Development Of Peri-implantitis Research Articles

Change in parameters of the microcirculatory tissue system of the peri implant zone in patients with peri implantitis during complex use of mesodiencephalic modulation and ozone therapy

Abstract. Purpose of the study: The article examines the role of microcirculation disorders in the pathogenesis of peri-implantitis in patients after dental implantation. Materials and methods. It is shown that the development of peri-implantitis is characterized by significant changes in the parameters of microhemodynamics and oxygen exchange in the tissue involved in the inflammatory process. The state of oxygen and energy deficiency prompts the progression of inflammatory changes with the formation of signs of tissue destruction around dental implants. The application of a standard scheme of peri-implantitis therapy is accompanied by a correction of the microcirculatory tissue system indicators. The supplementation of standard treatment with course use of medical physical factors promotes the strengthening of the positive dynamics of microcirculation parameters of the peri-implant zone. The corrective influence of MDM-therapy is connected with the activation of the mechanisms of neuroendocrine regulation of vegetative functions, while the basis of ozone therapy is the polymodality of the factor, including the relaxation of the precapillary blood flow, improvement of the rheological properties of the blood, and the stimulating effect on angiogenesis processes. Results. The complex application of medical physical factors, combining systemotropic and local impacts, different modalities and points of application of their corrective activity, contributes to the manifestation of functional potentiation with a maximal corrective effect.

Comprehensive analysis of the elemental composition and surface relief of titanium abutments from contemporary manufactures

Relevance. The transgingival part of the prosthetic components of implant systems is a substrate for the primary adaptation of soft tissues and the formation of the gingiva collar - a complex of tissues acting as a biological barrier and ensuring the normal functioning of artificial supports in the microenvironment of the oral cavity. At the same time, the morphology of the surface of the abutment which will be in constant contact with the gingiva part during the loading period is of great importance. A change in the properties of the surface morphology of the transgingival part of orthopedic structures is fraught with the formation of a microbial bio-film in the subgingival zone with the with the subsequent development of mucositis and peri-implantitis. Based on the above, the study of the surface characteristics of orthopedic components of implantation systems seems relevant in the light of understanding the pathogenesis of inflammatory processes and assessing risk factors for the development of complications of dental implantation.Purpose. Study of differences in the elemental composition and features (or characteristics) of the surface morphology of orthopedic components - transgingival implant abutments from a number of modern manufacturers.Materials and methods. Prosthetic components from five manufacturing companies were selected for the study. For the assessment, elemental analysis of the surface of the components was used using a Hitachi S-3400N scanning electron microscope with an Oxford Instruments X-Max20 energy dispersive spectrometer, as well as morphological analysis using a TESCAN VEGA 3 scanning electron microscope. The samples were assessed for surface uniformity, the presence of inclusions, cracks and marks.Results. The study revealed significant differences in the components both in elemental composition and surface topography. The results obtained can be summarized in the form of a table.Conclusion. The method of comprehensive surface assessment used in the study can be recommended for describing and comparing orthopedic components from different manufacturing companies.

Major approaches of inflammatory processes and peri-implant infections in the cellular and molecular scenario of mesenchymal stem cells, exosomes, and microRNAs: a systematic review

