Prevalence and risk/protective indicators of buccal soft tissue dehiscence around dental implants.

AIM: To evaluate the prevalence of buccal peri-implant soft tissue dehiscence (PISTD) in anterior implants and to identify the risk/protective indicators of PISTD in implants not suffering peri-implantitis. MATERIALS AND METHODS: 240 randomly selected patients from a university clinic database were invited to participate in the present cross-sectional study. Those who accepted, after the evaluation of their medical and dental records, were clinically examined to assess the prevalence of buccal PISTD in non-molar implants. Multilevel multivariate logistic regression analyses were then carried out to identify those factors associated either positively (risk) or negatively (protective) with buccal PISTD in implants without peri-implantitis. RESULTS: 92 patients with a total of 272 dental implants were analysed. At implant-level, the prevalence of buccal PISTD was 16.9%, while when selecting only implants without peri-implantitis it was 12.0%. Buccal PISTD was present in 26.7% of the implants diagnosed with peri-implantitis. The following factors were identified as risk/protective indicators of buccal PISTD in implants without peri-implantitis: malposition (too buccal vs. correct: OR=14.67), thin peri-implant phenotype (OR=8.31), presence of at least one adjacent tooth (OR=0.08) and presence of abutment (OR=0.12). CONCLUSIONS: PISTD are highly prevalent among patients with dental implants in this university-based population, and several factors were identified as risk and protective indicators of PISTD in implants not suffering peri-implantitis.

Prevalence and risk/protective indicators of peri-implant diseases: A university-representative cross-sectional study.

AIM: To evaluate the prevalence of peri-implant diseases and to identify risk/protective indicators of peri-implantitis. MATERIALS AND METHODS: Two hundred and forty randomly selected patients from a university clinic database were invited to participate. Those who accepted, once data from their medical and dental history were collected, were examined clinically and radiographically to assess the prevalence of peri-implant health and diseases. Peri-implantitis was defined as the presence of BoP/SoP together with radiographic bone levels (BL) ≧2 mm. An intermediate peri-implant health category between peri-implant mucositis and peri-implantitis was also identified, defined by the presence of BoP/SoP together with 1 mm ≦BL < 2 mm. A multilevel multivariate logistic regression analysis was carried out to identify those factors associated either positively (risk) or negatively (protective) with peri-implantitis. RESULTS: Ninety-nine patients with a total of 458 dental implants were analyzed. The prevalences of pre-periimplantitis and of peri-implantitis were, respectively, 31.3% and 56.6% at patient-level, while 31.7% and 27.9% at implant level. The following factors were identified as risk indicators for peri-implantitis: smoking (OR = 3.59; 95% CI: 1.52-8.45), moderate/severe periodontitis (OR = 2.77; 95% CI: 1.20-6.36), <16 remaining teeth (OR = 2.23; 95% CI: 1.05-4.73), plaque (OR = 3.49; 95% CI: 1.13-10.75), implant malposition (too vestibular: OR = 2.85; 95% CI: 1.17-6.93), implant brand (Nobel vs. Straumann: OR = 4.41;95% CI: 1.76-11.09), restoration type (bridge vs. single crown: OR = 2.47; 95% CI: 1.19-5.12), and trauma as reason of tooth loss (vs. caries: OR = 6.51; 95% CI: 1.45-29.26). Conversely, the following factors were identified as protective indicators: interproximal flossing/brushing (OR = 0.27; 95% CI: 0.11-0.68), proton pump inhibitors (OR = 0.08; 95% CI: 0.01-0.90), and anticoagulants (OR = 0.08; 95% CI: 0.01-0.56). CONCLUSIONS: Peri-implant diseases are highly prevalent among patients with dental implants in this university-based population. Several factors were identified as risk- and protective- indicators of peri-implantitis.

Clinical signs, symptoms, perceptions, and impact on quality of life in patients suffering from peri-implant diseases: a university-representative cross-sectional study.

OBJECTIVES: To study the symptoms and perception reported by patients with peri-implant diseases, as well as their signs and their potential impact on the oral health quality of life. MATERIAL AND METHODS: Two hundred and forty randomly selected patients were invited to participate. As part of the history assessment, the patient OHIP-14Sp was evaluated together with, for each implant, the patient perception regarding the peri-implant health status and the history of pain, spontaneous discomfort, bleeding, suppuration, swelling, and discomfort during brushing. As part of the clinical examination, the following potential signs of peri-implant diseases were collected: probing pocket depth (PPD), mucosal dehiscence (MD), extent of BoP, presence of SoP, and visual signs of redness and swelling. Those parameters were analyzed in relation to the actual peri-implant health diagnosis. RESULTS: Ninety-nine patients with a total of 458 dental implants were studied. Even in case of peri-implantitis, 88.9% of the implants were perceived by the patients as healthy. The total OHIP-14Sp sum score did not differ in relation to the peri-implant health diagnosis. Increased reports of spontaneous discomfort, bleeding, swelling, and discomfort during brushing were observed in presence of disease. However, only a minor proportion of implants with peri-implant diseases presented symptoms. PPD ≥ 6 mm was more frequent in diseased than in healthy implants (p < .01), while PPD ≥ 8 in pre-peri-implantitis/peri-implantitis than in healthy/mucositis implants (p < .01). Implants with peri-implantitis showed higher MD than implants without peri-implantitis (p < .01). CONCLUSION: Peri-implant diseases are in most cases asymptomatic and not perceived by the patients. Despite being unable to accurately discriminate between peri-implant mucositis and peri-implantitis, PPD and MD resulted as the only two clinical signs associated with pre-peri-implantitis/peri-implantitis.

