Does subgingival bacterial colonization differ between implants and teeth? A systematic review

Abstract The aim was of this study was to determine the current weight of evidence for the existence of specific differences between the microbiota of healthy teeth and healthy implants, or of teeth with periodontitis and implants with peri-implantitis. A systematic review was conducted according to the PRISMA statement. The MEDLINE, EMBASE and Cochrane databases were searched up to February 2018 for studies comparing microbiological data of biofilm samples collected from healthy teeth and implants or from teeth with periodontitis and implants with peri-implantitis. The weight of evidence was defined in three categories (strong, moderate and mild/some), according to the difference in number of studies showing statistically significantly higher counts and/or proportions and/or abundance and/or prevalence of microorganisms in health or in disease. Of the 132 articles identified, 8 were included. A wide range of microorganisms were present in different conditions but no microorganisms showed strong, moderate or mild/some evidence for a specific association with either teeth or implants. The results of this systematic review indicated that there is insufficient evidence in the literature to support specific differences between microorganisms colonizing teeth and implants, either in health or in disease.

Chemical and Microscopy Characterization of Trans-Endodontic Implants / Caracterización química y microscópica de implantes trans-endodónticos

Abstract Trans-endodontic implants are an artificial extension through root apex anchored in periradicular bone tissue. The aim is to improve the crown-root ratio and to provide stability to dental organ present. Zirconium oxide (ZrO2) is a material of great technological importance, having good natural color, high strength, high toughness, high chemical stability, does not suffer any corrosion, chemical and microbial resistance and excellent esthetic properties. Objective: The aim of this study was to evaluate chemical and microscopy of surface conditions of ZrO2 trans-endodontic implant. Materials and Methods: A blocks of ZrO2 were manufactured for produce trans-endodontic implants and divided in two groups: monoclinic and tetragonal phase. They were evaluated using Scanning Electroning Microscope (SEM), EnergyDispersive X-ray Spectroscopy (EDS), and Atomic Force Microscope (AFM) and Vickers Micro hardness. Results: The Monoclinic phase through AFM analysis showed roughness Ra = 0.320μm, whereas in the Tetragonal phase was 0.126μm, SEM/EDX indicated that the phases are not properly uniform and the addition of the Yttrium to favor the stabilization of the Tetragonal phase. The Vickers hardness analysis showed a value of 1500HV. Conclusion: The characterization of the surface of trans-endodontic zirconium oxide implants provides a guideline to know the surface characteristics of the material, since a greater roughness on the surface of the implant will favor the Osseo-integration capacity.

Resumen Los implantes trans-endodónticos son una extensión artificial a través del ápice radicular anclado en el tejido óseo periradicular. El objetivo es mejorar la relación corona-raíz y proporcionar estabilidad al órgano dental presente. El óxido de zirconio (ZrO2) es un material de gran importancia tecnológica, con buen color natural, alta resistencia, alta tenacidad, alta estabilidad química, no sufre corrosión, resistencia química y microbiana y excelentes propiedades estéticas. Objetivo: El objetivo de este estudio fue evaluar las condiciones superficiales de ZrO2 para su aplicación clínica a los implantes transendodónticos. Materiales y Métodos: se trituraron bloques de ZrO2 en implantes trans-endodónticos y se dividieron en: monoclínico y tetragonal. Luego se evaluaron mediante microscopía electrónica de barrido (SEM), espectroscopia de rayos X de energía dispersiva (EDS) y microscopio de fuerza atómica (AFM) y microdureza vickers. Resultados: La fase monoclínica a través del análisis AFM presenta Ra = 0.320 μm, mientras que en la fase Tetragonal es 0.126 μm, SEM / EDS muestra que las fases no son adecuadamente uniformes y la adición del Ytrio para favorecer la estabilización de la fase tetragonal. El análisis de microdureza mostro un valor de 1500HV. Conclusión: La caracterización de la superficie de los implantes trans-endodónticos de óxido de zirconio, brinda una pauta para conocer las características superficiales del material, ya que al haber una mayor rugosidad en la superficie del implante se verá favorecida la capacidad de oseointegración.

Successful and failed mini-implants: microbiological evaluation and quantification of bacterial endotoxin

Abstract Objectives Using two groups of mini-implants (successful and failed) the objectives of this in vivo study were: to evaluate the microbial contamination by the checkerboard DNA-DNA hybridization technique and to quantify the bacterial endotoxin by the limulus amebocyte lysate assay. Material and Methods The 15 successful and 10 failed mini-implants (1.6 mm diameter × 7.0 or 9.0 mm long), placed in the maxilla and/or mandible, were obtained from 15 patients undergoing orthodontic treatment. Data were analyzed statistically by the Wilcoxon rank-sum test using the SAS software (a=0.05). Results All 40 microbial species were detected in both groups of mini-implants, with different frequencies. No differences were observed between the groups with respect to microbial complexes (blue, purple, yellow, green, orange, red and other species) and endotoxin quantification (p>0.05). Conclusion Neither microbial contamination nor endotoxin quantification was determinant for the early loss of stability of the mini-implants.

