Prevalence of peri-implant diseases - a critical review on the current evidence

Abstract The objective of this paper was to evaluate the current evidence reporting on the prevalence of peri-implantitis and to determine the influencing factors. An electronic search for articles published until February 2019 reporting on the prevalence of peri-implantitis was performed in MEDLINE. Included criteria were published in international peer-reviewed journals, written in English language, reported on the prevalence of peri-implantitis, included implants with a minimum follow-up of one year after functional loading and used a clear definition for peri-implantitis and/or peri-implant mucositis with a clear cutoff for bone level changes according to the case definitions of Sanz and Chapple and Berglundh et al. 2018. Included papers were anaylized for factors affecting the reported prevalences for peri-implantitis. Twenty-five papers were included in the present review and a wide range for the reported prevalence of peri-implantitis was seen. Case definitions for peri-implantitis with various thresholds for bone loss together with the type of reporting on patient- or implant-level were the most significant factors that lead to a large variety of the occurrence of the disease. Additionally, follow-up time and the evaluation in a certain "convenience" population may have influenced the prevalence values. In conclusion, it can be stated that a wide range for reporting the prevalence of peri-implantitis can be found and no real estimation of the global burden of the disease can be made. Applying accurate case definitions for peri-implantitis is the most important factor for reporting the prevalence and should be strictly followed in future reports.

Doença peri-implantar follow-up microbiológico de 5 anos e revisão sistemática com meta-análise / Peri-implant disease: Microbiological 5-year follow-up and systematic review with meta-analysis

Objetivos: Avaliar, em um estudo longitudinal de 5 anos, a associação entre o diagnóstico da doença peri-implantar (DPi) e a contagem de patógenos na presença e ausência de terapia de manutenção periodontal/peri-implantar (TMPP). Realizar uma revisão sistemática de estudos observacionais para avaliar se dados presentes na literatura indicam uma maior prevalência de peri-implantite (PI) em indivíduos com diagnóstico ou histórico de periodontite (PE). Métodos: O estudo longitudinal microbiológico foi realizado avaliando-se, através da técnica da reação em cadeia da polimerase em tempo real, as seguintes espécies bacterianas: T. forsythia, T. denticola, P. gingivalis, P. intermedia, F. nucleatum e A. naeslundii em 80 indivíduos com mucosite peri-implantar (MP) que realizavam consultas para manutenção periodontal/peri-implantar regular (GTP, n = 39) comparados aos que não realizavam (GNTP, n = 41). Para a revisão sistemática uma busca eletrônica foi conduzida até março de 2016. Foram encontrados 1330 estudos, 17 artigos foram incluídos na análise final (PROSPERO CRD42015009518). A meta-análise foi realizada para presença ou ausência de PI. Medidas de efeito sumário e taxas de razão de chances (OR) com 95% IC foram calculadas. Resultados: Os resultados do estudo longitudinal mostraram que, após 5 anos, houve uma diminuição da carga bacteriana total (CBT), na frequência das bactérias analisadas do complexo laranja (p = 0.013) e nas frequências isoladas de T. forsythia (p = 0.000), P. gingivalis (p = 0.003) e P. intermedia (p = 0.013) no GTP. Indivíduos com PI apresentaram maiores frequências de P. gingivalis (GNTP: p = 0,030; GTP: p = 0,000), T. denticola (GNTP: p = 0,017) e F. nucleatum (GTP e GNTP; p = 0.002) comparados aos com MP. Indivíduos que desenvolveram PI apresentaram um aumento na CBT (GTP: p = 0.047; GNTP: p = 0,055) e na frequência isolada de P. gingivalis (GNTP: p = 0,002) e F. nucleatum (GTP e GNTP; p = 0.000). Não houve diferenças estatisticamente significativas intergrupos em relação aos patógenos do complexo vermelho (p > 0,05). Tanto nos indivíduos com MP (T1 e T2: p = 0,000), quanto nos indivíduos com PI (T2: p = 0,000), a frequência do complexo laranja foi significativamente menor no GTP. A meta-análise dos estudos coorte mostrou que indivíduos (OR = 7.22), e implantes (OR = 5.63) apresentaram maior risco de desenvolver PI. Nos estudos transversais, em análises não ajustadas, indivíduos com PE apresentaram maior chance de ter PI (OR = 3.18). Quando a análise foi ajustada para tabagismo e diabetes não houve aumento estatisticamente significativo no risco para PI (OR = 1.73; IC 95% 0.86- 3.45). Conclusões: Pôde-se concluir que a ausência de consultas regulares para manutenção periodontal/peri-implantar foi associada com pior condição clínica periimplantar, maior incidência de PI e um aumento significativo na CBT. Adicionalmente, indivíduos com diagnóstico de PI apresentaram maiores frequências de P. gingivalis, T. denticola e F. nucleatum e maior CBT. A revisão sistemática permitiu concluir que indivíduos com diagnóstico ou histórico de PE podem apresentar um risco aumentado para PI. Mais estudos prospectivos são necessários para confirmar a evidência, principalmente os ensaios clínicos controlados randomizados

