Efficacy of combined application of glycine powder air-polishing in non-surgical treatment of peri-implant diseases / 北京大学学报(医学版)

OBJECTIVE@#To compare the clinical efficacy of combined application of glycine powder air-polishing and mechanical submucosal debridement in non-surgical treatment of peri-implant diseases.@*METHODS@#A randomized controlled clinical study was carried out on patients diagnosed with peri-implant diseases in the Department of Periodontology, Peking University School and Hospital of Stomatology, between May of 2020 and June of 2021.Twenty-eight patients with totally sixty-two implants were enrolled.The patients were randomly divided into the test group and control group. The patients in the test group (13 subjects/32 implants) received mechanical submucosal debridement using titanium curettes combined with application of glycine powder air-polishing, while the control group (15 subjects/30 implants) received mechanical submucosal debridement using titanium only. Clinical parameters, such as plaque index (PLI), pocket probing depth (PPD), bleeding index (BI) and the percentage of suppuration on probing on implants' level (SoP%) were measured at baseline and 8 weeks after non-surgical intervention. Changes and group differences of clinical parameters of the implants before and 8 weeks after non-surgical intervention were compared.@*RESULTS@#Mean PLI, PPD, BI of both the test group and control group significantly reduced 8 weeks after non-surgical intervention (P < 0.05). Compared with the control group, the test group achieved lower BI (2.7±0.8 vs. 2.2±0.7, P < 0.05), more reduction of BI (0.6±0.7 vs. 1.1±0.6, P < 0.01) and more reduction of SoP% (21.9% vs. 10%, P < 0.05) after non-surgical intervention. Both the control and test groups exhibited comparable PLI and PPD reductions (P>0.05). For the implants diagnosed with peri-implant mucositis, the test group revealed more signi-ficant reduction in BI and SoP% than the control group (1.0±0.7 vs. 0.4±0.7, P=0.02; 6.3% vs. 0, P=0.012). There was no significant difference existing in PLI and PD improvement between the control group and test group (P>0.05). For the implants diagnosed with peri-implantitis, there was no significant difference existing in PLI, PPD, BI and SoP% improvement values between the test and control groups (P>0.05). No complications or discomforts were reported during the study.@*CONCLUSION@#Both treatment procedures could relieve the inflammation of peri-implant soft tissue. Non-surgical mechanical submucosal debridement combined application of glycine powder air-polishing is associated with significant reduction of soft tissue bleeding and suppuration on probing especially in the implants diagnosed with peri-implant mucositis.

Tratamento de mucosite periimplantar pela técnica de enxerto gengival livre: relato de caso / Treatment of peri-implant mucositis through free gingival graft technique: case report

A Mucosite peri-implantar é considerada a precursora da peri-implantite, ela é uma lesão inflamatória da mucosa peri-implantar na ausência de perda óssea marginal contínua. O objetivo desse relato de caso, foi descrever o tratamento da mucosite periimplantar através da cirurgia de enxerto gengival livre. Foi proposto, portanto, um tratamento reabilitador envolvendo uma abordagem multidisciplinar de forma a resgatar e restabelecer estética, função e bem-estar através do enxerto gengival livre para melhorar as características de mucosa e viabilizar uma previsibilidade de uma prótese definitiva implantosuportada em condições teciduais mais estáveis. O uso do EGL para aumento da gengiva queratinizada na cirurgia de implantes em paciente idosos é uma solução prática e segura para a manutenção da saúde periodontal ao redor do implante... (AU)

Peri-implant mucositis is considered the precursor of peri-implantitis, it is an inflammatory lesion of the peri-implant mucosa in the absence of continuous marginal bone loss. The purpose of this case report was to describe the treatment of peri-implant mucositis through free gingival graft surgery. Therefore, a rehabilitation treatment involving a multidisciplinary approach was proposed in order to rescue and reestablish aesthetics, function and well-being through the free gingival graft to improve the characteristics of the mucosa and enable a predictability of a permanent implant prosthesis under more stable tissue conditions. The use of EGL to increase keratinized gingiva in implant surgery in elderly patients is a practical and safe solution for maintaining periodontal health around the implant... (AU)

Clinical observation of cement-retained and screw-retained implant-supported denture in edentulous patients / 口腔疾病防治

