Peri-implant Tissue Inflammation Research Articles

Prosthetic design and choice of components for maintenance of optimal peri-implant health: a comprehensive review.

Current research has identified features of the prosthetic design with potential to significantly impact the long-term health of peri-implant tissues, while the choice of prosthetic components is also shown to be critical in an effort to reduce long-term complications of implant therapy. Overcontouring of the prosthesis emergence profile has been associated with marginal bone loss, recession and peri-implantitis, while the mucosal emergence angle is shown to have a strong association with peri-implant tissue inflammation. Further elements of interest include convexity/concavity of the restoration, the prosthetic connection and the different geometric configurations of junctions, as well as the peri-implant tissue dimensions. With regards to implant components, the choice between original and third-party-manufactured components might come with implications, as differences in material and microgeometry might impact precision of fit and overall performance, potentially leading to complications. Scrutiny of the specifications and manufacturing is essential when third-party-manufactured components are considered.The aim of this narrative review was to summarise the current evidence with regards to the restorative features of the implant prosthesis and also the selection of prosthetic components which can have implications for the long-term success of the implant therapy. Furthermore, the review aimed at interpretating current scientific evidence into meaningful strategies and recommendations to implement in clinical practice of implant dentistry.

Techniques for conservative treatment of peri-implantitis

Relevance. Dental implants are widely used to restore the patient’s teeth. They have become aworthy alternative to removable dentures. With the accumulation of clinical experience, the indications for dental implantation expanded, and as aresult, the evaluation of long-term results became possible. In parallel with the expansion of clinical use of dental implants and the introduction of the technology into everyday practice, the experience of complications and errors accumulated, and from single publications in the 1990s, at the very beginning of development, to large-­scale studies in the 10s. And if in the early period of implantology development the success of treatment was mainly associated with implant survival, then modern research focuses on the state of tissues around the implant, and the influence of processes in them on the overall outcome of treatment. One of the main complications is inflammation of peri-implant tissues - peri-implantitis. Modern authors define peri-implantitis as an inflammatory process affecting the tissues around afunctionally integrated implant, resulting in loss of supporting bone. Continued bone loss around the implant can significantly impair implant stability and function. The authors review the scientific literature describing experimental conservative treatment protocols for peri-implantitis and attempts to achieve osseointegration. Conclusion. The reviewed literature advocated various methods of surgical regenerative treatment for peri-implantitis, including the use of bone substitutes, methods of detoxification of implant surfaces, and the administration of antimicrobial agents. There are many different protocols for the treatment of peri-implantitis; they all share the same goal of reducing disease progression and bone loss by eliminating bacterial infection. The controversy over the proper approach to treating peri-implantitis and restoring osseointegration clearly demonstrates the need for more research to answer this question.

Evaluation of the efficacy of inter-dental brush and dental floss for peri-implant mucositis: A crossover randomized clinical trial.

To evaluate the most effective method for mechanical inter-dental plaque removal between inter-dental brushes (IDB) and dental floss (DF), in addition to toothbrushing in patients affected by peri-implant mucositis (PIM); to identify possible factors related to the patient or to the single implant-supported element that could influence plaque accumulation and inflammation of peri-implant tissues. Forty patients with PIM were recruited. They were randomly assigned to two different groups depending on inter-dental device used (IDB or DF). At baseline (T0), interproximal area (IA), interproximal emergence angle of the implant crown (A°) and manual dexterity (evaluated with Purdue Pegboard) have been recorded. At 14 days (T1), the inter-dental cleaning devices have been inverted between groups. After 14 days (T2), the Plaque Index (PI) and Gingival Index (GI) have been recorded. A questionnaire has been submitted to a patient for the analysis of preferences at T0, T1 and T2. Both inter-dental cleaning devices were effective in reducing PI and GI in the inter-dental area after 14 days of use. GI reduction was influenced by manual dexterity of the dominant hand. No significant differences were found for PI and GI at the variation of IA and A°. IDB was the most effective method for inter-dental plaque removal in all subjects regardless of their manual dexterity. DF seems to be more effective than IDB only in subjects with good dexterity.

An In Vivo Investigation of Non-Metallic vs. Metallic Hand Scalers on Zirconia Implant-Supported Crowns: A Year-Long Analysis of Peri-Implant Maintenance.