Estudio de medidas de control de la colonización microbiana de la cámara interna del implante y del sistema implante-pilar por medio de un estudio in vitro / In vitro study of measures to control microbial colonization in the internal chamber of the implant and the implant-abutment system

Objetivo: Determinar mediante un ensayo in vitro, medidas de control del biofilm en la cámara interna del implante. Método: Se seleccionaron diferentes agentes antimicrobianos que se colocaron en las cámaras de 3 grupos de implantes. Luego de 7 días de inmersos en una suspensión microbiana e incubados, realizamos la toma, cultivo e incubación de las muestras de las cámaras de cada grupo de estudio. Resultados: Se constató una filtración de microorganismos hacia la cámara interna en todos los grupos de implantes estudiados, obteniéndose un mayor recuento de Unidades Formadoras de Colonias (UFC) en el grupo control, mientras que en los grupos experimentales se identificó una reducción significativa en el recuento de UFC. Conclusiones: Se observó una disminución significativa en la cantidad de UFC en los grupos experimentales respecto al grupo control, lo que determina la ventaja de utilizar este tipo de antimicrobianos

Objective: To determine biofilm control measures in the internal chamber of the implant through an in vitro test. Method: Different antimicrobial agents were selected and placed in the chambers of three groups of implants. After seven days, we immersed them in a microbial suspension for incubation. We collected, cultured and incubated the samples from the chambers of each study group. Results: We detected a filtration of microorganisms into the internal chamber in all the groups of implants studied. This resulted in a higher count of colony-forming units (CFU) in the control group, whereas in the experimental groups we identified a significant reduction in the CFU count. Conclusions: We observed a significant decrease in the number of CFU in the experimental groups in relation to the control group, which determines the advantage of using this type of antimicrobials

Láser Er:YAG en el tratamiento de la periimplantitis: revisión de la literatura / Erbium:YAG laser in the treatment of peri-implantitis: a literature review

RESUMEN: La presente revisión bibliográfica describe la efectividad del uso del láser Er:YAG en los últimos 10 años, con el objetivo de esclarecer cuáles han sido sus efectos clínicos, sus efectos microbiológicos, sus efectos físicos y térmicos en la superficie del implante, su efecto en la biocompatibilidad y el tiempo de trabajo requerido. Se efectuó la búsqueda en la base de datos PubMed, seleccionando investigaciones publicadas entre los años 2005 y 2015. Se seleccionaron 14 investigaciones in vitro, un estudio en animales, un reporte de casos, 6 series de casos, 2 estudios clínicos controlados, 4 estudios clínicos controlados aleatorizados y 5 revisiones bibliográficas. La literatura disponible señala que el uso del láser Er:YAG en el tratamiento de la periimplantitis produce una mejoría clínica, expresada en una disminución del sangrado al sondaje, una disminución en la profundidad de sondaje y una ganancia de inserción que se limita a los primeros 6 meses luego del tratamiento. En relación con la descontaminación de la superficie del implante, la mayoría de los estudios reporta una disminución en el número de bacterias adheridas. Para no causar daños físicos y térmicos es necesario utilizar el láser Er:YAG en distintos niveles de energía, de frecuencia y de tiempo de exposición según el tipo de superficie del implante afectado. Respecto a la biocompatibilidad de la superfice existen aún resultados contradictorios. Las investigaciones coinciden en que el tratamiento con láser Er:YAG supone un menor tiempo de trabajo en comparación con terapias convencionales.

ABSTRACT: A literature review is presented on the effectiveness of the use of the erbium-doped yttrium aluminium garnet (Er:YAG) laser over the past 10 years, with the objective of clarifying its clinical, microbiological, physical, and thermal effects on the implant surface, as well as its effect on the biocompatibility and work time required. A search was conducted in PubMed database, selecting studies published between 2005 and 2015. A total of 14 in vitro studies were selected, including one animal study, one case report, six case series, two controlled clinical trials, four randomised controlled trials, and five literature reviews. The literature shows that the use of Er:YAG laser in the treatment of peri-implantitis leads to a clinical improvement, expressed as a decrease in bleeding on probing, a reduction in probing depth, and a clinical attachment gain, that is limited to the first six months after treatment. As regards decontamination of the implant surface, most studies report a decrease in the number of attached bacteria. To avoid physical and thermal damage, the Er:YAG laser must be used at different energy levels, frequency, and exposure times, according to the type of surface of the implant affected. There are still conflicting results as regards the biocompatibility of the surface. Studies agree that treatment with Er:YAG laser leads to less operating time compared to conventional therapies.

