Peri-implantitis: Associated microbiota and treatment

Introduction: Peri-implantitis is a late complication of dental implant treatment, induced by microbiological changes. Since the disorder is frequent, a review is indicated of the microorganisms that influence it and of the existing treatment options.Objective: To conduct a literature review of the microbiota associated to peri-implantitis and the existing treatmentoptions.Material and Method: A PubMed literature search was made of the studies on the microbiota associated to dental implants in healthy patients and patients with peri-implantitis, as well as of the latest treatment developments,using the following key words: “peri-implantitis AND microbiota”, “periimplantitis AND microbiota”, “periimplantitis AND treatment”, and “periimplantitis AND treatment”. Only clinical studies in humans were considered.The following criteria were applied for including articles in the analysis: a) for the peri-implant microbiota,the search limits were human studies after the year 2000; and b) for the treatment of peri-implantitis, the search limits were randomized and controlled clinical trials (RCTs) in humans, with a minimum follow-up of 4 months,and publication after the year 2000.Results: A total of 18 articles were selected in relation to peri-implant microbiota, and 13 in relation to the treatment of peri-implantitis (8 involving nonsurgical mechanical treatments and 5 surgical procedures).Conclusions: Evaluation of the literature has shown the microbiota associated to peri-implantitis to be more complex than that found under healthy peri-implant conditions – the main flora consisting of anaerobic gramnegative bacteria. No clear criteria have been identified for the diagnosis and treatment of peri-implantitis (AU)

Analysis of the peri-implant microbiota in 90 dental implants and itsr elationship to crevicular fluid volume

Objective: To evaluate the presence within the peri-implant sulcus of Tannerela forsythia (Tf), Porphyromonasgingivales (Pg), Treponema denticola (Td) and Aggregatibacter actinomycetemcomitans (Aa), and relate these bacteria to the peri-implant crevicular fluid volume (PICFV).Material and Method: A prospective and cross-sectional clinical case series study was made. For the measurement of crevicular fluid, use was made of the Periotron® 8000 (Proflow Incorporated. New York, USA), measuring the volume in Periotron units (PU). For the detection of period ontopathogenic bacteria we used the IAI-PadoTest 4.5 (IAI Inc., IAI Institute, Zuchwil, Switzerland) – a system for the detection of Tf, Pg, Td and Aa based on the use of RNA arrays.Results: We included 34 patients (19 females and 15 males) with a mean age of 56.4 years. Of these subjects, 30.8%were smokers and 69.2% non-smokers. Out of a total series of 213 implants, we analyzed the crevicular fluid and microbiota in 90 implants. A total of 16.5% of the implants presented mucositis, while 83.5% were in healthy peri implantconditions. The microbiological study revealed the presence of Tf in 17.1% of the implants, Pg in 9.3%, Tdin 13.6%, in Aa in none of the implants. The mean Periotron reading was 93.4 PU (range 12-198 PU). A statistically significant (p<0.05) relationship was observed between PICFV and the total percentage bacteria (Tf, Pg andTd) – with a strong association between the Td levels and smoking (p<0.01). In the implants with mucositis, the concentration of Pg and Td was greater.Conclusions: In the implants studied, the subgingival peri-implant microbiota was characterized by low levels ofPg, Tf, Td, and none of the patients proved positive for Aa. These bacteria showed a positive correlation to crevicular fluid volume, and a statistically significant relationship was observed between Td and smoking (AU)

Peri-implantitis: associated microbiota and treatment.

INTRODUCTION: Peri-implantitis is a late complication of dental implant treatment, induced by microbiological changes. Since the disorder is frequent, a review is indicated of the microorganisms that influence it and of the existing treatment options. OBJECTIVE: To conduct a literature review of the microbiota associated to peri-implantitis and the existing treatment options. MATERIAL AND METHOD: A PubMed literature search was made of the studies on the microbiota associated to dental implants in healthy patients and patients with peri-implantitis, as well as of the latest treatment developments, using the following key words: "peri-implantitis AND microbiota", "periimplantitis AND microbiota", "peri-implantitis AND treatment", and "periimplantitis AND treatment". Only clinical studies in humans were considered. The following criteria were applied for including articles in the analysis: a) for the peri-implant microbiota, the search limits were human studies after the year 2000; and b) for the treatment of peri-implantitis, the search limits were randomized and controlled clinical trials (RCTs) in humans, with a minimum follow-up of 4 months, and publication after the year 2000. RESULTS: A total of 18 articles were selected in relation to peri-implant microbiota, and 13 in relation to the treatment of peri-implantitis (8 involving nonsurgical mechanical treatments and 5 surgical procedures). CONCLUSIONS: Evaluation of the literature has shown the microbiota associated to peri-implantitis to be more complex than that found under healthy peri-implant conditions - the main flora consisting of anaerobic gramnegative bacteria. No clear criteria have been identified for the diagnosis and treatment of peri-implantitis.