This study examined whether the degree of abutment surface modification that may occur with regular periodontal instrumentation has a clinical impact in terms of increased plaque accumulation and increased peri-implant tissue inflammation on zirconia implant abutments. Thirteen patients who had zirconia implant crowns were recruited in this randomized clinical trial. Each patient acted as their control and had either the buccal or lingual surface of their screw-retained implant restoration scaled with a metallic scaler and the other surface with a non-metallic scaler at 3, 6, 9, and 12 months. Cytokine testing of the peri-implant crevicular fluid was completed at 0, 3, and 12 months for IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, or IFNγ. Implant crowns were removed at 12 months and evaluated under an atomic force microscope for the average roughness (Ra). The implant crowns were polished and re-inserted. The results were analyzed using the Kruskal-Wallis test, and post hoc tests were conducted with a significance level of α = 0.05. Significant differences in surface roughness (Ra) were observed between the metallic and non-metallic scalers. The median Ra values were 274.0 nm for metallic scalers and 147.1 nm for non-metallic scalers. However, there were no significant differences between the type of scaler used and the amount of clinical inflammation or cytokine production. Metallic scalers produced deeper, more aggressive surface alterations to the abutment/crown zirconia surface, but there was no statistically significant difference between the degree of surface alterations, amount of BOP, and the amplitude of cytokine inflammation produced.

AETIOLOGICAL CHARACTERISTICS OF DENTAL IMPLANT FAILURE

Dental implant placement is a predictable and widely used procedure in modern dentistry. Nevertheless, several factors can negatively affect the functioning and duration of implant restoration. Considering the significant data supporting the role of the microbial factor in the development of tissue inflammation around the prosthesis, the purpose of this review was to investigate the etiological structure of implant loss from a microbiological point of view. Materials and methods. We conducted a comprehensive content analysis of scientific publications available in the PubMed/MEDLINE and Google Scholar databases. Results and discussion. Six groups of microorganisms are known as potential contributor to the dental biofilm. These groups are designated by a specific color – yellow, green, purple, orange and red. The orange and red groups include pathogens of periodontal inflammation, and also play a significant role in the development of peri-implant (PI) inflammation. Implants and teeth share histopathological and ecological similarities, thus, we can suggest that the microbial communities around these structures are similar. In the studies, the composition of the PI-associated complex of microorganisms including Porphyromonas gingivalis, Porphyromonas endodontalis, Tannerella forsythia, Filifactor alocis, Fretibacterium fastidiosum, Desulfobulbus spp. and Treponema lecithinolyticum was decsribed. It has been reported that the PI microbiome is specific to the site where an implant is placed, and the microbial composition of the biofilm of the contralateral healthy sites is more similar to the spectrum of healthy prostheses, including other subjects, than those from the same oral cavity. We can suggest that the changes in the implant microbiocenosis are dynamic. Several studies have shown the long-term consequences of dental implant restoration that can include the modification of the microbiome consisting in the progressive increase of P. gingivalis, T. forsythia, A. actinomycetemcomitans and Prevotella intermedia within 3-6 months following the procedure of implant placement. There is also an opinion about the peculiarities of the biofilm microbiota of the peri-implant tissues in case of early and late loss of the dental prosthesis. Bacteria are an important component of the microbiocenosis in any ecological niche, but the role of archaea is often overlooked. Methanogenic archaea, and Methanobrevibacter oralis are components of the normal oral microbiome, but their considerable prevalence may also be associated with peri-implant tissue inflammation. Conclusions. We have elucidated the complex nature of microbial communities within peri-implant sites and established an association between peri-implant diseases and the dysbiosis of subgingival microbial communities. Our study underscores the pivotal role of microbiota in peri-implant diseases.

Investigation of the Clinical Effects of Peri-Implant Gingival Morphology on Tissue Health.

This study aims to determine the gingival phenotype around dental implants and the clinical evaluation of the existing phenotype in relation to the tissue health around the implant. Included were 202 dental implants applied to 60 individuals who applied to our service and had at least 1 implant in the mouth, whose prosthetic restoration was completed at least 1 year ago. The effects of keratinized mucosa width (KMW) and gingival thickness (GT), which form the gingival phenotype, on clinical periodontal parameters were evaluated with the obtained data. Of the implants included in the study, 115 were found to have adequate KMW and 87 had insufficient KMW. At the same time, the GT around 74 implants was found to be thick, and the GT around 128 implants was found to be thin. The KMW of those with thin GT was lower than those with thick GT. Plaque index (PI), gingival index (GI), bleeding on probing (BoP), probing depth (PD), gingival recession (GR), and suppuration (SuP) were found to be low in those with adequate KMW. GI, BoP, PD, GR, and SuP were low in patients with thick GT, but there was no significant difference between GT and PI. KMW and GT were associated with peri-implant tissue inflammation and GR. To maintain the health of the peri-implant tissues, it is recommended to have a KMW of at least 2 mm and a thick gingiva.

