Fig. 3. Histological magnifications of specimens exposing a significant areas of lamellar bone in-between and parallel to the surface of older trabeculae (accentuated by green overlay), b osteoclastic activity, and c active bone formation at intrabony marginal regions
Fig. 3. Histological magnifications of specimens exposing a significant areas of lamellar bone in-between and parallel to the ...
Fig. 2. Histological view (buccal aspect) displaying mean BIC (%) and mean bone density (%) at corresponding regions (500 μm zones) from BD to A. Blue lines along the implant perimeter display BIC presence and yellow lines display BIC absence
Fig. 2. Histological view (buccal aspect) displaying mean BIC (%) and mean bone density (%) at corresponding regions (500 μm zones) from BD to A. Blue...
Fig. 1. Histological section illustrating the landmarks to determine the conducted histomorphometrical length measurements: DL, RB, and BIC at buccal RB. The red square frames the intra-thread area (ROI) for OD and ELD analysis
Fig. 1. Histological section illustrating the landmarks to determine the conducted histomorphometrical length measurements: DL, RB, and BIC at buccal RB. The red squar...
SP ID Mean OD (number/mm2)Mean ELD (number/mm2)Osteocyte/empty lacuna ratio12932311.2622211021.3231122450.4541721021.6851621431.12Mean1921651.17SD ±6869.20.4595% CI(132–251)(103–225) Table 3 Mean osteocyte (OD) and empty lacunae density (ELD) at peri-implant residual bone
Specimen IDDL (mm)RB (mm)B.Ar/T.Ar (%)BIC (%)14.83.572.480.025.68.992.375.035.65.388.173.843.87.781.868.753.63.292.571.1Mean4.75.785.574.0SD ±1.02.58.04.095% CI3.1–4.93.3–6.878–9270.6–77.6Table 2 Results from histomorphometric measurements exhibiting DL, RB, bone density (%), residual bone-to-implant contact (%) values
Sample ID
Gender
Age
Location
Prosthesis type
Loading time (years)
lmplant surface
Mean BOP (%)
Supp (+/−)
Mean PD (mm)
MBL (mm)
1
M
69
Maxilla
Single-screwed
5.1
Machined
100
+
6.4
B: 4.0P: 6.0
2
F
60
Mandible
Single-screwed
10.0
Machined
100
−
6.0
B: 4.5L: 5.0
3
F
60
Mandible
Single-screwed
10.0
Machined
100
−
6.2
B: 4.0L: 5...
Galárraga-Vinueza, M., Tangl, S., Bianchini, M. et al. Histological characteristics of advanced peri-implantitis bone defects in humans. Int J Implant Dent 6, 12 (2020). https://doi.org/10.1186/s40729-020-00208-8
Download citation
Received: 08 January 2020
Accepted: 19 February 2020
Published: 25 March 2020
DOI: https://doi.org/10.1186/s40729-020-00208-8
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The study protocol no. 3437751 was approved by the Human Research Committee at Federal University of Santa Catarina-Brazil, 2016–2021, and all patients signed an informed consent according to the university ethics regulations.
Not applicable
The authors declare that they have no competing of interests.
MG, FS, RG, and MB contributed to the design of the study. ST and KO contributed to study selection and data extraction. MG, RM, FS, RG, MB, ST, and KO contributed to the drafting of the paper and revising it critically. All authors read, revised, and approved the final manuscript.
Correspondence to
Reinhard Gruber.
Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
Maria Elisa Galárraga-Vinueza, Karina Obreja & Frank Schwarz
Post-Graduate Program in Implant Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil
Maria Elisa Galárraga-Vinueza, Marco Bianchini & Ricardo Magini
Core Facility Hard Tissue and Biomaterial Rese...
The present study was funded by the authors’ own departments.
Kohal R-J, Patzelt SBM, Butz F, Sahlin H. One-piece zirconia oral implants: one-year results from a prospective case series. 2. Three-unit fixed dental prosthesis (FDP) reconstruction. J Clin Periodontol [Internet]. 2013 [cited 2018 Nov 15];40(5):553–562. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23506654.
Dallas SL, Prideaux M, Bonewald LF. The osteocyte: an endocrine cell ... and mor...
Berglundh T, Gislason O, Lekholm U, Sennerby L, Lindhe J. Histopathological observations of human periimplantitis lesions. J Clin Periodontol [Internet]. 2004 [cited 2019 Mar 13];31(5):341–347. Available from: http://doi.wiley.com/10.1111/j.1600-051X.2004.00486.x.
Zitzmann NU, Berglundh T, Ericsson I, Lindhe J. Spontaneous progression of experimentally induced periimplantitis. J Clin Periodonto...
Schwarz F, Herten M, Sager M, Bieling K, Sculean A, Becker J. Comparison of naturally occurring and ligature-induced peri-implantitis bone defects in humans and dogs. Clin Oral Implants Res [Internet]. 2007 [cited 2019 Mar 18];18(2):161–170. Available from: http://doi.wiley.com/10.1111/j.1600-0501.2006.01320.x.
Serino G, Turri A, Lang NP. Probing at implants with peri-implantitis and its relati...
Schwarz F, Derks J, Monje A, Wang H-L. Peri-implantitis. J Clin Periodontol. 2018;45(June 2016):S246–66.
Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, et al. Peri-implant diseases and conditions: consensus report of workgroup 4 of the 2017 World Workshop on the classification of periodontal and peri-implant diseases and conditions. J Clin Periodontol [Internet]. 2018 ...
Most apical extension of the residual bone tissue
Bone area
Bone defect
Bone-to-implant contact
Bleeding on probing
Cone beam computed tomography
Confidence interval
Disto-buccal
Defect length
Disto-oral
Empty lacuna density
Implant shoulder
Mesio-buccal
Marginal bone loss
Mesio-oral
Oral
Osteocyte density
Probing depth
Residual bone
Region of interest
Surface area
Standard de...
The data sets used and/or analyzed during the current study are available from the corresponding author or reasonable request.
In conclusion, the findings of this case series based on dental implants that had to be retrieved because of advanced peri-implantitis and the concomitant inflammatory osteolysis suggest that the residual peri-implant bone might accumulate the functional load and is consequently modeled and reinforced to become cortical bone.
When further interpreting the present study, the peri-implant osteocyte lacunae density after 1 to 27 years in function was reported [28]. In line with our findings, empty osteocytic lacunae adjacent to zirconia implants diagnosed with peri-implantitis were described [29]. Based on counting the osteocyte lacunae, we observed that numerous filled but also empty osteocytic lacunae were present withi...
The present study was inspired by the concept that upon advanced loss of cortical peri-implant bone, the remaining peri-implant trabecular bone is subjected to masticatory forces and reinforced as a consequence of functional adaptation [15]. This adaptation depends on vital osteocytes [16]. Therefore, the present human case series aimed at investigate the peri-implant bone in advanced peri-implant...
The clinical and radiographic characteristics of the implant sites are presented in Table 1. In total, 3 implants were located in the maxilla, while two implants were located in the mandible. While all implants showed bleeding on probing, only 2 implants presented with suppuration on gentle probing. Mean probing depth was 6.3 ± 0.4 mm corresponding to a mean marginal bone loss (MBL) of 4.7 ± 1.0...
RB was divided into 500-μm-wide horizontal zones (from BD to A) following the long axis of the implant. For each of these individual zones, BIC and bone density (B.Ar/T.Ar) were determined. Osteocyte and empty osteocytic lacunae were counted along the region of interest (ROI) (i.e., the area encompassing the intra-thread regions along the buccal RB extension) (Fig. 1) using a software program (Im...
Cone beam computed tomographic (CBCT) scans were obtained from each patient for the surgical planning of implant removal. Linear measurements of the defect length (DL) at affected implants were made by drawing a vertical line, following the long axis of the implant, from the implant shoulder (IS) to the bottom of the defect (BD) at buccal and oral aspects in the CBCT data sets (Implant viewer, ver...
The present study included 4 patients, 3 female and 1 male (mean age of 66 ± 5 years), who attended the Implant Dentistry Department at Federal University of Santa Catarina, complaining of pain, discomfort, suppuration, and/or bleeding at implant sites. All patients revealed a history of periodontal disease, were non-smokers (100%), and reported no additional systemic diseases. The patients exhi...
Peri-implantitis was recently defined as a “pathological condition occurring in tissues around dental implants”, which is “characterized by inflammation in the peri-implant connective tissue and a progressive loss of supporting bone” [1,2,3,4].
Human biopsies confirmed the presence of plasma cells, macrophages, and neutrophils [5] and elevated expression of inflammatory cytokines [6, 7] a...
Inflammatory osteolysis is the clinical hallmark of peri-implantitis. The morphology of the remaining peri-implant bone and the level of osseointegration, however, remain unknown. Our aim was to characterize advanced peri-implantitis bone defects in humans.
Four patients (3 female and 1 male) were diagnosed with peri-implantitis. A total of 5 implants with machined surfaces and a mean loading tim...
Fig. 5. Anti-RANKL and anti-RANKL+miR-146a treatments decreased gingival mRNA expression of TNF-α and RANKL with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. Gingival tissues around ligatured implants and non-ligation implants were excised and processed for RT-qPCR analysis to determine mRNA level of TNF-α of WT mice (a) and TLR2/4 KO mice (b) (mean ± SD, n = ...
Fig. 4. Anti-RANKL and anti-RANKL+miR-146a treatments decreased the inflammatory cell infiltration of the implant gingival tissues with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. HE staining of the gingival tissue around implants were performed in the control group, ligation group, ligation with anti-RANKL antibody treatment group, and ligation with anti-RANKL ...
Fig. 3. Anti-RANKL and anti-RANKL+miR-146a treatments decreased TRAP-positive cell quantities with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. TRAP-positive cells (red color) with 3 or more nuclei were considered osteoclasts and were shown in the control group, ligation group, ligation with anti-RANKL antibody treatment group, and ligation with anti-RANKL antibo...
Fig. 2. Anti-RANKL and anti-RANKL+miR-146a treatments decreased ligature-induced bone resorption with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. Buccal side images of the defleshed skulls were taken of the control (non-ligation) group, ligation (non-treatment) group, ligation with anti-RANKL antibody (ligation+AR) treatment group, and ligation with anti-RANKL a...
Fig. 1. Mouse model of ligature-induced experimental peri-implantitis. (a) Tooth extraction: left maxillary first and second molars extracted at 4 weeks old and the tooth extraction socket healed well with smooth gingiva surface after 6 weeks post-extraction. Implant placement: implant was put in alveolar bone without flap elevation. Ligature placement: at 4 weeks post-implant, 7-0 ligatur...
Total implantsLostLooseOsseointegratedSuccess rate (%)SR P valueWild type group60654981.670.595TLR2/4 KO group60445286.67Table 1 Success rate (SR) of osseointegrated implants 4 weeks after implant placement
Pan, K., Hu, Y., Wang, Y. et al. RANKL blockade alleviates peri-implant bone loss and is enhanced by anti-inflammatory microRNA-146a through TLR2/4 signaling. Int J Implant Dent 6, 15 (2020). https://doi.org/10.1186/s40729-020-00210-0
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Received: 24 September 2019
Accepted: 12 March 2020
Published: 15 April 2020
DOI: https://doi.org/10.1186/s40729-020-00210-0
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
The numerical data of all graphs.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Not applicable
Not applicable
Keqing Pan, Yang Hu, Yufeng Wang, Hao Li, Michele Patel, Danyang Wang, Zuomin Wang, and Xiaozhe Han certify that they do not have any commercial or associate interest that represents a conflict of interest in connection with the manuscript. The submitted work was not carried out in the presence of any personal, professional, or financial relationships that could pot...
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KP contributed to the conception and design; contributed to the acquisition, analysis, and interpretation of data; and drafted the manuscript. YH contributed to the conception and design, contributed to the acquisition, anal...
Department of Stomatology, The Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, 266003, Shandong, China
Keqing Pan
Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, MA, 02142, USA
Keqing Pan, Yang Hu, Yufeng Wang, Hao Li, Michele Patel & Xiaozhe Han
Department of Oral Medicine, Ninth People...
This study was supported by NIH NIDCR R01DE025255 and the Forsyth Institute FPILOT36 to X Han and the Forsyth Institute FPILOT52 to Y Hu.
Tu S, Zhong D, Xie W, Huang W, Jiang Y, Li Y. Role of toll-like receptor signaling in the pathogenesis of graft-versus-host diseases. Int J Mol Sci. 2016;17(8).
Gaddis DE, Michalek SM, Katz J. TLR4 signaling via MyD88 and TRIF differentially shape the CD4+ T cell response to Porphyromonas gingivalis hemagglutinin B. J Immunol. 2011;186(10):5772–83.
Zhang P, Liu J, Xu Q, et al. TLR2-dependent m...
Kawai T, Akira S. Toll-like receptors and their crosstalk with other innate receptors in infection and immunity. Immunity. 2011;34(5):637–50.
Song GG, Kim JH, Lee YH. Toll-like receptor (TLR) and matrix metalloproteinase (MMP) polymorphisms and periodontitis susceptibility: a meta-analysis. Mol Biol Rep. 2013;40(8):5129–41.
Lin J, Bi L, Yu X, et al. Porphyromonas gingivalis exacerbates ligat...
Shuto T, Wachi T, Shinohara Y, Nikawa H, Makihira S. Increase in receptor activator of nuclear factor kappaB ligand/osteoprotegerin ratio in peri-implant gingiva exposed to Porphyromonas gingivalis lipopolysaccharide. J Dent Sci. 2016;11(1):8–16.
O'Connell MB. Prescription drug therapies for prevention and treatment of postmenopausal osteoporosis. J Manag Care Pharm. 2006;12(6 Suppl A):S10-19; ...
Bertin TJC, Thivichon-Prince B, LeBlanc ARH, Caldwell MW, Viriot L. Current perspectives on tooth implantation, attachment, and replacement in amniota. Front Physiol. 2018;9:1630.
Schminke B, Vom Orde F, Gruber R, Schliephake H, Burgers R, Miosge N. The pathology of bone tissue during peri-implantitis. J Dent Res. 2015;94(2):354–61.
Mombelli A, Muller N, Cionca N. The epidemiology of peri-impl...
Receptor activator of nuclear factor-kappa Β ligand
Toll-like receptor
Wild type
MicroRNA 146a
Micro-computed tomography
Real-time quantitative PCR
Tumor necrosis factor alpha
Osteoprotegerin
Lipopolysaccharides
Hematoxylin and eosin
Tartrate-resistant acid phosphatase
Presented in the main paper
In summary, the present study suggests that anti-inflammatory miR-146a enhance anti-RANKL-induced inhibition of peri-implant bone resorption through the regulation of TLR2/4 signaling and inhibition of TNF-α expression. Combination of regimens antagonizing both osteoclastogenesis and inflammation may become a more effective strategy to ameliorate peri-implantitis bone loss.
According to the previous studies, miR-146a was regulated by NF-κB and blockade of miR-146a could decrease TLR4 and NF-κB in human cells [41, 42], suggesting that miR-146a is involved in TLR/NF-κB signaling pathway. Our recent study showed that miR-146a inhibited inflammatory cytokine secretion in B cells after challenged with P. gingivalis LPS and decreased bone resorption in experimental peri...
Our present study showed that anti-RANKL antibody can significantly inhibit the bone loss in peri-implantitis and additional miR-146a treatment will enhance this inhibition through its anti-inflammation effects via TLR2/4 signaling. This is the first report in a murine model of peri-implantitis to demonstrate that anti-RANKL antibody and miR-146a together can significantly reduce bone resorption a...
In both WT mice and TLR2/4 KO mice, a significantly higher number of inflammatory cells were found infiltrating around the peri-implant tissues in the ligation group compared with the non-ligation group (Fig. 4a–c). However, the number of inflammatory cells in tissues of the ligation group was not significantly changed when treated with anti-RANKL antibody alone in both WT and TLR2/4 KO mice com...
In our ligature-induced experimental peri-implantitis mouse model, teeth extraction, implant placement, ligation placement, and gingival injection will be performed in a 12-week process (Fig. 1). 86.67% (52 out of 60) of implants in TLR2/4 KO mice achieved osteointegration (no mobility when touched by needles, no obvious bleeding upon probing) after being placed for 4 weeks, which has no signifi...
Palatal gingival tissues were isolated from around ligatured implants and were homogenized in lysis buffer using a tissue homogenizer. Total RNA was extracted using PureLink® RNA Mini Kit (Ambion). cDNA was synthesized using the SuperScript III Reversed Transcriptase kit (Invitrogen) according to the manufacturer’s protocol. The mRNA expression of TNF-α and RANKL in gingival was determined by ...
The ligations were maintained for 2 weeks, and after which the mice were euthanized by CO2 inhalation and the maxilla were harvested. The gingival tissues of half group of mice were isolated and collected for mRNA expression study. The skulls left were defleshed by beetles for 1 week. Briefly, in beetle’s chamber, freshly dissected skull was put in a paper cup with 0.5 cm diameter holes at...
Wild-type (WT) C57BL/6 and TLR2 KO and TLR4 KO mice in C57/BL6 background were purchased from the Jackson Laboratory (Bar Harbor, ME). TLR2 and TLR4 double KO mice (TLR2/4 KO) were crossbreed from TLR2 KO and TLR4 KO mice and confirmed by genotyping. All the animal-associated protocols were reviewed and approved (#17-022) by the Institutional Animal Care and Use Committee of the Forsyth Institute....
Toll-like receptors (TLR) are a family of well-characterized pattern recognition receptors (PRRs) and play an important role in the induction of pro-inflammatory cytokines by recognizing the signature molecules of the host innate immunity [25,26,27]. Our previous studies showed that TLR2 are associated with implant bone loss in a mouse model of peri-implantitis [5] and TLR4 is essential for period...
Dental implant has become a preferable choice to restore the missing tooth in the past few decades for functional and esthetic purposes [1]. However, peri-implantitis has become prevalent accompanying the exponential growth of dental implant procedures [2, 3]. Peri-implantitis is indicated by infection of implant surrounding soft tissues and bone loss, resulting in implant failure eventually [4,5,...
This study suggests that anti-inflammatory miR-146a enhance anti-RANKL-induced inhibition of peri-implant bone resorption through the regulation of TLR2/4 signaling and inhibition of TNF-α expression.
The present study was to determine the effect of local anti-RANKL antibody administration in the presence or absence of microRNA-146a on ligature-induced peri-implant bone resorption, and the potential role of TLR2/4 signaling in such effect.