Aims: Evaluate, in a 5-year longitudinal study, the association between peri-implant disease's (DPi) diagnosis and the count of pathogens in the presence and absence of periodontal/peri-implant maintenance therapy. Conduct a systematic review of observational studies to evaluate whether data in the literature indicates a higher prevalence of peri-implantitis (PI) in subjects with diagnosis or history of periodontitis (PE). Methods: the microbiologic study was performed evaluating, through polymerase chain reaction in real time technique, the following bacterial species: T. forsythia, T. denticola, P. gingivalis, P. intermedia, F. nucleatum and A. naeslundii in 80 patients with peri-implant mucositis (PM) that were queries for periodontal/periimplant regular maintenance (GTP, n = 39) compared to those who were not (GNTP, n = 41). For the systematic review an electronic search was conducted until March 2016. It was found 1330 studies, 19 articles were included in the final analysis (PROSPERO CRD42015009518). The meta-analysis was performed for presence or absence of PI. Summary measures and odds ratio (OR) with 95% IC were calculated. Results: the results of the longitudinal study showed that, after 5 years, there was a decrease in the total bacterial load (TBL), the frequency of bacteria analyzed in the orange complex (p = 0.013) and in the frequencies of T. forsythia (p = 0.000), P. gingivalis (p = 0.003) and P. intermedia (p = 0.013) in the GTP. Individuals with PI had higher frequencies of P. gingivalis (GNTP: p = 0.030; GTP: p = 0.000), T. denticola (GNTP: p = 0.017) and T. nucleatum (GTP and GNTP; p = 0.002) compared to those with PM diagnosis. Individuals who have developed PI showed an increase in TBL (GTP: p = 0047; GNTP: p = 0.055) and in the isolated frequencies of P. gingivalis (GNTP: p = 0.002) and F. nucleatum (GTP and GNTP; p = 0.000). There were no statistically significant differences intergroups in relation to red complex pathogens (p > 0.05). Both in individuals with PM (T1 and T2: p = 0.000), as in individuals with PI (T2: p = 0.000), the frequency of orange complex was significantly lower in the GTP. The meta-analysis of cohort studies showed that individuals (OR = 7.22), and implants (OR = 5.63) presented a higher risk of developing PI. In the cross-sectional studies, in unadjusted analyses, individuals with PE presented a higher chance of having PI (OR = 3.18). When the analysis was adjusted for smoking and diabetes, there was no statistically significant increase in risk for PI (OR = 1.73; 95% CI 0.86-3.45). Conclusions: it might be concluded that the absence of regular periodontal/peri-implant maintenance was associated with worse peri-implant clinical condition, higher incidence of PI and a significant increase in TBL. Additionally, individuals diagnosed with PI showed greater frequencies of P. gingivalis, T. denticola and F. nucleatum and largest TBL. The systematic review showed that individuals diagnosed or with PE's history may have an increased risk for PI. More prospective studies are needed to confirm this evidence, especially the randomized controlled clinical trials

Incidence and Factors Influencing Oral Mucositis in Patients with Hematopoietic Stem Cell Transplantation