Multilevel Assessment of Stent-Induced Inflammation in the Adjacent Vascular Tissue.

A recent U.S. Food and Drug Administration report presented the currently available scientific information related to biological response to metal implants. In this work, a multilevel approach was employed to assess the implant-induced and biocorrosion-related inflammation in the adjacent vascular tissue using a mouse stent implantation model. The implications of biocorrosion on peri-implant tissue were assessed at the macroscopic level via in vivo imaging and histomorphology. Elevated matrix metalloproteinase activity, colocalized with the site of implantation, and histological staining indicated that stent surface condition and implantation time affect the inflammatory response and subsequent formation and extent of neointima. Hematological measurements also demonstrated that accumulated metal particle contamination in blood samples from corroded-stetted mice causes a stronger immune response. At the cellular level, the stent-induced alterations in the nanostructure, cytoskeleton, and mechanical properties of circulating lymphocytes were investigated. It was found that cells from corroded-stented samples exhibited higher stiffness, in terms of Young's modulus values, compared to noncorroded and sham-stented samples. Nanomechanical modifications were also accompanied by cellular remodeling, through alterations in cell morphology and stress (F-actin) fiber characteristics. Our analysis indicates that surface wear and elevated metal particle contamination, prompted by corroded stents, may contribute to the inflammatory response and the multifactorial process of in-stent restenosis. The results also suggest that circulating lymphocytes could be a novel nanomechanical biomarker for peri-implant tissue inflammation and possibly the early stage of in-stent restenosis. Large-scale studies are warranted to further investigate these findings.

Abnormal Decrease of Macrophage ALKBH5 Expression Causes Abnormal Polarization and Inhibits Osteoblast Differentiation.

Peri-implant tissue inflammation is an inflammatory injury that occurs in the soft and hard tissues surrounding the implant and is the main cause of short- or long-term failure of implant prosthetic restorations, which is compounded by bone loss and bone destruction in the alveolar bone of diabetes patients with peri-implantitis. However, the mechanisms underlying the persistence of diabetic peri-implantitis, as well as the essential connections and key molecules that regulate its start and progression, remain unknown. In this study, we discovered that M1 macrophage polarization was abnormally enhanced in diabetic peri-implantitis and influenced the osteogenic differentiation of mesenchymal stem cells. RNA sequencing revealed that ALKBH5 expression was abnormally reduced in diabetic peri-implantitis. Further mechanism study showed that ALKBH5 and its mediated m6A can influence osteogenic differentiation, which in turn influences the persistence of diabetic peri-implantitis. Our findings present a new mechanism for the suppression of osteoblast development in diabetic peri-implantitis and a new treatment strategy to promote anabolism by inhibiting ALKBH5.

Ozonized Hydrogels vs. 1% Chlorhexidine Gel for the Clinical and Domiciliary Management of Peri-Implant Mucositis: A Randomized Clinical Trial

Peri-implant mucositis consists of a reversible inflammation of peri-implant tissues characterized by bleeding on gentle probing in the absence of bone loss. Ozone therapy is being extensively studied for its efficacy in treating different dental conditions. To date, few studies have evaluated ozone as an adjunct to the oral hygiene measures of peri-implant mucositis patients. The aim of the present study is to assess the efficacy of an ozonized gel (Trial group) compared to chlorhexidine (Control group) after a domiciliary protocol of oral hygiene in a 6-month study. According to a split-mouth study design, patients were divided into Group 1 for the application of chlorhexidine gel in peri-implant mucositis sites of quadrants Q1 and Q3, whereas in quadrants Q2 and Q4, the ozonized gel was in-office administered. For Group 2, the quadrants were inverted. At baseline (T0), and after 1 (T1), 2 (T2), and 3 (T3) months, Probing Depth (PD), Plaque Index (PI), SI Suppuration Index (SI), Bleeding Score (BS) and Marginal Mucosa Condition (MMC) were measured. A statistically significant decrease was found for all the variables assessed in each group (p < 0.05), whereas significant intergroup differences were found only for PI, BoP, and BS. Accordingly, both agents tested in this study showed an efficacy in treating peri-implant mucositis. The ozonized gel deserves particular attention, considering the better outcome than chlorhexidine on specific clinical periodontal parameters, as well as its lesser shortcomings.