Titanium implants were placed in the left maxilla alveolar bone 6 weeks after extraction of first and second molars in C57/BL6 wild-type (WT) and TLR2−/...
Fig. 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Fig. 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Fig. 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d, vs Rot; e, vs Las which indicates p < 0.05
Fig. 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d...
Fig. 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Fig. 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Fig. 3. Decontamination methods. a Gauze soaked in saline applied using a sawing motion. b Ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon group, Bordeaux, France, power setting: P5, tip: Implant Protect IP3L/R). c Air abrasives (AIR-FLOW MASTER PIEZON®, EMS, Nyon, Switzerland, power setting: water flow 100%, air pressure 75%, powder: AIR-FLOW® PERIO POWDER, nozzle: PERIO-FLOW® nozzles, di...
Fig. 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Fig. 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Fig. 1. Hard resin splint model carrying 6 implants
Fig. 1. Hard resin splint model carrying 6 implants
Rough surfaceContGUSAirRotLasMedian137.53.446.513.04.816.3Min73.00.36.80.50.63.0Max785.027.0240.035.537.034.0Machine surfaceContGUSAirRotLasMedian84.50.98.53.23.325.3Min43.00.20.92.01.60.4Max295.04.236.014.05.661.5Table 3 Quantitative analysis of CFU counts (× 105) from rough and machined surface implants after cleansing by each method
Machined surface (microthread)No effectFairGoodExcellentG +US + Air + Rot +Las + Machined surface (macrothread)No effectFairGoodExcellentG +US + Air + Rot +Las + Table 2 Qualitative evaluation by SEM analysis of micro- and macrothread areas of machined surface implants
Rough surface (microthread)No effectFairGoodExcellentG + US + Air + Rot + Las+ Rough surface (macrothread)No effectFairGoodExcellentG + US + Air + Rot + Las+ Table 1 Qualitative evaluation by SEM analysis of micro- and macrothread areas of rough surface implants
Fig. 3. Histological magnifications of specimens exposing a significant areas of lamellar bone in-between and parallel to the surface of older trabeculae (accentuated by green overlay), b osteoclastic activity, and c active bone formation at intrabony marginal regions
Fig. 3. Histological magnifications of specimens exposing a significant areas of lamellar bone in-between and parallel to the ...
Fig. 2. Histological view (buccal aspect) displaying mean BIC (%) and mean bone density (%) at corresponding regions (500 μm zones) from BD to A. Blue lines along the implant perimeter display BIC presence and yellow lines display BIC absence
Fig. 2. Histological view (buccal aspect) displaying mean BIC (%) and mean bone density (%) at corresponding regions (500 μm zones) from BD to A. Blue...
Fig. 1. Histological section illustrating the landmarks to determine the conducted histomorphometrical length measurements: DL, RB, and BIC at buccal RB. The red square frames the intra-thread area (ROI) for OD and ELD analysis
Fig. 1. Histological section illustrating the landmarks to determine the conducted histomorphometrical length measurements: DL, RB, and BIC at buccal RB. The red squar...
SP ID Mean OD (number/mm2)Mean ELD (number/mm2)Osteocyte/empty lacuna ratio12932311.2622211021.3231122450.4541721021.6851621431.12Mean1921651.17SD ±6869.20.4595% CI(132–251)(103–225) Table 3 Mean osteocyte (OD) and empty lacunae density (ELD) at peri-implant residual bone
Specimen IDDL (mm)RB (mm)B.Ar/T.Ar (%)BIC (%)14.83.572.480.025.68.992.375.035.65.388.173.843.87.781.868.753.63.292.571.1Mean4.75.785.574.0SD ±1.02.58.04.095% CI3.1–4.93.3–6.878–9270.6–77.6Table 2 Results from histomorphometric measurements exhibiting DL, RB, bone density (%), residual bone-to-implant contact (%) values
Sample ID
Gender
Age
Location
Prosthesis type
Loading time (years)
lmplant surface
Mean BOP (%)
Supp (+/−)
Mean PD (mm)
MBL (mm)
1
M
69
Maxilla
Single-screwed
5.1
Machined
100
+
6.4
B: 4.0P: 6.0
2
F
60
Mandible
Single-screwed
10.0
Machined
100
−
6.0
B: 4.5L: 5.0
3
F
60
Mandible
Single-screwed
10.0
Machined
100
−
6.2
B: 4.0L: 5...
Galárraga-Vinueza, M., Tangl, S., Bianchini, M. et al. Histological characteristics of advanced peri-implantitis bone defects in humans. Int J Implant Dent 6, 12 (2020). https://doi.org/10.1186/s40729-020-00208-8
Download citation
Received: 08 January 2020
Accepted: 19 February 2020
Published: 25 March 2020
DOI: https://doi.org/10.1186/s40729-020-00208-8
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The study protocol no. 3437751 was approved by the Human Research Committee at Federal University of Santa Catarina-Brazil, 2016–2021, and all patients signed an informed consent according to the university ethics regulations.
Not applicable
The authors declare that they have no competing of interests.
MG, FS, RG, and MB contributed to the design of the study. ST and KO contributed to study selection and data extraction. MG, RM, FS, RG, MB, ST, and KO contributed to the drafting of the paper and revising it critically. All authors read, revised, and approved the final manuscript.
Correspondence to Reinhard Gruber.
Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
Maria Elisa Galárraga-Vinueza, Karina Obreja & Frank Schwarz
Post-Graduate Program in Implant Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil
Maria Elisa Galárraga-Vinueza, Marco Bianchini & Ricardo Magini
Core Facility Hard Tissue and Biomaterial Rese...
The present study was funded by the authors’ own departments.
Kohal R-J, Patzelt SBM, Butz F, Sahlin H. One-piece zirconia oral implants: one-year results from a prospective case series. 2. Three-unit fixed dental prosthesis (FDP) reconstruction. J Clin Periodontol [Internet]. 2013 [cited 2018 Nov 15];40(5):553–562. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23506654.
Dallas SL, Prideaux M, Bonewald LF. The osteocyte: an endocrine cell ... and mor...
Berglundh T, Gislason O, Lekholm U, Sennerby L, Lindhe J. Histopathological observations of human periimplantitis lesions. J Clin Periodontol [Internet]. 2004 [cited 2019 Mar 13];31(5):341–347. Available from: http://doi.wiley.com/10.1111/j.1600-051X.2004.00486.x.
Zitzmann NU, Berglundh T, Ericsson I, Lindhe J. Spontaneous progression of experimentally induced periimplantitis. J Clin Periodonto...
Schwarz F, Herten M, Sager M, Bieling K, Sculean A, Becker J. Comparison of naturally occurring and ligature-induced peri-implantitis bone defects in humans and dogs. Clin Oral Implants Res [Internet]. 2007 [cited 2019 Mar 18];18(2):161–170. Available from: http://doi.wiley.com/10.1111/j.1600-0501.2006.01320.x.
Serino G, Turri A, Lang NP. Probing at implants with peri-implantitis and its relati...
Schwarz F, Derks J, Monje A, Wang H-L. Peri-implantitis. J Clin Periodontol. 2018;45(June 2016):S246–66.
Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, et al. Peri-implant diseases and conditions: consensus report of workgroup 4 of the 2017 World Workshop on the classification of periodontal and peri-implant diseases and conditions. J Clin Periodontol [Internet]. 2018 ...
Most apical extension of the residual bone tissue
Bone area
Bone defect
Bone-to-implant contact
Bleeding on probing
Cone beam computed tomography
Confidence interval
Disto-buccal
Defect length
Disto-oral
Empty lacuna density
Implant shoulder
Mesio-buccal
Marginal bone loss
Mesio-oral
Oral
Osteocyte density
Probing depth
Residual bone
Region of interest
Surface area
Standard de...
The data sets used and/or analyzed during the current study are available from the corresponding author or reasonable request.
In conclusion, the findings of this case series based on dental implants that had to be retrieved because of advanced peri-implantitis and the concomitant inflammatory osteolysis suggest that the residual peri-implant bone might accumulate the functional load and is consequently modeled and reinforced to become cortical bone.
When further interpreting the present study, the peri-implant osteocyte lacunae density after 1 to 27 years in function was reported [28]. In line with our findings, empty osteocytic lacunae adjacent to zirconia implants diagnosed with peri-implantitis were described [29]. Based on counting the osteocyte lacunae, we observed that numerous filled but also empty osteocytic lacunae were present withi...
The present study was inspired by the concept that upon advanced loss of cortical peri-implant bone, the remaining peri-implant trabecular bone is subjected to masticatory forces and reinforced as a consequence of functional adaptation [15]. This adaptation depends on vital osteocytes [16]. Therefore, the present human case series aimed at investigate the peri-implant bone in advanced peri-implant...
The clinical and radiographic characteristics of the implant sites are presented in Table 1. In total, 3 implants were located in the maxilla, while two implants were located in the mandible. While all implants showed bleeding on probing, only 2 implants presented with suppuration on gentle probing. Mean probing depth was 6.3 ± 0.4 mm corresponding to a mean marginal bone loss (MBL) of 4.7 ± 1.0...
RB was divided into 500-μm-wide horizontal zones (from BD to A) following the long axis of the implant. For each of these individual zones, BIC and bone density (B.Ar/T.Ar) were determined. Osteocyte and empty osteocytic lacunae were counted along the region of interest (ROI) (i.e., the area encompassing the intra-thread regions along the buccal RB extension) (Fig. 1) using a software program (Im...
Cone beam computed tomographic (CBCT) scans were obtained from each patient for the surgical planning of implant removal. Linear measurements of the defect length (DL) at affected implants were made by drawing a vertical line, following the long axis of the implant, from the implant shoulder (IS) to the bottom of the defect (BD) at buccal and oral aspects in the CBCT data sets (Implant viewer, ver...
The present study included 4 patients, 3 female and 1 male (mean age of 66 ± 5 years), who attended the Implant Dentistry Department at Federal University of Santa Catarina, complaining of pain, discomfort, suppuration, and/or bleeding at implant sites. All patients revealed a history of periodontal disease, were non-smokers (100%), and reported no additional systemic diseases. The patients exhi...
Peri-implantitis was recently defined as a “pathological condition occurring in tissues around dental implants”, which is “characterized by inflammation in the peri-implant connective tissue and a progressive loss of supporting bone” [1,2,3,4].
Human biopsies confirmed the presence of plasma cells, macrophages, and neutrophils [5] and elevated expression of inflammatory cytokines [6, 7] a...
Inflammatory osteolysis is the clinical hallmark of peri-implantitis. The morphology of the remaining peri-implant bone and the level of osseointegration, however, remain unknown. Our aim was to characterize advanced peri-implantitis bone defects in humans.
Four patients (3 female and 1 male) were diagnosed with peri-implantitis. A total of 5 implants with machined surfaces and a mean loading tim...
Fig. 5. Anti-RANKL and anti-RANKL+miR-146a treatments decreased gingival mRNA expression of TNF-α and RANKL with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. Gingival tissues around ligatured implants and non-ligation implants were excised and processed for RT-qPCR analysis to determine mRNA level of TNF-α of WT mice (a) and TLR2/4 KO mice (b) (mean ± SD, n = ...
Fig. 4. Anti-RANKL and anti-RANKL+miR-146a treatments decreased the inflammatory cell infiltration of the implant gingival tissues with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. HE staining of the gingival tissue around implants were performed in the control group, ligation group, ligation with anti-RANKL antibody treatment group, and ligation with anti-RANKL ...
Fig. 3. Anti-RANKL and anti-RANKL+miR-146a treatments decreased TRAP-positive cell quantities with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. TRAP-positive cells (red color) with 3 or more nuclei were considered osteoclasts and were shown in the control group, ligation group, ligation with anti-RANKL antibody treatment group, and ligation with anti-RANKL antibo...
Fig. 2. Anti-RANKL and anti-RANKL+miR-146a treatments decreased ligature-induced bone resorption with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. Buccal side images of the defleshed skulls were taken of the control (non-ligation) group, ligation (non-treatment) group, ligation with anti-RANKL antibody (ligation+AR) treatment group, and ligation with anti-RANKL a...
Fig. 1. Mouse model of ligature-induced experimental peri-implantitis. (a) Tooth extraction: left maxillary first and second molars extracted at 4 weeks old and the tooth extraction socket healed well with smooth gingiva surface after 6 weeks post-extraction. Implant placement: implant was put in alveolar bone without flap elevation. Ligature placement: at 4 weeks post-implant, 7-0 ligatur...
Total implantsLostLooseOsseointegratedSuccess rate (%)SR P valueWild type group60654981.670.595TLR2/4 KO group60445286.67Table 1 Success rate (SR) of osseointegrated implants 4 weeks after implant placement
Pan, K., Hu, Y., Wang, Y. et al. RANKL blockade alleviates peri-implant bone loss and is enhanced by anti-inflammatory microRNA-146a through TLR2/4 signaling. Int J Implant Dent 6, 15 (2020). https://doi.org/10.1186/s40729-020-00210-0
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Received: 24 September 2019
Accepted: 12 March 2020
Published: 15 April 2020
DOI: https://doi.org/10.1186/s40729-020-00210-0
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
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Keqing Pan, Yang Hu, Yufeng Wang, Hao Li, Michele Patel, Danyang Wang, Zuomin Wang, and Xiaozhe Han certify that they do not have any commercial or associate interest that represents a conflict of interest in connection with the manuscript. The submitted work was not carried out in the presence of any personal, professional, or financial relationships that could pot...
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KP contributed to the conception and design; contributed to the acquisition, analysis, and interpretation of data; and drafted the manuscript. YH contributed to the conception and design, contributed to the acquisition, analysis, and interpretation of data; drafted the manu...
Department of Stomatology, The Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, 266003, Shandong, China
Keqing Pan
Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, MA, 02142, USA
Keqing Pan, Yang Hu, Yufeng Wang, Hao Li, Michele Patel & Xiaozhe Han
Department of Oral Medicine, Ninth People...
This study was supported by NIH NIDCR R01DE025255 and the Forsyth Institute FPILOT36 to X Han and the Forsyth Institute FPILOT52 to Y Hu.
Tu S, Zhong D, Xie W, Huang W, Jiang Y, Li Y. Role of toll-like receptor signaling in the pathogenesis of graft-versus-host diseases. Int J Mol Sci. 2016;17(8).
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Kawai T, Akira S. Toll-like receptors and their crosstalk with other innate receptors in infection and immunity. Immunity. 2011;34(5):637–50.
Song GG, Kim JH, Lee YH. Toll-like receptor (TLR) and matrix metalloproteinase (MMP) polymorphisms and periodontitis susceptibility: a meta-analysis. Mol Biol Rep. 2013;40(8):5129–41.
Lin J, Bi L, Yu X, et al. Porphyromonas gingivalis exacerbates ligat...
Shuto T, Wachi T, Shinohara Y, Nikawa H, Makihira S. Increase in receptor activator of nuclear factor kappaB ligand/osteoprotegerin ratio in peri-implant gingiva exposed to Porphyromonas gingivalis lipopolysaccharide. J Dent Sci. 2016;11(1):8–16.
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Receptor activator of nuclear factor-kappa Β ligand
Toll-like receptor
Wild type
MicroRNA 146a
Micro-computed tomography
Real-time quantitative PCR
Tumor necrosis factor alpha
Osteoprotegerin
Lipopolysaccharides
Hematoxylin and eosin
Tartrate-resistant acid phosphatase
Presented in the main paper
In summary, the present study suggests that anti-inflammatory miR-146a enhance anti-RANKL-induced inhibition of peri-implant bone resorption through the regulation of TLR2/4 signaling and inhibition of TNF-α expression. Combination of regimens antagonizing both osteoclastogenesis and inflammation may become a more effective strategy to ameliorate peri-implantitis bone loss.
According to the previous studies, miR-146a was regulated by NF-κB and blockade of miR-146a could decrease TLR4 and NF-κB in human cells [41, 42], suggesting that miR-146a is involved in TLR/NF-κB signaling pathway. Our recent study showed that miR-146a inhibited inflammatory cytokine secretion in B cells after challenged with P. gingivalis LPS and decreased bone resorption in experimental peri...
Our present study showed that anti-RANKL antibody can significantly inhibit the bone loss in peri-implantitis and additional miR-146a treatment will enhance this inhibition through its anti-inflammation effects via TLR2/4 signaling. This is the first report in a murine model of peri-implantitis to demonstrate that anti-RANKL antibody and miR-146a together can significantly reduce bone resorption a...
In both WT mice and TLR2/4 KO mice, a significantly higher number of inflammatory cells were found infiltrating around the peri-implant tissues in the ligation group compared with the non-ligation group (Fig. 4a–c). However, the number of inflammatory cells in tissues of the ligation group was not significantly changed when treated with anti-RANKL antibody alone in both WT and TLR2/4 KO mice com...
In our ligature-induced experimental peri-implantitis mouse model, teeth extraction, implant placement, ligation placement, and gingival injection will be performed in a 12-week process (Fig. 1). 86.67% (52 out of 60) of implants in TLR2/4 KO mice achieved osteointegration (no mobility when touched by needles, no obvious bleeding upon probing) after being placed for 4 weeks, which has no signifi...
Palatal gingival tissues were isolated from around ligatured implants and were homogenized in lysis buffer using a tissue homogenizer. Total RNA was extracted using PureLink® RNA Mini Kit (Ambion). cDNA was synthesized using the SuperScript III Reversed Transcriptase kit (Invitrogen) according to the manufacturer’s protocol. The mRNA expression of TNF-α and RANKL in gingival was determined by ...
The ligations were maintained for 2 weeks, and after which the mice were euthanized by CO2 inhalation and the maxilla were harvested. The gingival tissues of half group of mice were isolated and collected for mRNA expression study. The skulls left were defleshed by beetles for 1 week. Briefly, in beetle’s chamber, freshly dissected skull was put in a paper cup with 0.5 cm diameter holes at...
Wild-type (WT) C57BL/6 and TLR2 KO and TLR4 KO mice in C57/BL6 background were purchased from the Jackson Laboratory (Bar Harbor, ME). TLR2 and TLR4 double KO mice (TLR2/4 KO) were crossbreed from TLR2 KO and TLR4 KO mice and confirmed by genotyping. All the animal-associated protocols were reviewed and approved (#17-022) by the Institutional Animal Care and Use Committee of the Forsyth Institute....
Toll-like receptors (TLR) are a family of well-characterized pattern recognition receptors (PRRs) and play an important role in the induction of pro-inflammatory cytokines by recognizing the signature molecules of the host innate immunity [25,26,27]. Our previous studies showed that TLR2 are associated with implant bone loss in a mouse model of peri-implantitis [5] and TLR4 is essential for period...
