Management Of Peri-implant Diseases Research Articles

Continuing Professional Development (CPD) and Vocational Education and Training (VET) in Periodontology and Implant Dentistry.

To (i) evaluate structured postgraduate part-time programs in periodontology, including those addressing peri-implant diseases, among members of the European Federation of Periodontology (EFP), (ii) the impact of the 2018 classification scheme and EFP clinical practice guidelines and (iii) propose a framework for periodontal vocational education and training. A summary of relevant European guidelines for vocational education and training was compiled. In a survey and in a systematic review, current part-time programs in continuing professional education in periodontology as well as in prevention and management of peri-implant diseases were examined. The implementation and dissemination of the 2018 classification scheme and the EFP clinical practice guidelines were assessed by literature analysis. Based on these findings, a framework for periodontal vocational education and training was generated. Part-time programs for professional development in periodontology are established in nine EFP member countries. The systematic review identified lack of knowledge in prevention and management of peri-implant diseases among dental practitioners and hygienists. Continuing professional development was found to be important for education in prevention, classification and management of periodontal as well as peri-implant diseases. The proposed European framework consists of an escalator model with three levels (certificate, diploma and master). Considering the identified variation in the national programs, there is a need to improve education in periodontal and peri-implant diseases. The proposed frameworkmay will help harmonize the national structures. The proposed framework for part-time professional development is expected to enhance professional qualification.

The referral pattern and treatment modality for peri-implant disease between periodontists and non-periodontist dentists

ObjectivesThis study is to investigate the referral pattern and treatment modality of dentists in the management of peri-implant diseases between periodontists and non-periodontist dentists (NPDs).Materials and methodsA total of 167 validated questionnaires were obtained from periodontists and NPDs, who had experience of placing implants for at least one year. Question I to IV asked how the dentist would respond if a patient came for treatment of their peri-implant diseases with four different scenarios according to resource of patient and disease severity. For each Scenario, dentists also replied which treatment procedures they would use if they decide to treat the patient.ResultsPeriodontal training, resource of patient, and disease severity were shown to significantly influence the referral pattern and treatment modality in the management of peri-implant disease (p < 0.05). Periodontists were more likely to use variable treatment procedures, including occlusal adjustment (OR = 2.283, p < 0.01), oral hygiene instruction (OR = 3.751, p < 0.001), topical antiseptic agent (OR = 2.491, p < 0.005), non-surgical mechanical therapy (OR = 2.689, p < 0.001), surgical therapy (OR = 2.009, p < 0.01), and remove implant (OR = 3.486, p < 0.001) to treat peri-implant diseases, compared to NPDs.ConclusionThe periodontal specialty training, resource of patient, and disease severity significantly influenced the referral pattern and treatment modality of dentist treating an implant diagnosed with peri-implant disease. This study also highlighted the importance of educating basic periodontal and peri-implant disease-related knowledge to all dentists regularly performing dental implant treatments.Clinical relevancePeri-implant diseases are highly prevalent among patients with dental implants. Periodontal specialty training could enhance using variable treatment procedures to treat peri-implant diseases for dentists.

Prevention and management of peri-implant disease.

As more patients choose dental implants as their primary treatment option to restore edentulous ridges or to replace compromised dentition, preventive strategies for peri-implant diseases and complications have become an important topic. The aim of the review article is to summarize the current available evidence on the potential risk factors/indicators for peri-implant disease development and then focus on the preventive strategies for peri-implant diseases and conditions. After reviewing the diagnostic criteria and the etiology of peri-implant diseases and conditions, evidence on the possible associated risk factors/indicators for peri-implant diseases were searched and identified. Recent studies were also surveyed to explore the preventive measures for peri-implant diseases. The possible associated risk factors of peri-implant diseases can be divided into the following categories: patient-specific factors, implant-specific factors, and long-term factors. Patient-specific factors such as history of periodontitis and smoking have been conclusively associated with peri-implant diseases, whereas findings on others, such as diabetes and genetic factors, remain inconclusive. It has been suggested that both implant-specific factors, such as implant position, soft tissue characteristics, and the type of connection used, and long-term factors, such as poor plaque control and a lack of maintenance program, have a strong impact on maintaining the health of a dental implant. Assessment tool for evaluating the risk factors can be a potential preventive measure for peri-implant disease prediction, and it is needed to be properly validated. Proper maintenance program for early intervention to control peri-implant diseases at the initial stage and pretreatment assessment of the potential risk factors is the best strategy to prevent implant diseases.

