Peri-implant Bleeding On Probing Research Articles

Clinical and Radiographic Outcomes of Adjunctive Phototherapy Versus Antibiotic Therapy Against Peri-Implant Diseases: A Systematic Review and Meta-Analysis.

Background: Peri-implantitis, an inflammatory condition in implant tissues, requires bacterial eradication and implant surface decontamination, with aPDT as a helpful surgical adjunct. Objective:This project was designed to investigate the effect of antibiotic therapy versus aPDT, as adjuncts to conventional mechanical debridement (MD), on the peri-implant clinical and/or radiographic parameters among patients with peri-implant diseases. Methods: A comprehensive search was conducted across electronic databases, including PubMed, Scopus, and Web of Science, up to and including April 2023, without any restriction on the language and year of publication, focusing the following research question: "Does adjunctive aPDT improve the peri-implant clinical and/or radiographic parameters in treating peri-implant diseases compared to antibiotic therapy?" Statistical analysis was performed on peri-implant clinical [plaque index (PI), probing depth (PD), and bleeding on probing (BOP)] and radiographic parameters [marginal bone loss (MBL)]. The study included six randomized controlled trials and one clinical (nonrandomized) study. Results: The systematic review findings indicate that the application of aPDT as an adjunct to MD is equally effective as adjunctive antibiotic therapy in improving peri-implant clinical parameters and radiographic parameters in patients with peri-implant diseases. Only two studies were classified as having a low risk of bias (RoB), two were assessed as having an unclear RoB, and the remaining three studies were determined to have a high RoB. However, the meta-analysis results revealed no statistically significant difference in peri-implant PI, PD, and MBL scores between patients treated with adjunct aPDT or adjunct antibiotic therapy. Notably, there was a statistically significant difference favoring adjunct aPDT in peri-implant BOP values compared to the control group. Conclusions: Despite the limited number of included studies and the significant heterogeneity among them, the findings suggest that aPDT yields comparable peri-implant clinical and radiographic outcomes to adjunctive antibiotic therapy, as adjuncts to MD, for the potential treatment of peri-implant diseases.

Chloro-aluminum phthalocyanine-mediated photodynamic therapy improves peri-implant parameters and crevicular fluid cytokine levels in cigarette smokers with chronic hyperglycemia.

This clinical trial aimed to evaluate the effectiveness of chloroaluminum phthalocyanine-mediated photodynamic therapy (CAPC-PDT) as an adjunct to peri‑implant mechanical debridement (PID) in the treatment of peri‑implantitis in patients with chronic hyperglycemia and cigarette smoking. The selected participants with peri‑implantitis were divided into two groups: Group I (n=15) included hyperglycemic patients with no history of smoking and Group II (n=15) included hyperglycemic patients with a history of smoking cigarettes. Both groups were further divided into two subgroups based on the type of therapy provided: PDT+PIDand PIDalone. Peri-implant bleeding on probing (PiBOP), peri‑implant pocket depth (PiPD), peri‑implant plaque scores (PiPS), and crestal bone loss (CBL) were assessed. Peri-implant crevicular fluid (PICF) was sampled for quantification of interleukin (IL)-1β and tumor necrosis factor-alpha (TNF-α) using an enzyme-linked immunosorbent assay. All assessments were performed at baseline and at three and six months. PDT+PID showed a higher reduction in PiBOP than PID alone in hyperglycemic/non-smoking participants (p<0.01). PDT+PID and PID show a significant reduction in PiBOP in smokers only at 6 months (p<0.05), with comparable differences between PDT+PID and PID (p>0.05). PDT+PID significantly reduced PiPD hyperglycemic/smoking patients at 3 and 6 months (p<0.05), whereas PID only produced a significant reduction in PiPD at 6 months in smoking patients (p<0.05). CBL alone with PDT+PID in both smokers and non-smokers showed a statistically significant reduction at 6 months follow-up (p<0.05). IL-1β was significantly reduced in hyperglycemic/non-smoking participants at 6 months follow-up with both PDT+PID and PID alone (p<0.01). This trend was also observed in cigarette smokers, with an additional short-term reduction in IL-1β at 3 months with PDT+PID (p<0.05). Only the PDT+PID group showed a significant reduction in TNF-a among cigarette smoking patients with chronic hyperglycemia at 6 months follow-up (p<0.05) CONCLUSION: Chloroaluminum phthalocyanine-mediated PDT proved effective in improving peri‑implant clinical outcomes and reducing cytokine levels in smoking patients with chronic hyperglycemia.