Dental implant has become a preferable choice to restore the missing tooth in the past few decades for functional and esthetic purposes [1]. However, peri-implantitis has become prevalent accompanying the exponential growth of dental implant procedures [2, 3]. Peri-implantitis is indicated by infection of implant surrounding soft tissues and bone loss, resulting in implant failure eventually [4,5,...
This study suggests that anti-inflammatory miR-146a enhance anti-RANKL-induced inhibition of peri-implant bone resorption through the regulation of TLR2/4 signaling and inhibition of TNF-α expression.
The present study was to determine the effect of local anti-RANKL antibody administration in the presence or absence of microRNA-146a on ligature-induced peri-implant bone resorption, and the potential role of TLR2/4 signaling in such effect.
Titanium implants were placed in the left maxilla alveolar bone 6 weeks after extraction of first and second molars in C57/BL6 wild-type (WT) and TLR2−/...
Fig. 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Fig. 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Fig. 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d, vs Rot; e, vs Las which indicates p < 0.05
Fig. 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d...
Fig. 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Fig. 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Fig. 3. Decontamination methods. a Gauze soaked in saline applied using a sawing motion. b Ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon group, Bordeaux, France, power setting: P5, tip: Implant Protect IP3L/R). c Air abrasives (AIR-FLOW MASTER PIEZON®, EMS, Nyon, Switzerland, power setting: water flow 100%, air pressure 75%, powder: AIR-FLOW® PERIO POWDER, nozzle: PERIO-FLOW® nozzles, di...
Fig. 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Fig. 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Fig. 1. Hard resin splint model carrying 6 implants
Fig. 1. Hard resin splint model carrying 6 implants
Rough surfaceContGUSAirRotLasMedian137.53.446.513.04.816.3Min73.00.36.80.50.63.0Max785.027.0240.035.537.034.0Machine surfaceContGUSAirRotLasMedian84.50.98.53.23.325.3Min43.00.20.92.01.60.4Max295.04.236.014.05.661.5Table 3 Quantitative analysis of CFU counts (× 105) from rough and machined surface implants after cleansing by each method
Machined surface (microthread)No effectFairGoodExcellentG +US + Air + Rot +Las + Machined surface (macrothread)No effectFairGoodExcellentG +US + Air + Rot +Las + Table 2 Qualitative evaluation by SEM analysis of micro- and macrothread areas of machined surface implants
Rough surface (microthread)No effectFairGoodExcellentG + US + Air + Rot + Las+ Rough surface (macrothread)No effectFairGoodExcellentG + US + Air + Rot + Las+ Table 1 Qualitative evaluation by SEM analysis of micro- and macrothread areas of rough surface implants
Otsuki, M., Wada, M., Yamaguchi, M. et al. Evaluation of decontamination methods of oral biofilms formed on screw-shaped, rough and machined surface implants: an ex vivo study.
Int J Implant Dent 6, 18 (2020). https://doi.org/10.1186/s40729-020-00212-y
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Received: 06 February 2020
Accepted: 17 March 2020
Published: 22 April 2020
DOI: https://doi.org/10.118...
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
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All participants provided informed consent verbally. Study information was disseminated to participants both verbally and in written form. This study protocol was approved by the ethical committee of Osaka University (H26.E-36).
All participants consented to the publication of their data through a written consent form obtained from the ethical committee of Osaka University.
Motohiro Otsuki, Masa...
Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
Motohiro Otsuki, Masahiro Wada, Yoshinobu Maeda & Kazunori Ikebe
Department of Oral and Molecular Microbiology, Osaka University Graduate School of Dentistry, Osaka, Japan
Masaya Yamaguchi & Shigetada Kawabata
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GC Corporation provided the implants to this research.
The authors thank Tomoaki Mameno for his work on data analysis.
Romeo E, Ghisolfi M, Murgolo N, Chiapasco M, Lops D, Vogel G. Therapy of peri-implantitis with resective surgery. A 3-year clinical trial on rough screw-shaped oral implants. Part I: clinical outcome. Clin Oral Implants Res. 2007;16(1):9–18.
Aoki A, Mizutani K, Schwarz F, Sculean A, Yukna RA, Takasaki AA, et al. Periodontal and peri-implant wound healing following laser therapy. Periodontol 200...
Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, et al. Peri-implant diseases and conditions: consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018;89(Suppl 1):S313–8.
Sousa V, Mardas N, Spratt D, Boniface D, Dard M, Donos N. Experimental models for contamination of ti...
Schwarz F, Ferrari D, Popovski K, Hartig B, Becker J. Influence of different air-abrasive powders on cell viability at biologically contaminated titanium dental implants surfaces. J Biomed Mater Res B Appl Biomater. 2009;88(1):83–91.
Widodo A, Spratt D, Sousa V, Petrie A, Donos N. An in vitro study on disinfection of titanium surfaces. Clin Oral Implants Res. 2016;27(10):1227–32.
Sahrmann P,...
Derks J, Schaller D, Hakansson J, Wennstrom JL, Tomasi C, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: prevalence of peri-implantitis. J Dent Res. 2016;95(1):43–9.
Fransson C, Lekholm U, Jemt T, Berglundh T. Prevalence of subjects with progressive bone loss at implants. Clin Oral Implants Res. 2005;16(4):440–6.
Wada M, Mameno T, Onodera Y, Matsuda H, Daimon...
Control (no decontamination)
Gauze soaked in saline
Ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon Group, Bordeaux, France; power setting: P5, tip: Implant Protect IP3L/R)
Air abrasive (AIR-FLOW MASTER PIEZON®, EMS, Nyon, Switzerland; power setting: water flow 100%, air pressure 75%, powder: AIR-FLOW® PERIO POWDER, nozzle: PERIO-FLOW® nozzles, distance from the nozzle to the implant 2 ...
The datasets used during the current study are available from the corresponding author on reasonable request.
In the present ex vivo experimental study, none of the tested decontamination methods thoroughly eliminated biofilms formed on rough/machined surface implants intraorally. Gauze soaked in saline and the rotary stainless steel instrument showed better cleansability than the ultrasonic scaler in qualitative and quantitative analyses and may be advantageous for cleansing contaminated implant surfaces...
Through SEM analysis and CFU counts, it was demonstrated that, except for the Er:YAG laser, decontamination of the machined surface implant was easier than that of the rough surface implant regardless of decontamination method. Gauze soaked in saline and the ultrasonic scaler demonstrated a statistically significant difference in CFU counts between the two surfaces. In this context, a machined sur...
Sahrmann et al. [15] tested three instruments (ultrasonic scaler, Gracey curette, and air abrasive device with glycine powder) on rough surface implants stained with indelible ink used as artificial plaque. There was a statistically significant difference in terms of stain removal rate. The air abrasive device showed the best result among the tested instruments. The result of this study is in line...
It has been previously stated that the alteration of the implant surface during cleansing may attenuate biocompatibility [29]. However, several clinical studies revealed the considerable treatment effect even though there was certain expected damage on the implant surface [7, 34]. Therefore, it is assumed that the most important consideration for treating peri-implantitis in the clinical setting s...
Regarding the air abrasives, the cleansing effect in the SEM analysis was also as considerable as that achieved by the ultrasonic scaler in the present study, in contrast to the results of the aforementioned study. Louropoulou et al. [29] also stated in their systematic review that an air-powder abrasive system with sodium bicarbonate powder could cleanse contaminated rough/smooth implant surfaces...
Based on the results of the SEM qualitative analysis, gauze soaked in saline and the rotary stainless steel instrument consistently showed good cleansability on rough and machined surface implants compared with the other methods. Conversely, the Er:YAG laser showed inferior cleansability to all other methods especially on rough surface implants. The ultrasonic scaler and air abrasive exhibited fai...
This study was performed following an ex vivo design to overcome the drawbacks of previous studies. One particular difference in this study was the use of a commercially available screw-shaped implant. As the implant shape and design have rather complicated macro- and microstructures compared with titanium disks or different forms of titanium commonly used in experimental studies, previous results...
During the experiment, three participants experienced small ulcers caused by the implants carried on the splints; however, it did not affect their daily life. Additionally, there were no signs of gingival inflammation in any participant.
G and Rot achieved relatively clean implant surfaces compared with Las in micro- and macrothread areas. US and Air demonstrated fair cleansability in microthread...
The SEM analysis was performed as previously described [16,17,18]. The decontaminated implant samples were fixed with 2% glutaraldehyde-RPMI 1640 immediately for 1 h at room temperature and washed with distilled water. Then, the samples were dehydrated with 100% t-butyl alcohol and freeze-dried. Finally, the samples were coated with platinum and examined using an emission-scanning electron micro...
Eleven participants, nine men and two women between 28 and 42 years of age (mean age 31.3 ± 4.6), were recruited as the study subjects. All participants provided informed consent verbally. Study information was disseminated to participants both verbally and in written form. The inclusion criteria were as follows:
Generally healthy subjects
Dentate subjects without ill-fitting restorations (...
Dental implants are now used broadly for recovering loss of masticatory function and esthetics. Although it has been revealed that dental implants can often survive long term, biological and mechanical complications may arise. Recent cross-sectional and retrospective studies noted a higher prevalence of peri-implantitis at the implant and subject level than previously considered [1,2,3,4]. Additio...
To evaluate the effect of several representative decontamination methods of oral biofilms on different implant surfaces.
Eleven participants wore a hard resin splint carrying 6 rough (GC Aadva® implant; 3.3-mm diameter, 8-mm length) or machined (not commercially available) surface implants for 4 days to accumulate dental plaque naturally on the titanium surfaces of the implants. Apart from sur...
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. 1. Flow diagram
Fig. 1. Flow diagram
Outcome variable
Crude modela
β (95% CI)
p value
Adjusted modelb
β (95% CI)
p-value
% Sites BoP
...
Control
Test
T0 (n = 22)
T3 (n = 20)
T0 (n = 31)
T3 (n = 30)
...
N = 47a
Total anaerobic bacterial load
Log-transformed mean (SD)
T0
T3
Difference
β (95% CI)b
p value
Control
...
N = 40a
Total anaerobic bacterial load
Log-transformed mean (SD)
Tpre
Tpost
Difference
β (95% CI)b
p value
...
Characteristics
Control
Test
Number of patients
14
14
...
Hentenaar, D.F.M., De Waal, Y.C.M., Strooker, H. et al. Implant decontamination with phosphoric acid during surgical peri-implantitis treatment: a RCT.
Int J Implant Dent 3, 33 (2017). https://doi.org/10.1186/s40729-017-0091-5
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Received: 28 March 2017
Accepted: 22 June 2017
Published: 17 July 2017
DOI: https://doi.org/10.1186/s40729-017-0091-5
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...
Diederik F. M. Hentenaar, Yvonne C. M. de Waal, Hans Strooker, Henny J. A. Meijer, Arie-Jan van Winkelhoff, and Gerry M. Raghoe declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Gerry M. Raghoebar.
Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
Diederik F. M. Hentenaar, Henny J. A. Meijer & Gerry M. Raghoebar
Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Yvonne C. M. De Waal, Hans Strooker, He...
Van Winkelhoff AJ, van Steenbergen TJ, Kippuw N, De Graaff J. Further characterization of Bacteroides endodontalis, an asaccharolytic black-pigmented Bacteroides species from the oral cavity. J Clin Microbiol. 1985;22:75–9.
Zambon JJ. Periodontal diseases: microbial factors. Ann Periodontol. 1996;1:879–925.
Héritier M. Effects of phosphoric acid on root dentin surface. A scanning and transm...
Htet M, Madi M, Zakaria O, Miyahara T, Xin W, Lin Z, Aoki K, Kasugai S. Decontamination of anodized implant surface with different modalities for peri-implantitis treatment: lasers and mechanical debridement with citric acid. J Periodontol. 2016;87:953–61.
Mouhyi J, Sennerby L, Van Reck J. The soft tissue response to contaminated and cleaned titanium surfaces using CO2 laser, citric acid and hy...
Esposito M, Grusovin MG, Worthington HV. Treatment of peri-implantitis: what interventions are effective? A Cochrane systematic review. Eur J Oral Implantol. 2012;5:21–41.
Louropoulou A, Slot DE, Van der Weijden F. The effects of mechanical instruments on contaminated titanium dental implant surfaces: a systematic review. Clin Oral Implants Res. 2014;25:1149–60.
Ramanauskaite A, Daugela P, F...
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. J Clin Periodontol. 2011;38(Suppl):11,178–181.
Derks J, Tomasi C. Peri-implant health and disease. A systematic review of current epidemiology. J Clin Periodontol. 2015;42:158–71.
Derks J, Schaller D, Hå...
Gerry Raghoebar
Diederik Hentenaar
Yvonne de Waal
Implant surface decontamination is considered a highly susceptible step in the treatment of peri-implantitis. The application of 35% phosphoric acid after mechanical debridement is superior to mechanical debridement combined with sterile saline rinsing for decontamination of the implant surface during surgical peri-implantitis treatment. However, phosphoric acid as implant surface decontaminant do...
Recent studies that zoom in on titanium surface physico-chemistry reveal interesting results [38, 39]. Kotsakis et al. [38] hypothesized that chemical residues alter the titanium surface physicochemistry and subsequently compromise cellular response to these decontaminated surfaces. However, they report on effective restoring of biocompatibility when sterile saline, citric acid, and EDTA/sodium hy...
Phosphoric acid gel as agent for implant surface decontamination has only been investigated in two other clinical studies [26, 27]. Strooker et al. [26] used phosphoric acid 35% for peri-implant supportive therapy and found greater reductions in bacterial load, but no significant clinical differences compared to conventional mechanical supportive therapy. They concluded that local application of 3...
This randomized controlled trial aimed to determine the effect of 35% phosphoric etching gel on decontamination of the implant surface during resective surgical treatment of peri-implantitis. Both decontamination procedures (mechanical debridement with curettes and gauzes combined with phosphoric acid 35% and mechanical debridement combined with sterile saline) resulted in a significant immediate ...
The progress of patients throughout the different phases of the study is illustrated in Fig. 1. Table 1 depicts the baseline demographic patient and implant characteristics. The included patients had a total of 128 implants of which 53 implants showed signs of peri-implantitis. Different implant brands and types with different implant surfaces were present, including Straumann (Straumann AG, Bas...
Angular bony defects were eliminated, and bone was recontoured using a rotating round bur under saline irrigation. Mucosal flaps were apically positioned and firmly sutured (Vicryl Plus® 3-0; Ethicon Inc., Somerville, NJ, USA), and suprastructures were re-positioned. For both control and test group, surgery was followed by 2 weeks of mouth rinsing with 0.12% CHX + 0.05% CPC without alcohol t...
Implant mobility;
Implants at which no position could be identified where proper probing measurements could be performed;
Previous surgical treatment of the peri-implantitis lesions.
The study protocol was based on the study protocols of two previous studies evaluating the decontaminating effect of chlorhexidine during surgical peri-implantitis treatment [10, 32] and is briefly described below....
The present study is a double-blind randomized controlled trial evaluating the effect of 35% phosphoric etching gel (test group) compared to the effect of saline (control group) for implant surface decontamination combined with mechanical debridement during surgical peri-implantitis treatment. Patients were randomly assigned to the test or control group using a one-to-one allocation ratio. The stu...
Thus far, the use of phosphoric acid etching gel as decontaminating agent has not been evaluated in a randomized controlled trial. The aim of the present randomized controlled trial is to evaluate the short-term microbiological and clinical effectiveness of 35% phosphoric etching gel as a decontaminating agent of the implant surface during resective surgical treatment of peri-implantitis.
Triggered host defense responses initiate inflammation of the peri-implant soft tissue (peri-implant mucositis), which can lead to loss of peri-implant supporting bone (peri-implantitis), and eventually, result in implant failure [1]. An increasing prevalence of peri-implantitis has been described in recent literature [2], with current incidence ranging from 1 to 47%. A non-linear, accelerating pa...
Peri-implantitis is known as an infectious disease that affects the peri-implant soft and hard tissue. Today, scientific literature provides very little evidence for an effective intervention protocol for treatment of peri-implantitis. The aim of the present randomized controlled trial is to evaluate the microbiological and clinical effectiveness of phosphoric acid as a decontaminating agent of th...
Fig. 5. Change in BoP values according to the percentage of sites with a score of 1, 2 or 3 by visit
Fig. 5. Change in BoP values according to the percentage of sites with a score of 1, 2 or 3 by visit
Fig. 4. Percentages of sites with PPD 1–3, 4–5 and ≥6 mm by visit (p
Fig. 3. Changes in BoP values between baseline and the various examination time points
Fig. 3. Changes in BoP values between baseline and the various examination time points
Fig. 2. Changes in PPD values between baseline and the various examination time points
Fig. 2. Changes in PPD values between baseline and the various examination time points
Fig. 1. A chitosan brush (LBC, BioClean®, LABRIDA AS) seated in an oscillating dental handpiece
Fig. 1. A chitosan brush (LBC, BioClean®, LABRIDA AS) seated in an oscillating dental handpiece
Baseline
n = 306
2 weeks
n = 272
4 weeks
n = 267
12 weeks
n = 282
24 weeks
n = 294
P
...
Center
Oslo
Jonkoping
Rome
Stavanger
Kristianstad
Tons...
Wohlfahrt, J.C., Evensen, B.J., Zeza, B. et al. A novel non-surgical method for mild peri-implantitis- a multicenter consecutive case series.
Int J Implant Dent 3, 38 (2017). https://doi.org/10.1186/s40729-017-0098-y
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Received: 08 April 2017
Accepted: 13 July 2017
Published: 03 August 2017
DOI: https://doi.org/10.1186/s40729-017-0098-y
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...
J.C. Wohlfahrt is the inventor and patent holder of BioClean and is a shareholder in LABRIDA AS. B.J. Evensen, B. Zeza, H. Jansson, A. Pilloni, A.M. Roos-Jansåker, G.L. Di Tanna, A.M. Aass, M. Klepp and O.C. Koldsland state that there were no conflicts of interests during the undertaking of the study.
Ethical approval was provided by the regional ethical review boards of each center (Norway: 201...
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JCW, BJE, BZ, HJ, AP, AMR-J, AMA, MK and OCK par...
Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Pb. 1109 Blindern, 0317, Oslo, Norway
J. C. Wohlfahrt, A. M. Aass & O. C. Koldsland
Private Practice, Tønsberg, Norway
B. J. Evensen
Department of Dental and Maxillofacial Sciences, Section of Periodontology, Sapienza, University of Rome, Rome, Italy
B. Zeza & A. Pilloni
Center for Oral Health, Departmen...
