Prevalence and risk indicators of peri-implantitis: a university based cross-sectional study.

OBJECTIVES: To assess the prevalence of peri-implantitis and identify risk and protective indicators of peri-implantitis in a population that underwent implant therapy in a university dental clinic. METHOD AND MATERIALS: Randomly selected patients from a postgraduate university dental clinic were invited to participate. Clinical and radiographic examinations were recorded. Peri-implantitis was defined as the presence of bleeding and/or suppuration on probing, probing depths of ≥ 6 mm, and bone loss ≥ 3 mm. Patient-, implant-, and bone- related factors were recorded and analyzed using a multivariate logistic regression analysis. RESULTS: A total of 355 dental implants placed in 108 patients and exhibiting at least 1 year loading time were included. The prevalence of peri-implantitis was 21.3% at patient-level, while 10.7% at implant-level. Simultaneous guided bone regeneration (OR 2.76, 95% CI 1.07-7.12, P = .035), recurrent periodontitis (OR 3.11, 95% CI 1.02-9.45, P = .045) and significant medical history (OR 2.86, 95% CI 1.08-7.59, P = .034) were identified as risk indicators for peri-implantitis. The mean peri-implant bone loss was estimated to be 2.18 ± 1.57 mm for the total number of implants, whereas implants diagnosed with peri-implantitis demonstrated 4.42 ± 1.12 mm in a time period between 12 to 177 months. CONCLUSION: Within the limitations of the study, the prevalence of peri-implantitis in a cohort receiving dental implant therapy at a university dental clinic was 10.7% at implant level and 21.3% at patient level. Patient-reported systemic comorbidities and recurrent periodontitis as well as implants placed in ridge augmented sites were associated with greater risk of peri-implantitis.

The effect of rigid and non-rigid connections between implants and teeth on biological and technical complications: a systematic review and a meta-analysis.

OBJECTIVE: To assess survival, as well as technical and biological complication rates of partial fixed dental prostheses (FDPs) supported by implants and teeth. METHOD: An electronic Medline search was conducted to identify articles, published in dental journals from January 1980 to August 2015, reporting on partial FDPs supported by implants and teeth. The search terms were categorized into four groups comprising the PICO question. Manual searches of published full-text articles and related reviews were also performed. RESULTS: The initial database search produced 3587 relevant titles. Three hundred and eighty-six articles were retrieved for abstract review, while 39 articles were selected for full-text review. A total of 10 studies were selected for inclusion. Overall survival rate for implants ranged between 90% and 100%, after follow-up periods with a mean range of 18-120 months. The survival of the abutment teeth was 94.1-100%, while the prostheses survival was 85-100% for the same time period. The most frequent complications were "periapical lesions" (11.53%). The most frequent technical complication was "porcelain occlusal fracture" (16.6%), followed by "screw loosening" (15%). According to the meta-analysis, no intrusion was noted on the rigid connection group, while five teeth (8.19%) were intruded in the non-rigid connection group [95% CI (0.013-0.151)]. CONCLUSION: The tooth-implant FDP seems to be a possible alternative to an implant-supported FDP. There is limited evidence that rigid connection between teeth and implants presents better results when compared with the non-rigid one. The major drawback of non-rigidly connected FDPs is tooth intrusion.

Diagnosis and treatment of ankyloglossia: A narrative review and a report of three cases.

BACKGROUND: Ankyloglossia or tongue-tie is a congenital oral anomaly with short, tight, and thick lingual frenulum. It may be asymptomatic or can cause movement limitations of the tongue, speech and articulation difficulties, breastfeeding difficulties in neonates, as well as periodontal and malocclusion problems. The etiopathogenesis of ankyloglossia is unknown; it can occur either as a sole anomaly in the vast majority or in association with other craniofacial anomalies. OBJECTIVES: The aims of this paper were (1) to provide a comprehensive review on the criteria for clinical assessment and diagnosis, etiology and inheritance, and the therapeutic options of ankyloglossia; and (2) to demonstrate the treatment of ankyloglossia by means of frenuloplasty in three cases. REVIEW: The available evidence from the literature indicates that among neonates, children, and adults the prevalence of ankyloglossia is low and in some cases remains undiagnosed. The early clinical assessment, diagnosis, and treatment are beneficial for the patients and their mothers. CONCLUSIONS: Frenuloplasty is a safe, quick, effective, and economical method and for this reason the parents should not hesitate towards frenulum release. More clinical studies are needed to confirm the benefits of the surgical interventions and to compare the results with those obtained using nonsurgical therapy or with untreated cases.

Influence of placement depth and abutment connection pattern on bone remodeling around 1-stage implants: a prospective randomized controlled clinical trial.