Deworming protocols of island snakes kept in capitivity at the Butantan Institute

Bothrops insularis and B. alcatraz are critically endangered species inhabiting two different coastal islands of the state of São Paulo. Although they are closely related species, they show distinct morphological characteristics due to their isolation from the continent. There is a general lack of studies on conservation and captive husbandry of these species, including their parasites. Our aim was to evaluate the deworming protocols used in B. insularis and B. alcatraz in captivity. We evaluated three deworming protocols through fecal examination: (1) adult B. insularis were treated with ivermectin and praziquantel, (2) adult B. alcatraz were treated with ivermectin, and (3) juvenile B. insularis and B. alcatraz were treated with ivermectin. The snakes are kept in the Laboratory of Ecology and Evolution at the Instituto Butantan (São Paulo, Brazil) for conservation purposes. To evaluate the deworming protocols, we performed the Willis-Mollay (1921) technique. After treating with the first protocol, 19% of the animals showed only eggs of a pseudoparasite (Syphacia obvelata). After the second protocol, 75% of the animals showed cestodes (Ophiotaenia sp.). After the third protocol, 32% of the animals showed only the pseudoparasite, S. obvelata. The pseudoparasite was found only in B. insularis individuals that ate adult mice in captivity. However, cestode eggs were found only in those adult snakes of the second protocol that did not receive praziquantel. Based on the negative results for pathogenic parasites, we conclude that the first protocol was effective for adult snakes whereas the third protocol was effective for juveniles.

Deworming protocols of island snakes kept in capitivity at the Butantan Institute

Bothrops insularis and B. alcatraz are critically endangered species inhabiting two different coastal islands of the state of São Paulo. Although they are closely related species, they show distinct morphological characteristics due to their isolation from the continent. There is a general lack of studies on conservation and captive husbandry of these species, including their parasites. Our aim was to evaluate the deworming protocols used in B. insularis and B. alcatraz in captivity. We evaluated three deworming protocols through fecal examination: (1) adult B. insularis were treated with ivermectin and praziquantel, (2) adult B. alcatraz were treated with ivermectin, and (3) juvenile B. insularis and B. alcatraz were treated with ivermectin. The snakes are kept in the Laboratory of Ecology and Evolution at the Instituto Butantan (São Paulo, Brazil) for conservation purposes. To evaluate the deworming protocols, we performed the Willis-Mollay (1921) technique. After treating with the first protocol, 19% of the animals showed only eggs of a pseudoparasite (Syphacia obvelata). After the second protocol, 75% of the animals showed cestodes (Ophiotaenia sp.). After the third protocol, 32% of the animals showed only the pseudoparasite, S. obvelata. The pseudoparasite was found only in B. insularis individuals that ate adult mice in captivity. However, cestode eggs were found only in those adult snakes of the second protocol that did not receive praziquantel. Based on the negative results for pathogenic parasites, we conclude that the first protocol was effective for adult snakes whereas the third protocol was effective for juveniles.

Bothrops insularis e B. alcatraz são espécies criticamente ameaçadas de extinção que habitam duas ilhas diferentes da costa do estado de São Paulo. Embora elas sejam espécies intimamente relacionadas, apresentam características morfológicas distintas devido ao seu isolamento do continente. Há uma falta geral de estudos sobre conservação e criação em cativeiro dessas espécies, incluindo seus parasitas. O objetivo desse trabalho foi avaliar os protocolos de vermifugação utilizados em B. insularis e B. alcatraz em cativeiro. Foram avaliados três protocolos de vermifugação através do exame coproparasitológico: (1) B. insularis adultas foram tratadas com ivermectina e praziquantel, (2) B. alcatraz adultas foram tratadas com ivermectina, e (3) B. insularis e B. alcatraz juvenis foram tratadas com ivermectina. As serpentes são mantidas no Laboratório de Ecologia e Evolução do Instituto Butantan (São Paulo, Brasil) para projetos de conservação. Para avaliar os protocolos de vermifugação, foi realizado a técnica de Willis-Mollay (1921). Depois de tratado com o primeiro protocolo, 19% dos animais apresentaram somente ovos de pseudoparasitas, (Syphacia obvelata). Depois do segundo protocolo, 75% dos animais apresentaram cestóides (Ophiotaenia sp.). Depois do terceiro protocolo, 32% dos animais apresentaram somente pseudoparasitas, S. obvelata. O pseudoparasita foi encontrado somente em indivíduos de B. insularis que comeram camundongos adultos em cativeiro. Contudo, ovos de cestóides foram encontrados somente nas serpentes adultas do segundo protocolo que não receberam praziquantel. Com base nos resultados negativos para parasitas patogênicos, concluímos que o primeiro protocolo foi eficaz para serpentes adultas, enquanto que o terceiro protocolo foi efetivo para juvenis.