Ozone – A versatile therapy in implant dentistry

Oral cavity is an open ecosystem for many microorganisms making the oral environment more prone to bacterial colonization. Several studies have indicated that accumulation of bacteria on implant surface is a primary etiology for inflammatory conditions around implants, apparently leading to peri-implant diseases. Peri-implantitis is an inflammatory process that affects the tissues around an osseointegrated implant in function, resulting in the loss of the supporting bone. Hence, proper decontamination and disinfection may aid in successful osseointegration of dental implants. Ozone (O3) is a triatomic molecule, consisting of three oxygen atoms with a wide range of valuable properties which have been proven to be effective for applications in dentistry. O3 is a powerful oxidative agent with bactericidal, virucidal, and fungicidal properties. It can be used in gaseous, liquid (water/soil), or nanoparticle form as an adjunctive therapy in the management of peri-implant diseases and to decontaminate the implant surfaces. The application of ozone therapy is a novel approach in implant dentistry with limited literature. Therefore, the objective of the present review is to assess the impact of ozone therapy on the dental implant procedures and peri-implant diseases.

Assessment of salivary alpha amylase and mucin-4 before and after non-surgical treatment of peri-implant mucositis

BackgroundThe present study was based on the null hypothesis that there is no difference in clinicoradiographic parameters and whole salivary alpha amylase (AA) and mucin-4 levels before and after non-surgical mechanical debridement (NSMD) of patients with peri-implant mucositis (PM). The aim was to assess whole salivary AA and mucin-4 levels before and after treatment of PM.MethodsPatients with PM (Group-1) and individuals without peri-implant diseases (Group-2) were included. Demographic data was collected and peri-implant modified plaque and bleeding indices (mPI and mBI, respectively), probing depth (PD) and crestal bone loss were measured at baseline. Levels of AA and mucin-4 were assessed in unstimulated whole saliva samples. All patients underwent full-mouth non-surgical periodontal therapy (NSPT) and NSMD; and clinical parameters and salivary biomarkers were re-assessed after 3 months. Level of significance was set at P < 0.01.ResultsTwenty-six and 32 individuals were included in groups 1 and 2, respectively. None of the participants had periodontitis. At baseline clinical periodontal parameters (PI [P < 0.001], GI [P < 0.001], clinical AL [P < 0.001] and PD [P < 0.001]) were significantly high in Group-1 than Group-2. At 3-month follow-up, there was a statistically significant reduction in clinical periodontal and peri-implant parameters (PI [P < 0.01], GI [P < 0.01], and PD [P < 0.01]) in Group-1 compared with their baseline values. At baseline, salivary AA levels were significantly high in Group-1 than Group-2 (P < 0.01). At 3-month follow-up, there was no significant difference in whole salivary AA levels among patients in groups 1 and 2.ConclusionsThe AA and mucin-4 levels are potential biomarkers for evaluation of peri-implant diseases including PM. Mechanical instrumentation continues to be the most predictable treatment option for the management of peri-implant diseases.

Prevention and management of peri-implant mucositis and peri-implantitis: A systematic review of outcome measures used in clinical studies in the last 10 years.