Objective@# To evaluate the clinical effects of full-arch cement-retained implant-supported combined crowns and screw-retained implant-supported bridge dentures in complete or half edentulous patients. @*Methods @#A total of 25 patients with complete or partial edentulous dentures followed up for 1, 3, and 5 years in our hospital from June 2013 to June 2018 and were treated with Straumann bone horizontal implantation, cobalt-chromium stenting and cobalt-chromium porcelain restoration with cement-retained and screw-retained implant-supported fixed dental prostheses to evaluate the accumulative implant survival rate, accumulative prosthesis survival rate, mechanical complications, and biological complications in both groups. @*Results @#There were 25 complete or half edentulous patients who received 165 Straumann implants and 28 implant-supported fixed dental prostheses in this study. There were 11 cases with 69 implants in the cement group and 17 cases with 96 implants in the screw group. The accumulative implant survival rate was 100% in the cement group and 96.9% in the screw group. The accumulative prosthesis survival rate was 100% in both groups. The cumulative peri-implant mucositis rate was 23.2% in the cement group and 29.2% in the screw group, and the peri-implantitis rate was 6.8% in the cement group and 7.3% in the screw group. There was 1 case of porcelain collapse (n=1/11) and no screw of abutment loosening in the cement group and 4 cases of porcelain collapse (n=4/17) and 1 case of screw loosening in the screw group. No fracture of abutment was observed in either group. There was no difference in bone loss between the two groups in the first year (P > 0.05), and a higher rate of bone loss was found in the screw group in the third and fifth years (P < 0.05). There was no difference in the sulcus bleeding index(mSBI) between the two groups in the first year and the third year (P > 0.05) and a higher modified mSBI value in the cement group in the fifth year (P < 0.05).@*Conclusion @#The survival rates of the implant and prosthesis for cement-retained or screw-retained implant-supported fixed dental prostheses were both high, but there were more mechanical and biological complications in the traditional cobalt-chromium alloy screw-retainer group. The removal of residual adhesives must be reasonably considered when choosing the cement retention method.

A clinical practice guideline for the prevention and treatment of peri-implant diseases / Guía de práctica clínica para la prevención y el tratamiento de enfermedades periimplantares

ABSTRACT 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.

RESUMEN Introducción: la incidencia de las enfermedades periimplantarias es alta, y todavía existe polémica en torno a su óptima administración. El propósito del presente estudio consistió en explorar los niveles de evidencia disponibles y ofrecer recomendaciones basadas en la evidencia para el tratamiento de la mucositis periimplantaria y la periimplantitis. Métodos: se elaboró una guía de práctica clínica utilizando los criterios de la Red de Directrices Intercolegiales Escocesas (Scottish Intercollegiate Guidelines Network, SIGN). Se formuló una estrategia de búsqueda y se realizó una revisión crítica de las siguientes evidencias: 1) prevención de enfermedades periimplantarias, 2) tratamiento de la mucositis periimplantaria y 3) tratamiento de la periimplantitis. Las revisiones sistemáticas y los ensayos clínicos controlados aleatorios fueron los principals tipos de estudio identificados en la literatura. Se establecieron los niveles actuales de evidencias y se ofrecieron recomendaciones. Resultados: se incluyeron 67 artículos. En cuanto a la prevención de enfermedades periimplantarias, hay claras evidencias de la participación de los pacientes en los programas de mantenimiento regular, de acuerdo con su perfil de riesgo. En cuanto al tratamiento de la mucositis periimplantaria, se recomiendan medidas de control de infecciones; existe controversia sobre la utilidad de los agentes antimicrobianos, y hay evidencia en contra del uso de antibióticos. La selección del método de tratamiento de la periimplantitis depende de la gravedad de la afección y de los factores relacionados con el paciente. Para el tratamiento se pueden utilizar terapias resectivas y regenerativas. El uso de antibióticos sistémicos favorece la respuesta de los parámetros clínicos. Hay evidencia condicional en cuanto al uso de otras terapias adyuvantes. Conclusiones: la mejor manera de prevenir la periimplantitis es prevenir la mucositis periimplantar mediante la adherencia a la terapia periodontal de apoyo. El tratamiento de las enfermedades periimplantarias depende de las condiciones locales y sistémicas que afectan el éxito de otras opciones de tratamiento.