Interleukins IL-6, IL-8, IL-10, IL-12 and periimplant disease. An update

Introduction: A study is made of the usefulness of cytokines (such as interleukin-6 (IL-6), interleukin-8 (IL-8),interleukin-10 (IL-10) and interleukin-12 (IL-12)) as markers of periimplant disease (mucositis and periimplantitis).An increase in the levels of these cytokines in dental implant crevicular fluid may give rise to a lack of osteointegration,bone loss or implant failure.Objective: To review the literature relating IL-6, IL-8, IL-10 and IL-12 levels to dental implant surgery and periimplantitis.Material and Method: A PubMed literature search was made of articles in English and Spanish, using the keywords “cytokine and dental implants”, cytokine and periimplantitis”, “IL-6, IL-8, IL-10, IL-12 and dental implants”,“IL-6, IL-8, IL-10, IL-12 and periimplantitis”. Fourteen articles were found and classified into two groupsrelating interleukin levels to: a) periimplant disease; and b) their influence upon dental implant osteointegrationwithout periimplant disease.Conclusions: An increase in interleukin levels is observed in patients with periimplant disease, though there iscontroversy over the effect of interleukins in crevicular fluid and periimplantitis in relation to implant failure orthe development of periimplant disease (AU)

Dental implants in patients with oral mucosal alterations: An update.

OBJECTIVE: To determine whether a series of diseases of the oral mucosa - Sjögren syndrome, ectodermal dysplasia, epidermolysis bullosa and lichen planus - reduce the survival rate of dental implants. MATERIAL AND METHOD: A Medline search was carried out using the key words: " Sjögren syndrome ", "ectodermal dysplasia ", "epidermolysis bullosa ", "lichen planus " and "dental implants ", including those publications involving clinical series comprising more than one patient with the mentioned disorders and treated with dental implants, in the last 10 years. RESULTS: The study included three articles involving patients with Sjögren syndrome subjected to dental implant treatment, representing a total of 12 patients and 86 implants, with a mean pondered success rate of 86.33%. As regards ectodermal dysplasia, we included 14 articles, of which 11 corresponded to clinical series, two were reviews and one constituted a survey of dental professionals. The percentage success rate of the implants varied between 35.7-100%. In relation to epidermolysis bullosa, we included 6 articles corresponding to clinical series, with a total of 16 patients and 92 implants, and a success rate between 75-100%. In the case of oral lichen planus we found only two articles corresponding to clinical case series, with a total of 5 patients and 14 implants, and an implant survival rate of 100%. CONCLUSIONS: Based on our review of the literature, dental implant rehabilitation in patients of this kind is seen to be a valid treatment option, with a high percentage success rate. Long-term patient follow-up is essential in order to periodically monitor the condition of the disease and of the implants.

Interleukins IL-6, IL-8, IL-10, IL-12 and periimplant disease. An update.

INTRODUCTION: A study is made of the usefulness of cytokines (such as interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and interleukin-12 (IL-12)) as markers of periimplant disease (mucositis and periimplantitis). An increase in the levels of these cytokines in dental implant crevicular fluid may give rise to a lack of osteointegration, bone loss or implant failure. OBJECTIVE: To review the literature relating IL-6, IL-8, IL-10 and IL-12 levels to dental implant surgery and periimplantitis. MATERIAL AND METHOD: A PubMed literature search was made of articles in English and Spanish, using the key words "cytokine and dental implants", cytokine and periimplantitis", "IL-6, IL-8, IL-10, IL-12 and dental implants", "IL-6, IL-8, IL-10, IL-12 and periimplantitis". Fourteen articles were found and classified into two groups relating interleukin levels to: a) periimplant disease; and b) their influence upon dental implant osteointegration without periimplant disease. CONCLUSIONS: An increase in interleukin levels is observed in patients with periimplant disease, though there is controversy over the effect of interleukins in crevicular fluid and periimplantitis in relation to implant failure or the development of periimplant disease.