To evaluate outcome measures, methods of assessment, and analysis in clinical studies on the prevention and management of peri-implant mucositis and peri-implantitis. Systematic electronic searches (CENTRAL/MEDLINE/SCOPUS) up to April 2021 were conducted to identify longitudinal clinical studies with ≥10 patients on either the prevention or management of peri-implant diseases. Outcome measures of this analysis were the choice of outcome measures, methods of assessment, and analytical methods. Risk of bias was evaluated according to study design. Data were extracted into evidence tables and outcomes were analysed in a descriptive manner. The analysis of the 159 selected studies revealed that probing pocket depth (PPD) and bleeding/suppuration on probing (BOP) were reported in 89% and 87% of all studies, respectively. Additional outcome measures included plaque scores (reported in 64% of studies), radiographic outcomes (49%), soft tissue dimensions (34%), and composite outcomes (26%). Adverse events (8%) and patient-reported outcomes (6%) were only rarely mentioned. A primary outcome measure was clearly defined only in 36% of studies. Data on PPD, radiographic outcomes, and soft tissue dimensions were primarily reported as mean values and rarely as frequency distributions. For radiographic outcomes and soft tissue dimensions, it was frequently unclear how clustered data were handled. PPD and BOP were routinely reported in studies on the prevention and management of peri-implant mucositis and peri-implantitis, while composite outcomes, adverse events, and patient-reported outcomes were only infrequently described.

Prevention and management of peri-implant mucositis and peri-implantitis: A systematic review of outcome measures used in clinical studies in the last 10 years.

To evaluate outcome measures, methods of assessment, and analysis in clinical studies on the prevention and management of peri-implant mucositis and peri-implantitis. Systematic electronic searches (CENTRAL/MEDLINE/SCOPUS) up to April 2021 were conducted to identify longitudinal clinical studies with ≥10 patients on either the prevention or management of peri-implant diseases. Outcome measures of this analysis were the choice of outcome measures, methods of assessment, and analytical methods. Risk of bias was evaluated according to study design. Data were extracted into evidence tables and outcomes were analysed in a descriptive manner. The analysis of the 159 selected studies revealed that probing pocket depth (PPD) and bleeding/suppuration on probing (BOP) were reported in 89% and 87% of all studies, respectively. Additional outcome measures included plaque scores (reported in 64% of studies), radiographic outcomes (49%), soft tissue dimensions (34%), and composite outcomes (26%). Adverse events (8%) and patient-reported outcomes (6%) were only rarely mentioned. A primary outcome measure was clearly defined only in 36% of studies. Data on PPD, radiographic outcomes, and soft tissue dimensions were primarily reported as mean values and rarely as frequency distributions. For radiographic outcomes and soft tissue dimensions, it was frequently unclear how clustered data were handled. PPD and BOP were routinely reported in studies on the prevention and management of peri-implant mucositis and peri-implantitis, while composite outcomes, adverse events, and patient-reported outcomes were only infrequently described.

CURRENT CONCEPTS AND RECENT ADVANCES IN PERI-IMPLANT DISEASES: - A NARRATIVE REVIEW.

The insertion of the dental implant in order to replace missing teeth in partially and completely edentulous patients is a successful treatment modality for over 50 years now. However, its predictability and applicability for a variety of treatment options is still a clinical dilemma. Peri- implantitis represents a serious condition after implant therapy and affects both hard and soft tissues surrounding an implant. While implant therapy represents a safe treatment option with high long-term success, reported complications are associated with improper treatment planning, surgical and prosthetic replacement, material failure and maintenance. Peri-implant lesions may develop after several years of implant placement therefore regular check-ups and life-long supportive periodontal therapy is a must. The management protocol for peri-implant diseases consists of various conservative and surgical approaches. Peri-implant mucositis and moderate peri-implant lesions can be treated with a conservative approach using non-surgical therapy and local and systemic antibiotics. Resective and regenerative therapy are advocated for more severe lesions to completely eliminate the disease. However, due to the lack of prospective randomized long-term follow-up studies, no ideal implant therapy can be implicated. The aim of this review is to provide an overview of current data and to suggest different treatment modalities for diagnosis, prevention and management of peri-implant diseases.