Introduction: Bone diseases are denoted by fractures, osteoporosis, and osteoarthritis that affect a large number of individuals, with a rising prevalence of osteopenia for 64.3 million American individuals and osteoporosis for 11.9 million by the year 2030. Dental implants are not free from possible complications with consequent failure, the causes of which are still the subject of debate in the dental scientific community. In particular, peri-implant infections are multifactorial pathological conditions characterized by inflammation of the peri-implant mucosa with or without progressive loss of supporting bone. Specific expression profiles of microRNAs (miRNAs) extracted from peri-implant tissues are predictive of specific clinical outcomes of dental implants and can be used as biomarkers in implant dentistry for diagnostic and prognostic purposes. Objective: It was to address the main approaches to inflammatory processes and peri-implant infections and dental implants in the cellular and molecular scenarios of mesenchymal stem cells, exosomes, and microRNAs, emphasizing the main biomarkers in the therapeutic control of harmful dental implant processes. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October 2023 to January 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 138 articles were found, 44 articles were evaluated in full and 34 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 26 studies with a high risk of bias and 24 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=67.9%>50%. It was concluded that specific expression profiles of miRNAs extracted from peri-implant tissues are predictive of specific clinical outcomes of dental implants and can be used as biomarkers in implant dentistry for diagnostic and prognostic purposes. Studies have shown that many of the miRNAs extracted from the implant's peri-crevicular fluid were common to those detected in soft tissues taken from the same peri-implant sites. Evidence suggests that exosomes derived from adipose-derived stem cells exhibit similar functions to those cells, with low immunogenicity and no tumorization. Insufficient bone volume directly impacts the placement of dental implants. Adipose-derived stem cells can accelerate bone healing when combined with dental implants. An increase in the concentration of exosomes with negative expression of miRNA-21-3p and miRNA-150-5p may be related to the development of peri-implantitis.

Involvement of interlukin-17A (IL-17A) gene polymorphism and interlukin-23 (IL-23) level in the development of peri-implantitis

BackgroundDental implantation has been practiced since ancient times and has gone through several stages. Dentists use dental implants to support dental prostheses such as crowns, bridges, dentures, face prostheses, or as an orthodontic anchor. Thus, the purpose of this study is to detect the role of the immune-genetic variation of IL-17A and related inflammatory cytokine (IL-23) in the initiation and progress of peri implantitis.Material and methodsThis cross-sectional study included 80 subjects (15 peri-implantitis patients, 35 successful implants, and 30 healthy controls); their mean age was (43.91 ± 11.33) years. Blood samples and Peri-implant sulcus fluid (PISF) were collected from all subjects (patients with peri-implantitis, successful implants, and healthy controls) attending the Department of Oral and Maxillofacial Surgery in the Dental College Teaching Hospital, Baghdad University, Baghdad, Iraq. The blood sample detects gene polymorphisms in interleukin-17A by a polymerase chain reaction (PCR). An enzyme-linked immunosorbent assay (ELISA) was carried out to estimate the Peri-implant sulcus fluid (PISF) levels of interleukin-23.ResultThe current study revealed an obvious significant elevation in the mean level of interleukin-23 in the peri-implantitis patient’s group more than its level in the successful implant and control groups (P < 0.05). In addition, the result showed that A/A genotype is associated significantly with peri-implantitis OR (95%confidence interval) =6.9 (1.7121 to 27.4638) folds increase risk of peri-implantitis) (p = 0.0065), while G/A genotype had OR 4.9 (0.9539–24.9394) folds increased risk of peri-implantitis, (p = 0.0572). But it was not statistically significant and G/G genotype had a one-fold increase risk of peri-implantitis.ConclusionThe increased level of inflammatory cytokine (interleukin-23) might add to the systemic inflammatory burden a predisposing factor, which may lead to impaired osseointegration and subsequent bone loss or implant failure. In addition, IL-17A gene polymorphism may play a role in peri-implant disease susceptibility, especially in persons carrying the rs2275913 A allele at a higher risk of developing peri-implantitits as compared with those carrying the G allele.

Interactions between T-cells and B-cells in the microbiological and histopathological mechanisms of peri-implantitis development

Interactions between T-cells and B-cells in the microbiological and histopathological mechanisms of peri-implantitis development

ENHANCEMENT OF SOFT TISSUE SURROUNDING DENTAL IMPLANTS – AN OVERVIEW OF LITERATURE

Dental implants have traditionally been focused on bone quality and quantity to house the dental implant for successful restoration of the edentulous ridge. Rough surface implants provide predictable osseointegration but results in the development of peri-implantitis when exposed to the oral environment. The peri-implant mucosa provides protection to the underlying bone via its immune response and protection from apical biofilm migration. An adequate band of keratinized mucosa also improves comfort with performing oral hygiene, limit early marginal bone loss and improved aesthetic outcomes around implant prostheses. The purpose of this article is to provide a literature review on the importance of attached keratinized mucosa around dental implants. It also shares simple strategies to improve the peri-implant mucosa before, during and after implant placement

Involvement of IL-10 gene polymorphism (rs1800896) and IL-10 level in the development of periimplantitis.

