Prevention Of Peri-implant Diseases Research Articles

Characteristics of healthy peri-implant tissues.

This article forms part of the themed issue on dental implants, with the general dentist being the main intended reader and with particular relevance to primary care dental professionals. It aims to describe the various characteristics of the implant in health, address contemporary developments in implant dentistry and offer some novel insights on the prevention of peri-implant diseases. A healthy implant exhibits specific histological, clinical and radiographic characteristics. Understanding such aspects leads to proper diagnosis and measures to maintain tissue integrity and prevent the development and progression of peri-implant diseases. Moreover, internationally and widely accepted definitions and recommendations based on expert consensus have been put forward to guide day-to-day clinical practice. This information should provide general practitioners with the means necessary to achieve the best possible outcome for their patients.

Performance evaluation of carbon quantum dots impregnated glass ionomer cement to avoid peri-implant disease

Dental cement residues exacerbate peri-implant tissue irritation and peri-implantitis. The present study aims to evaluate the cytotoxicity, physiochemical, optical, and rheological properties of carbon quantum dots (CQDs) impregnated glass ionomer cement (GIC). Surface passivated fluorescent CQDs were synthesized using citric acid via thermal decomposition and blended with GIC. Characterization studies and rheological measurements were made to evaluate their performance. 3D-printed dental implant models cemented with GIC and GIC-CQD were compared to analyze excess cement residues. MTT assay was performed with human dental pulp stem cells (hDPSCs) and statistically analyzed using ANOVA and Tukey’s test. CQDs with a particle dimension of ∼2 nm were synthesized. The amorphous property of GIC-CQD was confirmed through XRD. The fluorescence properties of GIC-CQD showed three times higher emission intensity than conventional GIC. GIC-CQD attained maturation with a setting time extended by 64 s than GIC. Cement residue of size 2 mm was detected with a UV light excitation at a distance between 5 to 10 cm. Biocompatibility at 0.125 mg ml−1 dilution concentrations of GIC-CQD showed viability greater than 80% to hDPSCs. For the first time, we report that CQDs-impregnated GIC is a unique and cost-effective strategy for in-situ detection of excess cement rapidly using a hand-held device. A novel in-situ rapid detection method enables the dentist to identify residual cement of size less than 2 mm during the implantation. Therefore, GIC-CQD would replace conventional GIC and help in the prevention of peri-implant diseases.

Overview of strategies to improve the antibacterial property of dental implants.

The increasing number of peri-implant diseases and the unsatisfactory results of conventional treatment are causing great concern to patients and medical staff. The effective removal of plaque which is one of the key causes of peri-implant disease from the surface of implants has become one of the main problems to be solved urgently in the field of peri-implant disease prevention and treatment. In recent years, with the advancement of materials science and pharmacology, a lot of research has been conducted to enhance the implant antimicrobial properties, including the addition of antimicrobial coatings on the implant surface, the adjustment of implant surface topography, and the development of new implant materials, and significant progress has been made in various aspects. Antimicrobial materials have shown promising applications in the prevention of peri-implant diseases, but meanwhile, there are some shortcomings, which leads to the lack of clinical widespread use of antimicrobial materials. This paper summarizes the research on antimicrobial materials applied to implants in recent years and presents an outlook on the future development.

Prevention and treatment of peri-implant diseases-The EFP S3 level clinical practice guideline.

The recently published Clinical Practice Guidelines (CPGs) for the treatment of stages I-IV periodontitis provided evidence-based recommendations for treating periodontitis patients, defined according to the 2018 classification. Peri-implant diseases were also re-defined in the 2018 classification. It is well established that both peri-implant mucositis and peri-implantitis are highly prevalent. In addition, peri-implantitis is particularly challenging to manage and is accompanied by significant morbidity. To develop an S3 level CPG for the prevention and treatment of peri-implant diseases, focusing on the implementation of interdisciplinary approaches required to prevent the development of peri-implant diseases or their recurrence, and to treat/rehabilitate patients with dental implants following the development of peri-implant diseases. This S3 level CPG was developed by the European Federation of Periodontology, following methodological guidance from the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation process. A rigorous and transparent process included synthesis of relevant research in 13 specifically commissioned systematic reviews, evaluation of the quality and strength of evidence, formulation of specific recommendations, and a structured consensus process involving leading experts and a broad base of stakeholders. The S3 level CPG for the prevention and treatment of peri-implant diseases culminated in the recommendation for implementation of various different interventions before, during and after implant placement/loading. Prevention of peri-implant diseases should commence when dental implants are planned, surgically placed and prosthetically loaded. Once the implants are loaded and in function, a supportive peri-implant care programme should be structured, including periodical assessment of peri-implant tissue health. If peri-implant mucositis or peri-implantitis are detected, appropriate treatments for their management must be rendered. The present S3 level CPG informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to maintain healthy peri-implant tissues, and to manage peri-implant diseases, according to the available evidence at the time of publication.