Doenças peri-implantares, etiologia, diagnóstico e classificação. Revisão de literatura / Peri-implant diseases, etiology, diagnosis and classification. Literature review

Atualmente, a busca por saúde permeia desde o bem estar físico até conceitos estéticos, para se alcançar os parâmetros pessoais de cada indivíduo. Para um correto planejamento reabilitador, devemos considerar várias possibilidades para evitar falhas funcionais e estéticas. Dentre as falhas tardias observamos as doenças peri-implantares, como por exemplo a Mucosite Peri-implatar e a Peri-implantite. Considerando a complexidade e importância da compreensão das doenças Peri implantares, este trabalho tem como objetivo, através de uma revisão da literatura, discutir os aspectos inerentes à etiologia, diagnóstico e classificação das doenças peri-implantares. O tecido peri-implantar e o tecido periodontal possuem estruturas anatômicas similares, mas possuem diferenças estruturais também. Estes fatos também determinam semelhanças e diferenças nas doenças periodontais e peri-implantares. Sabe-se que o principal fator etiológico das doenças periodontais é o biofilme bacteriano, e nas doenças peri-implantares este também é o principal fator etiológico. O mesmo padrão prevalece para alguns fatores etiológicos secundários ou modificadores. Várias são as propostas de classificação das doenças e condições peri-implantares baseadas na gravidade dos comprometimentos clínicos, nos fatores etiológicos, na associação com outras enfermidades e até com fatores iatrogênicos determinantes. Mas nenhuma contempla estes fatores etiológicos juntos e sabe-se que um correto diagnóstico é determinante para um bom plano de tratamento e determinação de sucesso e longevidade das reabilitações peri-implantares (AU)

Currently, the pursuit for health permeates from the physical well-being to aesthetic concepts, in order to achievethe personal parameters of each individual. For a correct rehabilitation planning we must consider several possibilities to avoid functional and aesthetic failures. Among late failures, there are peri-implant diseases, such as Periimplantar Mucositis and Peri-implantitis. Considering the complexity and importance of the understanding of periimplant diseases, this paper aims, through a literature review, to discuss the inherent aspects of the etiology, diagnosis and classification of these peri-implant diseases. Although they have similar anatomical structure, periodontal and peri-impant tissues have some structural diferences. These facts determine similarities and diferences between periodontal and periimplant diseases. It is known that the main etiological factor of periodontal diseases is bacterial biofilm, and in peri-implant diseases this is also the main etiological factor. The same pattern prevails for some secondary or modifiers etiological factors. There are several suggestions for the classification of peri-implant conditions and diseases based on theseverity of clinical complications, etiological factors, association with other diseases and even iatrogenic factors. But none considers these factors together and it is knownthat a correct diagnosis is determinant for a good treatment plan and determination of success and longevity of the peri-implant rehabilitations (AU)

Periodontal disease, peri-implant disease and levels of salivary biomarkers IL-1ß, IL-10, RANK, OPG, MMP-2, TGF-ß and TNF-α: follow-up over 5 years

Abstract Objective The aim of this study was to evaluate the levels of salivary biomarkers IL-1β, IL-10, RANK, OPG, MMP-2, TG-β and TNF-α in individuals with diagnosis of peri-implant mucositis in the absence or presence of periodontal and peri-implant maintenance therapy (TMPP) over 5 years. Material and Methods Eighty individuals diagnosed with peri-implant mucositis were divided into two groups: one group that underwent periodontal and peri-implant regularly maintenance therapy, called GTP (n=39), and a second group that received no regular maintenance GNTP (n=41). Each participant underwent a complete periodontal and peri-implant clinical examination. Collection of saliva samples and radiographic examination to evaluate peri-implant bone levels were conducted at two times: initial examination (T1) and after 5 years (T2). The salivary samples were evaluated through ELISA for the following markers: IL-1β, IL-10, RANK, OPG, MMP-2, TGF and TNF-α. Results A higher incidence of peri-implantitis was observed in the GNTP group (43.9%) than in the GTP group (18%) (p=0.000). All individuals (n=12) who presented peri-implant mucositis and had resolution at T2 were in the GTP group. After 5 years, there was an increase in the incidence of periodontitis in the GNTP group compared to the GTP group (p=0.001). The results of the study revealed an increase in the salivary concentration of TNF-α in the GNTP group compared to the GTP group. The other salivary biomarkers that were evaluated did not show statistically significant differences between the two groups. Conclusions The salivary concentration of TNF-α was increased in individuals with worse periodontal and peri-implant clinical condition and in those with a higher incidence of peri-implantitis, especially in the GNTP group. Longitudinal studies in larger populations are needed to confirm these findings and elucidate the role of this biomarker in peri-implant disease.