Dental implant loss is the worst problem. Today, implant failure is precisely characterized, however the underlying reasons vary by instance. Multiple implant failures indicate genetic risk factors. This cross-sectional study included 80 subjects (15 peri-implantitis patients, 35 successful implants and 30 healthy controls); their mean age was 44.22±10.936 years). Blood samples and peri-implant sulcular fluid (PISF) were collected from all subjects (patients with peri-implantitits, successful implants and healthy controls) attending the Department of Oral and Maxillofacial Surgery in the Dental College Teaching Hospital/Baghdad University, and Shahid Ghazi Al-Hariri Hospital/Medical City Baghdad, Iraq. The blood sample is used for the detection of gene polymorphism of Interleukin-10 conducted by a polymerase chain reaction. While the PISF is used to measure IL-10 level by enzyme-linked immunosorbent assay (ELISA). In the peri-implantitis group, CC genotypes had higher PISF for IL-10 than TC and TT genotypes (P<0.05). IL-10 genetic polymorphism indicated an odds ratio of genotype related to peri-implantitis, with the C/C genotype having a 0.4-fold greater risk (P=0.0035). In the peri-implantitis group, the T/C genotype had a 1.3-fold greater risk (P<0.05) and the T/T genotype had a one-fold increased risk. The polymorphisms of IL-10 rs1800896 evaluated were not predictive of the failure of dental implants. However, a significant association between peri-implant disease and IL-10 level could be observed.

The Role of Caspase-11 and Pyroptosis in the Regulation of Inflammation in Peri-Implantitis.

Peri-implantitis is an important cause of oral implant failure. In the past, TLR4 and TLR2 in the Toll-like family were generally considered as the key immune recognition receptors regulating peri-implantitis. However, under the guidance of this theory, there are still some unexplainable peri-implantitis symptoms. With the discovery of novel intracellular LPS receptor Caspase-11, a new understanding of inflammatory signaling and immune regulation in the development of peri-implantitis has been gained. However, the regulatory role of Caspase-11 in peri-implantitis and its crosstalk with the TLR4 pathway remain unclear. The therapeutic effect of drugs targeting Caspase-11 on peri-implantitis is still in its early stages. In view of this situation, this paper reviews the possible role of Caspase-11 in peri-implant inflammation, elaborated the entry process of LPS and the activation mechanism of Caspase-11, and analyzes the differences in Caspase-11 between commonly studied animals, mice and humans. The current research hotspots and challenges are also analyzed to provide new insights and ideas for researchers.

Impact of surface characteristics on the peri-implant microbiome in health and disease.