Evaluating the Knowledge of General Dentist Towards the Management of Peri-Implant Diseases: A Multi-Center, Cross-Sectional Study

Background: Recently, implants have been widely considered as an option for replacing missing teeth. There are several biological conditions that must be considered for the success of an implant. Failure to satisfy any of these factors may result in complications, such as peri-implantitis or failure of the implant. Aim: The aim of this study was to evaluate the general dentist's attitude towards the management of peri-implant diseases in Saudi Arabia. Methods: A multicenter cross-sectional electronic-based questionnaire was formulated based on the validated questionnaire from a previous study. It was targeted towards the general dental practitioners in Saudi Arabia. The study sample consisted of 721 general dental practitioners. The questionnaire consisted of 17 questions divided into five sections. Pearson's chi-square test was used for inferential statistical analysis with Holm's correction, for adjusted p-value, the alpha at 95% confidence interval was 0.05, and all values below alpha were considered statistically significant. Results: The majority of participants had attended an implant training course (51.2%) while the rest had not (48.7%). The majority of the participants (67.3%) thought they need special instruments for the detection of peri-implantitis but only 29.5% thought they do not need any special instruments for the intended purpose. Most participants (79.3%) said they can identify and differentiate between normal and abnormal soft tissue around an implant, while 6.5% of the respondents could not. More than half of the participants (54.8%) could differentiate between peri-implant mucositis and peri-implantitis, and 19.4% had no idea about this. Amoxicillin &amp; metronidazole was considered as the best and most effective antibiotic by the majority of respondents (76%), while only (5%) of dentists selected ciprofloxacin. Conclusion: This study concludes by suggesting that most of the participants have adequate knowledge about peri-implant soft tissue assessment, mechanism of periodontitis and peri-implantitis, its initiation and progression along with its management. Most of the participants found the training courses on peri-implantitis to be efficient. It is recommended to conduct more courses and studies that would aim at understanding the pathogenesis, etiology, diagnosis, and treatment of peri-implant diseases so as to increase awareness among general dentists.

The Treatment of Peri-Implant Diseases: A New Approach Using HYBENX® as a Decontaminant for Implant Surface and Oral Tissues.

Background: Peri-implantitis is a pathological condition characterized by an inflammatory process involving soft and hard tissues surrounding dental implants. The management of peri-implant disease has several protocols, among which is the chemical method HYBENX®. The aim of this study is to demonstrate the efficacy of HYBENX® in the treatment of peri-implantitis and to compare HYBENX® with other chemical agents used in the surgical treatment of peri-implantitis. Methods: The present study included a population of ten subjects with severe peri-implantitis. The procedure used in the study involves the application of HYBENX® after open-flap debridement. Each patient has been followed for 12 months after a single application of the decontaminant agent. Clinical and radiographical parameters were recorded at baseline, 3 months, and 12 months after treatment completion. Results: At baseline, a mean pocket probing depth (PPD) of 7.3 ± 0.5 mm and a mean clinical attachment level (CAL) of 8.8 ± 0.8 mm was recorded. An average residual PPD of 4.2 ± 0.5 mm and a mean CAL of 5.2 ± 0.8 mm were observed after 1 year. Additionally, the average of bone gain was about 3.4 mm, with a mean marginal bone level (MBL) change from 5.8 mm (baseline) to 2.4 mm (12 months). In total, 90% of the treated implants reached the success rate after the 1-year follow-up. Only in one case out of ten treated implants was resolution of the disease not achieved. Conclusion: Clinical improvements highlight that the procedure of open-flap debridement (OFD) + HYBENX® may be considered an effective technique in the treatment of peri-implantitis. From the results obtained, it can be concluded that the use of HYBENX® in the surgical treatment of peri-implantitis is promising. Overall, this protocol demands further studies to better understand the role and potential benefits of HYBENX® in the treatment of peri-implantitis.

Management of Peri-Implant Diseases: A Survey of Australian Periodontists.