A review of peri-implant microbiology / 华西口腔医学杂志

Dental implants represent the majority of treatment strategies used to replace missing teeth. However, peri-implant diseases caused by disturbance in peri-implant microbiological balance are among the reasons for implant failure. Since the 1980s, peri-implant microorganisms have been a hot research topic in dental microbiology. The bacterial ecology between the disease and health largely differs, which directly or indirectly increases the risk of peri-implant diseases. Accordingly, the determination of the 'core microbiome' of peri-implantitis and peri-implant mucositis is a key point of recent research.

Nueva Clasificación sobre las Enfermedades y Condiciones Periodontalesy Peri-implantares: Una Breve Reseña / Nova Classificação da Condições e Doenças Periodontais e Peri-implantares: Uma Breve Revisão / New Classification of Periodontal and Peri-Implant Diseases and Conditions: A Brief Review

En junio de 2018 se propuso una nueva clasificación de enfermedades y condiciones periodontales y peri-im-plantares, en una reunión realizada conjuntamente por la Academia Americana de Periodoncia y la Federación Europea de Periodoncia, con el objetivo de actualizar la clasificación de 1999 en uso durante los últimos 19 años. El objetivo del artículo es introducir esta nueva clasificación para que tanto clínicos e investigadores pue-dan aplicarla. La nueva clasificación incorporará nuevos conceptos a medida que se reporten nuevos resultados sobre estudios que sean realizados en el futuro.

A new classification of periodontal and peri-implant diseases and conditions was proposed in June 2018, in a meeting jointly held by the American Academy of Periodontology and European Federation of Periodontology, with the aim to update the 1999 classification in use for 19 years. The article aimed at introducing the most re-cent periodontal and peri-implant classification to clinicians and scientific investigators. The new classification has an in-built plan for periodic revisions while upcoming studies are carried out.

Uma nova classificação das condições e doenças periodontais e peri-implantares foi proposta em junho de 2018, em um encontro que reuniu a Academia Americana de Periodontia e a Federação Europeia de Periodontia, que teve como objetivo atualizar a classificação de 1999, amplamente utilizada nos últimos 19 anos. Este artigo tem como objetivo introduzir a mais nova classificação periodontal e peri-implantar aos clínicos e pesquisadores. A nova classificação possui um planejamento para revisões periódicas a medida que novos estudos são realizados.

Doença peri-implantar e níveis dos marcadores salivares IL 1ß, IL-10, RANK, OPG, MMP-2, TGF e TNF-α: estudo observacional de 5 anos e revisão sistemática / Doença peri-implantar e níveis dos marcadores salivares IL-1ß, IL-10, RANK, OPG, MMP-2, TGF-ß, e TNF-α: estudo observacional de 5 anos e revisão sistemática / Peri-implant disease and levels of salivary biomarkers IL-1ß, IL-10, RANK, OPG, MMP-2, TGF and TNF-α: a 5 years follow-up and systematic review