Microbiological Seal of Two Types of Tapered Implant Connections

Abstract Tapered implant connections have gained wide popularity for being more resistant to fatigue and for promoting a better seal against bacterial infiltration than conventional connections. The aim of this study was to evaluate the bacterial seal at the implant-abutment interface using two Morse taper implant models, by in vitro microbiological analysis. Eleven non-indexed and 11 indexed abutments were selected and connected to their respective implants with a 20 N torque, according to manufacturer's recommendation. Microbiological analysis was carried out using colonies of Escherichia coli transported directly from a culture dish to the prosthetic component. For control, one non-contaminated abutment-implant set from each group (negative control) and one contaminated implant with no abutment (positive control) were used. The specimens were immersed in BHI broth and maintained in an incubator at 37 °C for 14 days to assess the development of bacterial contamination. The results revealed that 36.4% (n=4) of the indexed components and 90.9% (n=10) of the non-indexed components allowed bacterial leakage, with significant difference between groups (p=0.0237). In conclusion, both tapered components failed to provide adequate sealing to bacterial leakage, although the indexed type components showed a superior seal compared with non-indexed components.

Resumo Conexões de implantes cônicos cresceram em popularidade por serem mais resistentes à fadiga e por promover uma melhor vedação contra infiltração bacteriana do que as conexões convencionais. O objetivo deste estudo foi avaliar o selamento bacteriano na interface implante-pilar utilizando dois modelos de implantes cone Morse, por meio de análise microbiológica in vitro. Onze pilares não indexados e 11 pilares indexados foram selecionados e conectados aos seus respectivos implantes com um torque de 20 N, de acordo com a recomendação do fabricante. A análise microbiológica foi realizada utilizando colônias de Escherichia coli retirados diretamente a partir de uma placa de cultura para o componente protético. Para os grupos de controle, foi utilizado um pilar-implante não contaminado de cada grupo (controle negativo) e um implante contaminado sem pilar (controle positivo). Os espécimes foram imersos em caldo BHI e mantidos numa incubadora a 37 °C durante 14 dias, para monitorar o desenvolvimento de contaminação bacteriana. Os resultados revelaram que 36,4% (n=4) dos componentes indexados e 90,9% (n=10) dos componentes não indexados obtiveram infiltração bacteriana, com diferença significativa entre os grupos (p=0,0237). Como conclusão, os dois componentes cônicos não conseguiram proporcionar uma vedação adequada contra infiltração bacteriana, embora os componentes do tipo indexados mostrassem uma vedação superior, quando comparados com componentes não indexados.

Gram-negative enteric rods associated to early implant failure and peri-implantitis: case report and systematic literature review / Bacilos entéricos gram-negativos asociados a fracaso temprano de implantes y peri-implantitis: reporte de un caso y revisión sistemática de literatura

The microbiota associated with failed implants includes Pseudomonas and Gram-negative enteric rods. The present study reports a case of Escherichia coli associated to early implant failed that was resistant in vitro to doxycycline, amoxicillin, metronidazole, and clindamycin, but was susceptible in vitro to ciprofloxacin and aminoglycosides. The literature concerning the prevalence of the opportunistic microorganisms in early implant failure and peri-implantitis patients, and the usual treatment of these patients harboring Pseudomonas and enteric rods was also revised.

La microbiota asociada con los implantes fallidos incluye Pseudomonas y bacilos entéricos Gram-negativos. En el presente estudio se informa acerca de un caso de Escherichia coli asociada a un fallo temprano del implante resistente in vitro a la doxiciclina, amoxicilina, metronidazol y clindamicina, pero susceptible in vitro a ciprofloxacina y aminoglucósidos. Se realizó una revisión de la literatura sobre la prevalencia de los microorganismos oportunistas en pacientes con insuficiencia temprana del implante y periimplantitis, y el tratamiento habitual de estos pacientes portadores de Pseudomonas y bacilos entéricos.