The implant-abutment connection and its impact on prevention of peri-implant diseases and crestal bone stability—an academic and clinical evaluation of the literature

: The crestal bone stability and the long-term presence of bone crest at the level of the implant platform to achieve implant success and esthetic outcomes is of paramount importance. The paper presents and academic and clinical evaluation of the literature on the characteristic features of the implant-abutment connection, the main characteristic of an implant collar and platform to control the microgap and bacteria proliferation leading to prevention of crestal bone loss. In addition, the role of the abutment-disconnection, the size of the horizontal mismatch, and last but not least the importance of the Morse-tapered connection has been discussed as fundamental requirements for improvement of implant success and long-term successful esthetic outcomes. The author presents also clinical and histological information on the implant abutment connection, which is beneficial for the bone stability. All this scientific information must be critically analyzed in the modern implant dentistry when new implant surfaces and implant-abutment connections are developed to improve strategies for better osseointegration and sustainable crestal bone stability.

Prevention of peri-implant disease in edentulous patients with fixed implant rehabilitations.

To provide an overview about the current approaches to prevent peri-implant diseases in edentulous patients with complete-arch implant-supported prostheses, and to review the clinical applications of the latest digital technologies for implant prosthodontics. A review of the guidelines to prevent peri-implant diseases in patient's receiving complete-arch implant-supported prostheses including facially driven treatment planning procedures using either conventional or digital methods, computer-aided implant planning procedures, and prosthodontic design variables including the optimal number and distribution of dental implants, implant to abutment connection type, implant or abutment level design, screw- or cement-retained alternatives, prostheses contours, and material selection is provided. Furthermore, an outline of the current therapeutic management approaches to address peri-implant diseases is reviewed. Clinicians should understand and know different planning and design-related variables that can affect biological and mechanical complication rates of complete-arch implant-supported prostheses. Maintenance protocols are fundamental for minimizing biological and mechanical complications.

Effectiveness of Supportive Care in the Prevention of Peri-implant Diseases in Brånemark Protocol Rehabilitations: A Retrospective Cohort Study.

This retrospective cohort study aimed to evaluate the efficiency of supportive periodontal treatment (SPT) on peri-implant disease prevention. A total of 63 rehabilitated patients with 504 implants were selected with both maxillary and mandibular Brånemark-type protocols (all-on-four system) placed between 2004 and 2014 in a private practice with 5 to 15 years of follow-up. Study participants were divided into those who adhered to SPT with regular intervals of two or more times a year (Group 1) and those with irregular intervals with more than 1 year without attending SPT (Group 2). The implants placed were evaluated clinically and radiographically to assess peri-implant diseases. The prevalence of mucositis and peri-implantitis in the total population was 64.7% (326 implants) and 3.7% (19 implants), respectively. Group 2 had higher rates of mucositis (181 implants) and peri-implantitis (16 implants) than Group 1 (145 and 3 implants, respectively) (P < .05). The odds ratio for peri-implantitis in Group 2 was 7.1. The results suggest that patients who regularly received SPT had lower chances of developing peri-implant diseases.

Peri-implantitis: Definition, etiology, and prevention – a review

Peri-implant is a severe complication after implant surgery or treatment, influencing the surrounding tissues. Therefore, distinct and continuous clinical checkups and investigation and removal of causative factors (smoking and periodontitis) are effective precautionary measures against peri-implant. The primary aim of this review is to provide a summary of the current literature regarding the etiology and prevention of peri-implant disease for healthcare providers.