Effect of the oil-ether complex of Siberian fir on the fungal and periodontopathogenic flora of the mouth (microbiological study)

BACKGROUND: Peri-implantitis is mainly caused by the activity of periodontal pathogens with insufficient oral hygiene, which causes the disintegration of intraosseous dental implants against the background of chronic inflammation in peri-implant tissues. The correct techniques in the post-prosthetic stage in patients with dental implants include medical examination with regular professional oral hygiene, which is complicated by low patient compliance. In this regard, there are high requirements for the level of individual oral hygiene and for the effectiveness of local hygiene products, among which dental rinses occupy an important place. As rinses, it is possible to use pine-containing substances, particularly a complex of oil-essential fir Solagift of a Siberian company (Tomsk).&#x0D; AIM: To conduct a microbiological study of the sensitivity of periodontopathogens and Candida albicans to the oil-essential complex of Siberian fir of different concentrations.&#x0D; MATERIAL AND METHODS: A number of periodontopathogens and C. albicans were cultured in the presence of a complex of oilessential Siberian fir in the following proportions: 1:5, 1:10, and 1:15. Incubation for up to 3 days was conducted in the Reverse Spinner RTS-1 bioreactor (BioSan, Latvia) with automatic analysis of the optical density of the culture (OD) at a wavelength of =850 nm. The optical density was measured in McFarland units (Mcf). The assessment of culture growth control was based on the analysis of the growth phases of periodontopathogens: adaptive (lag phase), exponential (log phase), stationary, and dying. The following clinical isolates of microorganisms were used: Streptococcus constellatus, Staphylococcus aureus, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, and C. albicans.&#x0D; RESULTS: Joint cultivation of periodontopathogens with the oilether complex of Siberian fir reduces the OD of cultures of clinical isolates when breeding coniferous substance 1:151:5 by 13.727.1% (A. actinomycetemcomitans), 18.362.0% (F. nucleatum), 30.056.4% (S. aureus), and 19.274.1% (S. constellatus). The studied coniferous complex suppresses the culture of C. albicans at a concentration of 1:5, reducing the OD of the culture of fungi in the microbiological experiment by 29.8%.&#x0D; CONCLUSION. Joint cultivation of periodontopathogens with the oilether complex of Siberian fir reduces the OD of cultures of clinical isolates when breeding coniferous substance 1:151:5. The studied coniferous complex suppresses the culture of C. albicans at a concentration of 1:5, reducing the OD of the culture of fungi in the microbiological experiment by 29.8%. The bacteriostatic effectiveness of the Siberian fir oil-ether complex significantly exceeds the effect of the herbal preparation Stomatophyte.

СТЕПЕНЬ ПОДАВЛЕНИЯ ГРИБКОВОЙ ФЛОРЫ РТА ПРИ ИСПОЛЬЗОВАНИИ МАСЛЯНО-ЭФИРНОГО КОМПЛЕКСА ИЗ ХВОИ ПИХТЫ

The main cause of peri-implantitis is the activity of periodontal pathogens with insufficient oral hygiene, which causes disintegration of intraosseous dental implants against the background of chronic inflammation in peri-implant tissues. The correct tactics of the post-prosthetic stage in patients with dental implants is medical examination with regular professional oral hygiene, which is complicated by low patient compliance. In this regard, there are high requirements for the level of individual oral hygiene and for the effectiveness of local hygiene products, among which dental rinses occupy an important place. As rinses, it is possible to use pine-containing substances, in particular, a complex of oil-essential fir of Siberian production of the company “Solagift” (Tomsk). The purpose of the study: microbiological study of the sensitivity of periodontopathogens and C. albicans fungi to the oil-essential complex of Siberian fir of different concentrations. Material and methods: a number of periodontopathogens and C. albicans were cultured in the presence of a complex of oil-essential Siberian fir in the following proportions 1:5, 1:10, 1:15. Incubation lasting up to three days was carried out in the Reverse Spinner RTS-1 bioreactor (BioSan, Latvia) with automatic analysis of the optical density of the culture (OD) at a wavelength of λ = 850 nm. The optical density was measured in McFarland units (Mcf). The assessment of culture growth control was based on the analysis of the growth phases of periodontopathogens: adaptive (lag phase), exponential (log phase), stationary, dying. The following clinical isolates of microorganisms were used: Streptococcus constellatus; Staphylococcus aureus; Fusobacterium nucleatum; Aggregatibacter actinomycetemcomitans, as well as Candida albicans. Results of the study: Joint cultivation of periodontopathogens with the oil-ether complex of Siberian fir reduces the optical density of cultures of clinical isolates when breeding coniferous substance 1:15 – 1:5 by 13.7% – 27.1% (A. actinomycetemcomitans), 18.3% – 62.0% (F. nucleatum), 30.0% – 56.4% (S. aureus), 19.2% – 74.1% (S. constellatus). The studied coniferous complex suppresses the culture of C. albicans at a concentration of 1:5, reducing the optical density of the culture of fungi in the microbiological experiment by 29.8%