PURPOSE: This study was done to examine the incidence of oral mucositis in hematopoietic stem cell transplantation patients and to identify factors influencing oral mucositis and patient outcomes according to severity. METHODS: In this retrospective study, data were collected from electronic medical records of 222 patients who had received hematopoietic stem cell transplantation. Oral mucositis was evaluated using WHO's assessment scale. Data were analyzed using Chi-square test, Fisher exact test, Spearman's correlation, Ordinal logistic regression, ANOVA and Kruskal-Wallis test. RESULTS: A total of 69.8% of the patients evaluated developed oral mucositis (grade II and over). As a results of ordinal regression, factors influencing oral mucositis severity were found to be diagnosis, type of transplantation, oxygen inhalation and the number of antiemetics administration before transplantation. The severity of oral mucositis was found to increase the days of hospitalization, days of TPN administration, days of using antibiotics and the number and dosage of analgesics. CONCLUSION: The results would help predict severity of oral mucositis in hematopoietic stem cell transplantation patients and suggest that provision of appropriate nursing assessment and oral care would improve patient outcomes.

Oral health as a predictive factor for oral mucositis

OBJECTIVES: Oral mucositis is a complication frequently associated with hematopoietic stem cell transplantation, decreasing a patient's quality of life and increasing the occurrence of opportunistic infections. The purpose of this study was to determine the incidence and severity of oral mucositis and to assess the correlation of this disease with the oral health of an individual at the time of hematopoietic stem cell transplantation. METHODS: Before transplantation, patients' oral health and inflammatory conditions were determined using the gingival index and the plaque index, which are based on gingival bleeding and the presence of dental plaque, respectively. Additionally, the dental health status was determined using the decayed, missing, and filled teeth index. The monitoring of oral mucositis was based on the World Health Organization grading system and was performed for five periods: from Day 0 to D+5, from D+6 to D+10, from D+11 to D+15, from D+16 to D+20, and from D+21 to D+30. RESULTS: A total of 97 patients (56% male and 44% female) who underwent hematopoietic stem cell transplantation at the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo between January 2008 and July 2009 were prospectively examined. The incidence of ulcerative mucositis was highest from days +6 to +10 and from days +11 to +15 in the patients who underwent autologous and allogeneic hematopoietic stem cell transplantation, respectively. CONCLUSION: The data, including the dental plaque and periodontal status data, showed that these oral health factors were predictive of the incidence and severity of oral mucositis in a cohort of patients with similar conditioning regimens before hematopoietic stem cell transplantation. .

Ocorrência de estomatite protética e queilite actínica diagnosticadas no centro de especialidades odontológicas da Faculdade ASCES, Caruaru-PE / Occurrence of denture stomatitis and actinic cheilits diagnosed at center of dentistry specialties ASCES College, Caruaru-PE

O presente estudo teve por objetivo verificar a ocorrência de estomatite protética e queilite actínica diagnosticadas nos pacientes do CEO de Estomatologia Asa Branca, no período de 2008 a 2009.Fez-se um estudo descritivo transversal analisando as variáveis sexo, idade, diagnóstico clínico, localizaçãoe tratamento das lesões em 834 prontuários. Dos 706 pacientes com lesão 152 (21,5%)apresentavam estomatite protética e 32 (4,5%) queilite actínica. A idade dos pacientes em ambas as lesões não apresentaram associação significativa com a ocorrência, diferentemente do gênero. Nos pacientes com estomatite protética as mulheres são as mais afetadas representando 86,8%. Enquantona queilite actínica 56,2% dos acometidos são homens. A instrução de higiene oral (IHO) foi o tipo de tratamento realizado em 52,6% dos pacientes com estomatite. Porém, em 44,1% além da (IHO) sefez uso do miconazol. O tratamento indicado para queilite actínica em 81,3% dos casos foi através de medidas preventivas. Os demais, 18,7% dos pacientes foram submetidos a procedimentos cirúrgicos. Dessa forma, é fundamental o saber dos cirurgiões dentistas quanto ao diagnostico e tratamento adequados para as referidas lesões, ou encaminhá-lo para um atendimento especializado, pois constitui uma condição de fácil diagnóstico e tratamento.