Salvi GE, et al. Reversibility of experimental peri-implant mucositis compared with experimental gingivitis in humans. Clin Oral Implants Res. 2012;23(2):182–90.
Korsch M, Obst U, Walther W. Cement-associated peri-implantitis: a retrospective clinical observational study of fixed implant-supported restorations using a methacrylate cement. Clin Oral Implants Res. 2014;25(7):797–802.
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Muthukuru M, et al. Non-surgical therapy for the management of peri-implantitis: a systematic review. Clin Oral Implants Res. 2012;23(Suppl 6):77–83.
Esposito M, Grusovin MG, Worthington HV. Treatment of peri-implantitis: what interventions are effective? A Cochrane systematic review. Eur J Oral Implantol. 2012;5(Suppl):S21–41.
Armitage GC, Xenoudi P. Post-treatment supportive care for the n...
Rokn A, et al. Prevalence of peri-implantitis in patients not participating in well-designed supportive periodontal treatments: a cross-sectional study. Clin Oral Implants Res. 2017;28(3):314–9.
Faggion CM Jr, et al. A systematic review and Bayesian network meta-analysis of randomized clinical trials on non-surgical treatments for peri-implantitis. J Clin Periodontol. 2014;41(10):1015–25.
Me...
Koldsland OC, Scheie AA, Aass AM. Prevalence of peri-implantitis related to severity of the disease with different degrees of bone loss. J Periodontol. 2010;81(2):231–8.
Roos-Jansaker AM, et al. Nine- to fourteen-year follow-up of implant treatment. Part II: presence of peri-implant lesions. J Clin Periodontol. 2006;33(4):290–5.
Derks J, et al. Effectiveness of implant therapy analyzed in a ...
In this multicenter case series of implants affected by mild peri-implantitis, significant reductions in the clinical parameters of inflammation were demonstrated at all time points after the initial treatment with a chitosan brush. The use of an oscillating chitosan device appears to be safe and has potential merits for the treatment of mild peri-implantitis and for the maintenance of dental impl...
The chitosan brush used in this study is made of a material that is soft with the aim to make a device optimized for removal of the biofilm within the implant threads. The soft bristles on the contrary make the device suboptimal for removal of hard deposits, such as calculus and cement remnants. It has been reported that such cement remnants are a common finding around dental implants [41], and in...
In the present study, significant reductions were observed in the clinical parameters of peri-implant inflammation at 2, 4, 12 and 24 weeks relative to baseline after debridement with the chitosan brush seated in an oscillating dental drill piece. No progression in radiographic bone loss was reported at any of the implants at the final evaluation, and the method was thus judged safe to use in cas...
Identifying peri-implant disease at an early stage and promptly treating the inflammatory condition is crucial to prevent the progression of peri-implant bone loss and ensure long-term implant survival [23,24,25]. After completion of active treatment and when the condition is controlled, supportive peri-implant therapy will reduce the risk of disease re-occurrence [9]. A number of scientific repor...
During this study, all 63 implants were reported to have stable radiographic levels of osseous support as validated by the six different local examiners. No adverse events were reported during the study.
In total, 63 implants in 63 patients were ultimately included in the analysis. Demographic information is presented in Tables 1 and 2.
Significant reductions in both PPD and mBoP were seen at all time points relative to the baseline clinical measurements (p
Mann-Whitney rank sum tests were used to compare changes in the clinical parameters between baseline and subsequent time points. To assess the hierarchical structure of the data (center > patient > site), a linear mixed model using the restricted maximum likelihood method (multilevel logistic models for binary outcomes) was constructed to analyse the PPD, mBoP and suppuration, adjusting for fac...
All patient-related information and clinical recordings were recorded in a web-based clinical research form (VieDoc version 3.24, PCG solutions, Uppsala, Sweden).
Patients under 18 years of age; current smokers; patients who had undergone radiotherapy in the head and neck region, chemotherapy or systemic long-term corticosteroid treatment; patients who were pregnant or nursing; patients receivin...
A 6-month multicenter prospective consecutive case series was performed in six different periodontal specialist clinics in Norway, Sweden and Italy.
Ethical approval was provided by the regional ethical review boards of each center (Norway: 2014/852/REK sør-øst; Italy: Sapienza 2011/15, 3547; and Sweden: EPN Lund 2014/695.) Fifteen patients at each center were planned to be included in the stud...
A number of other studies also report that leaving fragments of the instrument on the implant surface or scratching the surface may impede optimal peri-implant healing [17,18,19,20].
Chitosan is a marine biopolymer which is based on chitin derived from the shells of marine crustaceans. The material has been approved for use in surgical bandages, as a haemostatic agent and as a dietary supplement ...
Inflammation and loss of attachment around dental implants (i.e. peri-implantitis) has become a growing concern within the field of dental implantology [1,2,3,4,5,6,7]. Peri-implantitis is a microbial infection-driven soft tissue inflammation with loss of bony attachment around an implant. Peri-implant mucositis is the precursor of peri-implantitis, as gingivitis is for periodontitis [8]. It is cl...
The aim of the present study was to evaluate the effect on peri-implant mucosal inflammation from the use of a novel instrument made of chitosan in the non-surgical treatment of mild peri-implantitis across several clinical centers.
In this 6-month multicenter prospective consecutive case series performed in six different periodontal specialist clinics, 63 implants in 63 patients were finally inc...
Fig. 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Fig. 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Fig. 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Fig. 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Patient
Implant-localization (region)
Implant loss (+/−)
Buccal width of keratinized peri-implant gingiva (mm)
Buccal thickness of keratinized peri-implant gi...
Patient
Gender (m/f)
Age (years)
Implant localization (region)
Implant diameter (mm)
...
Lorenz, J., Lerner, H., Sader, R.A. et al. Investigation of peri-implant tissue conditions and peri-implant tissue stability in implants placed with simultaneous augmentation procedure: a 3-year retrospective follow-up analysis of a newly developed bone level implant system.
Int J Implant Dent 3, 41 (2017). https://doi.org/10.1186/s40729-017-0104-4
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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...
This study was conducted in compliance with the principles of the Declaration of Helsinki, and the approval of the ethics committee required for the study was obtained from the Ethics Committee of the Medical Center of the Goethe University Frankfurt. The procedures to be performed were explained in detail, and the patients signed the consent form.
Jonas Lorenz, Henriette Lerner, Robert Sader, an...
Department for Oral, FORM-Lab, Cranio-Maxillofacial, and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
Jonas Lorenz, Robert A. Sader & Shahram Ghanaati
HL-Dentclinic, Baden-Baden, Germany
Henriette Lerner
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Lerner H, Lorenz J, Sader R, Ghanaati S. Two-year retrospective study of periimplant health and periimplant bone stability after immediate implant placement of a newly developed bone level implant system—a first report. EDI Journal (European Association of Dental Implantologists, Teamwork Media); 2017; ahead of print.
Ghanaati S, Lorenz J, Obreja K, Choukroun J, Landes C, Sader R. Nanocrystalli...
Gurgel BC, Montenegro SC, Dantas PM, Pascoal AL, Lima KC, Calderon PD. Frequency of peri-implant diseases and associated factors. Clin Oral Implants Res. 2016; doi: 10.1111/clr.12944
Qian J, Wennerberg A, Albrektsson T. Reasons for marginal bone loss around oral implants. Clin Implant Dent Relat Res. 2012;14(6):792–807.
Berglundh T, Lindhe J, Ericsson I, Marinello C, Liljenberg B, Thomsen P....
β-tricalcium phosphate
Bleeding on probing
Fixed prosthetics
Guided bone regeneration
Hydroxyapatite
Multinucleated giant cells
Pink Esthetic Score
Removable prosthetics
In the present study, the implant and peri-implant hard- and soft-tissue stability was analyzed in a bone level implant system placed simultaneously with a GBR procedure 3 years after prosthetic loading. Peri-implant hard- and soft-tissue parameters such as width and thickness of peri-implant keratinized gingiva, probing depth, BOP, PES, peri-implant bone loss, and the presence of peri-implant os...
Comparing the present results to the aforementioned study with the same implant system on immediately placed implants, it seems that the GBR augmentation procedure has no influence on the long-term stability of the implants. In both studies with different placement modalities and protocols, comparable clinical and radiological results were achieved. This leads to the assumption that the investigat...
The tissue reaction, however, did not only differ in bone substitute materials of different origin but also in bone substitute materials of the same origin. In an in vivo trial, two xenogeneic bone substitute materials processed with different techniques were implanted subcutaneously in CD-1 mice for up to 60 days. Both bone substitute materials showed good integration within the peri-implant tis...
In the present retrospective study, C-Tech bone level implants placed simultaneously with a GBR procedure around the implant shoulder were investigated clinically and radiologically after at least 3 years of loading to assess peri-implant tissue conditions and document peri-implant tissue stability.
A total of 47 implants were placed in the upper (23 implants) and lower jaw (24 implants) of 20 p...
Investigation of the esthetic appearance via PES revealed a mean point score of 10.1 (ranging from 7 to 13) from a maximum of 14. The highest values and therefore acceptance were found in the alveolar process deficiency and the soft-tissue level, which can be interpreted as a benefit of the augmentation procedure around the implant shoulder.
Peri-implant bone loss calculated using the average bon...
Altogether, 47 implants were placed in the upper and lower jaws of a total of 20 patients. In all implants, lateral augmentation in a GBR process was performed simultaneously with implant placement due to reduced horizontal or vertical height of the alveolar crest. A total of 23 implants were placed in the upper jaw and 24 implants in the lower jaw. The implant diameter varied between 3.5 mm (32 ...
Investigation parameters:
Implant being in situ
Width and thickness of peri-implant keratinized gingiva
Pink Esthetic Score (PES)
Probing depth
BOP
Peri-implant bone loss
Presence of peri-implant osteolysis
In the present retrospective study, bone level implants (C-Tech Esthetic Line implants) were investigated clinically and radiologically. The bone level implant system has a Morse-locking conical implant-abutment connection with platform switching and an indexing hex that allows subcrestal implant placement and aims to prevent peri-implant bone loss. The surface of the implant system is manufacture...
In the present retrospective study, 47 dental implants (C-Tech Esthetic Line implants) from 20 patients (11 female, 9 male) with a mean age of 58.5 years (45–75 years) were analyzed clinically and radiologically. Implant placement and follow-up investigation was performed at the HL Dentclinic in Baden-Baden, Germany. The study was approved by the ethics commission of the medical department of ...
The aim of the present retrospective investigation was to assess clinically and radiologically peri-implant tissue conditions and document peri-implant tissue stability in C-Tech implants when placed simultaneously with a GBR augmentation procedure after at least 3 years of loading.
The ability of bone substitute materials to form a sufficient and stable implantation bed has been proven in numerous clinical trials; however, it is still to a certain degree unclear if the different tissue reactions have an impact on the establishment of a peri-implant infection, especially when these biomaterials are used for augmentations around the implant shoulder. Due to the two-stage desig...
The prevalence of peri-implantitis has grown in the past few years and has become a major issue in implant dentistry. Long-term stable and healthy soft- and hard-tissue conditions should be achieved in combination with esthetically and functionally satisfying results. However, the rising number of placed implants in the past decades has come with an increase in the prevalence of peri-implantitis [...
Guided bone regeneration (GBR) has been proven to be a reliable therapy to regenerate missing bone in cases of atrophy of the alveolar crest. The aim of the present retrospective analysis was to assess peri-implant tissue conditions and document peri-implant tissue stability in C-Tech implants when placed simultaneously with a GBR augmentation procedure.
A total of 47 implants, which were placed ...
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs accompanied by moderate grade inflammatory cell infiltration (HE staining, bar: 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs a...
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Antibody
Sorce
Clone
Staining
Keratin 13
DAKO
DE-K13
...
Noguchi, M., Tsuno, H., Ishizaka, R. et al. Primary peri-implant oral intra-epithelial neoplasia/carcinoma in situ: a case report considering risk factors for carcinogenesis.
Int J Implant Dent 3, 47 (2017). https://doi.org/10.1186/s40729-017-0109-z
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Received: 15 March 2017
Accepted: 25 October 2017
Published: 16 November 2017
DOI: https://doi.org/10.1186...
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...
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Makoto Noguchi.
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama city, Toyama, 9300194, Japan
Makoto Noguchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue & Kei Tomihara
Department of Diagnosis Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, Univers...
Vasilescu F, Ceauşu M, Tänsen C, et al. P53, p63 and ki-67 assessment in HPV-induced cervical neoplasia. RJME. 2009;50:357–61.
Ndiaye C, Mena M, Alemany L, et al. HPV DNA, E6/E7 mRNA, and p16INK4a detection in head and neck cancers: a systematic review and meta-analysis. Lancet Oncol. 2014;15:1319–31.
Nagy K, Sonkodi I, Szöke I, et al. The microflora associated with human oral carcinoma. ...
Sah JP, Johnson NW, Batsakis JG. Oral cancer. London: Informa Healthcare; 2011. p. 3–32.
Japan Society for Oral Tumors. General rules for clinical and pathological studies on oral cancer. 1st ed. Tokyo: Kanehara-shuppan Co; 2010. p. 44–7.
Laprise C, Shahl HP, Madathil SA, et al. Periodontal diseases and risk of oral cancer in Southern India: results from the HeNCe Life Study. Int J Cancer. 2...
Deoxyribonucleic acid
Human papilloma virus
Oral intra-epithelial neoplasia/carcinoma in situ
Squamous cell carcinoma
In our case, the persistence of peri-implant mucositis or peri-implantitis around the dental implant was implicated as being a plausible risk factor for carcinogenesis. Regular follow-up to ensure the maintenance of oral hygiene after dental implant therapy has again been shown to be important for preventing peri-implantitis, a plausible risk factor for carcinogenesis.
The latest evidence implies that the human papilloma virus (HPV) may be responsible for carcinogenesis in the oral cavity [12, 13]; however, its role is debatable. The interaction of the HPV’s E6 and E7 oncoproteins with cell cycle proteins disturbs the cell cycle mechanism and subsequent alteration in the expression of proteins such as p53, p63, and Ki-67 [14]. In our case, the immunohistochemi...
OIN/CIS can sometimes be difficult to distinguish pathologically from epithelial dysplasia on hematoxylin- and eosin-staining sections; this has proved challenging for oral pathologists [9]. Recently, it has been reported that combined immunohistochemistry for k13 and k17 was useful for the differential diagnosis [9, 10]. K13 is a marker for cellular differentiation toward prickle cells in normal ...
A 65-year-old woman was referred to our clinic with a tumor in the right lower gingiva. Her medical history included breast cancer without metastatic lesion, diabetes mellitus, hyperlipidemia, and hypertension. She had taken orally aspirin, amlodipine, pravastatin, and bepotastine for 2 years. She drank alcohol socially, but she had no history of tobacco smoking habit.
About 10 years prior to h...
Oral cancer ranks sixth among the malignancies in terms of worldwide prevalence, with more than 90% being pathologically squamous cell carcinoma (SCC) [1]. Oral SCC generally develops via multistep carcinogenesis. The squamous epithelium goes into irreversible change, including epithelial dysplasia and oral intra-epithelial neoplasia/carcinoma in-situ (OIN/CIS) [2], finally resulting in the develo...
In this case, prolonged peri-implant mucositis or peri-implantitis may have been a plausible risk factor for carcinogenesis.
Major risk factors for oral squamous cell carcinoma (SCC) are tobacco smoking, a betel quid chewing habit, and heavy alcohol consumption. However, around 15% of oral SCCs cannot be explained by these risk factors. Although oral SCC associated with dental implants is quite rare, there has been a recent gradual accumulation of reports about it. Here, we report a case of primary peri-implant oral int...
Failure rate
n
Univariate analyses
Multivariate analyses
OR
(95% CI)
P
OR
...
Peri-implantitis
n
Univariate analyses
Multivariate analyses
OR
(95% CI)
P
...
Mucositis
n
Univariate analyses
Multivariate analyses
OR
(95% CI)
P
OR
...
Years
Patients (total)
GCP patients
GAP patients
Implants (total)
Implants maxilla
...
GCP
GAP
Patient
24
5
Sex
...
Mengel, R., Heim, T. & Thöne-Mühling, M. Mucositis, peri-implantitis, and survival and success rates of oxide-coated implants in patients treated for periodontitis 3- to 6-year results of a case-series study.
Int J Implant Dent 3, 48 (2017). https://doi.org/10.1186/s40729-017-0110-6
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Received: 29 August 2017
Accepted: 26 October 2017
Published: 28 Novemb...
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...
RM is a professor at the Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University, Marburg/Lahn, Germany. TH is a private practicioner in Gruben, Brandenburg, Germany. MT is a researcher at the Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University, Marburg/Lahn, Germany.
This clinical study was conducted in accordance with the World Medical A...
Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University, Marburg/Lahn, Germany
Reiner Mengel & Miriam Thöne-Mühling
Gruben, Brandenburg, Germany
Theresa Heim
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Kim K-K, Sung H-M. Outcomes of dental implant treatment in patients with generalized aggressive periodontitis: a systematic review. J Adv Prosthodont. 2012;4:210–7.
Pettersson K, Mengel R. Comments on the statistical analysis of the paper by Albouy et al comparing four different types of implants with respect to ‘spontaneous’ progression of peri-implantitis. Eur J Oral Implantol. 2011;1:9...
Kinane DF, Radvar M. The effect of smoking on mechanical and antimicrobial periodontal therapy. J Periodontol. 1997;69:467–72.
Swierkot K, Lottholz P, Flores-de-Jacoby L, Mengel R. Mucositis, peri-implantitis, implant success, and survival of implants in patients with treated generalized aggressive periodontitis: 3- to 16-year results of a prospective long-term cohort study. J Periodontol. 2012...
Jungner M, Lundqvist P, Lundgren S. A retrospective comparison of oxidized and turned implants with respect to implant survival, marginal bone level and peri-implant soft tissue conditions after at least 5 years in function. Clin Implant Dent Relat Res. 2014;16:230–7.
Rocci A, Rocci M, Rocci C, Scoccia A, Gargari M, Martignoni M, Gottlow J, Sennerby L. Immediate loading of Brånemark system TiU...
Esposito M, Ardebili Y, Worthington HV. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database Sys Rev. 2014;7:CD003815.
Salata LA, Burgos PM, Rasmusson L, Novaes AB, Papalexiou V, Dahlin C, Sennerby L. Osseointegration of oxidized and turned implants in circumferential bone defects with and without adjunctive therapies: an experimental study on BMP-2 and...