Microbiota Oral Presente en Pacientes Edentulos / Oral Microbiota in Edentulous Patients

El objetivo fue identificar las condiciones orales de pacientes edentulos que acudieron a rehabilitación a la Clínica de Prótesis Total de la Facultad de Odontología de la Universidad Autónoma del Estado de México. El diseño del estudio fue observacional, descriptivo, transversal y prospectivo con una muestra no probabilística de oportunidad y secuencial para estudiar en 160 pacientes el tipo de flora microbiana, portadores de prótesis orales. Los resultados reportan que el promedio de edad para la mayor población edéntula está entre los 56 y 65 años de edad. En relación a las patologías existentes en boca se encontró que el 80% de la población no presentaba signos o síntomas, del 20% eran sintomáticos, todos asociados a estomatitis subprotésica y en 2 de estos pacientes se diagnosticó síndrome de boca ardiente. En relación a la flora microbiana de la cavidad oral encontramos diversidad de microorganismos como: 17% para la flora cocoide Gram+, 2% para flora bacilar Gram-, 17% de presencia de leucocitos, 18% de bacterias, 18% de células epiteliales, 2% de diplococos, 5% de Staphylococcus, 7% de tétradas, 7% de micrococos, 5% de Streptococcus, 2% de enterobactereceas. No se encontraron Candida albicans ni levaduras. El sexo femenino el que presenta mayor tendencia a padecer edentulismo, a razón demográfica nacional que señala que hay más mujeres que hombres. En el apartado de microflora oral se identificó una gran cantidad de microorganismos abundando la flora bacteriana Gram+, pero se identifican varios organismos anaerobios que convierten la cavidad oral en un medio de cultivo, lo cual deberá correlacionarse con la edad y presencia de enfermedades sistémicas concomitantes, ya que microorganismos como el Staphylococcus y Streptococcus pueden tener una repercusión a nivel sistémico, tal y como se demuestra en la asociación de edentulismo a enfermedades cardiovasculares y metabólicas.

The objective of this research was to identify oral conditions of edentulous patients attending rehabilitation at the Total Prosthetics Clinic, Faculty of Dentistry, University of the State of Mexico. The study design was observational, descriptive, transversal and prospective with a nonrandom sample and sequential opportunity to study in 160 patients the type of microbial flora. The results report that the average age for most edentulous population is between 56 and 65 years of age. Regarding existing in mouth pathologies found that 80% of the population did not present signs or symptoms, in the remaining 20% the symptoms most recognized is the pain with 50%, ulcers in 30% and bleeding and inflammation by 10% respectively, all associated with denture stomatitis as the most frequently reported; burning mouth syndrome was reported in 2 of these patients' oral pathology. Regarding microbial flora of the oral cavity we found a variety of microorganisms which breaks down as follows: 17% for plants coccoid Gram +, 2% for plants bacillary Gram-, 17% of white blood cells, 18% of bacteria, 18% ofepithelial cells, 2% diplococci, 5% Staphylococcus, tetrads 7%, 7% of Micrococci, Streptococcus 5%, 2% Enterobactereceas. No yeast or Candida albicans were found. In conclusion, females are more prone to edentulism, national demographic reason. In the area of oral microflora a lot of abounding bacterial flora Gram + microorganisms identified, but several anaerobic organisms convert the oral cavity in a culture medium are identified, which must be correlated with age, presence of concomitant systemic disease, microorganismios as staphylococcus and streptococcus as can have an impact at the systemic level, as demonstrated by the association of edentulism cardiovascular and metabolic diseases.

Bacterial microleakage at the implant-abutment interface in Morse taper implants

AIM: To evaluate the microleakage at the implant-abutment (I-A) interface of Morse tapered implants inoculated with different volumes of bacterial suspension. METHODS: Morse tapered I-A sets were selected and divided in two groups depending on the type of abutment: passing screw (PS) and solid (S), and then subdivided into four subgroups (n=6) according to the suspension volume: PS1: 0.1 µL; PS3: 0.3 µL; PS5: 0.5 µL; PS7: 0.7 µL; S1: 0.1 µL; S3: 0.>3 µL; S5: 0.5 µL and S7: 0.7 µL. A control test was performed to verify the presence of external contamination during the inoculation and the implants were incubated for microbiological analysis. The microleakage was evaluated every 24 h for 7 days by the clarity of solution. After this period, the implants were disassembled for confirmation of bacterial viability. RESULTS: All the specimens with 0.7 µL and one sample of S5 presented turbidity in the control test indicating external contamination, and were excluded from the study. After 7 days of observation, none of the specimens presented positive results for microleakage and the bacterial viability was confirmed in all specimens. The 0.1 µL and 0.3 µL volumes did not present bacterial microleakage, meaning that these volumes may be inadequate for analysis. CONCLUSIONS: None of the sets evaluated showed bacterial microleakage at the I-A interface and the volume of 0.7 µL exceeded the internal capacity of the implants...

