groups according to the grafting of the site: non-grafted implant sites (29 patients/41 implants) and grafted implant sites (10 patients/16 implants).
The characteristics of the implant sites are presented in Table 1. In total, 26 implants (45.6%) were located in the max...
For all patients, the following clinical parameters were available: BOP (as measured within 60 s after probing) and PD (as measured in millimeters from the mucosal margin to the bottom of the probeable pocket). BOP and PD were assessed at six aspects around the implant: mesio-buccal, mid-buccal, disto-buccal, mesio-oral, mid-oral, and disto-oral. Maximum PD values (max PD) and mean BOP scores wer...
Peri-implantitis was defined as bleeding on probing (BOP) with or without suppuration (Supp) in addition to changes in the radiographic bone level. Interproximal bone level changes were estimated on intraoral radiographs. In the absence of available baseline radiographs taken at prosthesis installation, “a threshold vertical distance of 2 mm from the expected marginal bone level” was used to a...
For this retrospective analysis, standardized clinical record forms of a total of 39 partially/fully edentulous patients (25 female and 12 male) exhibiting 57 implants were screened. All patients had attended the Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany for the treatment of peri-implantitis between 2007 and 2010, and were under regular implant maintenance care. T...
Peri-implantitis is caused by a bacterial challenge and characterized by inflammation in the peri-implant soft tissues and a progressive loss of supporting bone [1, 2]. Consequently, its treatment is cause-related and primarily aimed at arresting disease progression [3].
Based on the currently available evidence, non-surgical mechanical debridement alone seems to have a limited efficacy for the m...
This retrospective analysis aimed at comparing the clinical outcomes following combined surgical therapy of peri-implantitis at initially grafted and non-grafted (i.e., pristine) implant sites.
A total of 39 patients exhibiting 57 implants diagnosed with peri-implantitis (i.e., 16 implants at grafted and 41 implants at non-grafted sites) were included. Each subject had received a combined (i.e., ...
Perbedaan utama antara peri-implant saras & jaringan periodontal
Perangkat implant tidak punya struktur pilah yang dipunyai oleh gigi seperti sementum akar, ligamen periodontal, dan tulang bundel (proper tulang alveolar). Bundel serat dento-alveolar dan dento-gingiva menghubungkan jaringan lunak dengan gigi (sementum akar), sementara tidak ada bundel serat yang terlihat pada jaringan peri-imp...
Jaringan tulang di punggungan edentula
Dalam suatu penelitian yang melibatkan sebagian subyek yang tidak bergigi, biopsi jaringan keras diambil sampelnya dari rahang atas dan rahang bawah dengan menggunakan bor trephine. Jaringan tulang ditemukan mencakup campuran sebagian besar tulang lamelar (46%) dan sumsum tulang (23%) dengan lebih sedikit jumlah jaringan fibrosa (12%) dan osteoid (4%).
Su...
Pengukuran tulang (bone sounding)
Bone sounding atau transmucosal sounding (TS) adalah pengukuran yang digunakan untuk menentukan ketinggian seluruh cuff (manset) jaringan lunak pada berbagai kelompok gigi dan implant. Matra mukosa peri-implan dan gingiva pada letak gigi yang berdekatan dipelajari dengan pengukuran klinis yang dilakukan terutama pada subjek edentulous sebagian yang telah dirawa...
Jaringan peri-implant dalam kesarasan klinis
Gingiva dan mukosa peri‐implant dan perlekatannya (segel) secara konsisten ditantang oleh lingkungan mulut, termasuk paparan mikroorganisme dalam biofilm yang ada pada gigi dan permukaan implant. Pada mukosa (dan gingiva) peri-implant normal secara klinis, tanggapan inang yang terus-menerus meliputi kejadian vaskular dan seluler. Dengan demikian, str...
Penelitian pada sato
Dimensi mukosa peri-implant, yang sering disebut lebar atau matra biologis, diperiksa dalam biopsi terutama diperoleh dari studi pada pada waung. Pengukuran semacam itu mengungkapkan bahwa lebar jaringan lunak tertentu bisa dibutuhkan untuk menutup tulang peri-implant. Penelitian ini mengacu pada panjang epitel (dari margin mukosa peri-implant ke bagian apikal dari epitel per...
Pembentukan pelekatan mukosa dipelajari pakai model waung. Perangkat implant one-piece dipasang di rahang waung pada bagian yang yang tidak ada giginya. Penyembuhan dipantau dengan menggunakan pemeriksaan biopsi pakai mikroskop cahaya dengan interval yang berbeda selama periode 3 bulan.
Pada fase purwa luka antara implant dan jaringan ikat yang dipotong, bekuan / koagulum fibrin terbentuk. Ini ...
The implant device lacks tooth characteristic structures such as root cementum, periodontal ligament, and bundle bone (alveolar bone proper). The dento‐alveolar and the dento‐gingival fiber bundles connect the soft tissues with the tooth (root cementum), while no such fiber bundles are apparent in the peri‐implant tissues. At periodontally healthy sites, the margin of the gingiva follow...
Bone tissue in the edentulous ridge
In a study involving partially edentulous subjects, hard tissue biopsies were sampled from the maxilla and the mandible with the use of trephine drills. The bone tissue was found to include a blend of mainly lamellar bone (46%) and bone marrow (23%) with less amounts of fibrous (12%) and osteoid (4%) tissue. Bone marrow was the dominant tissu...