This study aimed to describe the occurrence of denture stomatitis and actinic cheilitis in patientsdiagnosed CEO Asa Branca Stomatology College ASCES, in the period 2008 to 2009. There was across-sectional study examining gender, age, clinical diagnosis, localization and treatment of lesionsin 834 records. Of 706 patients with lesions 152 (21,5%) had denture stomatitis and 32 (4,5%) actiniccheilitis. The age of patients in both lesions were not significantly associated with the occurrence,unlike the genre. In patients with denture stomatitis women are most affected representing 86,8%.While in actinic cheilitis 56,2% of men are affected. The instruction in oral hygiene (IHO) was the treatmentperformed in 52,6% of patients with stomatitis. However, in addition to 44,1% (IHO) is madeuse of miconazole. The recommended treatment for actinic cheilitis in 81,3% of the cases throughpreventive measures. The remaining 18,7% of patients underwent surgical procedures. Thus, it is essentialknowledge of dentists regarding diagnosis and appropriate treatment for those injuries, or refer you to specialized service, because it is a condition easily diagnosed and treated.

[Frequency of oral mucosal disease in referral patients to dental faculty of Tabriz in 2007]

Oral disease is a significant burden to all countries of the world. Since there is little know about this in Iran we decided to identify of oral mucosal disease in patients referred to Oral Medicine Center affiliated to Tabriz Dental School. A consecutive sample of admitted patients to OMC between April to June 2007 were included in this study. We employed a standard questionnaire in order to. Eight hundred two patients were completed the requested questionnaire. Seventy percent was female. The mean age of the study sample was 32.68 [SD=12.25] years. Approximately 70% of subjects had oral lesion,%19.2 had normal mucosa and%21.60 of patients had oral mucosal lesions that need to follow and control. The most common lesions were ankiloglossia [%29.7] then fissural tongue [%25.7] and coated tongue [%23.7]. Many patients attending the center were unaware of oral lesions in their soft oral tissue which needed to follow up. This emphasizes that examination of soft oral tissue should be considered by health policy makers in oral health agenda at national level

O uso da terapia com laser de baixa potência como método de prevenção de mucosite oral nos pacientes submetidos ao transplante de medula óssea

O tratamento com quimioterapia de altas doses no condicionamento do transplante de medula ósea, produz efeitos indesejáveis na cavidade oral e o de maior magnitude c a mucosite oral (MO). Através do uso do laser de baixa potencia como terapia aplicada a mucosa oral, o autor avaliou a possibilidade da redução da incidência e/ou do grau de severidade da MO em pacientes submetidos ao transplante de medula óssea auto logo ou alogênico. Durante o período de janeiro de 2004 a maio de 2005, trinta e oito pacientes portadores de doenças hematol6gicas foram randomizados em um grupo composto de 19 pacientes que receberam radiação laser e outro grupo composto de 19 pacientes que não receberam a radiação laser. O laser utilizado foi um diodo de InGaAIP, com compril11ento de onda de 660 nm e 50 mW de potencia. A técnica utilizada foi pontual, tocando a mucosa, dosimetria de 4 J/cm2, ca1culado sobre a área do feixe de 0,196 cm2. A análise dos resultados mostrou que 0 grupo que recebeu a aplicação do laser teve uma menor incidência de mucosite oral e os pacientes que apresentaram mucosite neste grupo a apresentaram em menor proporção. Baseado nestes dados pode-se afirmar que o laser de baixa potencia e um instrumento capaz de reduzir a incidência de MO.

High-dose chemotherapy followed by bone marrow transplant produces undesirable effects in the oral cavity leading to oral mucositis (OM). Mucositis may be a painfull and debilitating side-effect. Through the use of the low power laser as therapy applied to the oral mucosa membrane, the author evaluated the potencial for a reduction in the incidence and/or severity of oral mucositis in patients submitted to autologus or alogenic bone marrow transplant. From January 2004 to May 2005, thirty eight patients bearers of hcmatological diseases were randomized into a group composed of 19 patients that received laser radiation and a group composed of 19 patients that did not receive the laser radiation. For the irradiation was used an diode InGaAIP, emiting light at 660 nm wavelenght with output power of 50 mW, giving an energy density of 4 J/cm2 measured at the end of fiberoptic with 0, 196cm2 of section area during the experiment. The tip of the laser device touched the oral mucosa.The results showed that the group which received the application of the laser had a smaller incidence of OM and even in the patients that presented mucositis in this group, it occurred in lower incidence. Based on these results we can affirm that the low level laser therapy is an instrument capable of reducing the incidence of OM.