Knowledge, Attitude and Practice towards Prevention of Peri-Implant Infection and Inflammation: A Cross-Sectional Descriptive Survey

Even till now, nothing much has been done to explore the inflammation and prevention of the same around the implants placed, hence the aim of this study was to evaluate factor associated with dentist knowledge, attitude along with practice in preventing peri-implant diseases. This was a descriptive, cross-sectional, questionnaire based study carried within Dental professionals of Patna city. Stratified random sampling technique was the sampling method utilized in this study. The survey was conducted among 132 dentists. A questionnaire was framed by using google forms. Most of dental professionals were having fair knowledge {61(46.21%)}, positive attitude {61 (46.21%)} and poor practice (47.72%)} towards prevention of Peri-implant diseases. On application of Chi-square test, it was found that knowledge of study participants was significantly (0.05*) associated with gender, average duration of doing Implant surgery while attitude was significantly (0.05*) associated with age and degree. It was concluded that knowledge was fair; attitude was positive and despite this practice was poor regarding the prevention of Peri-Implant diseases among Dental professionals. Factors associated with knowledge, attitude and practice of study participants was gender, average duration of doing Implant surgery, age and degree.

GUÍA DE PRÁCTICA CLÍNICA PARA LA PREVENCIÓN Y EL TRATAMIENTO DE ENFERMEDADES PERIIMPLANTARES

Introduction: the incidence of peri-implant diseases is high, and their optimal management is still debated. The purpose was to explore the levels of available evidence and to suggest evidence-based recommendations for the treatment of peri-implant mucositis and peri-implantitis. Methods: a clinical practice guideline was developed using the Scottish Intercollegiate Guidelines Network (SIGN) criteria. A search strategy was formulated, and a critical review of the following evidence was performed: 1) prevention of peri-implant diseases, 2) treatment of peri-implant mucositis, and 3) treatment of peri-implantitis. Systematic reviews and randomized controlled clinical trials were the primary study types identified in the literature. Current levels of evidence were established and recommendations were provided. Results: a total of 67 articles were included. Regarding the prevention of peri-implant diseases, there is strong evidence for the involvement of patients in a regular maintenance program according to their risk profile. Regarding the treatment of peri-implant mucositis, infection control measures are recommended; controversy exists over the usefulness of antimicrobial agents, and there is evidence against the use of antibiotics. Selection of the peri-implantitis treatment method depends on the severity of the condition and patient-related factors. Resective and regenerative therapies may be used for treatment. The use of systemic antibiotics favors the response of clinical parameters. There is conditional evidence for the use of other adjunctive therapies. Conclusions: the best way to prevent peri-implantitis is to prevent peri-implant mucositis through adherence to supportive periodontal therapy. Treatment of peri-implant diseases depends on local and systemic conditions that affect the success of other treatment options.

Interleukin – 17 and interleukin-10 as inflammatory and prevention biomarkers in periimplant diseases

Background:Periimplant diseases are inflammatory diseases. Thus, the level of preinflammatory cytokines which has important role in the inflammation processes can consider as biomchemical markers for early diagnosis and prevention of periimplant diseases. The aim of this study was to determine and compare the level of interleukin (IL)-17 and IL-10 in patients with periimplant mucositis and periimplantitis.Methods:This case--control study was conducted on 51 patients with implants which were loaded at least 1 year previously, 17 patients with periimplant mucositis, 17 patients with periimplantitis, and 17 individuals with healthy implants. After clinical examination, gingival crevicular fluid sampling was carried out by paper point number 25 for 4 min and the mean value of IL-17, IL-10 in samples was measured using enzyme linked immunosorbent assay (ELISA), least square differences (LSD) reader in laboratory. The data was analyzed using statistical software SPSS 22. Quantitative analysis was done using One-way analysis of variance (ANOVA) test and LSD past test.Results:The results of analysis showed that there was a significant difference in the mean value of IL-17 and IL-10 between the three study groups (P < 0.001). Individuals with healthy implants showed a significant lower level of IL-17 than patients with periimplantitis (P = 0.001) and for patients with periimplantitis, the level of IL-17 was significantly lower than that of patients with periimplant mucositis (P < 0.001) and IL-10 level was significantly lower in mucositis than periimplantitis (P < 0.001).Conclusions:The level of IL-17 and IL-10 increased in patients with periimplant compared to individuals with healthy periimplant tissues and the results showed that the highest concentrations of IL-17 and IL-10 were observed in patients with periimplant mucositis and periimplantitis, respectively.