The results of the present case series study should be interpreted in a critical light because of the small study population. However, it can be concluded that periodontally diseased subjects treated in a supportive periodontal therapy can be successfully rehabilitated with oxide-coated dental implants for a follow-up period of 3 to 6 years. The results suggest that implants in the maxilla and in...
These results from long-term clinical studies indicate that oxide-coated implants achieve equivalent survival rates and prevalence of mucositis and peri-implantitis when compared to implants with other surface characteristics. They support the assumption that the implant surface has little influence on the development of mucositis or peri-implantitis. This was subsequently confirmed in a Cochrane ...
The present study examines the success rates of oxide-coated implants in subjects with treated periodontal disease. Several long-term clinical studies on periodontally healthy subjects have revealed survival rates of 97.1 to 99.2% for oxide-coated implants [10, 24, 25]. The results of the present study show a comparable implant survival rate (96.2% in GAP and 97.1% in GCP subjects) for subjects wi...
The present study examines the success rates of oxide-coated implants in subjects with treated periodontal disease. Several long-term clinical studies on periodontally healthy subjects have revealed survival rates of 97.1 to 99.2% for oxide-coated implants [10, 24, 25]. The results of the present study show a comparable implant survival rate (96.2% in GAP and 97.1% in GCP subjects) for subjects wi...
The univariate analyses showed a significantly higher risk for peri-implantitis in GAP subjects (OR = 3.294 with p = 0.027) and at implants with bone quality grade 3 (OR = 21.200 with p = 0.000). However, these differences were not significant in multivariate analyses.
Both the uni- and multivariate patient-related analyses were non-significant.
The implant success rate was 77.9% for GCP...
All 29 subjects were examined over the period of 3 to 6 years (Table 2). For the duration of the observation period, all the remaining teeth were periodontally healthy, with PDs ≤ 3 mm and negative BOP. All subjects were non-smokers, had excellent oral hygiene, attended the follow-up examinations on a regular basis, and had no systemic disease.
In total, four implants (3.1%) were lost du...
Peri-implant mucositis was defined as PDs ≥ 5 mm with BOP and no bone loss after the first year of loading. Peri-implantitis was defined as PDs > 5 mm with or without BOP and an annual bone loss of > 0.2 mm after the first year of loading.
All technical and surgical complications (e.g., fracture of the abutment screw or superstructure, compromised wound healing) were recorded.
T...
All patients received a supportive periodontal therapy at the Dental School of Medicine, Philipps-University, Marburg, in the course of the observation period. The first clinical examination was 2 to 4 weeks before the non-retainable teeth were extracted. The periodontally healthy residual dentition and the implants were evaluated immediately after the superstructure was inserted. Subsequently, t...
Second-stage surgery was performed in the maxilla after 6 months and in the mandible after 3 months. Implant placement and second-stage surgery were performed by a single periodontist (R.M.).
About 4 weeks after the final abutments were placed, GCP subjects were rehabilitated with single crowns, implant-supported bridges, or removable superstructures, according to the Marburg double crown syst...
A total of 29 partially edentulous subjects were consecutively recruited from the Dental School of Medicine, Philipps-University, Marburg, Germany between April 2010 and April 2013 (Table 1). Subjects were excluded for the following reasons: history of systemic disease (e.g., cardiovascular diseases, diabetes mellitus, osteoporosis), pregnancy, untreated caries, current orthodontic treatment, con...
The aim of this long-term clinical study on partially edentulous subjects treated for periodontal disease was to evaluate the prevalence of mucositis and peri-implantitis and to determine the survival and success rates of dental implants with oxide-coated surfaces.
In recent years, a great number of different implant systems varying in materials, surface structure, and macroscopic design have been introduced to the dental market [1]. In studies using implants with modified surfaces, it was concluded that rough surfaces induce a stronger initial bone response, achieve stability more rapidly, and integrate more fully with extant bone [2,3,4,5,6]. Dental implan...
The aim of this case-series study is to evaluate the prevalence of mucositis, peri-implantitis, and survival and success rates of oxide-coated implants in subjects treated for periodontitis.
Twenty-four subjects treated for generalized chronic periodontitis (GCP) and five treated for generalized aggressive periodontitis (GAP) were orally rehabilitated with a total of 130 dental implants. Subjects...
Fig. 5. Change in BoP values according to the percentage of sites with a score of 1, 2 or 3 by visit
Fig. 5. Change in BoP values according to the percentage of sites with a score of 1, 2 or 3 by visit
Fig. 4. Percentages of sites with PPD 1–3, 4–5 and ≥6 mm by visit (p
Fig. 3. Changes in BoP values between baseline and the various examination time points
Fig. 3. Changes in BoP values between baseline and the various examination time points
Fig. 2. Changes in PPD values between baseline and the various examination time points
Fig. 2. Changes in PPD values between baseline and the various examination time points
Fig. 1. A chitosan brush (LBC, BioClean®, LABRIDA AS) seated in an oscillating dental handpiece
Fig. 1. A chitosan brush (LBC, BioClean®, LABRIDA AS) seated in an oscillating dental handpiece
Baseline
n = 306
2 weeks
n = 272
4 weeks
n = 267
12 weeks
n = 282
24 weeks
n = 294
P
...
Center
Oslo
Jonkoping
Rome
Stavanger
Kristianstad
Tons...
Variable
Number (%)
SD
Range (min; max)
Gender (female/male)
45/18 (71.4/28.6)
...
Wohlfahrt, J.C., Evensen, B.J., Zeza, B. et al. A novel non-surgical method for mild peri-implantitis- a multicenter consecutive case series.
Int J Implant Dent 3, 38 (2017). https://doi.org/10.1186/s40729-017-0098-y
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Received: 08 April 2017
Accepted: 13 July 2017
Published: 03 August 2017
DOI: https://doi.org/10.1186/s40729-017-0098-y
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...
J.C. Wohlfahrt is the inventor and patent holder of BioClean and is a shareholder in LABRIDA AS. B.J. Evensen, B. Zeza, H. Jansson, A. Pilloni, A.M. Roos-Jansåker, G.L. Di Tanna, A.M. Aass, M. Klepp and O.C. Koldsland state that there were no conflicts of interests during the undertaking of the study.
Ethical approval was provided by the regional ethical review boards of each center (Norway: 201...
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JCW, BJE, BZ, HJ, AP, AMR-J, AMA, MK and OCK par...
Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Pb. 1109 Blindern, 0317, Oslo, Norway
J. C. Wohlfahrt, A. M. Aass & O. C. Koldsland
Private Practice, Tønsberg, Norway
B. J. Evensen
Department of Dental and Maxillofacial Sciences, Section of Periodontology, Sapienza, University of Rome, Rome, Italy
B. Zeza & A. Pilloni
Center for Oral Health, Departmen...
Salvi GE, et al. Reversibility of experimental peri-implant mucositis compared with experimental gingivitis in humans. Clin Oral Implants Res. 2012;23(2):182–90.
Korsch M, Obst U, Walther W. Cement-associated peri-implantitis: a retrospective clinical observational study of fixed implant-supported restorations using a methacrylate cement. Clin Oral Implants Res. 2014;25(7):797–802.
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Muthukuru M, et al. Non-surgical therapy for the management of peri-implantitis: a systematic review. Clin Oral Implants Res. 2012;23(Suppl 6):77–83.
Esposito M, Grusovin MG, Worthington HV. Treatment of peri-implantitis: what interventions are effective? A Cochrane systematic review. Eur J Oral Implantol. 2012;5(Suppl):S21–41.
Armitage GC, Xenoudi P. Post-treatment supportive care for the n...
Rokn A, et al. Prevalence of peri-implantitis in patients not participating in well-designed supportive periodontal treatments: a cross-sectional study. Clin Oral Implants Res. 2017;28(3):314–9.
Faggion CM Jr, et al. A systematic review and Bayesian network meta-analysis of randomized clinical trials on non-surgical treatments for peri-implantitis. J Clin Periodontol. 2014;41(10):1015–25.
Me...
Koldsland OC, Scheie AA, Aass AM. Prevalence of peri-implantitis related to severity of the disease with different degrees of bone loss. J Periodontol. 2010;81(2):231–8.
Roos-Jansaker AM, et al. Nine- to fourteen-year follow-up of implant treatment. Part II: presence of peri-implant lesions. J Clin Periodontol. 2006;33(4):290–5.
Derks J, et al. Effectiveness of implant therapy analyzed in a ...
In this multicenter case series of implants affected by mild peri-implantitis, significant reductions in the clinical parameters of inflammation were demonstrated at all time points after the initial treatment with a chitosan brush. The use of an oscillating chitosan device appears to be safe and has potential merits for the treatment of mild peri-implantitis and for the maintenance of dental impl...
In this multicenter case series of implants affected by mild peri-implantitis, significant reductions in the clinical parameters of inflammation were demonstrated at all time points after the initial treatment with a chitosan brush. The use of an oscillating chitosan device appears to be safe and has potential merits for the treatment of mild peri-implantitis and for the maintenance of dental impl...
The chitosan brush used in this study is made of a material that is soft with the aim to make a device optimized for removal of the biofilm within the implant threads. The soft bristles on the contrary make the device suboptimal for removal of hard deposits, such as calculus and cement remnants. It has been reported that such cement remnants are a common finding around dental implants [41], and in...
In the present study, significant reductions were observed in the clinical parameters of peri-implant inflammation at 2, 4, 12 and 24 weeks relative to baseline after debridement with the chitosan brush seated in an oscillating dental drill piece. No progression in radiographic bone loss was reported at any of the implants at the final evaluation, and the method was thus judged safe to use in cas...
Identifying peri-implant disease at an early stage and promptly treating the inflammatory condition is crucial to prevent the progression of peri-implant bone loss and ensure long-term implant survival [23,24,25]. After completion of active treatment and when the condition is controlled, supportive peri-implant therapy will reduce the risk of disease re-occurrence [9]. A number of scientific repor...
During this study, all 63 implants were reported to have stable radiographic levels of osseous support as validated by the six different local examiners. No adverse events were reported during the study.
In total, 63 implants in 63 patients were ultimately included in the analysis. Demographic information is presented in Tables 1 and 2.
Significant reductions in both PPD and mBoP were seen at all time points relative to the baseline clinical measurements (p
Mann-Whitney rank sum tests were used to compare changes in the clinical parameters between baseline and subsequent time points. To assess the hierarchical structure of the data (center > patient > site), a linear mixed model using the restricted maximum likelihood method (multilevel logistic models for binary outcomes) was constructed to analyse the PPD, mBoP and suppuration, adjusting for fac...
All patient-related information and clinical recordings were recorded in a web-based clinical research form (VieDoc version 3.24, PCG solutions, Uppsala, Sweden).
Patients under 18 years of age; current smokers; patients who had undergone radiotherapy in the head and neck region, chemotherapy or systemic long-term corticosteroid treatment; patients who were pregnant or nursing; patients receivin...
A 6-month multicenter prospective consecutive case series was performed in six different periodontal specialist clinics in Norway, Sweden and Italy.
Ethical approval was provided by the regional ethical review boards of each center (Norway: 2014/852/REK sør-øst; Italy: Sapienza 2011/15, 3547; and Sweden: EPN Lund 2014/695.) Fifteen patients at each center were planned to be included in the stud...
A number of other studies also report that leaving fragments of the instrument on the implant surface or scratching the surface may impede optimal peri-implant healing [17,18,19,20].
Chitosan is a marine biopolymer which is based on chitin derived from the shells of marine crustaceans. The material has been approved for use in surgical bandages, as a haemostatic agent and as a dietary supplement ...
Inflammation and loss of attachment around dental implants (i.e. peri-implantitis) has become a growing concern within the field of dental implantology [1,2,3,4,5,6,7]. Peri-implantitis is a microbial infection-driven soft tissue inflammation with loss of bony attachment around an implant. Peri-implant mucositis is the precursor of peri-implantitis, as gingivitis is for periodontitis [8]. It is cl...
The aim of the present study was to evaluate the effect on peri-implant mucosal inflammation from the use of a novel instrument made of chitosan in the non-surgical treatment of mild peri-implantitis across several clinical centers.
In this 6-month multicenter prospective consecutive case series performed in six different periodontal specialist clinics, 63 implants in 63 patients were finally inc...
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs accompanied by moderate grade inflammatory cell infiltration (HE staining, bar: 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs a...
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Antibody
Sorce
Clone
Staining
Keratin 13
DAKO
DE-K13
...
Noguchi, M., Tsuno, H., Ishizaka, R. et al. Primary peri-implant oral intra-epithelial neoplasia/carcinoma in situ: a case report considering risk factors for carcinogenesis.
Int J Implant Dent 3, 47 (2017). https://doi.org/10.1186/s40729-017-0109-z
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Received: 15 March 2017
Accepted: 25 October 2017
Published: 16 November 2017
DOI: https://doi.org/10.1186...
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...
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Makoto Noguchi.
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama city, Toyama, 9300194, Japan
Makoto Noguchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue & Kei Tomihara
Department of Diagnosis Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, Univers...
Vasilescu F, Ceauşu M, Tänsen C, et al. P53, p63 and ki-67 assessment in HPV-induced cervical neoplasia. RJME. 2009;50:357–61.
Ndiaye C, Mena M, Alemany L, et al. HPV DNA, E6/E7 mRNA, and p16INK4a detection in head and neck cancers: a systematic review and meta-analysis. Lancet Oncol. 2014;15:1319–31.
Nagy K, Sonkodi I, Szöke I, et al. The microflora associated with human oral carcinoma. ...
Sah JP, Johnson NW, Batsakis JG. Oral cancer. London: Informa Healthcare; 2011. p. 3–32.
Japan Society for Oral Tumors. General rules for clinical and pathological studies on oral cancer. 1st ed. Tokyo: Kanehara-shuppan Co; 2010. p. 44–7.
Laprise C, Shahl HP, Madathil SA, et al. Periodontal diseases and risk of oral cancer in Southern India: results from the HeNCe Life Study. Int J Cancer. 2...
Deoxyribonucleic acid
Human papilloma virus
Oral intra-epithelial neoplasia/carcinoma in situ
Squamous cell carcinoma
In our case, the persistence of peri-implant mucositis or peri-implantitis around the dental implant was implicated as being a plausible risk factor for carcinogenesis. Regular follow-up to ensure the maintenance of oral hygiene after dental implant therapy has again been shown to be important for preventing peri-implantitis, a plausible risk factor for carcinogenesis.
The latest evidence implies that the human papilloma virus (HPV) may be responsible for carcinogenesis in the oral cavity [12, 13]; however, its role is debatable. The interaction of the HPV’s E6 and E7 oncoproteins with cell cycle proteins disturbs the cell cycle mechanism and subsequent alteration in the expression of proteins such as p53, p63, and Ki-67 [14]. In our case, the immunohistochemi...
OIN/CIS can sometimes be difficult to distinguish pathologically from epithelial dysplasia on hematoxylin- and eosin-staining sections; this has proved challenging for oral pathologists [9]. Recently, it has been reported that combined immunohistochemistry for k13 and k17 was useful for the differential diagnosis [9, 10]. K13 is a marker for cellular differentiation toward prickle cells in normal ...
A 65-year-old woman was referred to our clinic with a tumor in the right lower gingiva. Her medical history included breast cancer without metastatic lesion, diabetes mellitus, hyperlipidemia, and hypertension. She had taken orally aspirin, amlodipine, pravastatin, and bepotastine for 2 years. She drank alcohol socially, but she had no history of tobacco smoking habit.
About 10 years prior to h...
Oral cancer ranks sixth among the malignancies in terms of worldwide prevalence, with more than 90% being pathologically squamous cell carcinoma (SCC) [1]. Oral SCC generally develops via multistep carcinogenesis. The squamous epithelium goes into irreversible change, including epithelial dysplasia and oral intra-epithelial neoplasia/carcinoma in-situ (OIN/CIS) [2], finally resulting in the develo...
In this case, prolonged peri-implant mucositis or peri-implantitis may have been a plausible risk factor for carcinogenesis.
Major risk factors for oral squamous cell carcinoma (SCC) are tobacco smoking, a betel quid chewing habit, and heavy alcohol consumption. However, around 15% of oral SCCs cannot be explained by these risk factors. Although oral SCC associated with dental implants is quite rare, there has been a recent gradual accumulation of reports about it. Here, we report a case of primary peri-implant oral int...
Failure rate
n
Univariate analyses
Multivariate analyses
OR
(95% CI)
P
OR
...
Peri-implantitis
n
Univariate analyses
Multivariate analyses
OR
(95% CI)
P
...
Mucositis
n
Univariate analyses
Multivariate analyses
OR
(95% CI)
P
OR
...
Years
Patients (total)
GCP patients
GAP patients
Implants (total)
Implants maxilla
...
GCP
GAP
Patient
24
5
Sex
...
Mengel, R., Heim, T. & Thöne-Mühling, M. Mucositis, peri-implantitis, and survival and success rates of oxide-coated implants in patients treated for periodontitis 3- to 6-year results of a case-series study.
Int J Implant Dent 3, 48 (2017). https://doi.org/10.1186/s40729-017-0110-6
Download citation
Received: 29 August 2017
Accepted: 26 October 2017
Published: 28 Novemb...
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...
RM is a professor at the Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University, Marburg/Lahn, Germany. TH is a private practicioner in Gruben, Brandenburg, Germany. MT is a researcher at the Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University, Marburg/Lahn, Germany.
This clinical study was conducted in accordance with the World Medical A...
Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University, Marburg/Lahn, Germany
Reiner Mengel & Miriam Thöne-Mühling
Gruben, Brandenburg, Germany
Theresa Heim
You can also search for this author in
PubMed Google Scholar
You can also search for this author in
PubMed Google Scholar
You can also search for this au...
Kim K-K, Sung H-M. Outcomes of dental implant treatment in patients with generalized aggressive periodontitis: a systematic review. J Adv Prosthodont. 2012;4:210–7.
Pettersson K, Mengel R. Comments on the statistical analysis of the paper by Albouy et al comparing four different types of implants with respect to ‘spontaneous’ progression of peri-implantitis. Eur J Oral Implantol. 2011;1:9...
Kinane DF, Radvar M. The effect of smoking on mechanical and antimicrobial periodontal therapy. J Periodontol. 1997;69:467–72.
Swierkot K, Lottholz P, Flores-de-Jacoby L, Mengel R. Mucositis, peri-implantitis, implant success, and survival of implants in patients with treated generalized aggressive periodontitis: 3- to 16-year results of a prospective long-term cohort study. J Periodontol. 2012...