Polyspecies biofilm formation on implant surfaces with different surface characteristics

Objective: To investigate the microbial adherence and colonization of a polyspecies biofilm on 7 differently processed titanium surfaces. Material and Methods: Six-species biofilms were formed anaerobically on 5-mm-diameter sterilized, saliva-preconditioned titanium discs. Material surfaces used were either machined, stained, acid-etched or sandblasted/acid-etched (SLA). Samples of the latter two materials were also provided in a chemically modified form, with increased wettability characteristics. Surface roughness and contact angles of all materials were determined. The discs were then incubated anaerobically for up to 16.5 h. Initial microbial adherence was evaluated after 20 min incubation and further colonization after 2, 4, 8, and 16.5 h using non-selective and selective culture techniques. Results at different time points were compared using ANOVA and Scheffé post hoc analysis. Results: The mean differences in microorganisms colonizing after the first 20 min were in a very narrow range (4.5 to 4.8 log CFU). At up to 16.5 h, the modified SLA surface exhibited the highest values for colonization (6.9±0.2 log CFU, p<0.05) but increasing growth was observed on all test surfaces over time. Discrepancies among bacterial strains on the differently crafted titanium surfaces were very similar to those described for total log CFU. F. nucleatum was below the detection limit on all surfaces after 4 h. Conclusion: Within the limitations of this in vitro study, surface roughness had a moderate influence on biofilm formation, while wettability did not seem to influence biofilm formation under the experimental conditions described. The modified SLA surface showed the highest trend for bacterial colonization.

Micro-leakage at the implant-abutment interface with different tightening torques in vitro

OBJECTIVES: This study evaluated the microleakage at the implant/abutment interface of external hexagon (eH) implants and abutments with different amounts of bacteria and tightening torques. MATERIAL AND METHODS: A bacterial suspension was prepared to inoculate the implants. The first phase of this study used nine EH implants and abutments that were divided into three groups with different amounts of bacterial suspension (n=3): V0.5: 0.5 µL; V1.0: 1.0 µL e V1.5: 1.5 µL, and tightened to the manufacturer's recommended torque. The second phase of this experiment used 27 assemblies that were similar to those used in the first phase. These samples were inoculated with 0.5 µL of bacterial suspension and divided into three groups (n=9). T10: 10 Ncm; T20: 20 Ncm and T32: 32 Ncm. The samples were evaluated according to the turbidity of the broth every 24 hours for 14 days, and the bacteria viability was tested after that period. The statistical evaluation was conducted by Kruskal-Wallis testing (p<.05). RESULTS: During the first phase, groups V1.0 and V1.5 was presented with bacterial contamination in all samples after 24 h. During the second phase, two samples from group T10 and one from T20 presented positive results for bacterial contamination. Different amounts of bacterial solution led to overflow and contamination during the first 24 h of the experiment. The tightening torques did not statistically affect the microleakage in the assemblies. However, the group that was tightened to 32 Ncm torque did not show any bacterial contamination. CONCLUSION: After 14 days of experimentation, the bacteria were proven to remain viable inside the implant internal cavity.

Microbial colonization in orthodontic mini-implants

Peri-implant inflammation contributes for loss of secondary stability of orthodontic mini-implants. The investigation of microbial colonization in this area would benefit its control, and consequently favor the long-term success of mini-implants. Therefore, the aim of this study was to determine the establishment and the evolution of microbial colonization process in orthodontic mini-implants for 3 months, since the time of their installation. One-hundred and fifty samples collected from 15 mini-implants were investigated from baseline up to 3 months. The biological material was obtained from peri-implant area using paper points. Nonspecific, Streptococcus spp, Lactobacillus casei and Candida spp colonizations were analyzed by cell growth methods. Porphyromonas gingivalis colonization was observed by 16S rDNA-directed polymerase chain reaction. Data from cell growth were submitted to the Wilcoxon sign rank test and results from molecular analysis were presented in a descriptive way. There was no significant difference in the microbial colonization among the examined time intervals, except for Streptococcus spp, between baseline and 24 h, which characterized the initial colonization in this time interval. Lactobacillus casei and Candida spp colonizations were insignificant. No Porphyromonas gingivalis was detected among the analyzed samples. The microbial colonization of mini-implants did not significantly change during the study. However, it should be monitored by orthodontists, since it is an important factor for mini-implants success.