A literatura recente apresenta inúmeros estudos sobre associação entre as doenças peri-implantares (DPi) e níveis de marcadores inflamatórios no fluido do sulco peri-implantar, em biópsias de tecido gengival e sangue. Surpreendentemente, poucos são os estudos de marcadores salivares relacionados à presença e progressão das DPi, uma vez que a saliva representa um meio não invasivo, de fácil coleta e baixo custo. Neste contexto, esta tese apresenta dois estudos distintos: (1) Estudo observacional longitudinal sobre a condição clínica peri-implantar associada aos níveis dos marcadores salivares IL-1ß, IL-10, RANK, OPG, MMP-2, TGF e TNF-α em indivíduos com diagnóstico de mucosite peri-implantar (MP) na ausência e presença de terapia regular de manutenção periodontal e peri-implantar (TMPP); e (2) Revisão sistemática com a seguinte questão focal: "Os níveis de biomarcadores salivares podem ajudar a distinguir implantes saudáveis de implantes com doença peri-implantar ?" A metodologia do estudo longitudinal envolveu 80 indivíduos diagnosticados com MP, que foram divididos em dois grupos: um que realizou terapia de manutenção periodontal e peri-implantar, chamado de GTP (n=39), e um outro sem manutenção (GNTP, n=41). Cada participante submeteu-se a um exame clínico periodontal e peri-implantar completo [registro do nível clínico de inserção (NCI); profundidade de sondagem periodontal (PS) e peri-implantar (PSi); sangramento à sondagem periodontal (SS) e peri-implantar (SSi); supuração (Si); índice de placa periodontal (IP) e peri-implantar (IPi)], exame radiográfico, para avaliação dos níveis ósseos peri-implantares e coleta de amostras de saliva em dois tempos: exame inicial (T1) e decorridos 5 anos (T2). As amostras salivares foram congeladas e posteriormente avaliadas através do teste de ELISA. Observou-se uma maior incidência de peri-implantite (PI) no grupo GNTP (43,9%) do que no grupo GTP (18%) (p = 0.000). Todos os indivíduos (n = 12) que apresentaram resolução da MP em T2 estavam no GTP. Houve um aumento no número de indivíduos com periodontite no GNTP quando comparado T1 (22,0%) e T2 (41.5%) (p = 0.001). Os resultados imunológicos revelaram um aumento na concentração salivar do TNF-α no GNTP comparado ao GTP. Os demais marcadores salivares avaliados não mostraram alteração estatisticamente significativa entre os dois grupos. Concluiu-se que a ausência de consultas regulares para manutenção periodontal/peri-implantar foi associada com pior condição clínica periodontal e peri-implantar, maior incidência de PI e um aumento significativo nos níveis de TNF-α, sugerindo ser este um marcador salivar promissor para a progressão das DPi. Adicionalmente, a revisão sistemática demonstrou que não há evidências sólidas para concluir que os biomarcadores salivares poderiam ajudar a distinguir entre implantes saudáveis de implantes com PI. Além disso, sugere-se que os resultados devem ser interpretados com cautela devido a inclusão de muitos estudos na revisão sistemática com um alto risco de viés.(AU)

Recent literature presents numerous studies on the association between peri-implant diseases (DPi) and levels of inflammatory biomarkers in peri-implant sulcus fluid, in gingival tissue and blood biopsies. Surprisingly, rare are studies on salivary markers related to the presence and progression of DPi, since saliva is abundant, its collection is an easy, low cost and, non-invasive method. In this sense, this thesis presents two distinct studies. The first (longitudinal) study that aimed to evaluate the peri-implant clinical condition and levels of the salivary markers IL 1ß, IL-10, RANK, OPG, MMP-2, TGF, and TNF-α in individuals in the presence and absence of periodontal/ peri-implant maintenance (TMPP). The second study, a systematic review, focused in answer the following question: Could biomarker levels in the saliva help to distinguish between healthy implants and implants with peri-implant disease? The longitudinal study methodology involved 80 individuals diagnosed with mucositis (MP), who were divided into two groups: a group that underwent periodontal and peri-implant maintenance therapy, called GTP (n = 39), and a second group without regular maintenance, called GNTP (n = 41). Each participant underwent a complete periodontal and peri-implant clinical examination [recording of the clinical level of insertion (NCI), periodontal probing depth (PS) and peri-implant probing depth (PSI), periodontal bleeding (SS) and peri-implant bleeding (SSi), suppuration (SU); periodontal plaque (IP) and peri-implant plaque (IPi) indexes], radiographic examination for evaluation of peri-implant bone levels and collection of saliva samples at two times: initial examination (T1) and after 5 years (T2). The salivary samples were frozen and then evaluated by ELISA's method for the following markers: IL 1ß, IL-10, RANK, OPG, MMP- 2, TGF and TNF-α. Results: A higher incidence of peri-implantitis (PI) was noted in the GNTP group (43.9%) than in the GTP group (18%) (p = 0.000). All the individuals (n = 12) who presented resolution of MP in T2 were from the GTP group. There was an increase in the number of individuals with periodontitis in GNTP when comparing T1 (22.0%) to T2 (41.5%) (p = 0.001). The result of the study revealed an increase in the salivary concentration of TNF-α in GNTP compared to GTP. The other salivary markers evaluated did not show statistically significant alteration between the two groups. Conclusion: The absence of regular consultations for periodontal / peri-implant maintenance was associated with worse periodontal and peri-implant clinical condition, higher incidence of PI, and a significant increase in TNF-α levels: suggesting this promising salivary marker for the prognosis and diagnosis of DPi.Additionally, the systematic review has shown that there is no solid evidence to conclude that salivary biomarkers could help distinguish between healthy implant implants with PI. Besides that, it is suggested that the results should be interpreted with caution due to the inclusion of many studies, in the systematic review, with a high risk of bias.(AU)

