RESUMO

During implant maintenance, preserving a smooth surface on the machined transmucosal abutment is critical to reduce biofilm attachment and colonization. The present study compared the surface roughness and bacterial colonization of machined titanium surfaces after instrumentation with various materials. Forty-four machined grade 23 titanium discs were instrumented with a round polyether ether ketone (PEEK) tip, a plastic curette tip, or a pure titanium curette tip with piezoelectric devices. Before and after instrumentation, the surface roughness (Ra and Rz) values were analyzed with a profilometer and scanning electron microscopy (SEM). Streptococcus sanguinis was cultured and incubated for 24 hours on the instrumented discs, and colony-forming units per milliliter were obtained for each group. Samples instrumented with the metal ultrasonic tip significantly increased surface roughness compared with the other groups. This resulted in greater colonization by S. sanguinis than surfaces instrumented with PEEK tips or the negative control. Samples instrumented with PEEK and plastic tips did not exhibit any statistically significant increase in surface roughness, and SEM analysis revealed a significantly rougher surface of discs instrumented with metal compared with discs instrumented with plastic or PEEK tips despite the possibility of debris from tip dissolution. Our results suggest that instrumentation with metal ultrasonic tips with piezoelectric devices significantly increased machined titanium's surface roughness and elicited higher biofilm formation in vitro. Meanwhile, instrumentation of machined titanium with PEEK or plastic ultrasonic tips did not affect the surface roughness or bacterial adhesion.

Assuntos

RESUMO

Peri-implant disease (PID) is a general term for inflammatory diseases of soft and hard tissues that occur around implants, including peri-implant mucositis and peri-implantitis. Cytokines are a class of small molecule proteins, which have various functions such as regulating innate immunity, adaptive immunity, and repairing damaged tissues. In order to explore the characteristics and clinical significance of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-10, and tumor growth factor (TGF)-β1 expression levels in serum of patients with peri-implant disease, 31 patients with PID and 31 patients without PID were enrolled. The modified plaque index (mPLI), modified sulcus bleeding index (mSBI), and peri-implant probing depth (PD) were recorded. The levels of serum TNF-α, IL-6, IL-10, and TGF-β1 were detected by ELISA. TNF-α, mPLI, mSBI, and PD levels were significantly higher in the PID group. TGF-β1 levels were significantly higher in the control group. There was a significant positive correlation between TNF-α and mPLI, mSBI, and PD. TGF-β1 was negatively associated with TNF-α, mPLI, mSBI, and PD. Multiple logistic regression analysis showed that TNF-α and PD were risk factors for the severity of PID. The receiver operating curve analysis showed that high TNF-α levels (cut-off value of 140 pg/mL) and greater PD values (cut-off value of 4 mm) were good predictors of PID severity with an area under the curve of 0.922. These results indicated that TNF-α and PD can be used as a biological indicator for diagnosing the occurrence and progression of PID.

RESUMO

Currently, researchers are focused on the study of cytokines as predictive biomarkers of peri-implantitis (PI) in order to obtain an early diagnosis and prognosis, and for treatment of the disease. The aim of the study was to characterize the peri-implant soft and hard tissues in patients with a peri-implantitis diagnosis. A descriptive observational study was conducted. Fifteen soft tissue (ST) samples and six peri-implant bone tissue (BT) samples were obtained from 13 patients who were diagnosed with peri-implantitis. All the samples were processed and embedded in paraffin for histological and immunohistochemical analyses. A descriptive and quantitative analysis of mast cells and osteocytes, A proliferation-inducing ligand (APRIL), B-cell activating factor (BAFF), osteonectin (ON), and ∝-smooth muscle actin (∝-SMA) was performed. We observed the presence of mast cells in peri-implant soft tissue in all samples (mean 9.21 number of mast cells) and osteocytes in peri-implant hard tissue in all samples (mean 37.17 number of osteocytes). The expression of APRIL-ST was 32.17% ± 6.39%, and that of APRIL-BT was 7.09% ± 5.94%. The BAFF-ST expression was 17.26 ± 12.90%, and the BAFF-BT was 12.16% ± 6.30%. The mean percentage of ON was 7.93% ± 3.79%, and ∝-SMA was 1.78% ± 3.79%. It was concluded that the expression of APRIL and BAFF suggests their involvement in the bone resorption observed in peri-implantitis. The lower expression of osteonectin in the peri-implant bone tissue can also be associated with a deficiency in the regulation of bone remodeling and the consequent peri-implant bone loss.