OBJECTIVES: The aim of this study is to evaluate peri-implant marginal bone level changes in relation to crestal or subcrestal implant placement and type of fixture/abutment connection 3 months after implant placement. MATERIALS AND METHODS: The duration of the study was 3 months. A total of 105 implants were placed in 81 subjects following a one-stage surgical procedure and assigned into four groups. In the first and second groups, implants with a screwed tapered internal connection were placed subcrestally and crestally, respectively, while in the third and fourth groups, implants with an internal conical seal connection were similarly placed. Clinical recordings and standardized periapical digital radiographs were taken the day of implantation and 3 months later, before placement of the final prosthetic restoration. The modified plaque index (mPLI), modified gingival index (mGI), and probing depths (PD) were recorded at four sites around each implant, and the vertical distance between fixture/abutment junction and alveolar crest at the mesial and distal sites of each implant utilizing subtractive radiography were all measured on placement and at 3 months. RESULTS: There was no statistically significant difference between the four groups for PD. The highest values of mPLI and mGI were recorded for Group 2. The mean (±SE) peri-implant bone loss was recorded as follows: Group 1: 0.68 ± 0.07 mm, Group 2: 0.79 ± 0.06 mm, Group 3: 0.49 ± 0.06 mm, and Group 4: 0.40 ± 0.07 mm. The statistical analysis revealed significant differences in bone resorption between groups with different abutment connections. CONCLUSIONS: The connection between fixture/abutment rather than vertical implant placement in relation to alveolar bone level seems to affect peri-implant marginal bone resorption.

Antibacterial activity of moxifloxacin on bacteria associated with periodontitis within a biofilm.

The activity of moxifloxacin was compared with ofloxacin and doxycycline against bacteria associated with periodontitis within a biofilm (single strain and mixed population) in vitro. MICs and minimal bactericidal concentrations (MBCs) of moxifloxacin, ofloxacin and doxycyline were determined against single strains and mixed populations in a planktonic state. Single-species biofilms of two Porphyromonas gingivalis and two Aggregatibacter actinomycetemcomitans strains and a multispecies biofilm consisting of 12 species were formed for 3 days. The minimal biofilm eradication concentrations (MBECs) were determined after exposing the biofilms to the antibacterials (0.002-512 µg ml(-1)) for 18 h, addition of nutrient broth for 3 days and subsequent subcultivation. Photographs were taken using confocal laser-scanning microscopy and scanning electron microscopy. The MICs and MBCs did not differ between ofloxacin and moxifloxacin against A. actinomycetemcomitans, whilst moxifloxacin was more active than the other tested antibacterials against anaerobes and the mixed population. The single-species biofilms were eradicated by moderate concentrations of the antibacterials, and the lowest MBECs were always found for moxifloxacin (2-8 µg ml(-1)). MBECs against the multispecies biofilms were 128, >512 and >512 µg ml(-1) for moxifloxacin, ofloxacin and doxycycline, respectively. In summary, moxifloxacin in a topical formulation may have potential as an adjunct to mechanical removal of the biofilms.

Clinical factors correlated with the success rate of miniscrews in orthodontic treatment.

Miniscrews offer a reliable alternative for anchorage during orthodontic treatment, particularly for non-cooperative patients or periodontal patients with alveolar bone loss. The study aims at assessing the correlation of various clinical indicators with the success or failure of miniscrews used for anchorage during orthodontic treatment. Thirty-four consecutive patients with a cumulative total of 82 miniscrews implanted participated in the study. Generalized Estimating Equations were used to assess the correlation of various factors with success rates. The miniscrew was considered the unit of analysis clustered within site and within patient. The overall success rate of miniscrews was 90.2%. For every additional miniscrew used in a patient's oral cavity, the success rate was reduced by 67%. Retromandibular triangle and palatal placement and in movable mucosa resulted in lower success rate. The miniscrew length and diameter were found to correlate with success rates. Orthodontic force applied on miniscrews for uprighting purposes showed a lower success rate than that used for retraction. This study revealed that miniscrews present high success rates. The number of miniscrews used per patient, the miniscrew site placement, the soft tissue type of placement, the miniscrew length and diameter as well as the orthodontic force applied on the miniscrew showed significant correlation with success rates.

Management of root dilaceration of an impacted maxillary central incisor following orthodontic treatment: an unusual therapeutic outcome.

There are rare cases of impacted permanent central incisors with dilaceration, a dental deformity characterized by pronounced angulation of the longitudinal tooth axis. This paper presents the orthodontic alignment of a permanent maxillary left central incisor in a 7.5-year-old boy, which appeared impacted radiologically and displayed root dilaceration. Following surgical exposure with the closed-eruption technique and appropriate orthodontic traction, the tooth was successfully aligned into the dental arch and the root was radiologically shown to be straightened and relatively well developed.

Dilaceration of maxillary central incisor: a literature review.

The main purpose of this review is to present the aetiological factors and the mechanism that cause dilaceration of the maxillary central incisors. In early developmental stages, the permanent tooth germ of the maxillary incisor is situated palatally and superiorly to the apex of the primary incisor and gradually changes direction in a labial direction with its crown coming closer to the resorbing primary root. For reasons of this close relationship between the permanent tooth germ and the apex of the primary incisor, it is believed that an acute trauma to the primary predecessor can cause dilaceration of the long axis of the permanent successor. Clinically, dilaceration can be revealed by palpation high in the labial sulcus or in the hard palate, while its radiographic view is characteristic. The therapeutic approach to the dilacerated maxillary central incisors has to be carefully planned and needs the cooperation of several specialities to attain the final objective.