A inflamação peri-implantar contribui para a perda da estabilidade secundária dos mini-implantes ortodônticos. A investigação da colonização microbiana desta área beneficiaria o seu controle e, consequentemente, favoreceria o sucesso dos mini-implantes a longo prazo. Portanto, o objetivo dos autores foi determinar o estabelecimento e evolução do processo de colonização microbiana em mini-implantes ortodônticos por três meses desde a instalação. Cento e cinquenta amostras coletadas de 15 mini-implantes foram investigadas desde o tempo inicial até 3 meses. O material biológico foi obtido da área peri-implantar com auxílio de cones de papel absorvente. As colonizações inespecíficas de Streptococcus spp, Lactobacillus casei e Candida spp foram analisadas por métodos de crescimento celular. A colonização por Porphyromonas gingivalis foi observada por meio da reação em cadeia da polimerase 16S rDNA. Os dados do crescimento celular foram submetidos ao teste de Wilcoxon sign rank e os resultados da biologia molecular foram apresentados de modo descritivo. Não houve diferença estatisticamente significante da colonização microbiana entre os intervalos de tempo avaliados, exceto para Streptococcus spp entre os tempos inicial e 24 h, o que caracterizou o início da colonização neste intervalo de tempo. As colonizações por Lactobacillus casei e Candida spp foram insignificantes. Não foi detectada a presença de Porphyromonas gingivalis nas amostras analisadas. A colonização microbiana nos mini-implantes não se alterou significativamente durante o estudo. No entanto, deve ser monitorada por ortodontistas, uma vez que é um fator importante para o sucesso dos mini-implantes.

Análise microbiológica comparativa da ação de diferentes agentes descontaminantes sobre superfícies de titânio / Microbiological comparison of different decontaminant agents on rough and smooth titanium surfaces: microbiological analysis

Os implantes de titânio estabeleceram-se, ao longo do tempo, como uma opção de tratamento com grande índice de sucesso. Entretanto, falhas são passíveis de ocorrer, devido à exposição de suas superfícies ao meio bucal, imediatamente ou até muito tempo passado de sua implantação. Estas superfícies de titânio podem se infectar por bactérias e seus produtos, de forma semelhante à que ocorre na superfície de raízes dentais. Tais contaminantes intensificam a resposta inflamatória, além de alterar a estrutura superficial do implante podendo dar origem às doenças peri-implantares, como a mucosite peri-implantar e a peri-implantite. Para o tratamento destas doenças, diversos métodos de descontaminação de superfícies de implantes têm sido propostos, incluindo o uso substâncias anti-sépticas, jatos abrasivos, ácidos, antibióticos e lasers. O objetivo foi avaliar comparativamente a capacidade de descontaminação do peróxido de hidrogênio a 1,5 % (H2O2), do gluconato de clorexidina a 0,12% (CLX) e do soro fisiológico (SF) já que, até o momento, nenhuma metodologia está estabelecida como padrão ouro para a limpeza superficial. Placa bacteriana foi colhida de sítios de doença periodontal crônica para contaminação de discos de titânio de superfícies lisas e rugosas. Posteriormente, os discos foram submersos em 10 mL das substâncias estudadas por 1 minuto, friccionados com swab e enxaguados em solução fisiológica. Discos controle (C) foram somente enxaguados em soro fisiológico. Desta forma resultaram os seguintes grupos de estudo, constituídos de 5 discos de cada tipo de superfície lisa (L) e rugosa (R): H2O2 R , CLXR, SFR, CR, H2O2L, CLXL , SFL e CL. A avaliação do potencial descontaminante das substâncias foi realizada através da quantificação do crescimento bacteriano pela contagem das unidades formadoras de colônia (UFCs) após semeadura em Agar-brucella e incubação em jarra de CO2 a 37oC por 24 horas. Os resultados após descontaminação foram comparados através da...

Actually, the titanium implants are a successful option of treatment in Dentistry. However, failures are possible to occur due to surface exposition to oral environment immediately or lately after its implantation. The titanium implants surfaces can be infected by bacteria and its products similarly to dental roots surfaces. The contaminants turn the inflammatory response tissues more intensive and them alter the surface structure of the implant and cause periimplant diseases like mucositis and peri-implantitis. Several methods of treatment for those diseases have been proposed in the literature, including antiseptics rinses, abrasives air powder, acids, antibiotics and lasers. The aim of this work was to comparatively evaluate the potential for decontamination of the hydrogen peroxide at 1,5% (H2O2), the 0,12% chlorhexidine gluconate (CLX) and the saline solution (SF) as cleaning methods, once until this moment there is not a gold standard method established for this purpose. Bacterial plaque harvested from sites of chronic periodontal disease was used to contaminate smooth and rough surfaces of titanium. Subsequently, decontamination procedures were realized by submerging the discs in 10 ml of the studied substances for 1 minute, cleaned by rubbing with swab and washed on saline solution. Control discs (C) were only washed in saline solution. The following test groups composed by 5 discs of each surface, smooth (L) and rough (R):, were then originated: H2O2 R , CLXR, SFR, CR, H2O2L, CLXL , SFL and CL. The decontaminant potential of studied substances was realized by counting the colony forming units after seeding in Agar-brucella, under anaerobiosis condition for 24 hours under 37oC. The data analysis was made by Variance Analysis (ANOVA) at 5% of significance level. The results lead to the following conclusions: the chronic periodontal biofilm adhesion was possible on smooth and rough titanium surfaces; the surface characteristic had no significant...