Avaliação do uso do laser de baixa intensidade e do Light-Emitting Diode (LED) no comportamento de fibroblastos e na redução da incidência da mucosite bucal em crianças sob tratamento quimioterápico / Evaluation of the use of low-intensity laser and Light-Emitting Diode (LED) on the behavior of fibroblasts and in reducing the incidence of oral mucositis in children under chemotherapy

Avaliou-se o uso do laser de baixa intensidade e do Light-Emitting Diode (LED) no comportamento de fibroblastos e na redução da incidência da mucosite bucal em crianças sob tratamento quimioterápico. Para tanto, o estudo foi executado em dois períodos experimentais distintos. No primeiro período, foi realizada a análise da viabilidade de fibroblastos Balb/c 3T3 cultivados sob déficit nutricional irradiados com laser vermelho (660nm, 40mW), laser infravermelho (780nm, 50mW) e LED vermelho (637 ± 15nm, 40mW) por 4 e 8 segundos através dos ensaios de redução do MTT e captação do vermelho neutro. No segundo período experimental realizou-se ensaio clínico randomizado duplo-cego para avaliar a eficácia do laser vermelho (660nm, 40mW) e do LED vermelho (637 ± 15nm, 40mW) na redução da incidência e da severidade da mucosite bucal e da dor relacionada em crianças portadoras de câncer submetidas a quimioterapia utilizando-se o sistema de graduação da mucosite bucal da Organização Mundial de Saúde e a Escala de Dor de Faces Revisada associada à escala analógica visual. A análise estatística foi realizada utilizando-se o teste não paramétrico de Kruskal-Wallis e analise de variância do modelo linear geral com nível de significância de 5% (p = 0,05). Observou-se com a redução do MTT uma tendência de aumento da proliferação celular relacionado diretamente com o tempo de irradiação, no entanto, não significante estatisticamente. Após 72 horas, os grupos que apresentaram maior proliferação celular foram: grupo irradiado com laser infravermelho, grupo irradiado com LED, grupo irradiado com laser vermelho, grupo controle positivo e grupo controle negativo. Já através da captação do vermelho neutro, após 72 horas o grupo que apresentou maior proliferação celular foi o grupo controle positivo (cultivado sob condições nutricionais ideais) seguido pelo grupo irradiado com laser infravermelho, grupo controle negativo e grupos irradiados com LED e laser vermelho.

The use of low-intensity laser and Light-Emitting Diode (LED) on the behavior of fibroblasts and in reducing the incidence of oral mucositis in children under chemotherapy were evaluated. The study was performed in two separate experiments. In the first moment, the viability of fibroblasts Balb/c 3T3 cultured under nutritional stress irradiated with red laser (660nm, 40mW), infrared laser (780nm, 50mW) and red LED (637 ± 15nm, 40mW) for 4 and 8 seconds was analyzed through the MTT and neutral red assays. The second experiment carried out was a double-blind randomized clinical trial aiming to assess the effectiveness of red laser (660nm, 40mW) and red LED (637 ± 15nm, 40mW) in reducing the incidence and severity of oral mucositis and related pain in children with cancer undergoing chemotherapy using the World Health Organization oral mucositis grading system and the Faces Pain Scale - Revised associated with a visual analogue scale. Statistical analysis was performed using the Kruskal-Wallis nonparametric test and ANOVA with a significance level of 5% (p = 0.05). It was observed with the MTT assay a trend of cell proliferation increase directly related to the irradiation time, however, not statistically significant. After 72 hours, the groups that showed higher cell proliferation were: infrared laser irradiated group, LED irradiated group, red laser irradiated group, positive control group and negative control group. By the neutral red assay, though, after 72 hours the group that showed higher cell proliferation was the positive control (grown under ideal nutritional conditions) followed by the group irradiated with infrared laser, the negative control group and groups irradiated with red laser and LED. By analyzing the results and considering the used parameters and phototherapy protocol, it is plausible to conclude that phototherapy with lowintensity laser and light emitting diode (LED) showed no toxicity at...

Prevalence of oral lesions in relation to habits: Cross-sectional study in South India.