Assuntos

RESUMO

OBJECTIVE: The objective of this study was to evaluate the potential association between liver cirrhosis and peri-implant diseases, as well as the influence of different risk indicators on this association. METHODS: This case-control study included 64 cases with liver cirrhosis and 128 controls without liver diseases that presented the same socio-demographic and economic profile. The specific inclusion criteria were the following: aged group of 35-55 years and presenting at least one osseointegrated implant functioning for >5 years. A full-mouth peri-implant and periodontal examination was performed and risk variables were recorded. The association between risk variables and the occurrence of peri-implant diseases was tested through univariate analysis and multivariate logistic regression, stratified by alcohol status. Additionally, a mediation analysis was performed to examine the mediating effect of age with peri-implantitis. RESULTS: A high prevalence of peri-implantitis (29.7%) was observed among cases when compared to controls (18.0%). Individuals with cirrhosis presented ~2.5 higher chance of having peri-implantitis than controls (p<0.001). Significant variables associated with the occurrence of peri-implantitis in the final logistic model were the following: cirrhosis, alcohol use, age (>55 years), male sex, smoking, periodontitis, and number of ≤14. CONCLUSIONS: An important risk association between liver cirrhosis and peri-implantitis was reported. Future studies with a larger sample size controlling for the patient- and implant-related confounders are needed to better understand the link between peri-implantitis and liver cirrhosis. CLINICAL RELEVANCE: Cirrhosis individuals, age, and periodontitis, as well as alcohol use and smoking interaction, should be considered as potential risk indicators for peri-implantitis.

Assuntos

RESUMO

As doenças peri-implantares são classificadas como mucosite peri-implantar e peri-implantite, têm como fator etiológico primário a placa bacteriana e apresentam variada prevalência mundial. A maioria dos protocolos de tratamento tem como objetivo o controle do biofilme e a descontaminação da superfície dos implantes infectados, porém, ainda não se sabe qual tratamento é capaz de aumentar a taxa de sobrevivência e, consequentemente, a longevidade dos implantes afetados. Sendo assim, o objetivo deste trabalho foi realizar uma revisão sistemática da literatura, sobre diferentes protocolos de tratamentos da peri-implantite, para responder a seguinte questão: "O tratamento da peri-implantite aumenta a longevidade dos implantes dentários?" Para tal, uma pesquisa MEDLINE (PubMed), Embase e Cochrane Library foi realizada. Estudos em humanos publicados, sem restrição de língua, até Julho de 2019 foram incluídos. Além desta, foi realizada uma busca manual por artigos publicados no período de Janeiro de 2017 à Abril de 2019 e também incluiu as bibliografias de todos os artigos selecionados, bem como de revisões relevantes publicadas anteriormente. Oito ensaios clínicos randomizados alcançaram os critérios de inclusão, porém, a grande heterogeneidade das metodologias e das apresentações dos resultados entre os estudos não permitiu a realização de uma metanálise. Além disto, apesar de estar claro que a peri-implantite apresenta rápida progressão, ainda não se sabe, de fato, em quanto tempo ocorre a perda do implante não tratado. Sendo assim, dentro das limitações desta revisão sistemática e de acordo com a análise qualitativa dos estudos incluídos, pode-se concluir que, apesar de ainda não existir um consenso quanto ao protocolo de tratamento para a peri-implantite, a realização do desbridamento mecânico cirúrgico com descontaminação da superfície do implante, bem como as terapias ressectivas e regenerativas, promovem uma taxa de sobrevivência que varia de 50 a 100%, com os resultados positivos se mantendo estáveis por até 7 anos. Estes resultados são obtidos, principalmente, quando um regime de manutenção com intervalo bem definido de visitas, de acordo com as necessidades de cada paciente, é mantido (AU)