Risk factors, diagnosis and treatment of peri-implant diseases / 中华口腔医学杂志

With the wide spread of dental implantation, more and more soft and hard tissue illness related to dental implants occurred. According to a statistical analysis, about 1/4 to 1/2 patients are under the risk of suffering from peri-implant diseases. Peri-implant diseases include peri-implant mucotitis and peri-implantitis. The former is connected with soft tissue while the latter is related to hard tissue around dental implant. This article reviews the diagnosis, classification and treatment of peri-implant diseases.

Pathogenicity Factors of Kocuria kristinae Contributing to the Development of Peri-Implant Mucositis

@#Introduction: The formation of bacterial biofilms by opportunistic microorganisms on the surfaces of the implants is the leading etiopathogenetic factor of peri-implant mucositis and peri-implantitis. The purpose of this research was to study the adhesive and biofilm-forming properties of clinical strains of K. kristinae isolated from patients with peri-implant mucositis. Methods: 18 clinical strains of K. kristinae isolated from the patients were the object of the study. The adhesion of the microorganisms was determined by using formalized human red blood cells of the blood group O (1) Rh+ by the G. Brilis technique. The study of biofilm-forming properties of clinical isolates of K. kristinae was performed by using the spectrophotometric technique by G.D. Christensen (MtP microtiter plate test). Results: The representatives of genus Kocuria were isolated in 70% of patients. Total proportion of clinical isolates of Kocuria spp. among all isolated microorganisms reached 18.3%. The representatives of the species K. kristinae showed a high adhesion to red blood cells and high ability to form biofilms. The r-Pearson coefficient (+0.87) between adhesion and the ability to form biofilms by K. kristinae strains pointed out a direct correlation. Conclusions: Obviously, Kocuria spp. take part in peri-implant mucositis development. It is proved by their presence on the mucous membrane of peri-implant area of patients with complications after dental implant placement. The representatives of the species K. kristinae showed a high adhesion and high biofilmformation.

Research progress in microbiological characteristics of peri-implant disease / 中华口腔医学杂志

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.

Efficacy of subgingival glycine air polishing on patients with early peri-implant diseases / 中华口腔医学杂志

Objective@#To compare the clinical efficacies of subgingival glycine air polishing and ultrasonic scaling combined with 0.12% chlorhexidine rinsing on patients with early peri-implant diseases (peri-implant mucositis and early peri-implantitis).@*Methods@#Twenty-two systemically healthy patients with totally 42 implants and early peri-implant diseases, were recruited in this study. The patients were randomly divided into the test group and the control group. Patients in the test group were treated with subgingival glycine air polishing and patients in the control group were treated with ultrasonic scalers combined with 0.12% chlorhexidine rinsing. Periodontal parameters such as probing depth, bleeding index, plaque index and clinical attachment loss, at baseline and 2 months after treatment, respectively, were collected and compared between the test and control groups.@*Results@#For the natural teeth, the parameters of probing depth, bleeding index, plaque index and attachment loss in the two groups were significantly improved after treatments (medians were 0.48 mm vs 0.22 mm, 1.00 vs-0.13, 0.38 vs 0.50, 0.48 mm vs 0.22 mm, respectively for test and control group). There was no statistical difference of median between the two groups after treatment except for that of the attachment loss (medians, 0.48 mm vs 0.22 mm, P=0.034). For the implants, differences of parameters in the two groups at baseline were insignificant. After treatments, the probing depths significantly decreased by 0.67 mm and 0.33 mm in the test group and the control group, respectively. The inter-group differences, however, were insignificant. Significant difference of the bleeding index after treatment was found in the test group (P=0.019), but not in the control group. No adverse reactions were found on patients in the two groups after treatments.@*Conclusions@#Efficacy of subgingival glycine air polishing and ultrasonic scaling combined with 0.12% chlorhexidine rinsing is competitive on patients with early peri-implant diseases. However, the former treatment may be more effective oncontrolling the early peri-implant inflammation.