Avaliação da adaptação e capacidade de infiltração microbiana na interface implante/pilar / Evaluation of fit and bacterial leakage at implant-abutment interface at different implant systems

Esta pesquisa objetivou avaliar a capacidade de infiltração bacteriana e a desadaptação vertical ao longo da interface implante/pilar protético e classificar a desadaptação vertical e horizontal nos pontos externos da interface, segundo uma nova proposta. Material e métodos: 40 implantes de cinco sistemas nacionais foram inoculados com Escherichia coli e colocados em meio de cultura para observação da infiltração em um, dois, cinco, sete e 14 dias pela turvação do mesmo. Posteriormente, as amostras foram embutidas e desgastadas para avaliação da desadaptação ao longo de toda a interface em microscopia eletrônica de varredura. Resultados: somente um dos sistemas apresentou infiltração bacteriana em 25% das amostras. Os menores valores da desadaptação foram para o sistema Neodent (0,51 μm ± 0,39) e Dentoflex (1,44 μm ± 0,73), seguidos do Titanium Fix (1,88 μm ± 1,28), SIN (2,46 μm ± 3,38) e Conexão (2,68 μm ± 3,02). Os Tipos II e IV da classificação para o desajuste vertical e horizontal foram predominantes. Concluiu-se que todos os grupos apresentaram desadaptação ao longo da interface em pelo menos um dos seis pontos avaliados entre implante e pilar protético. O aumento da desadaptação, nesta interface, não é o único fator determinante para a ocorrência do infiltrado bacteriano, devendo-se levar em consideração a extensão da área de acoplamento na interface e quanto à classificação da desadaptação, o Tipo I, que é a desejada, só ocorreu em 7,5% das amostras.

This study aims to access bacterial leakage capacity and vertical misfit along the prosthetic implantabutment interface and classify the vertical and horizontal misfits at the external interface points, according to a new proposal. Materials and methods: 40 implants of five commercial implant manufacturers were inoculated with Escherichia coli and placed in a culture medium to observe the leakage within 1, 2, 5, 7, and 14 days through media cloud. After, the samples were fitted and the implant-abutment interface evaluated by scanning electron microscopy. Results: Only one of the systems showed bacterial infiltration in 25% of the samples. The lowest values of misfit were presented by Neodent- 0.51 ± 0.39 μm and Dentoflex systems- 1.44 ± 0.73 μm, followed by Titanium Fix - 1.88 ± 1.28 μm; SIN 2.46 ± 3.38 μm and Conexão - 2.68 ± 3.02 μm. Types II and IV of the classification for the vertical and horizontal misfits were predominant. The conclusion was that all groups presented misfit along the interface of at least one of the six points evaluated between the implant and the prosthetic abutment. Increased misfit in the interface is not the only determining factor for occurrence of the bacterial leakage. Also, it must be taken into account the extent of the coupling interface, and concerning the classification of the misfit, type I, which is the most desired, occurred only in 7.5% of the samples.

Preload loss and bacterial penetration on different implant-abutment connection systems

Preload loss can favor the occurrence of implant-abutment interface misfit, and bacterial colonization at this interface may lead to implant failure. The aim of this study was to evaluate the preload loss and bacterial penetration through the implant-abutment interface of conical and external hexagon connection systems subjected to thermal cycling and mechanical fatigue (TM). Four different implant-abutment connection systems were evaluated (n=6): external hexagon with universal post, Morse taper with universal post, Morse taper with universal post through bolt, and locking taper with standard abutment. The assemblies (implant-abutment) were subjected to a thermal cycling regimen (1,000 cycles of 5°C and 55°C) and to mechanical fatigue (1.0 million cycles, 1.0 Hz, 120 N). The assemblies were immersed in Tryptic Soy + Yeast Extract broth containing Streptococcus sanguinis and incubated at 37°C and 10 percent CO2 for 72 h. Detorque values were recorded. The bacterial penetration was assessed and the abutments were observed by scanning electron microscopy. The preload data were analyzed statistically by two-way ANOVA and Tukey’s test at 5 percent significance level. All screw abutment systems showed significantly higher (p<0.05) detorque values when subjected to TM and all conical systems presented bacterial penetration. The results show no relationship between the preload loss and the bacterial penetration.