Assessment of clinical and radiographic peri‑implant parameters in the obese and non-obese, along with destructive pro-inflammatory cytokines IL-1β - and IL-6 in patients treated with Photodynamic therapy

AimThe present study aims to compare and evaluate radiographic and clinical parameters along with salivary proinflammatory cytokine profiles (IL-1β - and IL-6) in the obese with peri‑implantitis. Material and methodsObese and non-obese participants in the present study were 80. The nonobese and obese participants were scrutinized based on inclusion and exclusion criteria. All participants both obese and non-obese were subjected to full mouth mechanical debridement (MD). A single session of Photodynamic therapy (PDT) was provided to all obese participants. Clinical peri‑implant parameters peri‑implant plaque index (PIPI), Peri-implant bleeding on probing (PIBoP), peri‑implant probing depth (PIPD) were assessed at baseline, three months, and six months. Marginal bone loss (MBL) was also assessed. Enzyme-linked immunosorbent assay (ELISA) was used to check the levels of IL-1β - and IL-6 in unstimulated whole saliva samples. All the parameters were assessed using the Kruskal Wallis test and analysis of variance (ANOVA). Overall characteristics were assessed using descriptive statistics. SPSS software was used for statistical analysis. ResultsClinical baseline periodontal parameters PIPI, PIBoP, PIPD, and MBL in non-obese participants were significantly lower compared to group I obese participants at baseline (p < 0.05). At 3 months follow-up PDT adjunct to MD in group 1 obese participants PIPI and PIPD were significantly lower compared to MD alone in non-obese participants PIP1 and PIPD. At 6 months follow up, non-obese participants with peri‑implantitis treated with MD demonstrated PIPI and PIPD significantly lower compared to obese participants treated with PDT adjunct to MD ConclusionPDT adjunctive to MD enhanced periodontal parameters i.e., peri‑implant probing depth, peri‑implant plaque index, and peri‑implant bleeding on probing in obese with peri‑implantitis. Moreover, obese individuals with peri‑implantitis demonstrated high levels of proinflammatory cytokines IL-1β and IL-6 than control.

Risk indicators of long-term outcome of implant therapy in patients with a history of severe periodontitis or no history ofperiodontitis: A retrospective cohort study.

The aim of this retrospective cohort study was to assess factors associated with peri-implant disease in partially edentulous patients with a history of severe periodontitis or no history of periodontitis. Partially edentulous patients with a history of severe periodontitis/without history of periodontitis who received implant surgery within the past 6 to 8years were recalled. Clinical and radiographic examinations were recorded. Periodontal probing depth, marginal bone loss (MBL) and peri-implantitis were considered as the primary outcome and peri-implant bleeding on probing (BOP) was considered as the secondary outcome. The following criteria were considered as the predictors, as well: history of severe periodontitis, gender, age, smoking, brushing frequency, recall interval, full-mouth plaque score, full-mouth bleeding score, splinted prosthesis, open/tight interproximal contact, width of keratinized mucosa, mucosal thickness, implants placed in the grafted bone and implant type. Univariate and multivariate regression analyses were utilized. A total of 88 patients (186 implants) fulfilled the study. Forty-seven patients (108 implants) had a history of severe periodontitis and 41 patients (78 implants) had no history of periodontitis. There was a higher chance of peri-implantitis in patients with a history of severe periodontitis (OR=11.13; p=0.045), implants with lack of peri-implant KM (<2mm) and implants placed in the grafted bone (OR=14.94, p<0.001; OR=4.93, p=0.047). The risk of peri-implant MBL ≥3mm was higher in patients with greater FMBS (OR=1.20; p<0.001). The chance of peri-implant BOP was independently higher in patients who brushed their teeth at most once per day (OR=3.20; p=0.04), higher FMBS (OR=1.16; p<0.001) and irregular recall visits (OR=15.34; p=0.001). Partially edentulous patients with the history of severe periodontitis, lack of peri-implant KM and implants placed in bone-grafted sites expressed higher probability of peri-implantitis. In addition, inadequate frequency of brushing (at most once daily) and irregular recall visits were associated with greater chance of peri-implant BOP.

Influence of Soft Tissue and Crestal Bone Resorption in Moderate Cigarette-Smokers and Nonsmokers: A 5-Year Study.