Background/Aim: This survey-based study aims to explore the clinical management protocols of followed by Australian periodontists in relation to peri-implant diseases. Materials and Methods: A five-part online questionnaire was developed and administered through email. Descriptive statistics were used for analysis, with the univariate associations between a categorical outcome and the variables evaluated using Pearson’s Chi-squared test. Results: The survey yielded 99 responses, resulting in a response rate of 41.8%. Most participants were male and aged 35–44 years. More than a quarter of practitioners had been placing implants for 6–10 years and almost two-fifths of practitioners placed 1–10 implants per month. The estimated prevalence of peri-implant mucositis and peri-implantitis in the general Australian population was 47% and 21%, respectively. Practitioners reported using systemic antibiotics to manage peri-implant mucositis (7%) and (72%) peri-implantitis lesions, with a combination of amoxicillin and metronidazole. Most common treatment modalities were oral hygiene instructions, nonsurgical debridement and antimicrobial gel/rinse. Surgical debridement and systemic antibiotics were also often used for peri-implantitis treatment. Practitioners preferred a 3-month clinical follow-up and 6-month radiographic evaluation. Furthermore, three-quarters of practitioners rated their management as moderately effective, although upwards of nine-tenths expressed the need for further training and awareness. Conclusion: This study confirms a significant use of empirical treatment modalities due to lack of standard therapeutic protocol. However, some approaches followed by the specialists may provide a basis to formulate a therapeutic protocol for peri-implant disease management.

Preliminary evaluation of dental hygiene curriculum: Assessment and management of peri-implant conditions and diseases.

The purpose of this study was to investigate dental hygiene (DH) educational programs' didactic and clinical curriculum in the management of peri-implant diseases and conditions. The specific aims were (1) assess if evidence-based content for peri-implant diseases and conditions are currently included in didactic and clinical DH curriculum and (2) determine if DH education programs are currently preparing students at a level of clinical competency for the assessment and management of peri-implant diseases and conditions. A cross-sectional study of DH faculty member(s) from 331 United States entry-level programs responsible for didactic and clinical curriculum for peri-implant diseases and conditions were surveyed. The survey was disseminated electronically via Qualtricsxm August 2019 for a response rate of 26%. The results showed didactic courses taught DH students the etiology of peri-mucositis and peri-implantitis (98%), clinical characteristics (98%), and risk factors contributing to these implant diseases (96%). Evaluation methods to determine student level of competency in a didactic setting included quizzes/examinations (98%), case-based examinations (63%), and written essays (6%). Eighty-five percent reported DH students are not required in a clinical setting to provide care for patients with peri-implant diseases and conditions. Study results suggest DH education programs may need to revise didactic and clinical curriculum to ensure students graduate at a level of clinical competency for assessing and managing peri-implant conditions and diseases. DH educational programs should consider requiring clinical patient experiences for the assessment and management of peri-mucositis and peri-implantitis to prepare students for their professional role.

Does chlorhexidine improve outcomes in non-surgical management of peri-implant mucositis or peri-implantitis?: a systematic review and meta-analysis.

Background With greater number of implants being placed in clinical practice, incidence of peri-implant diseases are on the rise. It is not known whether chlorhexidine (CHX) improves outcomes in the management of peri-implant diseases. The aim of this systematic review and meta-analysis was to evaluate the role of CHX in improving outcomes with non-surgical management of peri-implant mucositis and peri-implantitis. Material and Methods An electronic search of PubMed, Scopus, Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) databases up to 1st August 2019 was carried out to search for studies evaluating the efficacy of CHX for non-surgical management of peri-implant diseases. Results Seven studies were included. Four studies evaluated the role of CHX in peri-implant mucositis and three in peri-implantitis. Oral prophylaxis with mechanical cleansing of implant surface prior to CHX use was carried out in all seven studies. Meta-analysis indicated that use of CHX did not improve probing depths in peri-implant mucositis (SMD= 0.11; 95% CI: -0.16 to 0.38; p=0.42, I2= 0%). Similarly, CHX did not significantly reduce probing depths in patients with peri-implantitis (MD= 1.57; 95% CI: -0.88 to 4.0; p=0.21, I2= 98%). Results on the efficacy of CHX in reducing BOP in peri-implantitis are conflicting. Conclusions Results of our study indicate that adjunctive therapy with CHX may not improve outcomes with non-surgical management of peri-implant mucositis. Conclusions with regards to its role in non-surgical management of peri-implantitis cannot be drawn. There is a need for more homogenous RCTs with large sample size to define the role of CHX in non-surgical management of peri-implant mucositis and peri-implantitis. Key words:Peri-implant disease, disinfection, dental implants, oral hygiene, chlorhexidine.