Analysis of 3-year survival of implants in patients with chronic periodontitis / 上海交通大学学报（医学版）

Objective · To observe short and medium term survival of implants in patients with chronic periodontitis after implantation. Methods · 54 patients with chronic periodontitis (133 implants) were enrolled from August 2011 to August 2013. The survival of implants was observed and the periimplant diseases were compared and analyzed between patients with different degrees of chronic periodontitis. Results · The 3-year survival rate of implants was 97.74%. The differences between patients with different degrees of chronic periodontitis were not statistically significant (P=0.452). Periodontal pocket depth (PPD) and modified plaque index (mPLI) were significantly higher in patients with severe chronic periodontitis than in patients with mild and moderate chronic periodontitis. For patients not receiving supportive periodontal therapy (SPT), the peri-implantitis rate in patients with severe chronic periodontitis was significantly higher than that in patients with mild and moderate chronic periodontitis (P=0.009). For smokers, the periimplantitis rate in patients with severe chronic periodontitis was significantly higher than that in patients with mild and moderate chronic periodontitis (P=0.016). Conclusion · For patients with chronic periodontitis, the theraputic effect of implant treatment is good. Plaque control, SPT, and smoking cessation can reduce the incidence of peri-implantitis.

Periimplantitis: revisión de la literatura / Peri-Implantitis: literature review

El uso de implantes ha tomado un gran auge en los últimos años, sin embargo así como se ha visto un aumento en la demanda también se ha visto un incremento en el fracaso de los mismos, existen múltiples razones que intervienen para esto como son; deficiencias en la cantidad y calidad de hueso, patologías óseas preexistentes, mala técnica quirúrgica, implante inadecuado, hábito tabáquico, entre otras. La mucositis periimplantaria y la periimplantitis son las primeras causas de complicaciones en los implantes, los pacientes con enfermedades crónico degenerativas, fumadores y con mala higiene son considerados pacientes de riesgo para presentar periimplantitis. La literatura ofrece tratamientos quirúrgicos y no quirúrgicos los cuales van enfocados a la eliminación de microorganismos y a la desinfección de la superficie del implante, el tratamiento quirúrgico como la debridación y curetaje tienen la finalidad de eliminar la placa bacteriana, desinfectar la superficie del implante así como retirar el tejido dañado por el proceso inflamatorio, el realizar una adecuada historia clínica y valoración previa, permitirá identificar a los pacientes con mayor o menor riesgo de desarrollar periimplantitis, las citas de mantenimiento ayudan a detectar oportunamente posibles complicaciones.

The use of implants has taken a giant leap in recent years, however, greater demand has also resulted in an increase in the failure of these procedures. There are multiple reasons involved such as; deficiencies in the amount and quality of bone, preexisting bone disease, poor surgical technique, improper implant, tobacco habit, among others. The peri-implant mucositis and peri-implantitis are the main causes of complications in implants, patients with chronic degenerative diseases, smokers and patients with poor oral hygiene are considered risk patients to present peri-implantitis. The literature provides surgical and nonsurgical treatments which are focused on the elimination of microorganisms and the disinfection of the implant surface; surgical treatment as debridement and curettage are designed to remove plaque, disinfect the implant surface and remove damaged tissue caused by the inflammatory process, the performance of an adequate medical history and prior assessment will identify patients with greater or lesser risk of developing peri-implantitis, maintenance appointments help in the early detection of possible complications.