KERATINIZED MUCOSA (KM)
Keratinized mucosa is a term used to describe the masticatory mucosa that is present at many, but not all, implant sites. Keratinized mucosa extends from the margin of the peri‐implant mucosa to the movable lining (oral) mucosa. Keratinized mucosa is comprised of a lamina propria (fibrous connective tissue that contains fibroblasts and equal amounts of ty...
BONE SOUNDING
Bone sounding or transmucosal sounding (TS) is a measurement that is used to determine the height of the entire soft tissue cuff at various groups of teeth and implants. The dimensions of the peri‐implant mucosa and the gingiva at adjacent tooth sites was studied by clinical measurements performed mainly in partially edentulous subjects who had been treated with im...
PERI‐IMPLANT TISSUES IN CLINICAL HEALTH
The gingiva and the peri‐implant mucosa and their adhesion (seal) are consistently challenged by the oral environment, including the steady exposure to microorganisms in the biofilm present on the tooth and implant surfaces. In the clinically normal peri‐implant mucosa (and gingiva), the continuous host response includes both vascular ...
Animal studies
The dimension of the peri‐implant mucosa, often called the biological width or dimension, was examined in biopsies mainly obtained from studies in dogs. Such measurements disclosed that a certain width of soft tissue may be required to cover the peri‐implant bone. The studies referred to the length of the epithelium (from the peri‐implant mucosa margin to the...
The formation of the mucosal adhesion was studied in a dog model. One‐piece implant devices were placed in the edentulous mandible of dogs, and healing was monitored using light microscopic examination of biopsies sampled at different intervals during a 3‐month period. In the initial phase of the wound between the implant and cut connective tissue, a fibrin clot/coagulum formed that was inf...
PERI‐IMPLANT MUCOSA
Most information regarding the structural features of the peri‐implant mucosa is derived from animal studies using dog models. In such studies implants were placed in the edentulous ridge (alternatively, the fresh extraction socket), the outer osseous part of which was covered with masticatory mucosa. It was also shown that the healed peri‐implant mucosa on the buccal a...
Peri‐implant tissues are those that occur around osseointegrated dental implants. They are divided into soft and hard tissue compartments. The soft tissue compartment is denoted “peri‐implant mucosa” and is formed during the wound healing process that follows implant/abutment placement. The hard tissue compartment forms a contact relationship to the implant surface to secure implant stab...
Abstract
Objective
The aim is to define clinical and histologic characteristics of peri‐implant tissues in health and describe the mucosa–implant interface.
Importance
An understanding of the characteristics of healthy peri‐implant tissues facilitates the recognition of disease (i.e., departure from health).
Findings
The healthy peri‐implant mucosa is, at the microscopic ...
Diagnosis
Diagnosa pericoronitis/ perikoronitis didasarkan pada gejala-gejala dan tampilan selama evaluasi klinis yang dilakukan oleh profesional perawatan kesarasan, yaitu dokter gigi atau dokter bedah mulut.
nyeri
bengkak pada gusi
terasa empuk
gusi jadi berwarna lebih merah daripada sekitarnya
bau mulut (halitosis)
rasa mulut tidak enak karena ada nanah
sulit membuka mulut (tri...
Ada banyak faktor yang memengaruhi diagnosis dan perencanaan perawatan dalam kerangka kerja praktik kesarasan masyarakat.
Masing-masing faktor ini berdampak pada ketepatan perencanaan bagi pasien dan kemampuan untuk menyediakan layanan-layanan itu. Rencana perawatan didasarkan pada jumlah total pengaruh-pengaruh ini.
Dari sekian banyak faktor tersebut, ada 4 faktor utama yang memengaruhi diagno...
B. Scaling and root planing (Pengikisan dan pengetaman akar gigi) [Lanjutan]
Prosedur Scaling and root planing lebih dikenal dengan nama "skeling" saja alih-alih terjemahannya. Prosedur skeling memerlukan penggunaan kuret berbahan plastik dan pasta pemoles yang halus untuk pemeliharaan kesarasan implan.
Pemeliharaan implant secara profesional harus mencakup penghapusan deposit lunak dan depos...
Diagnosis
Kesarasan
Apabila tanda-tanda klinis inflamasi tidak terdeteksi, maka pasien implant diklasifikasi saras.
Mukositis implan
Mukositis adalah lesi inflamasi lokal dalam jaringan lunak tanpa penyusutan tulang progresif, terpisah 0,2 – 2 mm kawah yang terjadi segera setelah memasang abutment di sekitar implant yang telah sukses berpadu dengan tulang. Mukositis bisa diidentifikasi se...
Pasien mudah didiagnosis menderita gingivostomatitis primer dengan melihat gambaran klinis gejala umum yang pilah dan yang diikuti dengan:erupsi vesikel oralulkus oral simetris yang dangkalgingivitis marginal akutpasien tidak punya sejarah herpes kambuhanKarena infeksi virus HSV 1 mudah dikenali, maka tes laboratorium jarang digunakan. Tes laboratorium digunakan apabila infeksi virus HSV tidak ...