Awareness and management of peri-implantitis and peri-mucositis among private dental Practitioners in Hyderabad - A cross-sectional study.

Background:Implant therapy, in India, has flourished in recent years and is being practiced widely by many dental practitioners today. Along with the increasing number of implants being placed today, there has also been a constant rise in the number of complications associated with it.Objectives:The aim of this study is to evaluate the knowledge and awareness of implant placement and management of peri-implant diseases among dental professionals.Materials and Methods:A total of 568 dental practitioners were approached with a questionnaire for collecting data related to demographic details, experience, and knowledge about implant placement and management of its complications. Of these, only 262 were included as part of the statistical analysis. This data collected were compiled and analyzed using descriptive statistics.Results:Results showed that most dentists who participated in this study have adequate knowledge about etiological factors and its management. Those who acquired implant skills through sources that are not in accordance with accepted standards had unsatisfactory knowledge and practice behavior.Conclusion:The awareness and knowledge regarding the implant procedures and their complications such as peri-implant mucositis and peri-implantitis were higher in self-trained dentists and by dentists who are practicing for >10 years and calls for updating of knowledge.

Peri-implant disease part 2: management of peri-implant disease

Unfortunately, peri-implant disease is a common clinical finding in patients with dental implants. Whilst preventive and supportive regimens are best practice, many patients still present with signs of peri-implant disease. Treatment options include non-surgical or surgical approaches but there does not appear to be a consensus for management of these challenging conditions. This paper discusses the current management options of peri-implant mucositis and peri-implantitis. CPD/Clinical Relevance: This paper discusses the management of peri-implant diseases placing emphasis on regular supportive care and follow up.

Tooth preservation or dental implants

Extraction and replacement with a dental implant or preservation of compromised natural teeth through comprehensive treatment is a complex decision and should be made while taking into consideration the endodontic, periodontal and reconstructive aspects of these teeth. Placement of dental implants is associated with several biological complications that can cause functional impairment of the dentition. Therefore, various meticulous preventive and therapeutic modalities are recommended for the management of peri-implant diseases.

Adjunctive efficacy of diode laser in the treatment of peri-implant mucositis with mechanical therapy: A randomized clinical trial.

Due to the inconclusive findings on the effect of laser therapy in the management of peri-implant diseases, the aim of this study was to analyze the adjunctive clinical efficacy of 980-nm diode laser (DL) irradiation in the treatment of peri-implant mucositis with mechanical debridement. Two hundred and twenty patients with one implant diagnosed with peri-implant mucositis (probing depth [PD]≥4mm and bleeding on probing [BoP] [primary outcome]) were randomly allocated to test and control treatments. Patients in the control group (n=110) received debridement using curettes and ultrasonic devices, while patients allocated in the test group (n=110) received mechanical therapy in combination with DL irradiation (setting 980nm, 2.5W, 10kHz, pw, 30s). BoP, presence of plaque, and PD were recorded at baseline, 1month, and 3months after treatment. Both therapeutic modalities yielded similar clinical improvements with comparable reductions in the number of BoP-positive sites, plaque scores, and PD values at 3months (all p-values>0.05). Complete disease resolution was obtained in 38/110 (34.5%) implants in the test group compared with 34/110 (30.9%) implants in the control group at the end of the observation period. Based on these results, the adjunct use of DL did not yield any statistically significant clinical benefit as compared to nonsurgical mechanical treatment alone in controlling peri-implant inflammation at 3months.