Остеоинтегративные свойства имплантатов из титанового сплава с различным диаметром пор в эксперименте

Introduction. Additive technologies make it possible to create implants to replace bone defects. Determining the optimal parameters of a porous structure remains an urgent issue. The experimental research aimed to study the biocompatibility of implants made of titanium alloy with different pore diameters. Materials and methods. The study was carried out in two stages. The first stage included an in vitro study carried out on test cultures of diploid human fibroblasts to assess the cytotoxicity of the titanium alloy, from which samples were made for the second stage in vivo. The in vivo study was performed on three groups of rabbits (n=18), which received samples of the developed implants. The average age of subjects was 7±1 months, the weight being 4.675±258 g. All samples were 4 mm in diameter and 6 mm high. In group 1, the pore size was 100 μm; in group 2 – 200 μm; and in group 3 – 400 μm; the porosity was 55%, 62%, and 70%, respectively. The animals were sacrificed on day 90 after placement of the samples. Histological, morphological, and electron microscopic studies were performed to assess the osseointegrative properties of the implants. Results. In the in vitro study, we detected no toxic effects of the material on the test culture. In the in vivo study, the histological analysis did not reveal inflammation in peri-implant tissues in any of the groups. The morphological study showed a newly formed tissue in the area of the formed defect which consisted of young bone trabeculae with osteoblasts located on their surface. In group 3, we found the greatest prevalence of mature bone trabeculae. The samples with a 400-μm pore diameter revealed the largest area of filling the implant with newly formed bone tissue. Conclusion. Samples with a pore diameter of 400 μm have the highest osteointegrative properties. Keywords: osteointegration, biocompatibility, titanium implants, additive technologies, 3D-printing

Impact of tribocorrosion and titanium particles release on dental implant complications - A narrative review.

Titanium particles as a product of degradation have been detected in periimplant oral tissues and it has been assumed that implants were the source of these particles. Periimplantitis sites had higher concentrations of particles in comparison to healthy implant sites. Several factors have been identified in the degradation of dental implant surface, such as mechanical wear, contact with chemical agents, and the effects of biofilm adhesion. Titanium particles silently prompt the immune-system activation and generate a pro-inflammatory response in macrophages, T lymphocytes and monocytes. During the activation, inflammatory cytokines are released including, granulocyte–macrophage colony-stimulating factor (GM-CSF), prostaglandin, and TNF-α, IL-1β, IL-6. The nanoparticles depict unique features such as high level of biological reactivity and potentially harmful compared to microparticles since they have a relatively greater surface area to volume ratio. Allergic response to titanium as a cause of implant failure has not been well documented. Evidence demonstrating biological complication due to titanium particles release includes peri-implant tissue inflammation that lead terminally to implant loss. There is a biological probability for a relation between the presence of titanium particles and ions, biological complication, and corrosion, but there is no justifiable evidence for unidirectional series of causative actions.