Because little is known about the impact of implant surface modifications on the peri-implant microbiome, we aimed to examine peri-implant communities in various surface types in order to better understand the impact of these surfaces on the development of peri-implantitis (PI). One hundred and six systemically healthy individuals with anodized (AN), hydroxyapatite-coated (HA), or sandblasted acid-etched (SLA) implants that were >6 months in function were recruited and categorized into health (H) or PI. Peri-implant biofilm was analyzed using 16S rRNA gene sequencing and compared between health/disease and HA/SLA/AN using community-level and taxa-level metrics. Healthy implants did not demonstrate significant differences in clustering, alpha- or beta-diversity based on surface modification. AN and HA surfaces displayed significant differences between health and PI (p<0.05); however, such a clustering was not evident with SLA (p>0.05). AN and HA surfaces also differed in the magnitude and diversity of differences between health and PI. Six species belonging to the genera Shuttleworthia, Scardovia, and Prevotella demonstrated lower abundances in AN implants with PI, and 18 species belonging to the genera Fretibacterium, Tannerella, Treponema, and Fusobacterium were elevated, while in HA implants with PI, 20 species belonging to the genera Streptococcus, Lactobacillus, Veillonella, Rothia, and family Ruminococcaceae were depleted and Peptostreptococcaceae, Atopobiaceae, Veillonellaceae, Porphyromonadaceae, Desulfobulbaceae, and order Synergistales were enriched. Within the limitations of this study, we demonstrate that implant surface can differentially modify the disease-associated microbiome, suggesting that surface topography must be considered in the multi-factorial etiology of peri-implant diseases.

ГИСТОПАТОЛОГИЧЕСКИЕ ИЗМЕНЕНИЯ В ДЕСНЕ НА ПРЕДИМПЛАНТАЦИОННОМ ЭТАПЕ: АНАЛИЗ СЕРИИ КЛИНИЧЕСКИХ СЛУЧАЕВ

An inflammatory process in the gingival and/or periodontal tissues prior to implantation seems to be a significant risk factor contributing to impaired osteointegration with implant rejection in the early or late stages due to the development of periimplantation mucositis followed by periimplantitis. In this regard, the task of searching for highly informative markers, both morphological and laboratory, as well as molecular genetic markers, remains extremely relevant, allowing predicting the risk of developing periimplantitis in various populations. An equally urgent task is the search for effective means of adjuvant therapy and prevention of inflammatory complications after dental implantation. The aim of this study was a comprehensive histopathological assessment of the state of the gingiva by biopsy at the stage before implantation in a clinical case series.&#x0D; In a clinical case series (25 patients), using a descriptive histological method, a histopathological analysis of gingival biopsy samples obtained at the stage of implant placement was performed. The data of the descriptive histological analysis were supplemented by the results of an immunohistochemical study for the expression of vitamin D receptors (VDR) in the gingival tissues and inflammatory infiltration cells.&#x0D; According to the results of a descriptive histopathological analysis, in 7 out of 25 cases (28%) in the gingival tissues of the edentulous area of the jaw in the area of the included defect of the dentition, the phenomenon of less or more pronounced chronic inflammation was revealed, manifested in lymphocytic or mixed lymphohistiocytic infiltration. Other significant histopathological changes were presented by the changes in the gingival epithelium, as well as disorders in the vessels of the microvasculature. Immunohistochemical analysis demonstrated the presence of a strong nuclear and/or cytoplasmic expression of VDR both in the epithelium and cells of the inflammatory infiltrate, regardless of the age and gender of the patients or the severity of inflammatory changes in the gingival tissues.&#x0D; The results of the pilot analysis of clinical case series are of interest for further study of pre-implantation gingival or periodontal lesions, and may help identify biomarkers of the subsequent development of periimplantitis, as well also provide a fundamental rationale for the use of vitamin D as a prophylactic or therapeutic adjuvant.

Association between smoking and peri-implant diseases: A retrospective study.