Peri-implant diseases are classified as peri-implant mucositis and peri-implantitis, their primary etiological factor is bacterial plaque and they have varied worldwide prevalence. Most treatment protocols aim to control biofilm and decontaminate the surface of infected implants, but it is not yet known which treatment is capable of increasing the survival rate and, consequently, the longevity of the affected implants. Therefore, the objective of this study was to make a systematic review of the literature about different protocols for peri-implantitis treatments, to answer the following question: "Does the treatment of peri-implantitis increase the longevity of dental implants?" To this end, a MEDLINE (PubMed), Embase and Cochrane Library research was carried out. Published human studies, without language restriction, until July 2019 were included. In addition to this, a manual search was performed for articles published from January 2017 to April 2019 and also included the bibliographies of all selected articles, as well as relevant reviews previously published for this systematic review. Eight randomized clinical trials met the inclusion criteria, however, the great heterogeneity of the methodologies and the presentation of the results between the studies did not allow the performance of a meta-analysis. In addition, although it is clear that peri-implantitis has rapidly progressing, it is not yet known, in fact, how long the loss of the untreated implant occurs. Thus, within the limitations of this systematic review and according to the qualitative analysis of the included studies, it can be concluded that although there is still no consensus on the treatment protocol for peri-implantitis, the performance of surgical mechanical debridement for with decontamination of the implant surface, as well as resective and regenerative therapies, promote a survival rate that varies from 50 to 100%, with positive results remaining stable for up to 7 years. These results are obtained mainly when a maintenance regime with a well-defined visit interval, according to the needs of each patient, is maintained (AU)

Assuntos

RESUMO

OBJECTIVE: To evaluate the frequency of peri-implant diseases and factors associated with its occurrence. MATERIAL AND METHODS: One hundred and fifty-five patients with dental implants were evaluated in this cross-sectional study. Dental implants were clinically and radiographically evaluated to diagnose their peri-implant condition, according to Mombelli (Proceedings of the 3rd European Workshop on Periodontology, 1999, Quintessence, London). Associations between peri-implant diseases and independent variables (socioeconomic, demographic and periodontal characteristics) were evaluated through bivariate analysis with chi-squared and Fisher's exact tests, as well as by multiple logistic regression. The significance level was set at 5%. RESULTS: The frequencies of the peri-implant diseases, mucositis and peri-implantitis, in individuals were 54% and 28% (CI, 95%), respectively. The sample was almost exclusively of patients with untreated periodontal disease (93%). Bivariate analysis showed that these peri-implant diseases were associated with male patients (prevalence ratio [PR], 3.38), medication use (PR, 2.94), systemic diseases (PR, 2.25), number of implants (PR, 2.53), visible plaque index (PR, 2.49) and gingival index (PR, 2.70). Multiple logistic regression analysis showed that medication use (prevalence ratio adjusted [PRadj], 1.23; 95% CI: 1.04-1.46; P = 0.017), having two or more implants (PRadj, 1.22; 95% CI: 1.02-1.46; P = 0.029) and gingival bleeding index > 10% (PRadj, 1.22; 95% CI: 1.03-1.44; P = 0.022) were associated with the presence of peri-implant disease. CONCLUSION: Peri-implant diseases were diagnosed in 54% of patients; gingival index of greater than 10%, having more than two implants and use of medication were associated with the frequency of peri-implant disease.