Häusliche und professionelle Maßnahmen zur Prävention periimplantärer Erkrankungen

The maintenance of peri-implant health and the prevention of peri-implant diseases are essential for a long-term implant success. Considering both issues, a consequent implementation of an individual, risk-oriented prevention concept must be developed prior to implant placement. Therefore, a targeted patient management in the so-called supportive implant therapy (SIT) is an important contribution to healthy implants.Apart from an adequate individual oral hygiene at home, a professional dental team that performs clinical diagnostics and implant cleaning is just as necessary and important for the patient. Thus, SIT must not only consist of a mechanical cleaning of the implants but must also cover a regular re-motivation and re-instruction for individual oral hygiene. Regular intervals of (at least) six months are recommended.A mechanical bio film management–at home as well as in the dental office–can be performed with well-established tools, such as tooth brushes (manual or electric), interdental brushes, or floss as well as with specific instruments or systems for implant cleaning (manual instruments, oscillating sonic or ultra-sonic scalers, air-flow polishing device). The additional use of chemical agents does not offer an additional clinical benefit. Up to now, no superiority of one of the aforementioned procedures has been documented. Accordingly, a regular mechanical implant cleaning is the most important tool in implant follow-up care, independent from the instruments applied. However, even with regular professional care, the development of peri-implant diseases cannot be avoided completely.

Microbiological Aspect in Dental Implants and Natural Teeth with the Impact of Aloe vera Gel

The health of peri-implant tissues is one of the most important aspects for the long-term success of dental implants. Thus the control of bacterial plaque which is the main etiological factor in peri-implant diseases by using an effective preventive regimen and a therapeutic agent is of vital importance in prevention of any irreversible pathological conditions of peri‑implant tissues. The purposeof this study wasto investigate and compare microbiological aspect of subgingival plaque at implants and contralateral natural teeth in the same patients with the impact of Aloe vera gel. 20 females aged 25- 45 year who exhibited the presence of one clinically stable implant carrying a full ceramic crown and one contralateral natural tooth were selected to be enrolled in a split-mouth study. All participants were apparently healthy with no history of any systematic diseases and they have been treated with a two-piece implant system which should be in function for at least 6 months. Samples of subgingival plaque were collected from implants and contralateral teeth for microbial analyses (Gram positive bacteria, Gram negative bacteria and Candida species) at base line and 2 weeks after the application of Aloe vera gel. Microbial analyses revealed no statistically significant difference (p&gt; 0.05) in the counts of microorganisms between implants and teeth, although they were lower in implant than that in teeth. Finding also revealed a significant reduction (p&lt; 0.01) in the count of Gram-positive bacteria and Candida speciesafter application of Aloe vera for both implants and teeth. On the other hand, the count of Gram-negative bacteria seems not to be affected by Aloe vera gel. No differences were found in microbiological analysis of subgingival plaque from dental implants and teeth in the same patient. Moreover, Aloe vera is a promising herb with antimicrobial activity that could be used as a beneficial agent in treatment and prevention of peri-implant diseases.

Prevention of peri-implant disease by design and protocol

Prevention of peri-implant disease by design and protocol

Research progress in microbiological characteristics of peri-implant disease

Peri-implant disease is an inflammatory status which leads to the destruction of the soft and hard tissues around osseointegrated implants, including peri-implant mucositis and peri-implantitis. It is generally accepted that bacterial infection appears to be responsible for peri-implant lesions. This review aims to summarize the characteristics of the subgingival microbiota in healthy and diseased implants and compare the microbial composition of subgingival biofilm in teeth with periodontal disease and in diseased implant, so as to provide biological basis on the diagnosis, therapy and prevention of peri-implant disease in clinical practice.

Implant maintenance for the prevention of biological complications: Are you ready for the next challenge?

With increasing knowledge of wound biology and material sciences, the provision of dental implants as a treatment modality has become increasingly predictable and more commonly used to replace missing teeth. However, without appropriate follow up, peri-implant diseases could develop and affect the long-term success of implants. Currently, there is not enough focus on the prevention of peri-implant diseases, as compared to the definition of the disease, its prevalence, and treatment. In the present study, we aim to summarize various factors influencing the successful maintenance of dental implants and highlight current gaps in knowledge. Factors influencing the successful maintenance of dental implants can be divided into three categories: implant-, dentist-, and patient-related factors. Patients with dental implants are often more dentally aware, and this offers an advantage. Compared to gingiva, peri-implant mucosa responds at a different pace to the bacterial challenge. Dental practitioners should be aware of how treatment protocols affect long-term success, and be vigilant in detecting peri-implant diseases at an early stage. Compared to periodontal maintenance, less longitudinal studies on implant maintenance are available, and therefore, there is a tendency to rely heavily on information extrapolated from the periodontal literature. More studies on the significance of implant maintenance care are required.