Jungner M, Lundqvist P, Lundgren S. A retrospective comparison of oxidized and turned implants with respect to implant survival, marginal bone level and peri-implant soft tissue conditions after at least 5 years in function. Clin Implant Dent Relat Res. 2014;16:230–7.
Rocci A, Rocci M, Rocci C, Scoccia A, Gargari M, Martignoni M, Gottlow J, Sennerby L. Immediate loading of Brånemark system TiU...
Esposito M, Ardebili Y, Worthington HV. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database Sys Rev. 2014;7:CD003815.
Salata LA, Burgos PM, Rasmusson L, Novaes AB, Papalexiou V, Dahlin C, Sennerby L. Osseointegration of oxidized and turned implants in circumferential bone defects with and without adjunctive therapies: an experimental study on BMP-2 and...
The results of the present case series study should be interpreted in a critical light because of the small study population. However, it can be concluded that periodontally diseased subjects treated in a supportive periodontal therapy can be successfully rehabilitated with oxide-coated dental implants for a follow-up period of 3 to 6 years. The results suggest that implants in the maxilla and in...
These results from long-term clinical studies indicate that oxide-coated implants achieve equivalent survival rates and prevalence of mucositis and peri-implantitis when compared to implants with other surface characteristics. They support the assumption that the implant surface has little influence on the development of mucositis or peri-implantitis. This was subsequently confirmed in a Cochrane ...
The present study examines the success rates of oxide-coated implants in subjects with treated periodontal disease. Several long-term clinical studies on periodontally healthy subjects have revealed survival rates of 97.1 to 99.2% for oxide-coated implants [10, 24, 25]. The results of the present study show a comparable implant survival rate (96.2% in GAP and 97.1% in GCP subjects) for subjects wi...
The univariate analyses showed a significantly higher risk for peri-implantitis in GAP subjects (OR = 3.294 with p = 0.027) and at implants with bone quality grade 3 (OR = 21.200 with p = 0.000). However, these differences were not significant in multivariate analyses.
Both the uni- and multivariate patient-related analyses were non-significant.
The implant success rate was 77.9% for GCP...
All 29 subjects were examined over the period of 3 to 6 years (Table 2). For the duration of the observation period, all the remaining teeth were periodontally healthy, with PDs ≤ 3 mm and negative BOP. All subjects were non-smokers, had excellent oral hygiene, attended the follow-up examinations on a regular basis, and had no systemic disease.
In total, four implants (3.1%) were lost du...
Peri-implant mucositis was defined as PDs ≥ 5 mm with BOP and no bone loss after the first year of loading. Peri-implantitis was defined as PDs > 5 mm with or without BOP and an annual bone loss of > 0.2 mm after the first year of loading.
All technical and surgical complications (e.g., fracture of the abutment screw or superstructure, compromised wound healing) were recorded.
T...
All patients received a supportive periodontal therapy at the Dental School of Medicine, Philipps-University, Marburg, in the course of the observation period. The first clinical examination was 2 to 4 weeks before the non-retainable teeth were extracted. The periodontally healthy residual dentition and the implants were evaluated immediately after the superstructure was inserted. Subsequently, t...
Second-stage surgery was performed in the maxilla after 6 months and in the mandible after 3 months. Implant placement and second-stage surgery were performed by a single periodontist (R.M.).
About 4 weeks after the final abutments were placed, GCP subjects were rehabilitated with single crowns, implant-supported bridges, or removable superstructures, according to the Marburg double crown syst...
A total of 29 partially edentulous subjects were consecutively recruited from the Dental School of Medicine, Philipps-University, Marburg, Germany between April 2010 and April 2013 (Table 1). Subjects were excluded for the following reasons: history of systemic disease (e.g., cardiovascular diseases, diabetes mellitus, osteoporosis), pregnancy, untreated caries, current orthodontic treatment, con...
The aim of this long-term clinical study on partially edentulous subjects treated for periodontal disease was to evaluate the prevalence of mucositis and peri-implantitis and to determine the survival and success rates of dental implants with oxide-coated surfaces.
In recent years, a great number of different implant systems varying in materials, surface structure, and macroscopic design have been introduced to the dental market [1]. In studies using implants with modified surfaces, it was concluded that rough surfaces induce a stronger initial bone response, achieve stability more rapidly, and integrate more fully with extant bone [2,3,4,5,6]. Dental implan...
The aim of this case-series study is to evaluate the prevalence of mucositis, peri-implantitis, and survival and success rates of oxide-coated implants in subjects treated for periodontitis.
Twenty-four subjects treated for generalized chronic periodontitis (GCP) and five treated for generalized aggressive periodontitis (GAP) were orally rehabilitated with a total of 130 dental implants. Subjects...
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., ...
Figure 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Figure 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Patient
Implant-localization (region)
Implant loss (+/−)
Buccal width of keratinized peri-implant gingiva (mm)
Buccal thickness of keratinized peri-implant gingiva (mm)
Pink Esthetic Score (PES)
Probing depth (mm) at four sites (mb, db, mo, do)
Bleeding on Probing (+/−) at four sites (mb, db, mo, do)
Peri-implant bone loss (mm)
Presence of peri-implant osteolysis (+/−)
...
Patient
Gender (m/f)
Age (years)
Implant localization (region)
Implant diameter (mm)
Implant length (mm)
Augmentation material
Prosthetic rehabilitation
1
f
50
32
3.5
13
HA + β-TCP
r.p
34
4.3
11
HA + β-TCP
r.p
42
3.5
13
HA + β-TCP
r.p
44
4.3
11
HA + β-TCP
r.p
2
m
61
36
3.5
11
HA + β-TCP
...
Abbreviations
β-TCP:
β-tricalcium phosphate
BOP:
Bleeding on probing
F.P.:
Fixed prosthetics
GBR:
Guided bone regeneration
HA:
Hydroxyapatite
MNGCs:
Multinucleated giant cells
PES:
Pink Esthetic Score
R.P.:
Removable prosthetics
References
Gurgel BC, Montenegro SC, Dantas PM, Pascoal AL, Lima KC, Calderon PD. Frequency o...
Comparing the present results to the aforementioned study with the same implant system on immediately placed implants, it seems that the GBR augmentation procedure has no influence on the long-term stability of the implants. In both studies with different placement modalities and protocols, comparable clinical and radiological results were achieved. This leads to the assumption that the inve...
The tissue reaction, however, did not only differ in bone substitute materials of different origin but also in bone substitute materials of the same origin. In an in vivo trial, two xenogeneic bone substitute materials processed with different techniques were implanted subcutaneously in CD-1 mice for up to 60 days. Both bone substitute materials showed good integration within the peri-impla...
Discussion
In the present retrospective study, C-Tech bone level implants placed simultaneously with a GBR procedure around the implant shoulder were investigated clinically and radiologically after at least 3 years of loading to assess peri-implant tissue conditions and document peri-implant tissue stability.
A total of 47 implants were placed in the upper (23 implants) and lower jaw (24...
Results
Altogether, 47 implants were placed in the upper and lower jaws of a total of 20 patients. In all implants, lateral augmentation in a GBR process was performed simultaneously with implant placement due to reduced horizontal or vertical height of the alveolar crest. A total of 23 implants were placed in the upper jaw and 24 implants in the lower jaw. The implant diameter varied between 3...
C-Tech implant system
In the present retrospective study, bone level implants (C-Tech Esthetic Line implants) were investigated clinically and radiologically. The bone level implant system has a Morse-locking conical implant-abutment connection with platform switching and an indexing hex that allows subcrestal implant placement and aims to prevent peri-implant bone loss. The surface of the implan...
Methods
Patient population
In the present retrospective study, 47 dental implants (C-Tech Esthetic Line implants) from 20 patients (11 female, 9 male) with a mean age of 58.5 years (45–75 years) were analyzed clinically and radiologically. Implant placement and follow-up investigation was performed at the HL Dentclinic in Baden-Baden, Germany. The study was approved by the ethics commissio...
Regarding the stability of peri-implant hard and soft tissue, biological or anatomical factors are not the only elements that could be proven to have an impact. Technical factors such as the implant-abutment connection are also known to be key factors for long-term stable hard- and soft-tissue health [11]. Regarding the implant-abutment connection, which seems to be the key issue, located on the i...
However, in most patients, the local bone amount is reduced due to atrophy, inflammatory processes, or resectional defects. Therefore, in the past few years, different techniques have been described to enlarge the local bone amount in prospective implant sites [7]. Besides methods such as GBR or the sinus augmentation technique, different augmentation materials have been investigated and establish...
Background
The prevalence of peri-implantitis has grown in the past few years and has become a major issue in implant dentistry. Long-term stable and healthy soft- and hard-tissue conditions should be achieved in combination with esthetically and functionally satisfying results. However, the rising number of placed implants in the past decades has come with an increase in the prevalence of ...
Investigation of peri-implant tissue conditions and peri-implant tissue stability in implants placed with simultaneous augmentation procedure: a 3-year retrospective follow-up analysis of a newly developed bone level implant system
Abstract
Background
Guided bone regeneration (GBR) has been proven to be a reliable therapy to regenerate missing bone in cases of atrophy of the alveolar crest. T...
Figure 1. Flow diagram
Figure 1. Flow diagram
Table 5 Average differences in BoP, SoP, and PPD between the control and test group at 3-month follow-up
Outcome variable
Crude modelaβ (95% CI)
p value
Adjusted modelbβ (95% CI)
p-value
% Sites BoP% Sites SoPMean PPD
16.2 (−7.9 to 40.3)0.0 (−10.9 to 10.9)0.6 (−0.6 to 1.8)
0.7431.0000.205
7.9 (−16.4 to 32.3)0.7 (−10.1 to 11.4)0.2 (−1.0 to 1.3)
0.8210.882...
Table 4 Descriptive statistics of clinical parameters
Control
Test
T0 (n = 22)
T3 (n = 20)
T0 (n = 31)
T3 (n = 30)
Plaque
% of sites (SD)% of implants (n)
4.5 (12.5)13.6 (3)
10.0 (18.8)25.0 (5)
4.0 (9.3)16.1 (5)
2.5 (7.6)9.7 (3)
BoP
% of sites (SD)% of implants (n)
86.4 (18.5)100 (22)
28.8 (35.6)50 (10)
66.1 (29.3)96.8 (30)
39.2 (31.3...
Table 3 Log-transformed mean bacterial anaerobic counts (SD) for the control and test group before (T0) and 3 months after (T3) the surgical treatment (paperpoint samples)
N = 47a
Total anaerobic bacterial loadLog-transformed mean (SD)
T0
T3
Difference
β (95% CI)b
p value
Control
6.69 (1.32)
6.31 (1.30)
0.38 (1.36)
−0.26 (−0.84–0.33)
0.377
...
Table 2 Log-transformed mean bacterial anaerobic counts (SD) of culture-positive implants for the control and test group before (Tpre) and after (Tpost) debridement and decontamination of the implant surface (intra-operative microbrush samples)
N = 40a
Total anaerobic bacterial loadLog-transformed mean (SD)
Tpre
Tpost
Difference
β (95% CI)b
p value
Control
5.57 ...
Table 1 Characteristics of included patients/implants
Characteristics
Control
Test
Number of patients
14
14
Age (years; mean [SD])
57.0 (13.7)
60.9 (7.2)
Gender; M (male), F (female)
M5, F9
M7, F7
Smoking; n subjects (%)
1 (7%)
3 (21%)
History of periodontitis; n subjects (%)
4 (29%)
5 (36%)
Dental status; n subjects (%)
- Partially edentul...
References
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. J Clin Periodontol. 2011;38(Suppl):11,178–181.
Derks J, Tomasi C. Peri-implant health and disease. A systematic review of current epidemiology. J Clin Periodontol. 2015;42:158–71.
Derks ...
The residual biofilm area was significantly greater after treatment with phosphoric acid compared to air abrasive treatment with powder or even control treatment without powder. Apparently, only water and air might be effective in reducing the biofilm. Nonetheless, when the titanium surface was viewed under a scanning electron microscopy (SEM), no visible titanium surface change was seen aft...
A gel as application mode has the great advantage of being precisely applicable with minimal touching of the surrounding bone or connective tissue. A disadvantage of a gel might be the limited flow in deeper areas of the rough implant surface. To overcome this problem, it was decided to continuously rub the etching gel onto the implant surface with a small brush during the decontamination pe...
Discussion
This randomized controlled trial aimed to determine the effect of 35% phosphoric etching gel on decontamination of the implant surface during resective surgical treatment of peri-implantitis. Both decontamination procedures (mechanical debridement with curettes and gauzes combined with phosphoric acid 35% and mechanical debridement combined with sterile saline) resulted in a sign...
Clinical outcomes
Descriptive statistics of the clinical outcomes at baseline and follow-up are depicted in Table 4. At 3-month follow-up, 75% of the implants (66.7% of the patients) in the control group and 63.3% of the implants (53.8% of the patients) in the test group showed no clinical signs of inflammation (PPD ≤4 mm without bleeding and/or suppuration on probing) (Table 4). The results...
Results
The progress of patients throughout the different phases of the study is illustrated in Fig. 1. Table 1 depicts the baseline demographic patient and implant characteristics. The included patients had a total of 128 implants of which 53 implants showed signs of peri-implantitis. Different implant brands and types with different implant surfaces were present, including Straumann (Strauman...
Assuming a two-sided two sample t test with a significance level (α) of 0.05 and a power (β) of 80% required a sample size of 34 implants. A 20% compensation for dropouts was taken into account (34/0.8 = 42.5 implants). Based on a previous study [10], it was expected that not all baseline microbiological samples would yield a detectable number of cultivable bacteria ([10], 19 out of 79 =...
Peri-implant pocket depth was measured at four sites per implant (mesial, buccal, distal, and lingual) using a pressure sensitive probe (KerrHawe Click Probe®, Bioggo, Switzerland) (probe force of 0.25 N). Bleeding and suppuration were scored up to 30s after pocket probing. Microbiological peri-implant sulcus samples were collected from each implant with peri-implantitis using four sterile paper...
Angular bony defects were eliminated, and bone was recontoured using a rotating round bur under saline irrigation. Mucosal flaps were apically positioned and firmly sutured (Vicryl Plus® 3-0; Ethicon Inc., Somerville, NJ, USA), and suprastructures were re-positioned. For both control and test group, surgery was followed by 2 weeks of mouth rinsing with 0.12% CHX + 0.05% CPC without alcohol t...
Interventions
The study protocol was based on the study protocols of two previous studies evaluating the decontaminating effect of chlorhexidine during surgical peri-implantitis treatment [10, 32] and is briefly described below.
Within 1 month before surgical treatment, all patients received extensive oral hygiene instructions and mechanical non-surgical debridement of implants and remaining de...
Methods
Trial design
The present study is a double-blind randomized controlled trial evaluating the effect of 35% phosphoric etching gel (test group) compared to the effect of saline (control group) for implant surface decontamination combined with mechanical debridement during surgical peri-implantitis treatment. Patients were randomly assigned to the test or control group using a one-to-one al...
Background
Triggered host defense responses initiate inflammation of the peri-implant soft tissue (peri-implant mucositis), which can lead to loss of peri-implant supporting bone (peri-implantitis), and eventually, result in implant failure [1]. An increasing prevalence of peri-implantitis has been described in recent literature [2], with current incidence ranging from 1 to 47%. A non-linear, acc...
Implant decontamination with phosphoric acid during surgical peri-implantitis treatment: a RCT
Abstract
Background
Peri-implantitis is known as an infectious disease that affects the peri-implant soft and hard tissue. Today, scientific literature provides very little evidence for an effective intervention protocol for treatment of peri-implantitis. The aim of the present randomized controlled t...
Figure 6. BIC percentage measured with ImageJ analysis software
Figure 5. Time arrow about the stages of the study
Figure 4. A 2-month period was allowed for plaque retention and peri-implantitis
Figure 3. Silk ligatures placed in a submarginal position around the implants
Figure 2. Edentulous posterior mandible of the dog at 3 months after tooth extraction
Figure 1. Flowchart of the research design employed in the study. *Three dogs were used in each group 1 and 2. Three implants were inserted right side of the mandibles. After peri-implantitis period, extracted implants were inserted into the left side of the mandibles. **Two dogs were used in each group 3 and 4. Six failed implants from human inserted into the one dog’s mandible bilaterall...
Table 3 Inter- and intra-group ISQ analysis and measurements on day of surgery and at 3-month follow-up
Mean ± SDISQ day 0
Mean ± SDISQ at 3 month
p
Group 1
69.33 ± 8.48
77.77 ± 1.78
.019
Group 2
68.88 ± 5.90
79.44 ± 2.55
.001*
Group 3
71.77 ± 5.71
75.11 ± 5.84
.366
Group 4
70.44 ± 5.15
79.12 ± 4...
Table 2 Comparison of BIC percentages of 3 mm crestal area of the implants at 3-month follow-up
Group 1[Mean ± SD]
Group 2[Mean ± SD]
Group3[Mean ± SD]
Group 4[Mean ± SD]
p
77.67 ± 5.03
75.28 ± 10.65
71.86 ± 8.34
80.63 ± 5.58
.144*
Group 1[Mean ± SD]
Group 2[Mean ± SD]
Group3[Mean ± SD]
Group 4[Mean± SD]
p
83.39 ± 6.37
79.93 ± 11.83
75.45 ± 9.09
80.53 ± 5.22
290*
Levin et al. conducted a similar study and investigated the success rate of retrieved dental implants that were re-implanted into dogs. The infected implants were re-implanted into dog jaws without any chemical or mechanical cleaning and the authors reported that there was no difference in terms of BIC percentage between the infected/reinserted and new dental implants after a...
Levin et al. conducted a similar study and investigated the success rate of retrieved dental implants that were re-implanted into dogs. The infected implants were re-implanted into dog jaws without any chemical or mechanical cleaning and the authors reported that there was no difference in terms of BIC percentage between the infected/reinserted and new dental implants after an appropriate he...
Discussion
Approximately two million new dental implants are inserted per year around the world and tens of millions of implants are still in use. Moreover, it is estimated that approximately 200,000–250,000 implants are removed every year. Peri-implantitis is the major cause of the implant retrieval and also the most common complication caused by implant surgery. Mombelli et al. reported...
Results
The experimental period and the laboratory workup of the study were unremarkable. Surgical operations were uneventful and the post-operative healing periods were completed with no complications. Histologic analysis and the ISQ values indicated that osseointegration was achieved in all the implants.