To determine the association between tobacco and peri-implant diseases in a sample of patients who had received implant-supported restorations in a university dental clinic. Furthermore, the study aimed to investigate patient- and implant-related variables associated with peri-implant diseases. The present retrospective study analyzed data from 117 patients treated with implant-supported restorations from 2001 to 2013. A total of 450 implants were evaluated. Patients were selected from an electronic database, and patient- and implant-related variables were evaluated. Detailed information regarding the smoking history (i.e., smoking status, lifetime cumulative dose, duration of exposure, intensity of the habit, and smoking cessation) was recorded. The primary study outcome was peri-implant status [i.e., health (H), peri-implant mucositis (PM) and peri-implantitis (PI)]. Univariate and multinomial regression models comparing PM and PI versus peri-implant health were conducted. A total of 117 subjects [55 (47%) females and 62 (53%) males] with a mean age at examination of 64.2 years (SD 11.6) and rehabilitated with 450 implants were included. The average number of implants per patient was 4.6 (SD 3.3) with a mean time in function of 8.0 years (SD 1.9). Fifty-six patients (47.9%) were non-smokers, 42 (35.9%) were former-smokers, and 19 (16.2%) were current-smokers. Thirty-nine subjects (33.4%) were H, whereas 41 (35%) and 37 (31.6%) exhibited PM and PI, respectively. At implant level, the corresponding values were 142 (31.6%), 230 (51.1%) and 78 (17.3%). In the multinomial regression model, significant associations for peri-implant diseases were observed for the mean number of implants per patient (p = .016), function time (p = .048), implants placed simultaneously with guided bone regeneration (p = .016), implant surface (p = .020), keratinized mucosa at the buccal aspect (p = .032), and access to interproximal hygiene (p < .001). In addition, ever smokers >23 pack-years exhibited a significantly higher risk for peri-implantitis (p = .002). Finally, the multinomial regression analysis revealed that subjects who had stopped smoking more than 21 years before the last examination presented a significantly lower risk of peri-implant diseases than a smoking cessation of ≤21 years (p = .028). Smoke intensity was associated with an increased risk of the development of peri-implantitis. Moreover, the risk of peri-implant diseases might be similar in those subjects who had stopped smoking for more than 21 years with respect to never-smokers.

Oxidative stress and peri-implantitis: The role of oxidants and antioxidants

Background: Peri-implantitis is the main cause of implant failure and is associated with augmented oxidative stress or tissue destruction. In this study, it was aimed to investigate the oxidant-antioxidant balance parameters in individuals with peri-implantitis, considering the clinical findings and the control group. Methods: Peri-implantitis (n=30) and healthy (n=30) individuals participated in the study. Peri-implant clinical parameters, including probing depth (PD), gingival index (GI), plaque index (PI), bleeding on probing (BoP), and keratinized mucosa width (KMW), were recorded. The levels of total antioxidant capacity (TAC), total oxidant capacity (TOC), oxidative stress index (OSI), and arylesterase (ARE) in saliva were examined. To identify the relationship between oxidative stress biomarkers and clinical parameters was used Spearman’s correlation coefficient. Results: TOC values were higher in peri-implantitis, and they correlated with BoP, GI, PD, and PI (P=0.004, r=0.370; P=0.010, r=0.328; P=0.038, r=0.268; P=0.007, r=0.342, respectively). TAC values were higher in healthy and correlated with PI, BoP, and GI (P=0.021, r=-0.297; P=0.035, r=-0.273; P=0.012, r=-0.321, respectively). OSI showed a negative correlation with the KMW (mm) (P=0.046, r=-0.259). Conclusion: Increased TOC and decreased TAC and ARE activity could be predictors of peri-implantitis development. Adequate KMW is important in the production of antioxidants.

A Retrospective Service- Evaluation of Implant Success, Survival, Periimplant Health and Prosthetic Complications in a Cohort of Head and Neck Cancer Patients.

To determine the success, survival, peri-implant health and prosthetic complications in head and neck cancer patients receiving oral rehabilitation utilising dental implants between 2008 and the present day. Service evaluation. Survival Group: Retrospective review of records to determine implant survival and prosthetic complications. Success Group: Examination to determine implant success and health. Survival Group: 260 implants in 81 individuals, median follow up 49.2 months. 89.3% implant survival at 96 months, no further failures up to 133 months. 40.9% individuals required repair or remake of prosthesis by 72 months - mostly denture re-lines. Success group: 164 implants in 48 individuals, median follow up 56 months. Peri-implant mucositis detected in 22% of fixtures (37.5% individuals); peri-implantitis in 12.8% (25% individuals); 33.3% fixtures exhibiting periimplantitis at 120 months. Previous smoking significantly associated with development of peri-implantitis (HR 2.372, p=0.032, 95CI:1.232, 93.317). Compromised survival (e.g. peri-implantitis), absolute (not in mouth) or clinical failure estimated to occur in 28.1% fixtures at 101 months, mostly due to peri-implantitis. There is a large burden of ongoing care in this cohort, requiring interventions to improve peri-implant health and maintain complex prostheses. Oral rehabilitation and ongoing maintenance in this cohort is complex and multi-disciplinary.