This study aimed to determine the impact of implant placement depth (bone-level [BL] and subcrestal [SC]) on soft-tissue inflammatory parameters bleeding on probing (BOP), probing depth (PD), and crestal bone resorption (CBR) in moderate cigarette-smokers and nonsmokers at 5 years postplacement. Patient details were recorded, including sex, age, smoking history, duration of implants in function, implant arch location, and daily toothbrushing and flossing habits. Peri-implant BOP, PD, and CBR were measured in all groups, and group comparisons were done; a probability score < .05 was selected as a value for statistical significance. Fifty-three patients (27 smokers, 26 nonsmokers) had BL implants, and 55 patients (28 smokers, 27 nonsmokers) had SC implants. Among all patients, PD was higher in smokers than nonsmokers (P < .05). The peri-implant sites that demonstrated BOP were higher (P < .05) in nonsmokers than smokers. Among smokers, the CBR was higher in those with BL implants than those with SC implants (P < .05). Among nonsmokers, there was a difference in BOP, PD, and CBR at the 5-year follow-up. At 5 years, SC implants demonstrated less CBR than BL implants. Peri-implant PD is higher in smokers than nonsmokers, irrespective of the implant placement depth.

Influence of body fat in patients with dental implant rehabilitation treated with adjunctive photodynamic therapy.

Obesity appears to govern peri-implant hard and soft tissue health. We hypothesized that adjunctive photodynamic therapy (aPDT), improves clinical peri-implant perimeters and alleviates peri-implant crevicular fluid (PICF) levels of tumour necrosis factor (TNF)-α, interleukin (IL)-6 and high sensitivity C-reactive protein (hsCRP) in obese with moderate peri-implantitis. The current clinic-laboratory study aimed to determine whether obesity influences the outcomes of aPDT in patients with moderate peri-implantitis. A total of 49 patients (24 obese and 25 non-obese) with moderate periodontitis receiving aPDT were included. Clinical characteristics including peri-implant probing depth (PIPD), peri-implant bleeding on probing (PIBOP), and peri-implant plaque index (PIPI) were measured. PICF levels of TNF-a, IL-6 and hsCRP were assessed using enzyme-linked immunosorbent assay (ELISA). Both clinical and cytokine assessments were performed at baseline, three months and six months, respectively. Intra-group comparisons of changes in clinical parameters pre and post PDT was performed using Friedman test. Comparison of changes of TNF-a, IL-6 and hsCRP levels within group was performed using Kruskal-Wallis test. When compared with the baseline, a considerable reduction in PIPI, PIBOP and PIPD was observed in obese as well as non-obese patients at three- and six-months follow-up. At three months follow-up, a statistically significant difference was observed in PIPI (p < 0.05), PIBOP (p < 0.05) and PIPD (p < 0.05) among obese and non-obese individuals. Additionally, when compared with the baseline, a statistically significant difference was noticed in PICF volume (p < 0.05) and levels of TNF-α (p < 0.05) and IL-6 (p < 0.05) in non-obese as well as obese at three- and six-months follow-up. With the application of aPDT, considerable improvement was observed in peri-implant inflammatory parameters among obese and non-obese patients with moderate peri-implantitis. Obesity did not appear to influence aPDT outcome in patients with moderate peri-implantitis.

Comparison of cotinine levels in the peri-implant sulcular fluid among cigarette and waterpipe smokers, electronic-cigarette users, and nonsmokers.

Assessment of cotinine levels in the peri-implant sulcular fluid (PISF) may serve as a valuable biomarker of peri-implant diseases in nicotine-product users. The aim of the present study was to compare cotinine levels in the PISF among cigarette smokers, waterpipe users, electronic-cigarette users, and nonsmokers. Cigarette smokers, waterpipe smokers, electronic-cigarette users, and nonsmokers were included. A questionnaire was used to collect information about age, gender, duration of smoking and vaping, family history of smoking, duration of smoking/vaping, and daily frequency of smoking/vaping. Implant-related data including implant dimensions and duration of implants in function were also recorded. In all groups, peri-implant probing depth (PD), bleeding on probing (BoP), and plaque index (PI) were assessed. Using standard techniques, PISF was collected and levels of cotinine in the PISF were measured. Sample-size estimation was performed, and statistical comparisons were done using one-way analysis of variance and Bonferroni post hoc adjustment tests. P values below .05 were categorized as statistically significant. One hundred two male individuals (35 cigarette smokers, 33 waterpipe smokers, 34 electronic-cigarette users, and 35 nonsmokers) were included. Scores of peri-implant PI (P < .05) and PD (P < .05) were significantly higher among cigarette smokers, waterpipe smokers, and electronic-cigarette users compared with nonsmokers. Peri-implant BoP was more often manifested in nonsmokers compared with cigarette smokers (P < .05), waterpipe smokers (P < .05), and electronic-cigarette users (P < .05). The volume of collected PISF was significantly higher among cigarette (P < .05) and waterpipe smokers (P < .05) and electronic-cigarette users (P < .05) than nonsmokers. Cotinine levels were significantly higher in the PISF of cigarette (P < .05) and waterpipe smokers (P < .05) and electronic-cigarette users (P < .05) than nonsmokers. Habitual use of nicotinic products enhances the expression of cotinine in the PISF. Cotinine levels in the PISF of cigarette and waterpipe smokers and electronic-cigarette users are comparable.