Decision Making for Management of Periimplant Diseases.

Nonsurgical and surgical management of periimplant mucositis and periimplantitis have shown promising results in arresting periimplant marginal bone loss (MBL) and preventing implant loss. However, management of periimplant diseases still remains unpredictable for full reconstruction of lost tissues and completely arrests disease progression. The present study proposes a decision tree that compiles both clinical and radiographic presentation of failing implants to aid in the decision making for their management. An extensive literature review was performed using 3 electronic databases (PubMed, Ovid MEDLINE, and Cochrane Central) on the most recent treatment modalities for the management of periimplant diseases. Evidence-based treatment suggestions were primarily derived from periimplant defect morphology, presence, and severity of periimplant MBL. More evidence is required supporting soft-tissue augmentation for the treatment of periimplant diseases. Management of periimplant diseases can include lasers, mechanical instrumentation, chemical detoxification, and antimicrobial agents for nonsurgical approaches. On the other hand, removal of failing implants, resective surgery, guided bone regeneration, and soft-tissue grafting are presented as valid options for the surgical treatment of periimplantitis.

Antibacterial Peptide-Based Gel for Prevention of Medical Implanted-Device Infection.

Implanted medical devices are prone to infection. Designing new strategies to reduce infection and implant rejection are an important challenge for modern medicine. To this end, in the last few years many hydrogels have been designed as matrices for antimicrobial molecules destined to fight frequent infection found in moist environments like the oral cavity. In this study, two types of original hydrogels containing the antimicrobial peptide Cateslytin have been designed. The first hydrogel is based on alginate modified with catechol moieties (AC gel). The choice of these catechol functional groups which derive from mussel’s catechol originates from their strong adhesion properties on various surfaces. The second type of gel we tested is a mixture of alginate catechol and thiol-terminated Pluronic (AC/PlubisSH), a polymer derived from Pluronic, a well-known biocompatible polymer. This PlubisSH polymer has been chosen for its capacity to enhance the cohesion of the composition. These two gels offer new clinical uses, as they can be injected and jellify in a few minutes. Moreover, we show these gels strongly adhere to implant surfaces and gingiva. Once gelled, they demonstrate a high level of rheological properties and stability. In particular, the dissipative energy of the (AC/PlubisSH) gel detachment reaches a high value on gingiva (10 J.m-2) and on titanium alloys (4 J.m-2), conferring a strong mechanical barrier. Moreover, the Cateslytin peptide in hydrogels exhibited potent antimicrobial activities against P. gingivalis, where a strong inhibition of bacterial metabolic activity and viability was observed, indicating reduced virulence. Gel biocompatibility tests indicate no signs of toxicity. In conclusion, these new hydrogels could be ideal candidates in the prevention and/or management of periimplant diseases.

Peri-Implantitis In Dental Implants: An Updated Review

ABSTRACT The use of dental implants has revolutionized the treatment of partially and fully edentulous patients today. While in many cases dental implants have been reported to achieve long-term success, these are also not immune from the complicationsincludingperi-implant mucositis and peri-implantitis. Peri-implantitis is an inflammatory process which involves bone loss around osseointegrated implant in function. The etiology of the disease has been attributed to bacterial infections, occlusal overload, surgical trauma, faulty or incorrect prosthetic design and/ or improper implant placement. Diagnosis is based on changes in colour of the gingiva, bleeding and probing depth of peri-implant pockets, suppuration, x-ray and gradual loss of bone height around the tooth. Treatment modalities will differ depending upon whether it is a case of periimplantmucositis or periimplantitis, Therapeutic objectives focus on control of infection, detoxification of the implant surface and regeneration of the alveolar bone. This review article gives a brief description of etiopathogenesis, diagnosis and various treatment options in the management of periimplant disease.