Inflammatory complications in the state of peri-implant tissues and their causes according to the results of a survey of dentists

The causes of mucositis or peri-implantitis may be insufficient oral hygiene, overload of implants. Recently, the attention of implantologists has been drawn to the design of the abutment connection node with the implant, which is able to accumulate the microflora of the oral cavity and maintain inflammation in the gum. The purpose of this work was to find out the opinion of dentists about the causes and methods of prevention of mucositis and peri-implantitis based on the results of many years of experience in prosthetics on implants. At the Department of Clinical Dentistry and Implantology of the Academy of Postgraduate Education of the FMBA of Russia, a survey was conducted of 48 orthopedic dentists who had at least 5 years of experience working with dental implants. The questionnaire contained 15 questions about the causes of peri-implant inflammation and its prevention methods. The above results of the questionnaire contain data on the frequency of use of 11 implant systems used in Russia; the detectability of inflammation in peri-implant tissues, bone resorption and gum recession when using various implant systems; the causes of inflammation in periimplant tissues; the role of the implant-abutment junction node. According to the results of the questionnaires, the importance of personal and professional hygiene in the care of installed implants was particularly noted, as well as the advantages of a deep cone connection of the abutment with the implant for the prevention of inflammation.

Breaking the wave of peri-implantitis.

Peri-implant diseases are prevalent with a weighted mean prevalence rate of 43% across Europe and 22% across South and North America. Although the main etiologic agent is bacterial biofilm, a myriad of factors influence the initiation and progression of the disease. Unfortunately, the treatment of peri-implant diseases is at best favorable in the short term with a high rate of persistent inflammation and recurrence. Therefore, it is sensible to consider and control all potential factors that may predispose an implant to peri-implant tissue inflammation in an attempt to avoid the disease. This paper reviews recent evidence on factors that may predispose implants to peri-implantitis and measures that can be taken to prevent it.

Laser-assisted regenerative surgical therapy for peri-implantitis: A randomized controlled clinical trial.

Different surgical approaches have been proposed to treat peri-implantitis defects with limited effectiveness and predictability. Laser has been proposed as an effective tool to assist in bacterial decontamination and modulating peri-implant tissue inflammation. The aim of this pilot clinical trial was to evaluate the adjunctive benefits of Er:YAG laser irradiation for regenerative surgical therapy of peri-implantitis-associated osseous defects. Twenty-four patients diagnosed with peri-implantitis with a radiographic infrabony defect were randomized into two groups. Both test and control groups received the following treatment: open flap mechanical debridement, supracrestal implantoplasty, bone grafting using a mixture of human allograft with demineralized bone matrix human allograft putty, and then covered with acellular dermal matrix membrane. The only difference in the test group was the adjunctive use of Er:YAG laser to modulate and remove inflammatory tissue as well as to decontaminate the implant surface. Clinical assessments, including pocket depth (PD), clinical attachment level (CAL), and gingival index (GI) were performed by calibrated masked examiners for up to 6 months following surgery. Standardized radiographs were also taken to evaluate linear bone gain and defect bone fill. Student t-tests were used to analyze those clinical parameters. Both groups showed significant reductions in PD, GI, and CAL gain overtime. The test group demonstrated significantly higher PD reductions at the site level compared to the control group (2.65 ± 2.14 versus 1.85 ± 1.71 mm; test versus control, P = 0.014). There were no statistical differences found in CAL gain (1.90 ± 2.28 versus 1.47 ± 1.76 mm; test versus control), GI reduction (-1.14 ± 1.15 versus -1.04 ± 0.89; test versus control), radiographic linear bone gain (1.27 ± 1.14 versus 1.08 ± 1.04 mm; test versus control) or proportional defect size reduction (- 24.46 ± 19.00% versus -15.19 ± 23.56%; test versus control). There was a positive trend for test patients on PD reduction and CAL gain found in narrow infrabony defects. Major membrane exposure negatively impaired the overall treatment outcome of CAL gain (2.47 ± 1.84 versus 1.03 ± 1.48 mm; no/minor versus major exposure, P = 0.051) and PD reduction in the test group (-3.63 ± 2.11 versus -1.66 ± 1.26 mm, P = 0.049). This pilot study indicated using laser irradiation during peri-implantitis regenerative therapy may aid in better probing PD reduction. Nonetheless, a larger sample size and longer follow-up is needed to confirm if Er:YAG laser irradiation provides additional clinical benefits for peri-implantitis regenerative therapy (Clinicaltrials.gov: NCT03127228).

Ultrasonography for diagnosis of peri-implant diseases and conditions: a detailed scanning protocol and case demonstration.