Histomorphometric analysis
Histomorphometric analysis demonstrated that adequate bone f...
Removal and preparation of the implant-bone specimens
The implants with a neighboring bone were removed en bloc, and the adhesive soft tissues were dissected to investigate the healing status and the bone-implant contact (BIC) percentage. The specimens were fixed in 10% neutral buffered formalin for 48 h and dehydrated in subsequent concentrations of 70–99.9% ethanol. After dehydration, the sp...
Subsequently, the implant surfaces were rinsed with sterile saline solution and then all the implants were inserted in the contralateral side of the mandible of the same dog. After a 3-month osseointegration period, the animals were sacrificed with a high dose of pentobarbital (i.v.).
In group 2, the same procedures were applied as in group 1. However, unlike the implants in group 1, the implants...
Infiltration anesthesia with 2% articaine (Ultracaine DS, Sanofi Aventis Drugs, Istanbul, Turkey) was applied to the premolar area for hemostasis and for post-operative pain control. A full-thickness vestibular flap was elevated gently, and surgical tooth extraction was performed using surgical burs with straight elevators. Surgical wounds were closed with 3/0 vicryl sutures and streptomycin 0.5 g...
Methods
Research design
This in vivo study had a comparative, randomized, prospective research design, and each group consisted of 10 male beagle dogs that were veterinarian-controlled, healthy, and of similar weight. Animal Research Reporting in Vivo Experiment (ARRIVE) guidelines were used, and surgical procedure was approved by the Local Animal Experiments Ethical Committee of Erciyes Unive...
Background
Branemark et al. conducted the first experimental trial with titanium dental implants and created a new vision by defining the term “osseointegration” in the 1960s. Despite the advances in implant technology and protocols and the accumulating evidence in the literature, implant failure/loss may still occur due to several reasons. On the other hand, although dental implant therapy...
Reusing dental implants: an experimental study for detecting the success rates of re-osseointegration
Abstract
Background
The aim of this study was to histomorphometrically compare the implant-host integration between retrieved implants and new implants.
Methods
Jaws in 10 male beagle dogs were divided into four groups, and 36 dental implants were inserted into the jaws. In groups 1 and...
Author
Year
Study type
Selection bias (homogeneity and confounders)
Performance bias (fidelity to protocol)
Attrition bias (loss of participants)
Detection bias (reliable measures)
Reporting bias (selective reporting or conflict interests)
Summary assessment risk of bias
Alsaadi
2007
Retrospective
H
U
U
L
L
L
Aguilar-Salvatierra
2015
Prospective
H
L
L
L
L...
Table 1 List of the included studies and its main characteristics
Author
Year
Study type
Diabetes type
Control
Diabetes therapy
Glycemic control [HbA1c %]
Duration of diabetes (years)
Number of patients
Number of implants
Duration of study (years)
Implant survival [%]
Conclusion
Alsaadi
2007
Retrospective
Type II
Non-diabetes
n.d.
n.d.
n.d.
2004 (overall)
6...
Figure 1. Selection process of the included literature
References
Moraschini V, Poubel LA, Ferreira VF, Barboza Edos S. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg. 2015;44(3):377–88.
Khader YS, Dauod AS, El-Qaderi SS, Alkafajei A, Batayha WQ. Periodontal status of diabetics compared with nondiabetics...
Conclusions
The literature included to this review is very heterogeneous concerning the investigated objects, methods, and conclusions. Diabetes is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period. When looking at the complications and side effects resulting from diabetes, it is important to know which type of diabetes the pati...
While four studies conclude better implant survival and less peri-implant complications in the well-controlled group, the three others see no difference in implant success even in the poorly controlled patients. The study of Khandelwal treated exclusively patients with poor glycemic control (HbA1c 7.5–11.4 %) and had 98 % implant survival, after 4 months; therefore, he concluded that impla...
Diabetes and bone augmentation
We identified two prospective studies that evaluated “advanced” implant surgery covering sinus lift procedure and guided bone regeneration.
The study of Erdogan consists of type II diabetics moderately and well-controlled (HbA1c 6–7.5 %) with a mean duration of disease of 7.5 years and a healthy control group. Augmentation of the maxilla was perform...
The bleeding on probing is more often in the poorly controlled population, but the probing depth is not increased.
Diabetes and implant survival
Implant survival is an easily defined and measured endpoint for dental implant therapy. Nearly every study reports its implant survival rate. Our literature search identified 18 publications with these data. We divided them into two groups: the ...
The results in the prospective study of Gomez-Moreno show that elevated HbA1c causes more bone resorption after 3 years, but this effect is not significant.
We identified two prospective studies investigating the influence of type II diabetes on osseointegration.
They are published by the same author but are independent studies from different years. In both studies, the patients included...
Results
Study selection
There are no guidelines existing to the topic of dental implants and diabetes mellitus. A total of 327 potentially relevant titles and abstracts were found by the electronic search and additional evaluation of reference lists. During the first screening, 230 publications were excluded based on the title and keywords. Additionally, 24 titles were excluded based on abstract...
Materials and methods
The substructure of the systematic review is based on the PRISMA statement. The focused question according to the PICO schema is: “Do diabetic patients with dental implants have a higher complication rate in comparison to healthy controls?”
Search strategies
The systematic literature search was performed by an independent scientist (Burkhard Kunzendorf). The following ...
Review
Introduction
Today, dental implants are one of the restorative methods to replace missing teeth. Improvements in implant design, surface characteristics, and surgical protocols made implants a secure and highly predictable procedure with a mean survival rate of 94.6 % and a mean success rate of 89.7 % after more than 10 years. Implant survival is initially dependent on successful osseoi...
Abstract
Dental implant surgery has developed to a widely used procedure for dental rehabilitation and is a secure and predictable procedure. Local and systemic risk factors can result in higher failure rates. Diabetes mellitus is a chronic disease that goes in with hyperglycemia and causes multifarious side effects. Diabetes as a relative contraindication for implant surgery is controversially...
While four studies conclude better implant survival and less peri-implant complications in the well-controlled group, the three others see no difference in implant success even in the poorly controlled patients. The study of Khandelwal treated exclusively patients with poor glycemic control (HbA1c 7.5–11.4 %) and had 98 % implant survival, after 4 months; therefore, he concluded that implant the...
Diabetes and bone augmentation
We identified two prospective studies that evaluated “advanced” implant surgery covering sinus lift procedure and guided bone regeneration. The study of Erdogan consists of type II diabetics moderately and well-controlled (HbA1c 6–7.5 %) with a mean duration of disease of 7.5 years and a healthy control group. Augmentation of the maxilla was performed by g...
The bleeding on probing is more often in the poorly controlled population, but the probing depth is not increased.
Diabetes and implant survival
Implant survival is an easily defined and measured endpoint for dental implant therapy. Nearly every study reports its implant survival rate. Our literature search identified 18 publications with these data. We divided them into two groups: the first on...
We identified two prospective studies investigating the influence of type II diabetes on osseointegration. They are published by the same author but are independent studies from different years. In both studies, the patients included were stratified by HbA1c levels as well-controlled (HbA1c 6.1–8 %), moderately controlled (HbA1c 8.1–10 %), and poorly controlled (HbA1c ≥10 %).
The healthy...
Materials and methods
The substructure of the systematic review is based on the PRISMA statement. The focused question according to the PICO schema is: “Do diabetic patients with dental implants have a higher complication rate in comparison to healthy controls?”
Search strategies
The systematic literature search was performed by an independent scientist (Burkhard Kunzendorf). The follow...
Conclusions
The literature included to this review is very heterogeneous concerning the investigated objects, methods, and conclusions. Diabetes is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period. When looking at the complications and side effects resulting from diabetes, it is important to know which type of diabetes the patient suffers from, if...
Results
Study selection
There are no guidelines existing to the topic of dental implants and diabetes mellitus. A total of 327 potentially relevant titles and abstracts were found by the electronic search and additional evaluation of reference lists. During the first screening, 230 publications were excluded based on the title and keywords. Additionally, 24 titles were excluded based on abstract...
Introduction
Today, dental implants are one of the restorative methods to replace missing teeth. Improvements in implant design, surface characteristics, and surgical protocols made implants a secure and highly predictable procedure with a mean survival rate of 94.6 % and a mean success rate of 89.7 % after more than 10 years. Implant survival is initially dependent on successful osseointegration...
Abstract
Dental implant surgery has developed to a widely used procedure for dental rehabilitation and is a secure and predictable procedure. Local and systemic risk factors can result in higher failure rates. Diabetes mellitus is a chronic disease that goes in with hyperglycemia and causes multifarious side effects. Diabetes as a relative contraindication for implant surgery is controversially...
Table 3 Quantitative analysis of CFU counts (× 105) from rough and machined surface implants after cleansing by each method
Rough surface
Cont
G
US
Air
Rot
Las
Median
137.5
3.4
46.5
13.0
4.8
16.3
Min
73.0
0.3
6.8
0.5
0.6
3.0
Max
785.0
27.0
240.0
35.5
37.0
34.0
Machine surface
Cont
G
US
Air
Rot
Las
Median
84.5
0.9
8.5
3.2
3.3
...
Table 2 Qualitative evaluation by SEM analysis of micro- and macrothread areas of machined surface implants
Machined surface (microthread)
No effect
Fair
Good
Excellent
G
+
US
+
Air
+
Rot
+
Las
+
Machined surface (macrothread)
No effect
Fair
Good
Excellent
G
+
US...
Table 1 Qualitative evaluation by SEM analysis of micro- and macrothread areas of rough surface implants
Rough surface (microthread)
No effect
Fair
Good
Excellent
G
+
US
+
Air
+
Rot
+
Las
+
Rough surface (macrothread)
No effect
Fair
Good
Excellent
G
+
US
...
Figure 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Figure 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d, vs Rot; e, vs Las which indicates p < 0.05
Figure 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Figure 3. Decontamination methods. a Gauze soaked in saline applied using a sawing motion. b Ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon group, Bordeaux, France, power setting: P5, tip: Implant Protect IP3L/R). c Air abrasives (AIR-FLOW MASTER PIEZON®, EMS, Nyon, Switzerland, power setting: water flow 100%, air pressure 75%, powder: AIR-FLOW® PERIO POWDER, nozzle: PERIO-FLOW®...
Figure 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Surface characteristics
Through SEM analysis and CFU counts, it was demonstrated that, except for the Er:YAG laser, decontamination of the machined surface implant was easier than that of the rough surface implant regardless of decontamination method. Gauze soaked in saline and the ultrasonic scaler demonstrated a statistically significant difference in CFU counts between the two surfaces. ...
Our results are also in accordance with their results in terms of the high cleansability of the rotary metal instrument. In addition, the cotton pellet showed moderate cleansability among the tested methods, but the cleansing time for the cotton pellet (60 s) was shorter than that of the titanium brush with (120 s + 60 s)/without (120 s) photodynamic therapy. If adjusting the d...
Charalampakis et al. examined the effectiveness of mechanical and chemical decontamination methods using titanium disks contaminated intraorally. They employed four decontamination methods: gauze in saline, chlorhexidine, delmopinol, and an essential oil mixture. The authors discovered there was no significant difference in CFU counts among the four methods. In the present study, our findin...
However, the rotary stainless steel instrument created numerous shallow scratches, especially on machined surface implants. John et al. compared the supragingival plaque cleansability of a rotary titanium instrument to that of a stainless metal curette on contaminated titanium disks. The residual biofilm area left on implant treated with the rotary titanium instrument was significantl...
However, the rotary stainless steel instrument created numerous shallow scratches, especially on machined surface implants. John et al. compared the supragingival plaque cleansability of a rotary titanium instrument to that of a stainless metal curette on contaminated titanium disks. The residual biofilm area left on implant treated with the rotary titanium instrument was significantl...
Regarding the air abrasives, the cleansing effect in the SEM analysis was also as considerable as that achieved by the ultrasonic scaler in the present study, in contrast to the results of the aforementioned study. Louropoulou et al. also stated in their systematic review that an air-powder abrasive system with sodium bicarbonate powder could cleanse contaminated rough/smooth implant surface...
The SEM analysis demonstrated that three different rough surface disks harbored complex and firmly attached biofilms after gauze scrubbing irrespective of which antiseptic or saline was used.
However, the disks with a turned surface hosted fewer biofilm clusters after scrubbing. This finding is in line with our result showing the better cleansability of gauze soaked in saline on the m...
Augthun et al. examined the cultivability of mouse fibroblasts after cleansing machined or plasma-splayed surface implants carried on acrylic plates that had been contaminated with supragingival plaque from individuals. A plastic hand scaler and an air-abrasive system with sodium bicarbonate powder were employed in their study. A similar number of viable fibroblasts were observed after clean...
Discussion
Study design
This study was performed following an ex vivo design to overcome the drawbacks of previous studies. One particular difference in this study was the use of a commercially available screw-shaped implant. As the implant shape and design have rather complicated macro- and microstructures compared with titanium disks or different forms of titanium commonly used in experi...
Results
Complications
During the experiment, three participants experienced small ulcers caused by the implants carried on the splints; however, it did not affect their daily life. Additionally, there were no signs of gingival inflammation in any participant.
SEM analysis (Fig 4, Tables 1 and 2)
Rough surface implants
G and Rot achieved relatively clean implant surfaces compared with Las in...
This study protocol was approved by the ethical committee of Osaka University (H26.E-36).
SEM analysis
The SEM analysis was performed as previously described. The decontaminated implant samples were fixed with 2% glutaraldehyde-RPMI 1640 immediately for 1 h at room temperature and washed with distilled water. Then, the samples were dehydrated with 100% t-butyl alcohol and freeze-dried. Finall...
At the end of the 4-day experimental period, the implants were carefully removed from the splints by breaking the resin caps that held them in place. Each implant was randomly assigned to a treatment method (Cont, control (no decontamination); G, gauze soaked in saline; US, ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon Group, Bordeaux, France; power setting: P5, tip: Implant Protect IP3L/R); ...
Materials and methods
Study subjects
Eleven participants, nine men and two women between 28 and 42 years of age (mean age 31.3 ± 4.6), were recruited as the study subjects. All participants provided informed consent verbally. Study information was disseminated to participants both verbally and in written form. The inclusion criteria were as follows:
Generally healthy subjects
Dent...
Background
Dental implants are now used broadly for recovering loss of masticatory function and esthetics. Although it has been revealed that dental implants can often survive long term, biological and mechanical complications may arise. Recent cross-sectional and retrospective studies noted a higher prevalence of peri-implantitis at the implant and subject level than previously considered. Add...
Abstract
Background
To evaluate the effect of several representative decontamination methods of oral biofilms on different implant surfaces.
Material and methods
Eleven participants wore a hard resin splint carrying 6 rough (GC Aadva® implant; 3.3-mm diameter, 8-mm length) or machined (not commercially available) surface implants for 4 days to accumulate dental plaque naturally on the ti...
Figure 5. The effect of grade 4 and grade 5 implant particles on human gingival fibroblast viability in vitro. Viability was determined using an MTT metabolic activity assay. Cells were exposed to either a dissolution products (ions and nanoparticles) or b culture medium containing suspended implant particles throughout the duration of the culture period. Cells were exposed to various con...
Figure 4. Titanium (Ti) and vanadium (V) content in Dulbecco’s Modified Eagle Medium (DMEM). a, b Dissolution products (media filtered through 0.2 μm PTFE membrane following initial soaking of the particles for 3 days) and c, d DMEM sampled during cell culture studies where cells were cultured with the particles over a period of 10 days (particles removed prior to ICP measurem...
Figure 3. Titanium (Ti) and vanadium (V) release from the particles in simulated body fluid (SBF). Experimental duration was 10 days. Results presented as mean ± standard deviation, n = 3
Figure 2. EDX spectra of particles produced by the mock implantoplasty procedure (SEM images in Fig. 1). a, b Particles from grade 4 commercially pure titanium implant, a angular microparticles and b small spheres. c, d particles from grade 5 titanium alloy, c angular microparticles and d small spheres (grade 5)
Figure 1. Representative photo of implants and SEM images of particles produced by mock implantoplasty procedure. a–c Straumann 021.4512, bone level, diameter 4.1 mm, regular CrossFit®, SLA® 12 mm Roxolid® (commercially pure grade 4 titanium). d–f Biohorizons PBR 50105, RBT 5.0 × 10.5 mm, 5.7 Platform (grade 5 titanium alloy). Arrows indicate titanium oxide spheres. Scale ba...
Further, the effect of implant particles on other cell types within the oral and systemic environments should not be overlooked. Although the health hazards of FPs and NPs are relatively less well established, literature in the fields of toxicology does indicate a glimpse of possible toxicity that should compel clinicians to carefully weigh the possible adverse human health effec...
This is due to the lack of vanadium and possibly larger particle size. Here, G5 particles are. Although a range of particle size of G5 was measured in this study, a portion of the particles generated from the mock implatoplasty process in the current study is comparable to that reported by Pioletti et al.. The internalisation of G5 particles, especially sub-micron particles, and the su...
There was no distinct difference in the amount of titanium ions released from G4 and G5 particles. Direct exposure to G5 implant particles in culture did result in significantly reduced cell viability at all-time points, from 3 to 10 days of culture, while G4 implant particles demonstrated no adverse effect on cell viability (Fig. 5b). The cytotoxic effects of vanadium are well docum...
Discussion
Unalloyed titanium, often referred to as commercially pure grade 4 titanium (CpTi), usually contains some trace elements of carbon, oxygen, nitrogen and iron (American Society for Testing and Materials international standards). These trace elements improve the mechanical properties of CpTi and are found in higher amounts from grade 1 to 4 CpTi. Many dental implants are made from ...
Results
Particles released from implants following the mock implantoplasty procedure were collected, and microparticle size of particles produced from the grade 4 (G4) and grade 5 (G5) implants was 77.4 ± 9.1 μm (modal number 66.3 μm) and 48.4 ± 6.4 μm respectively (modal number 43.1 μm). DLS analysis showed nano-sized particles were also present: hydrodynamic diameters were 125.4...
The media were filtered through 0.2 μm PTFE membrane syringe filters following incubation to remove the particles before use in cell culture. Group 2 (particle): Sterilised grade 4 and 5 Ti particles were suspended in DMEM at concentrations of 0.75, 1.5 and 3 mg ml−1 and used for cell culture without filtering. Basal DMEM and DMEM containing unprocessed grade 4 and 5 implants were used a...