Matrix Metalloproteinases in Oral Health—Special Attention on MMP-8

Matrix metalloproteinases (MMPs) are a large family of Ca2+ and Zn2+ dependent proteolytic enzymes, able to cleave the various components of the extracellular matrix (ECM), as well as a range of other regulatory molecules. Several reports have proven the important role of both MMPs and their endogenous inhibitors, TIPMs, in oral health, the initial development of the tooth, and during enamel maturation. In this mini-review, we aim to summarize the literature information about the functions of MMPs, paying more attention to MMP-8 (collagenase-2 or neutrophil collagenase) in the development and progression of periodontitis, peri-implantitis, and carious lesions. We also emphasize the role of particular gene variants in MMP8 as predisposing factors for some oral diseases.

СПЕЦИФИЧЕСКАЯ ПРОФИЛАКТИКА ВОСПАЛИТЕЛЬНЫХ ОСЛОЖНЕНИЙ У ПОЛЬЗОВАТЕЛЕЙ ПРОТЕЗАМИ НА ДЕНТАЛЬНЫХ ИМПЛАНТАТАХ

Purpose: analysis of the preventive effectiveness of the agent based on bacteriophages “Phagodent” in persons with dental implants. Material and methods: two groups were compared: with standard hygienic oral care and with additional applications of Phagodent gel on the gum (main group, 15 people, bridges on 49 implants; comparison group, 10 people, bridges on 42 implants); observation of patients with implants. For comparison, hygienic periodontal indices (oral hygiene index, hygiene index, gingivitis index, Mulleman index) were used. Results: when using the Phagodent gel at home and with standard oral hygiene, no development of periimplantitis with bone resorption was recorded during the year of observation. At the same time, mucositis was found in one implant in the main group (2.0%) and in two in the comparison group (4.8%). A year later, the index of oral hygiene of IG-U deteriorated in the main group to 1.9±0.1, in the comparison group to 2.1± 0.2; the index of hygiene of IG in the comparison group corresponded to 1.3±0.3, in the main group – 1.0±0.1; the index of gingivitis of IG in the main group was 0.1± 0.1; in the control group 0.2 ±0.1; The Mulleman index in a year it did not exceed 0.1 ±0.1 in both groups. Thus, the use of “Phagodent” gel in the main group of patients prevented the development of mucositis due to the positive effect on oral hygiene, reflected by the hygienic indices of IGM-U and IGIM. Due to the positive effect on oral hygiene in patients with dentures on dental implants, the gel based on bacteriophages “Phagodent” has a preventive effect on inflammatory complications in the state of periimplant tissues and can be used by the patient independently at home.

Patient's experiences of dental implants, peri-implantitis and its treatment-A qualitative interview study.

The aim of the present study was to explore peri-implantitis patients' sensations, expectations, and experiences of dental implants, the disease, as well as undergoing treatment with laser or mucosal flap surgery. Interviews were conducted with 18 patients who had been referred for treatment of peri-implantitis at a specialist clinic. The participants underwent either laser treatment or mucosal flap surgery of affected implants. Qualitative content analysis was used for processing the transcribed interviews with coding in categories and subcategories. The analysis of the interviews was presented in a narrative way to display the variety of experiences in this patient group. Losing teeth was perceived as frustrating and negatively impacted their quality of life; however, receiving dental implants improved some aspects of the patients' lives. While some have symptoms, others did not seem to notice the incidence and development of peri-implantitis. Local anaesthesia was the worst part of both treatments and both modalities yielded only minor discomforts. There were a variety of positive and negative sensations and experiences perceived by patients with dental implants as a consequence of peri-implantitis, including a negative impact on quality of life. These findings emphasize the importance of thoroughly informing the potential and established dental implant patients of the risk of developing disease and its impact. The treatment of peri-implantitis created in general only slight discomfort for the patient.