BACKGROUND: Smoking, drinking and chewing tobacco product, common habits in India have been positively associated with oral lesions. No study has been conducted in this part of Tamilnadu regarding the prevalence of oral lesions in relation to habits. METHODS: A hospital based cross-sectional study was carried out at Ragas Dental College, Chennai. Already existing data of two thousand and seventeen consecutive patients from sub-urban areas of Chennai, who attended the outpatient department, at Ragas Dental College, for dental complaints during a period of three months in 2004, who underwent oral examination and interviewer based questionnaire was used. RESULTS: Oral soft tissue lesions were found in 4.1% of the study subjects. The prevalence of leukoplakia, OSF and oral lichen planus was 0.59%, 0.55%, and 0.15% respectively. The prevalence of smoking, drinking alcoholic beverages and chewing was 15.02%, 8.78% and 6.99% respectively. Smoking and chewing were significant predictors of leukoplakia in this population. DISCUSSION: The prevalence of leukoplakia, OSF and oral lichen planus in our study population is similar to those found in other populations. The prevalence of consumption of alcoholic beverages in our study population was higher when compared to the Indian National Sample Survey study. However the prevalence of smoking and chewing was found to be lower. Smokers were more likely to develop smoker's melanosis compared to other lesions. Among those who consumed alcoholic beverages alone, the prevalence of leukoplakia was higher compared to other lesions. OSF was the most prevalent lesion among those who chewed panmasala or gutkha or betel quid with or without tobacco.

Estomatite Vesicular Alagoas (VSA) am tilápia nilótica (Oreochromis niloticus). Possível implicaçäo epidemiológica / Vesicular Stomatitis Alagoas (VSA) in tilapia nilotica (Oreochromis niloticus). Possible epidemiological concern

Foram realizadas inoculaçöes experimentais do vírus da Estomatite Vesicular Alagoas (VSA) em tilápia nilótica (Oreochromis niloticus), pela via intraperitoneal e por imersäo em suspensäo viral, com o objetivo de verificar se o mesmo se replicava neste sistema hospedeiro e se o vírus era eliminado na água, o que poderia representar um importante papel no ciclo epidemiológico da virose. Os peixes foram dispostos em grupos testemunhos e inoculados com suspensäo de vírus VSA, tanto pela via intraperitoneal quanto por imersäo. Foram observadas alteraçöes anatomopatológicas em órgäos da cavidade abdominal e cérebro. Esses órgäos e a água do aquário foram inoculados em células BHK21 e observados a presença de efeito citopático característico dos vírus pertencentes a este gênero. A segunda passagem do vírus em peixes confirmou as lesöes encontradas anteriormente e o isolamento em novas inoculaçöes em cultivo celular. Os resultados sugerem que a tilápia é sensível ao VSA nas duas vias de inoculaçäo, elimina formas infectantes do vírus na água, podendo representar um importante elo na cadeia epidemiológica da estomatite vesicular.

Estudo epizootiológico da estomatite vesicular no Vale do Paraíba, SP / Epizootiological study of the vesicular estomatitis in Paraiba Valley, SP

Realizou-se estudo epizootiologico da estomatite vesicular ocorrida em bovinos e equídeos da regiäo do Vale do Paraíba, SP. Coletaram-se amostras de sangue de 2.673 animais, pertencentes a 367 rebanhos. A pesquisa de anticorpos foi feita pela técnica de dupla difusäo em gel de ágar e revelou 41 rebanhos positivos (11,17 por cento) sendo que a prevalência nos equídeos (4,36 por cento) foi maior que nos bovinos (1,64 por cento). Dos rebanhos positivos, apenas dois apresentaram histórico de ocorrência de enfermidade vesicular. Foram aplicados testes estatísticos com a finalidade de se estabelecerem relaçöes entre rebanhos infectados pelo vírus Indiana 3 e fatores ambientais. Os testes de associaçäo revelaram-se positivos para a presença de rio, como local onde os animais bebiam água, e a presença de cultura de milho e feijäo. O teste de duas proporçöes mostrou que, quando comparadas as faixas etárias, a espécie eqüina foi mais susceptível ao vírus da estomatite vesicular e os animais que mostraram maior susceptibilidade situaram-se entre as faixas etárias de 3-5 e 5-7 anos. Os resultados obtidos demonstraram a necessidade de maiores estudos relacionados à epidemiologia da doença, em nosso meio