Ion release from titanium particles
Simulated body fluid (SBF) was chosen as the dissolution test solution as we were interested in what happens when the particles become embedded in the soft/hard tissue rather than their interaction with saliva. SBF was prepared using the Kokubo method. Seven hundred millilitres of deionised (DI) water in a 1-L polypropylene beaker was warmed to 37 °C in a wa...
Materials and methods
Materials
Reagents and solvents were purchased from Sigma-Aldrich (Dorset UK). Commercially pure grade 4 titanium implants (n = 3) were purchased from Straumann (Sussex UK, Model number 021.4512, bone-level implant diameter 4.1 mm, Regular CrossFit®, SLA® 12 mm Roxolid®) (Fig. 1a). Grade 5 Ti-6Al-4 V titanium alloy implants were purchased from Biohorizons (Berk...
However, if previous records are available, then the diagnosis can be made with any increase in pocket depth with post remodelling bone loss of greater than 0.5 mm in the presence of bleeding and/or suppuration on gentle probing, A number of studies suggested this inflammatory disease is associated with anaerobic plaque bacteria. It has also been suggested peri-implantitis can also be related to...
Background
Dental implants offer a viable long-term treatment option for patients with missing teeth. The use of metallic dental implants has relatively high reliability and long-term success rates; however, it is not without complications and the need for ongoing maintenance persists. Particles are generated during the life span of an implant, and this can have significant physiological implic...
Abstract
Background
With increasing numbers of dental implants placed annually, complications such as peri-implantitis and the subsequent periprosthetic osteolysis are becoming a major concern. Implantoplasty, a commonly used treatment of peri-implantitis, aims to remove plaque from exposed implants and reduce future microbial adhesion and colonisation by mechanically modifying the implant sur...
Bagaimana kita mendefinisikan kasus peri‐implantitis dalam keadaan pendidikan dan praktek sehari-hari?
Diagnosa peri‐implantitis membutuhkan:
keberadaan pendarahan dan/ atau penanahan dengan probing lembut.
Peningkatan kedalaman probing bila dibandingkan dengan pemeriksaan sebelumnya.
Keberadaan penyusutan tulang di luar perubahan tingkat tulang kresta yang diperoleh dari pemodelan ula...
Definisi kasus dan karakteristik peri-implant saras, mukositis peri-implant, dan peri-implantitis berikut harus dilihat dalam konteks beberapa faktor pembaur tersembunyi.
Diketahui bahwa tidak ada implant generik dan bahwa ada banyak desain implant dengan karakteristik permukaan, protokol bedah dan pembebanan yang berbeda. Tingkat pemodelan ulang fisiologi pasca pemasangan implant dapat berbeda...
Apa faktor utama yang berkaitan dengan kekurangan jaringan lunak & jaringan keras pada tempat yang akan dipasangi implant?
Proses penyembuhan pasca kehilangan gigi marakke penyusutan matra proses alveolar / punggungan alveolar yang menggambarkan kekurangan jaringan lunak dan jaringan keras. Kekurangan yang lebih besar dapat terjadi di tempat yang terpapar faktor-faktor berikut: hilangnya duku...
What is peri‐implantitis?
Peri-implantitis adalah kondisi patologi yang berhubungan dengan plak atau gadhel, yang terjadi pada jaringan di sekeliling implant gigi, ditandai dengan peradangan pada mukosa peri-implant, dan selanjutnya diikuti dengan kehilangan tulang pendukung progresif.
Apa buktinya gadhel / biofilm merupakan faktor etiologi utama untuk terjadinya peri‐implantitis?
...
Apa ciri klinis mukositis peri-implant?
Ciri klinis utama mukositis peri-implant adalah perdarahan kala probing lembut. Eritema, bengkak, dan / atau nanah juga bisa muncul.
Apakah mukositis peri‐implant bisa ada tanpa tanda-tanda klinis peradangan?
Tanda-tanda klinis peradangan dibutuhkan untuk diagnosa mukositis peri-implant.
Bagaimana kedalaman probing berkaitan dengan pengenal...
Peri-implant saras : Penyakit dan ketentuan peri‐implant
Apa ciri klinis tempat peri-implant yang saras?
Tempat kedudukan peri-implat yang saras dicirikan dengan erithema, pendarahan kala probing, pembengkakan dan nanah.
Apa perbedaan klinis utama antara peri implant yang saras dan jaringan periodontal?
Dalam keadaan saras, tidak ada perbedaan yang nampak antara jaringan peri‐imp...
Tujuan Workgroup 4 adalah untuk menyajikan penggolongan tentang penyakit dan ketentuan peri-implant. Lima karya tulis posisi yang menjelaskan ciri peri-implant saras, mukositis peri-implant, peri-implantitis, kekurangan jaringan lunak, kekurangan jaringan keras, penentuan kasus, dan pertimbangan diagnostik disiapkan sebelum lokakarya.
Dalam menyiapkan laporan konsensus mengenai kr...
Laporan konsensus kelompok kerja 4 tahun 2017 Lokakarya Buana Tentang Penggolangan Penyakit Periodontal dan Peri-implant Beserta Ketentuan-Ketentuannya
Abstrak
Penggolongan untuk penyakit peri-implant dan ketentuannya disajikan dalam lokakarya tersebut. Pertanyaan berfokus pada ciri peri‐implant yang saras, mukositis peri‐implant, peri‐implantitis, dan di sini diwedhar pula kekurangan ja...
Implant oral memperbesar pilihan perawatan untuk mengganti gigi yang hilang dan sudah terbukti jadi, seperti yang ditunjukkan dalam tinjauan sistematik dengan tindak lanjut jangka panjang. Meskipun tingkat kelangsungan hidup tampak mitayani, peri-implantitis di sekitar implant gigi adalah tantangan dalam praktik sehari-hari, dengan kelumrahan sekitar 20%. Tingkat kelumrahan peri-implantitis sangat...
Latar belakang
Tujuan penelitian perintis ini adalah klasifikasi hisologis jaringan lunak peri-implant yang meradang di sekitar implant keramik dibandingkan dengan implant titanium.
Metode
Jaringan peri-implant diambil dari 15 pasien (berusia 34 hingga 88 tahun, tujuh laki-laki / delapan perempuan) yang menderita peri-implantitis parah (delapan implant keramik, tujuh implant titanium). Sampel j...
Penelitian pada manusia
Penelitian-penelitian eksperimental pada manusia telah mengevaluasi respons terhadap penumpukan biofilm 3 minggu, sesuai dengan kerangka kala penelitian gingivitis eksperimental oleh Löe et al., di mana reversibilitas lesi radang di seputar gigi ditunjukkan setelah reinstitusi kontrol biofilm setelah 3 minggu. Ada penelitian yang melaporkan biopsi manusia dari jaringan pe...
Indikator risiko
Publiskasi
Ringkasan
Rasio ganjil (95% CI), analisis multivariat
Signifikansi
Keberadaan biofilm plak
Roos‐Jansaker et al.
218 subyek, 9 tahun sampai 14 tahun tindak lanjut, analisis multivariat
1.9 (1.2 –2.9)
P = 0.004
Skor plak:
buruk = skor plak median 1 < x < 2
Ferreira et al.
212 subyek semua non‐smokers, 6 bulan sampai 5 tah...
Persamaan & perbedaan antara indikator / faktor risiko untuk penyakit periodontal vs mukositis peri-implant
Tinjauan sistematis terbaru merinkes indikator risiko potensial untuk mukositis peri-implant dan mengidentifikasi penumpukan biofilm dan merokok sebagai indikator risiko. Selain itu, penelitian lintas bagian menunjukkan bahwa skor plak merupakan indikator risiko mukositis peri-implant den...
Desain prostesis yang didukung implant
Aksesibilitas untuk penghapusan biofilm di sekeliling prostesis yang didukung implant memainkan peran penting dalam upaya pencegahan dan penatalaksanaan penyakit peri‐implant. Implant dengan margin restorasi supramukosa metokke penurunan kedalaman probing yang jauh lebih besar setelah perawatan mukositis peri-implant dibandingkan implant dengan margin rest...
Pada pasien edentula sebagian, mukositis peri-implant pra-ada yang disertai dengan kurangnya kepatuhan pada SIT punya hubungan dengan tingkat kejadian peri-implantitis yang lebih tinggi selama periode tindak lanjut 5 tahun. Weton penelitian itu metokke tingkat kejadian peri-implantitis 5 tahun sebesar 18.0% pada kelompok pasien dengan SIT dan 43.9% dalam kelompok tanpa SIT. Analisis regresi logi...
Kebersihan mulut
Weton penelitian klinis penampang telah dengan jelas menunjukkan bahwa penumpukan biofilm berkaitan dengan adanya mukositis peri-implant di seputar implant gigi yang ter-osseointegrata. Ferreira et al melaporkan tentang 212 pasien yang dirawat dengan tiga sistem implant yang berbeda dan didiagnosis dengan mukositis peri-implant. Semua implant telah berfungsi untuk jangka wayah mu...
Pada Lokakarya Buana sebelumnya tentang Periodontologi, definisi faktor risiko disetujui sebagai "faktor lingkungan, perilaku, atau biologis yang dikonfirmasi oleh urutan temporal, biasanya dalam studi longitudinal, yang jika ada, secara langsung meningkatkan peluang penyakit terjadi dan, jika tidak ada atau dihapus mengurangi peluang itu." Untuk mengidentifikasi faktor risiko yang sebenarnya, but...
Penelitian eksperimental pada manusia dan sato telah menunjukkan bahwa penumpukan biofilm de novo memicu lesi radang dalam mukosa peri-implant dengan migrasi leukosit melalui epitel penghalang dan pembentukan infiltrat radang dengan peningkatan proporsi sel T dan sel B di dalam jaringan ikat yang berada dekat dengan epitel penghalang.
Model sato
Model mukositis peri-implant eksperimental telah...
Meskipun hubungan daruna-daruni antara akumulasi biofilm eksperimental dan pengembangan mukositis peri-implant eksperimental diklaim dalam dua penelitian yang disebutkan sebelumnya, kasus untuk hubungan daruna-daruni yang sebenarnya akan diperosa oleh bukti reversibilitas untuk tingkat pra-eksperimental kesarasan mukosa.
Dalam penelitian oleh Salvi et al, GI di situs implant turun secara signifik...
Mukosa peri-implant yang saras ditandai dengan adanya epitel oral yang meluas ke epitel penghalang non-keratin dengan lamina basal dan hemidesmosome yang menghadap ke permukaan implant atau abutmen. Dalam jaringan ikat yang berdekatan dengan penghalang epitel, ada infiltrat sel radang yang menyulihi pertahanan inang terhadap tantangan bakteri. Dalam kondisi mukosa peri-implant yang saras, epitel p...
Gingivitis
Mukositis peri‐implant
Pengertian
Peradangan gingival tanpa susut perlekatan periodontal
Peradangan mukosa peri‐implant tanpa penyusutan tulang peri-implant berkelanjutan
Tanda klinis
Kemerahan, bengkak, dan perdarahan dengan probing lembut
Kemerahan, bengkak, perdarahan dengan probing lembut, dan nanah
Peradangan eksperimental pada manusia
P...
Mukosa peri-implan telah didefinisikan dalam lokakarya sebelumnya sebagai lesi inflamasi mukosa yang mengelilingi implant endosseous tanpa kehilangan tulang peri-implant pendukung. Kriteria penting untuk pengertian mukositis peri-implant adalah peradangan pada mukosa peri-implant dan tidak adanya keropos tulang peri-implant marjinal yang berkelanjutan. Tanda klinis peradangan adalah pendarahan pad...
Pencarian literatur MEDLINE (PubMed) dan The Cochrane Library hingga dan termasuk 31 Juli 2016, dilakukan menggunakan strategi pencarian (peri-implant[All Fields] AND ("mucositis"[MeSH Terms] OR "mucositis"[All Fields])) OR (periimplant[All Fields] AND mucositis[All Fields]), memunculkan 224 karya kawidyan. Penelitian prospektif, retrospektif, dan lintas bidang dan karya tinjauan yang berfokus pad...
Penyakit peri-implant, termasuk peri-implant mucositis dan peri-implantitis, pertama kali didefinisikan dan dijelaskan pada Lokakarya Eropa Pertama tentang Periodontologi di Ittingen pada tahun 1993. Setelah itu, ada banyak lokakarya yang medhar definisi, kelumrahan, dan pengobatan penyakit ini. penyakit. Mucositis peri-implan dianggap sebagai prekursor peri-implantitis. Tujuan dari tinjauan narat...
Tujuan
Tinjauan naratif ini disiapkan untuk Lokakarya Buana 2017 Akademi Periodontologi Amerika dan Federasi Periodontologi Eropa untuk menanggapi pertanyaan-pertanyaan kunci terkait dengan kondisi klinis mukositis peri-implant, termasuk:
definisi mukositis peri-implant,
perubahan kesarasan peri-implant jadi lesi mukositis peri-implant yang diinduksi oleh biofilm,
reversibilitas mukositis ...
Gambar 1. Peri-implant mucositis vs peri-implantitis vs peri-implant health
Risk indicator
Publication
Summary
Odds ratio (95% CI), multivariate analysis
Significance
Plaque biofilm presence
Roos‐Jansaker et al.
218 subjects, 9‐ to 14‐year follow‐up, multivariate analysis
1.9 (1.2 –2.9)
P = 0.004
Plaque score: poor = median plaque score > 1 and
SIMILARITIES AND DIFFERENCES BETWEEN RISK INDICATORS/FACTORS FOR PERIODONTAL DISEASES VERSUS PERI‐IMPLANT MUCOSITIS
A recent systematic review summarized potential risk indicators for peri‐implant mucositis and identified biofilm accumulation and smoking as risk indicators. In addition, a cross‐sectional study showed that plaque score was a risk indicator for peri‐implant mucositis in a...
Design of implant‐supported prostheses
Accessibility for biofilm removal around implant‐supported prostheses plays an important role in the prevention and management of peri‐implant diseases. Implants with supramucosal restoration margins yielded significantly greater reductions in probing depths following treatment of peri‐implant mucositis compared with those with submucosal restoration...
In partially edentulous patients, pre‐existing peri‐implant mucositis in conjunction with lack of adherence to SIT was associated with a higher incidence of peri‐implantitis during a 5‐year follow‐up period. The outcomes of that study yielded a 5‐year incidence of peri‐implantitis of 18.0% in the group of patients with SIT and of 43.9% in the group without SIT, respectively. The ...
Oral hygiene
Outcomes of cross‐sectional clinical studies have clearly indicated that biofilm accumulation is associated with the presence of peri‐implant mucositis around osseointegrated dental implants. Ferreira et al. reported on 212 patients treated with three different implant systems and diagnosed with peri‐implant mucositis. All implants had been in function for a period ranging f...
At a previous World Workshop on Periodontology the definition of a risk factor was agreed as, “an environmental, behavioral or biologic factor confirmed by temporal sequence, usually in longitudinal studies, which if present, directly increases the probability of a disease occurring and, if absent or removed reduces that probability.” To identify a true risk factor, prospective studies are req...
Experimental studies in humans and animals have demonstrated that de novo biofilm accumulation results in an inflammatory lesion within the peri‐implant mucosa with migration of leukocytes through the barrier epithelium and the establishment of an inflammatory infiltrate with an increased proportion of T‐ and B‐cells in the connective tissue adjacent to the barrier epithelium.
Animal mod...
Although a cause–effect relationship between experimental biofilm accumulation and the development of experimental peri‐implant mucositis was claimed in the two studies mentioned previously, the case for a true cause–effect relationship would be strengthened by the proof of reversibility to pre‐experimental levels of mucosal health. In the study by Salvi et al., the GI at implant sites dr...
Healthy peri‐implant mucosa is characterized by the presence of an oral epithelium extending into a non‐keratinized barrier epithelium with basal lamina and hemidesmosomes facing the implant or abutment surface. In the connective tissue adjacent to the epithelial barrier, inflammatory cell infiltrates representing the host's defense against the bacterial challenge are present. In healthy peri...
Gingivitis
Peri‐implant mucositis
Definition
Gingival inflammation without periodontal attachment loss
Peri‐implant mucosal inflammation in absence of continuous marginal peri‐implant bone loss
Clinical signs
Redness, swelling, and bleeding on gentle probing
Redness, swelling, bleeding on gentle probing, and suppuration
Experimental inflammation in humans
I...
Peri‐implant mucositis has been defined in previous workshops as an inflammatory lesion of the mucosa surrounding an endosseous implant without loss of supporting peri‐implant bone. The important criteria for the definition of peri‐implant mucositis are inflammation in the peri‐implant mucosa and the absence of continuing marginal peri‐implant bone loss. The clinical sign of inflammation...
A literature search of MEDLINE (PubMed) and The Cochrane Library up to and including July 31, 2016, was carried out using the search strategy (peri‐implant[All Fields] AND (“mucositis”[MeSH Terms] OR “mucositis”[All Fields])) OR (periimplant[All Fields] AND mucositis[All Fields]), resulting in 224 papers. Prospective, retrospective, and cross‐sectional studies and review papers focused...
Peri‐implant diseases, including peri‐implant mucositis and peri‐implantitis, were first defined and described at the First European Workshop on Periodontology in Ittingen in 1993. Following this, there have been numerous workshops addressing the definition, prevalence, and treatment of these diseases. Peri‐implant mucositis is considered to be the precursor of peri‐implantitis. The ob...
Objectives
This narrative review was prepared for the 2017 World Workshop of the American Academy of Periodontology and European Federation of Periodontology to address key questions related to the clinical condition of peri‐implant mucositis, including: 1) the definition of peri‐implant mucositis, 2) conversion of peri‐implant health to the biofilm‐induced peri‐implant mucositis lesi...
Peri-implantitis adalah penyakit yang tidak bisa pulih dengan sendirinya. Sekali merusak, maka bekas kerusakannya akan tetap ada. Karena itu, penyakit ini sebaiknya dicegah. Untuk bisa mencegah, Anda perlu tahu penyebabnya.Etiologi peri-implantitisEtiologi atau penyebab peri-implantitis antara lain sebagai berikut:InfeksiPlak yang dibentuk oleh bakteri atau produk turunannya adalah penyebab infe...
Mengganti gigi ompong dengan gigi implant sudah jadi tren dalam kedokteran gigi modern di negara-negara maju. Prosedur peri-implantitis memberi hasil yang dapat diprediksi tapi sekaligus menimbulkan penyakit baru, yaitu: peri-implantitis. Dibandingkan implant yang sukses dan saras, pasien yang terkena penyakit ini relatif sedikit dan dapat ditangani dengan baik asalkan tidak terlambat. Karena itu...