A perda da pré-carga pode favorecer o desajuste da interface implante-pilar e a colonização bacteriana nesta interface pode levar a perda de implantes. O objetivo deste estudo foi avaliar a perda de pré-carga e a infiltração bacteriana através da interface implante-pilar de sistemas de conexão cônica e hexágono externo, submetidos à ciclagem térmica e fadiga mecânica (CF). Quatro diferentes sistemas de conexão implante-pilar foram avaliados (n=6): hexágono externo com munhão universal, cone Morse com munhão universal, cone Morse com munhão universal parafuso passante e cônica justaposição com pilar padrão. Os espécimes (implante-pilar) foram submetidos à ciclagem térmica (1000 ciclos a 5°C e 55°C) e à fadiga mecânica (1,0 milhão de ciclos, 1,0 Hz, 120 N). Os espécimes foram imersos em caldo Tryptic Soy + Yeast Extract contendo Streptococcus sanguinis e incubados a 37°C e 10 por cento de CO2 por 72 h. Os valores de destorque foram registrados. A infiltração bacteriana foi avaliada e os pilares foram observados por microscopia eletrônica de varredura. Os dados de pré-carga foram analisados estatisticamente por ANOVA a dois critérios e teste de Tukey, com nível de significância de 5 por cento. Todos os sistemas de pilares parafusados apresentaram maiores valores de destorque quando submetidos à CF (p<0,05) e todos os sistemas cônicos apresentaram infiltração bacteriana. Os resultados mostram que não houve relação entre a perda da pré-carga e a infiltração bacteriana.

Infecção de sítios periimplantares por microrganismos periodontopatogênicos: relato de caso / Peri-implant site infection by periodontopathogenic microorganisms: a case report

A colonização do sítio periimplantar por microrganismos periodontopatogênicos está relacionada à inflamação da mucosa na região, condição denominada mucosite, que pode evoluir para periimplantite em caso de perda óssea ao redor do implante, sendo considerada a causa mais frequente de perda de implantes. O objetivo deste trabalho é, através de uma revisão de literatura e da descrição de um caso clínico, identificar os prováveis nichos destes microrganismos.

Colonization of periimplant sites by periodontopathogens is associated with periimplant mucosa inflammation, denominated mucositis, which can evolutes to periimplantitis when marginal bone loss occurs around the implant. This condition is considered the most frequent cause of implant failure. The aim of this study is, through a literature review and a clinical case presentation, to evaluatethe probable originally sites of these microorganisms.

Periimplantitis: checkerboard DNA-DNA hybridization for bacterial pathogen identification

A recent innovation in medical field is the use of DNA probes in microbiological diagnosis of the oral cavity. Thus, this study has the objective to present the mainly characteristics of Checkerboard DNA-DNA Hybridization method for bacterial pathogens identification related to periimplantitis, commonly disease found in the oral cavity, as wells as, to show the uses and applications of this technique.

Una innovación reciente en medicina es la utilización de sondas de DNA para diagnóstico microbiológico. Este trabajo tiene como objetivo, presentar las principales características del método Checkerboard DNA-DNA Hybridization para la identificación de bacterias patógenas associadas a periimplantite en la cavidad oral, mostrando las diferentes utilizaciones y aplicaciones de esta técnica.

Ocorrência dos patógenos do complexo vermelho em sítios periodontais e periimplantares nas mesmas bocas / Occurrence of pathogens of the red complex in periodontal and peri-implant sites of the same mouths

O objetivo deste trabalho foi avaliar, pela reação em cadeia da polimerase (PCR), dirigida para as espécies do complexo vermelho (Porphyromonas gingivalis, Tannerella forsythensis e Treponema denticola), a ocorrência semiquantitativa desses patógenos em sulcos gengivaiscontrole (SG-C), bolsas periodontais (BP) e sulcos periimplantares (SPI) de cinco pacientesparcialmente desdentados portadores de implantes dentários havia mais de dois anos. Nos SG-C de três pacientes foi detectado o DNA de P. gingivalis, em um deles juntamente com o de T. forsythensis. Nas BP de todos, além de T. forsythensis e/ou T. denticola, foi constatada maior freqüência de P. gingivalis e a relação desses patógenos com a profundidade e o sangramentoà sondagem. Apesar da presença em sítios periodontais, nenhuma das espéciesalvo foi identificada nos SPI, embora quatro apresentassem sangramento à sondagem. Nossosresultados, obtidos em SPI sem periimplantite, confirmam que o método PCR possibilita um diagnóstico aplicável na análise de risco de doença, pois os patógenos da BP podem se translocar para os SPI, obrigando a um maior rigor no controle do biofilme dental.