Primordial and primary prevention of peri-implant diseases: A systematic review and meta-analysis.

This systematic review and meta-analysis aims to assess the efficacy of risk factor control to prevent the occurrence of peri-implant diseases (PIDs) in adult patients awaiting dental implant rehabilitation (primordial prevention) or in patients with dental implants surrounded by healthy peri-implant tissues (primary prevention). A literature search was performed without any time limit on different databases up to August 2022. Interventional and observational studies with at least 6months of follow-up were considered. The occurrence of peri-implant mucositis and/or peri-implantitis was the primary outcome. Pooled data analyses were performed using random effect models according to the type of risk factor and outcome. Overall, 48 studies were selected. None assessed the efficacy of primordial preventive interventions for PIDs. Indirect evidence on the primary prevention of PID indicated that diabetic patients with dental implants and good glycaemic control have a significantly lower risk of peri-implantitis (odds ratio [OR]=0.16; 95% confidence interval [CI]: 0.03-0.96; I2 : 0%), and lower marginal bone level (MBL) changes (OR=-0.36 mm; 95% CI: -0.65 to -0.07; I2 : 95%) compared to diabetic patients with poor glycaemic control. Patients attending supportive periodontal/peri-implant care (SPC) regularly have a lower risk of overall PIDs (OR=0.42; 95% CI: 0.24-0.75; I2 : 57%) and peri-implantitis compared to irregular attendees. The risk of dental implant failure (OR=3.76; 95% CI: 1.50-9.45; I2 : 0%) appears to be greater under irregular or no SPC than regular SPC. Implants sites with augmented peri-implant keratinized mucosa (PIKM) show lower peri-implant inflammation (SMD=-1.18; 95% CI: -1.85 to -0.51; I2 : 69%) and lower MBL changes (MD=-0.25; 95% CI: -0.45 to -0.05; I2 : 62%) compared to dental implants with PIKM deficiency. Studies on smoking cessation and oral hygiene behaviors were inconclusive. Within the limitations of available evidence, the present findings indicate that in patients with diabetes, glycaemic control should be promoted to avoid peri-implantitis development. The primary prevention of peri-implantitis should involve regular SPC. PIKM augmentation procedures, where a PIKM deficiency exists, may favour the control of peri-implant inflammation and the stability of MBL. Further studies are needed to assess the impact of smoking cessation and oral hygiene behaviours, as well as the implementation of standardized primordial and primary prevention protocols for PIDs.

Implant connection and abutment selection as a predisposing and/or precipitating factor for peri-implant diseases: A review.

Peri-implant mucosal integration is becoming a critical aspect for long term implant health and can be triggered the selection of implant components. The aim of this review is therefore to investigate the evidence concerning implant connection and abutment characteristics (abutment materials, design, handling) as predisposing or precipitating factor for peri-implant mucositis and peri-implantitis. Although the evidence that these features can directly predispose/precipitate peri-implant diseases is limited, there are -few- studies showing a potential role of the implant connection, trans-mucosal configuration, and handling in the development of early bone loss and/or peri-implantitis.With bone level implants, conical internal connections (with inherent platform switching) might be preferred over internal flat-flat and external connections to decrease the risk of early bone loss and potentially the risk of peri-implant disease. Moreover, there is a trend suggesting moving the prosthetic interface coronally (to the juxta-mucosal level) as soon as possible to reduce the number of disconnections and to limit the risk of cements remnants. This can be achieved by choosing a tissue-level implant or to place a trans-mucosal abutment (one abutment-one time approach) to optimize the peri-implant soft tissue seal. In absence of evidence for the biocompatibility regarding several restorative materials, biocompatible materials such as titanium or zirconia should be preferred in the trans-mucosal portion. Finally, longer implants (≥2mm) with an emergence angle below 30° seem more favourable.It should however be noted that some of this information is solely based on indirect information (such as early bone loss) and more research is needed before making firm recommendations about abutment choice.