Factores asociados a la prevalencia de mucositis periimplantar: estudio retrospectivo de 10 años / Factors associated with the prevalence of peri-implant mucositis: Retrospective of 10 years

Resumen Introducción y objetivo: Los tejidos que soportan los implantes osteointegrados son susceptibles a patologías como la periimplantitis y la mucositis periimplantar. Su detección y tratamiento temprano son importantes para prevenir la progresión de la enfermedad y que llegue a comprometerse la estabilidad del implante. Por lo tanto, este estudio retrospectivo tiene como objetivo determinar los factores asociados a la prevalencia de mucositis periimplantar en pacientes tratados en la Clínica de la Maestría en Periodoncia de la Universidad de San Martín de Porres. Materiales y métodos:De 318 historias clínicas correspondientes a un total de 955 implantes colocados entre los años 2001 y 2010, se evaluaron 212 implantes dentales colocados en un total de 74 pacientes. Se utilizó la presencia de sangrado al sondaje como parámetro de diagnostico para la mucositis periimplantar. Resultados: La prevalencia de Mucositis periimplantar obtenida para el total de 212 implantes evaluados fue 58,96%. Adicionalmente, se encontró diferencias estadísticamente significativas al comparar los grupos de implantes con y sin mucositis periimplantar en relación al nivel de higiene oral. Conclusión: La prevalencia de mucositis periimplantar en la Clínica de la Maestría en Periodoncia de la Universidad de San Martin de Porres entre los años 2001 y 2010 fue de 58.96%. Además, se encontró asociación entre la presencia de mucositis periimplantar y el nivel de higiene oral.

Abstract Introduction and objective: Tissues supporting osseointegrated implants are susceptible to diseases such as periimplantitis and periimplant mucositis. Early detection and treatment are important to prevent disease progression and loss of implant stability. Therefore, the aim of this retrospective study was determine the factors associated with the prevalence of peri-implant mucositis of subjects treated at the Clinic of the Master in Periodontics at the University of San Martín de Porres. Materials and methods: 318 medical records with a total of 955 implants were placed from 2001 to 2010. Of these, 212 dental implants evaluated in a total of 74 medical records were included in this study. We used the presence of bleeding on probing as a diagnostic parameter for peri-implant mucositis. Results: The prevalence of peri-implant mucositis obtained for the total of 212 implants was 58,96%. Additionally, statistically significant differences were found when comparing the groups of implants with peri-implant mucositis and without regard to the oral hygiene level. Conclusion:The prevalence of peri-implant mucositis at the University of San Martin De Porres is 58.96%. It has been found statistically significant association between the presence of peri-implant mucositis and oral hygiene level.

Diagnóstico das doenças peri-implantares: uma abordagem clínica / Diagnoses of periimplant diseases – A clinical approach

Os parâmetros clínicos e radiográficos estão sendo amplamente utilizados no diagnóstico das doenças peri-implantares. O exame dos tecidos peri-implantares através desses parâmetros permite a detecção de sinais e sintomas da mucosite peri-implantar e da peri-implantite. Além disso, os estudos atuais mostram um aumento na prevalência dessas alterações, o que sugere a necessidade de um diagnóstico precoce. Os parâmetros clínicos que podem ser utilizados neste diagnóstico são os índices de placa, gengival e de sangramento, a profundidade de sondagem, a posição da margem gengival, o nível de inserção clínica, a presença ou ausência de supuração, a quantidade de mucosa queratinizada, o teste de mobilidade e a verificação de perda óssea radiográfica. O objetivo deste estudo foi, através de uma revisão da literatura sobre os parâmetros clínicos e radiográficos, discutir e indicar quais os índices que podem ser utilizados na prática clínica diária a fim de diagnosticar as doenças peri-implantares.

Clinical and radiographic parameters have been widely used on periimplant diseases diagnoses. Peri-implant examination, through these parameters, allows detection of signs and symptoms of Peri-implant Mucositis and Peri-implantitis. Moreover, several studies have shown an increase in the prevalence of those diseases suggesting a necessity for early diagnoses. Peri-implant plaque index, gingival and bleeding index, probing deep, gingival margin position, clinical attachment level, presence or absence of suppuration, keratinized mucosa, mobility test, and radiographic peri-implant bone loss are the most commonly used parameters in peri-implant disease diagnosis. The aim of this literature review is to describe clinical and radiographic parameters, and to discuss and indicate which parameters can be used to diagnose peri-implant diseases.