Comparison of peri-implant clinical and radiographic inflammatory parameters among cigarette and waterpipe (narghile) smokers and never-smokers.

The authors hypothesized that peri-implant clinical and radiographic inflammatory parameters are worse in waterpipe smokers (WS) and cigarette smokers (CS) compared with never-smokers (NS). The aim of the present retrospective study is to compare peri-implant clinical and radiographic inflammatory parameters among WS, CS, and NS. Forty-four CS (group 1), 41 WS (group 2), and 43 NS (group 3) were included. Demographic data were collected using a questionnaire. Peri-implant plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were measured, and crestal bone loss (CBL) was assessed on standardized digital radiographs. Sample size was estimated, and statistical analyses were performed using Kruskal-Wallis and Wilcoxon rank-sum tests. For multiple comparisons, Bonferroni post hoc test was performed. P values<0.05 were considered statistically significant. Peri-implant PI and PD were higher in groups 1 (P<0.05) and 2 (P<0.05) compared with group 3. Peri-implant BOP was significantly higher in group 3 compared with individuals in groups 1 (P<0.01) and 2 (P<0.01). Peri-implant total marginal bone loss was significantly higher in groups 1 (P<0.05) and 2 (P<0.05) compared with group 3. There were differences in PI, BOP, PD, and CBL among participants in groups 1 and 2. Peri-implant soft tissue inflammatory parameters and CBL are worse in CS and WS compared with NS. There is no difference in these parameters between CS and WS.

Peri-implant clinical and radiographic status and whole salivary cotinine levels among cigarette and waterpipe smokers and never-smokers.

The aim was to compare the peri-implant clinical and radiographic inflammatory parameters and whole salivary cotinine levels among cigarette smokers (CS), waterpipe smokers (WS) and never-smokers (NS). Thirty-four CS (Group 1), 33 WS (Group 2), and 31 NS (Group 3) were included. Peri-implant plaque index (PI), bleeding-on-probing (BOP), and probing depth (PD) were measured, and crestal bone loss (CBL) was assessed on standardized digital radiographs. Unstimulated whole saliva samples were collected and whole salivary cotinine levels were measured. Peri-implant PI and PD were higher in Groups 1 (P < 0.05) and 2 (P < 0.05) than in Group 3. Peri-implant BOP was significantly higher in Group 3 than in Groups 1 (P < 0.01) and 2 (P < 0.01). Peri-implant MBL was significantly higher in Groups 1 (P < 0.05) and 2 (P < 0.05) than in Group 3. There were significant differences in PI, BOP, PD, and CBL between Groups 1 and 2. There was no significant difference in the whole salivary cotinine levels in Groups 1 and 2. Peri-implant sites with plaque accumulation, PD, CBL, and whole salivary cotinine levels were higher in CS and WS than in NS, but did not differ between CS and WS.

Clinical and radiographic peri-implant parameters and proinflammatory cytokine levels among cigarette smokers, smokeless tobacco users, and nontobacco users.