Assuntos

RESUMO

Objetivo: analisar a etiologia e os possíveis meios de tratamento da peri-implantite, por meio de pesquisas de trabalhos recentemente publicados acerca do tema e estudos realizados em humanos. Material e métodos: foram selecionados 50 artigos relacionados à etiologia e ao tratamento das doenças peri-implantares. Destes, foram analisados seus títulos e resumos, seguindo os critérios de exclusão e inclusão, e escolhidos nove artigos para a realização desta revisão da literatura. Esta tinha como critérios de inclusão artigos publicados na língua inglesa, que abordavam os tipos de bactérias presentes em volta dos implantes e induzem o estabelecimento e a progressão das doenças peri-implantares. Trabalhos com o objetivo de descrever as possíveis formas de tratamento, desde as mais simples, como uma terapia mecânica de raspagem na mucosite, até uma terapia mais complexa, como a regeneração óssea na peri-implantite. Resultados: as principais bactérias presentes em volta dos implantes são: Aggregatibacter actinomycetemcomitans, Fusobacterium, Prevotela intermedia e Phorphyromonas gingivalis, além de ocorrer diminuição dos Streptococcus e aumento das espiroquetas. Em relação ao tratamento da peri-implantite, este consiste em uma intervenção cirúrgica com a elevação do retalho, remoção do tecido de granulação, limpeza e desinfecção da superfície dos implantes. Em alguns casos, este tratamento é complementado com uma cirurgia regenerativa, utilizando enxerto ósseo. Conclusão: a peri-implantite uma doença imunoinflamatória, sendo a placa bacteriana o principal agente etiológico. O seu tratamento tem como objetivo reduzir a colonização bacteriana em volta do implante, eliminar a microbiota bacteriana e promover a formação de um tecido peri-implantar saudável.

Objective: to analyze the etiology and possible treatments for periimplantitis through recently published papers and human studies. Material and methods: 50 related references were selected in this review. From these, after title and abstract analyses following the inclusion/exclusion criteria, 9 articles were selected. The inclusion criteria were papers published in the English language involving bacterial species at the peri-implant region which lead to establishment and progression of peri-implant diseases. Also, papers with the aim to describe treatment therapies, even from mechanical debridement to mucositis until a more complex approach such as bone regeneration were included. Results: the most prevalent species around the peri-implant region were Aggregatibacter actinomycetemcomitans, Fusobacterium, Prevotela intermedia and Phorphyromonas gingivalis, along with a reduction on Streptococcus and an increase on the spirochaete levels. The treatment basically consists on flap elevation, granulation tissue removal, cleaning and disinfection of peri-implant surfaces. Conclusion: peri-implantitis is a immunoinfl ammatory disease, being the bacterial build-up the main etiological agent. The proposed treatments aim to reduce the bacterial colonization around the dental implant, to eliminate the microfl ora, and to promote the formation of a healthy peri-implant tissue.

Assuntos

RESUMO

Resumen Introducción y objetivo: Los tejidos que soportan los implantes osteointegrados son susceptibles a patologías como la periimplantitis y la mucositis periimplantar. Su detección y tratamiento temprano son importantes para prevenir la progresión de la enfermedad y que llegue a comprometerse la estabilidad del implante. Por lo tanto, este estudio retrospectivo tiene como objetivo determinar los factores asociados a la prevalencia de mucositis periimplantar en pacientes tratados en la Clínica de la Maestría en Periodoncia de la Universidad de San Martín de Porres. Materiales y métodos:De 318 historias clínicas correspondientes a un total de 955 implantes colocados entre los años 2001 y 2010, se evaluaron 212 implantes dentales colocados en un total de 74 pacientes. Se utilizó la presencia de sangrado al sondaje como parámetro de diagnostico para la mucositis periimplantar. Resultados: La prevalencia de Mucositis periimplantar obtenida para el total de 212 implantes evaluados fue 58,96%. Adicionalmente, se encontró diferencias estadísticamente significativas al comparar los grupos de implantes con y sin mucositis periimplantar en relación al nivel de higiene oral. Conclusión: La prevalencia de mucositis periimplantar en la Clínica de la Maestría en Periodoncia de la Universidad de San Martin de Porres entre los años 2001 y 2010 fue de 58.96%. Además, se encontró asociación entre la presencia de mucositis periimplantar y el nivel de higiene oral.

