Abstract
Microbial contamination could compromise the stability of dental implants increasing the risk of inflammatory reactions in the surrounding soft tissues. In this human, randomized, double-blind, clinical study, the presence of Porphyromonas gingivalis on the healing abutment and the inflammatory infiltrate surrounding peri-implant soft tissues were investigated. Experiments were done in order to clarify the effect of 0.20% chlorhexidine (CHX) versus placebo, applied during each rehabilitation stage. Thirty patients (15 per group) were included. The load of adhering P. gingivalis on the healing screw were quantified by quantitative Polymerase Chain Reaction (qPCR) Taq-Man. Immunohistochemical analysis was carried out on the gingival biopsy. Moreover, clinical data were recorded. Analysis of variance and the Holm–Sidak test was used to evaluate differences between groups. The results showed a significant low presence of P. gingivalis load in healing abutments belonging to the 0.20% CHX group. Overall, the differences in terms of P. gingivalis DNA copy number between two groups were statistically significant (p < 0.01). All implants showed very low plaque and bleeding scores, but the placebo group appeared to have the highest expression of inflammation markers for T Lymphocytes, B Lymphocytes and macrophages Cluster definitions (CD3, CD20 and CD68). The use of 0.20% CHX could be recommended in all clinical procedures as it reduces significantly P. gingivalis load and host inflammatory response around implants.
Highlights
Dental implants are used by dentists for oral rehabilitation in partially and completely edentulous patients
No clinical signs of inflammation or infection were detected during all surgical phases and all implants were osseointegrated with a survival rate of 100%
All registered indices demonstrated that in both groups (A, placebo group and B, 0.20% CHX group) were less than 25% during the two surgical phases with a slight increase at the second surgical stage in both groups, but without statistically significant differences (Table 2)
Summary
Dental implants are used by dentists for oral rehabilitation in partially and completely edentulous patients. Different factors can lead to dental implant failure [1,2,3]. This implant failure has been mainly attributed to peri-implantitis, a biological complication of oral implants, where periodontal pathogens cause sub-acute and chronic inflammation of the hard and soft tissues surrounding the implants [4,5]. Derks et al reported an increase in peri-implantitis with frequencies ranging from 14% to 30% between 3 to 9 years of function [5]. The production of bacterial metabolites can stimulate the increase of inflammatory markers that can cause the destruction of peri-implant tissues [6]
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