It is postulated that clinical and radiographic peri-implant parameters are worse and levels of interleukin (IL)-1β and matrix metalloproteinase (MMP)-9 in the peri-implant sulcular fluid (PISF) are higher in cigarette-smokers (CS) and smokeless-tobacco users (STU) compared with nontobacco user (NTU). The present study aimed to compare clinical and radiographic peri-implant inflammatory parameters and levels of IL-1β and MMP-9 levels among CS, STU, and NTU. Forty-five CS (Group-1), 42 STU (Group-2), and 44 NTU (Group-3) were included. Demographic data was collected using a structured baseline questionnaire. Peri-implant plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were recorded and crestal bone loss (CBL) were assessed using standardized digital radiographs. PISF volume and levels of IL-1β and MMP-9 in PISF were quantified using enzyme-linked immunosorbent assay. Clinical peri-implant parameters and PISF IL-1β and MMP-9 concentrations were analyzed with Kruskal-Wallis test. Bonferroni post hoc adjustment test was used for multiple comparisons. P-value was set at .05. Peri-implant PI and PD were significantly worse in group-1 and group-2 patients as compared to group-3 individuals (P < .05). Peri-implant CBL was also significantly higher in group-1 and group-2 compared with group-3 (P < .05). Peri-implant BOP was significantly higher in group-2 and group-3 as compared to group-1 individuals (P < .05). The PISF volume (P < .05) collected and levels of IL-1β and MMP-9 were statistically significantly elevated among individuals in group-1 and group-2 compared with group-3 (P < .01). There was no significant difference in PI, PD, CBL, and PISF levels of IL-1β and MMP-9 among participants in groups 1 and 2. Clinical and radiographic peri-implant parameters were compromised among CS and STU as compared to NTU. Increased expression of local proinflammatory cytokines may explain greater susceptibility of CS and STU to peri-implant breakdown.

Comparison of Clinical, Radiographic, and Immunologic Inflammatory Parameters Around Dental Implants with Cement-Retained and Screw-Retained Restorations: A 5-Year Prospective Cohort Study in Men

To compare bleeding on probing (BoP), probing depth (PD; ≥ 4 mm), radiographic (peri-implant crestal bone loss [CBL]), and immunologic inflammatory (interleukin-1beta [IL-1β] and matrix metalloproteinase-9 [MMP-9]) parameters around dental implants with cement-retained (CR) and screw-retained (SR) implant-supported crowns. Based on the mode of retention of the restoration, 51 patients were divided into two groups: Group 1, consisting of 26 single implants restored with CR crowns, and Group 2, consisting of 25 single implants restored with SR crowns. Peri-implant BoP, PD, and CBL were scored, and levels of IL-1β and MMP-9 in the peri-implant crevicular fluid (PICF) in both groups were measured in duplicate using enzyme-linked immunosorbent assay. Full-mouth mechanical debridement was performed biannually in both groups. Statistical analysis was performed using Kruskal-Wallis test with the significance level set at P < .05. The mean CBL among implants in groups 1 and 2 was 1.7 ± 0.5 mm and 1.7 ± 0.4 mm, respectively. There was no statistically significant difference in mean BoP, PD, and CBL among implants in both groups (P > .05). There was no statistically significant difference between groups 1 and 2 in the PICF levels of IL-1β (7.3 ± 0.5 and 7.2 ± 0.5, respectively) and MMP-9 (165 ± 9.4 and 182 ± 10.6, respectively) (P > .05). The mode of retention of implant-supported crowns does not appear to affect their clinical correlations with BoP, PD, CBL, and levels of IL-1β and MMP-9 in the PICF when zinc oxide eugenol cement is used.

Efficacy of periimplant mechanical debridement with and without adjunct antimicrobial photodynamic therapy in patients with type 2 diabetes mellitus

ObjectiveThere are no studies that have assessed the efficacy of mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) in the treatment of periimplant inflammation in patients with type 2 diabetes mellitus (T2DM). The aim of the present 12-month follow-up study was to assess the efficacy of MD with and without adjunct aPDT in the treatment of periimplant inflammation in patients with T2DM. MethodsSixty-seven patients with diagnosed periimplant inflammation and T2DM were included. Treatment-wise, the patients were divided into 2 groups: (a) test-group (n=34): patients receivedMD+aPDT; and (b) control group (n=33): patients received MD only. Periimplant bleeding on probing (BOP), probing depth (PD) ≥4mm and mesial and distal marginal bone loss (MBL) were measured at baseline and after 6 and 12 months of therapy in both groups. The Kruskal-Wallis test was used to compare the periimplant BOP, PD, MBL and HbA1c levels in both groups. P-values less than 0.05 were considered statistically significant. ResultsMean preoperative hemoglobin A1c (HbA1c) for patients in the control group and test group were 8.5% and 8.8%, respectively. In the control group, there was no significant difference in HbA1c levels at all follow-up durations. Among patients in test group, there was a significant decrease (P<0.05) in HbA1c levels at 6 and 12 months of follow-up. Both PD and BOP were significantly lower in the test group compared to the control group at all follow-up durations. At 6 and 12 months of follow-up, there was no significant difference in MBL in both groups. ConclusionIn patients with T2DM, MD with adjunct aPDT is more effective in the treatment of periimplant inflammation compared with MD alone.