Abstract Introduction and objective: Tissues supporting osseointegrated implants are susceptible to diseases such as periimplantitis and periimplant mucositis. Early detection and treatment are important to prevent disease progression and loss of implant stability. Therefore, the aim of this retrospective study was determine the factors associated with the prevalence of peri-implant mucositis of subjects treated at the Clinic of the Master in Periodontics at the University of San Martín de Porres. Materials and methods: 318 medical records with a total of 955 implants were placed from 2001 to 2010. Of these, 212 dental implants evaluated in a total of 74 medical records were included in this study. We used the presence of bleeding on probing as a diagnostic parameter for peri-implant mucositis. Results: The prevalence of peri-implant mucositis obtained for the total of 212 implants was 58,96%. Additionally, statistically significant differences were found when comparing the groups of implants with peri-implant mucositis and without regard to the oral hygiene level. Conclusion:The prevalence of peri-implant mucositis at the University of San Martin De Porres is 58.96%. It has been found statistically significant association between the presence of peri-implant mucositis and oral hygiene level.

RESUMO

Objetivos: Avaliar a condição peri-implantar de indivíduos submetidos à reabilitação com implantes em um curso de especialização em implantodontia. Materiais e Métodos: de um total de 350 indivíduos, 110 com prontuários odontológicos completos foram considerados elegíveis. A amostra final incluiu 30 indivíduos de ambos os sexos, 18-75 anos, baixo nível socioeconômico, grupo racial heterogêneo, com implantes dentários submetidos à carga protética por no mínimo 12 meses. Dados de interesse foram coletados dos prontuários odontológicos. Mucosite foi definida como presença de um ou mais sítios com sangramento a sondagem peri-implantar (SSi), e a peri-implantite como presença de profundidade de sondagem (PS) ≥ 5mm em um ou mais sítios com perda óssea radiográfica, associadas ou não ao SSi e/ou supuração periimplantar. Resultados: A prevalência de mucosite foi de 50% (n=15) e periimplantite 3,3% (n=1). Indivíduos com mucosite apresentaram maior média de PS em dentes (p=0,042), maior índice de placa (IP) em dentes (p=0,016), maior IP em implantes (p=0,048), maior tempo pós-cirurgia (p=0,037), e maior tempo de função dos implantes (p=0,047) quando comparados com indivíduos com saúde periimplantar. Em relação ao caso de periimplantite, o indivíduo era do sexo feminino, 54 anos, fumante, apresentando 2 implantes em função há 24 meses, ambos com diagnóstico de periimplantite. Ao exame clínico, foi observado pequena faixa de gengiva ceratinizada ao redor dos implantes e alguns dentes e sítios com PS alterada. Conclusões: A mucosite foi associada a PS, IP, tempo pós-cirurgia e tempo de função dos implantes

Aims: Evaluate periimplantar condition of subjects who underwent oral rehabilitation with dental implants in a specialization course. Methods: From a total of 350 subjects, 110 with complete dental records were determined to be eligible. Final sample comprised 30 subjects from both gender, 18-57 years of age, low socioeconomic status, multiethinic group, with implants in function for at least 12 months. Variables of interest were collected from dental records. Mucositis were defined as the presence of one or more sites with periimplantar bleeding on probing (BOPi), and periimplantitis as the presence of probing depth (PD) ≥ 5mm in one or more sites with radiographic bone loss, associated or not with BOPi and/or periimplantar suppuration. Results: Prevalence of mucositis was 50.0% (n=15) and periimplantitis was 3.3% (n=1). Subjects with mucositis presented higher mean PD in tooth (p=0.042), higher plaque index (PI) in tooth (p=0.016), higher PI in implants (p=0.048), higher time since surgery (p=0.037), and higher function time (p=0.047) when compared to subjects with periimplantar health. Regarding the periimplantitis case, the subject was female, 54 years-old, smoker, with 2 dental implants in function for 24 months, both implants diagnosed with periimplantitis. Clinical examination showed narrow width of keratinized gingiva and some teeth and sites with altered PD. Conclusions: Mucositis was associated with PD, PI, time since surgery and function time.

Assuntos