Ultrasonography has shown its promising diagnostic value in dental implant imaging research in the three treatment phases, namely, planning, intraoperative, and postoperative phase. With increasing awareness of peri-implant diseases and a lack of an efficient diagnostic method, the aim is to propose ultrasound imaging as a potential solution by providing a detailed scanning protocol and case demonstration. Ultrasound device specification and the setup for optimizing peri-implant tissue imaging was described. Two useful imaging modes, viz. B-mode and color flow, were introduced. Important anatomical structures for accurate diagnosis of peri-implant diseases were illustrated. Finally, a detailed scanning sequence was proposed. Ultrasound images were acquired on live humans to exemplify the four peri-implant diseases and conditions, endorsed by the 2017 World Workshop organized by the American Academy of Periodontology and the European Federation of Periodontology. Ultrasound can provide not only cross-sectional anatomical images but also functional images (color flow images) that may be useful for evaluating the degree of peri-implant tissue inflammation. High-frequency ultrasonography could be another cross-sectional imaging modality in adjunct to radiographs for diagnosing imminent peri-implant diseases and conditions that negatively influence quality of life of millions of patients with implants. This case study provides a framework for future related research work and clinical scanning guidelines.

Concernment of various abutments for enhancing emergence profile in implant prosthodontics

Implant abutments are artificial devices that are connected to the dental implants after the healing process is over. The abutments are used to attach a crown, bridge, or removable denture to the implant fixtures. Accurate prosthodontic rehabilitation is the key factor for providing the long-term success and the survival of osseointegrated implants. A precise fit of the implant is crucial since microgaps at the implant–abutment interface allow for microbial colonization, which can lead to peri-implant tissue inflammation. Polyetheretherketone (PEEK) has been used for academic investigations and commercialization of several dental devices, such as dental implants, abutments, healing caps, orthodontic braces, and most notably denture prosthetic frameworks. Keywords: Implant Abutment, PEEK, CAD/CAM, Emergence profile.

Comparative evaluation of biofilm formation among three differently treated surface on titanium samples

Background: Use of osseointegrated oral implants has been an excellent method for replacement of missing teeth. Biofilm formation on oral implants can cause inflammation of peri-implant tissues, which can affect the long-term success of osseointegrated implants. Aims and Objectives: Comparative evaluation of biofilm formation among three differently treated surface on titanium samples Methodology: Samples were blasted and later loaded with gentamicin drug by vacuum drying and evaluation of the strains was done for biofilm. Bacterial adhesion was evaluated on time intervals of 0 h, 1 h, 4 h 24 h, and 48 h. Results: Bacterial adhesion was sequentially increasing in polished samples. Initial bacterial adhesion was more on surface modified samples when compared to polished samples in the 1st h. Bacterial adhesion was retarded in gentamicin-coated hydroxyapatite (HA)-blasted samples up to 24 h. Bacterial adhesion was considerably less on TiO2-blasted samples up to 48 h. Conclusion: Implant surface modified with TiO2and gentamicin showed delayed biofilm formation even up to 48 h. Surface modification with HA has gained considerable osteoconductive surface which is a boon for the production of future implants with less expense; however, further studies are to be carried out to prove its efficacy.

The influence of implant design and smoking to pH of peri‐implant crevicular fluid around one‐piece and two‐piece dental implants

Background Although success rates of both one-piece and two-piece dental implants are high, the number of peri-implant pathologies are increasing. Smoking and design of dental implant are associated with peri-implant disease, but final evidences are still missing. Current diagnostic methods are often not sensitive enough to determine the activity of peri-implant tissue inflammation, therefore the investigation of pH of peri-implant crevicular fluid has been proposed as a new potential diagnostic method. Aim/Hypothesis To determine pH of PICF around healthy one-piece and two-piece implants and pH of GCF around healthy teeth in smokers and non-smokers. Material and Methods Thermo Fisher Scientificô Orionô 9863BN glass microelectrode was used to determine pH of PICF around 81 one-piece (ROOTT, TRATE AG), 62 two-piece dental implants (various manufacturers) and pH of GCF around 108 healthy teeth. Results In non-smokers group pH of PICF around two-piece implants was more acidic (P < 0.001). Average pH around one-piece implants was 6.46 and around two-piece implants 6.15. Mean pH of GCF was 6.64. In smokers group pH of PICF around two-piece dental implants was more acidic (P < 0.05). Average pH around one-piece implants was 5.85, while around two-piece implants 5.72. Mean pH of GCF was 5.92. pH was more acidic in smokers than in non-smokers (P < 0.001). Conclusion and Clinical Implications pH of PICF was more acidic in smokers and around two-piece dental implants than in non-smokers and around one-piece dental implants.