Silver Nanoparticles Produced by Laser Ablation and Re-Irradiation Are Effective Preventing Peri-Implantitis Multispecies Biofilm Formation

Implant-associated infection due to biofilm formation is a growing problem. Given that silver nanoparticles (Ag-NPs) have shown antibacterial effects, our goal is to study their effect against multispecies biofilm involved in the development of peri-implantitis. To this purpose, Ag-NPs were synthesized by laser ablation in de-ionized water using two different lasers, leading to the production of colloidal suspensions. Subsequently, part of each suspension was subjected to irradiation one and three times with the same laser source with which it was obtained. Ag-NPs were immobilized on the surface of titanium discs and the resultant materials were compared with unmodified titanium coupons. Nanoparticles were physico-chemically analysed to determine their shape, crystallinity, chemical composition, and mean diameter. The materials were incubated for 90 min or 48 h, to evaluate bacterial adhesion or biofilm formation respectively with Staphylococcus aureus or oral mixed bacterial flora composed of Streptococcus oralis, Actinomyces naeslundii, Veionella dispar, and Porphyromonas gingivalis. Ag-NPs help prevent the formation of biofilms both by S. aureus and by mixed oral bacterial flora. Nanoparticles re-irradiated three times showed the biggest antimicrobial effects. Modifying dental implants in this way could prevent the development of peri-implantitis.

Diagnostically significant culturable obligate microorganisms in the development of periimplantitis

BACKGROUND: The urgency of the problem is conditioned by insufficient study of peri-implantitis microbiota, its changes in the dynamics of the process and in the concurrent course with periodontitis.&#x0D; AIM: To justify the diagnostically significant cultivated obligate microorganisms involved in the development of inflammatory processes in the area of the placed implants.&#x0D; MATERIALS AND METHODS: The study was conducted in the period 20182022. The study involved 127 patients of a private dental clinic in Kirov, Russia. Kirov LLC Dental Clinic aged 35 to 69 years (53.81.9 years). Men made up 48% and women 52%. Biological material from the peri-implant area was examined. Inoculation on dense culture media of biological material with subsequent calculation of microorganism concentration was carried out according to the Gold method of quantitative four-section inoculation. The species identification of the isolated cultures was carried out by MALDI-TOF mass spectrometry using a Vitek-MS bacteriological analyzer (BioMerieux, France).&#x0D; RESULTS: Microorganisms obligate anaerobes playing an important role in the development of peri-implantitis were identified in the investigation. Microorganisms that reduce the development of inflammatory changes in periimplantitis, having an inverse correlation between the concentration of microorganisms and the degree of clinical, hygienic and radiological changes in persons with implants, were named periodontal protectors. Microorganisms contributing to the development of pathological processes in the periimplant zone, having a direct correlation relationship between the concentration of microorganisms and the degree of severity of clinical, hygienic and radiological changes periodontopathogens. This was more pronounced in patients with associated periodontitis. The regularity in the increase of frequency and concentration of several pathogens during the progression of peri-implantitis with predominance of micro-organisms in the periimplant area in those with periodontitis was found.&#x0D; CONCLUSION: The microbiota of the peri-implant zones has been analyzed by means of the modern bacteriological method mass-spectrometry. On the basis of the study we substantiate the diagnostically significant microorganisms, respectively increasing (periodontopathogens) and reducing (periodontoprotectors) the development of inflammatory changes at periimplantitis.