Outcome indicators of non-surgical therapy of peri-implantitis: a prospective case series analysis.

OBJECTIVES: This study aims to identify patient and implant indicators influencing the non-surgical therapeutic outcomes of peri-implantitis at 6 months of follow-up. METHODS: This case series involved patients with at least one implant diagnosed with peri-implantitis according to the 2017 World Workshop criteria. Non-surgical therapy consisted of mechanical debridement of the peri-implant pockets combined with metronidazole 500 mg 3 times a day for 7 days. At baseline and at 6 months, clinical and radiographic variables were collected to calculate treatment success (probing pocket depth reduction to 5 mm without bleeding on probing or < 5 mm irrespective of bleeding on probing at all implant sites, and lack of bone loss progression). The primary outcome was treatment success (%) at 6 months. The influence of the patient and implant/prosthetic variables upon disease resolution was assessed through simple and multiple logistic regression analyses at patient and implant level, using generalized estimation equations models. RESULTS: A total of 74 patients and 107 implants were analyzed at 6 months. Disease resolution was established in 25.7% of the patients and 24.1% of the implants. Patients with stage IV and grade C periodontitis, inadequate oral hygiene at baseline, and wide diameter (≥ 4.5 mm) presented significantly greater treatment failure, whereas smokers and former smokers demonstrated a tendency toward failure. At 6 months, there was a significant decrease in probing pocket depth and bleeding on probing of 1.08 ± 1.06 mm and 14%, respectively. Radiographically, a significant gain in marginal bone level of 0.43 ± 0.56 mm was observed. CONCLUSION: Disease resolution after non-surgical treatment of peri-implantitis is negatively influenced by the loss of support of the adjacent periodontium, poor baseline oral hygiene, and wide diameter implants (≥ 4.5 mm). CLINICAL RELEVANCE: This study helps to discriminate the clinical situations in which non-surgical treatment is less likely to achieve treatment success at short term.

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.

Epidemiology of mid-buccal gingival recessions in NHANES according to the 2018 World Workshop Classification System.

AIM: There are no nationally representative epidemiological studies available reporting on the different recession types according to the 2018 classification system or focusing on the aesthetic zone. The aims of this cross-sectional study were (a) to provide estimates on the prevalence, severity and extent of mid-buccal GRs according to the 2018 classification and (b) to identify their risk indicators in the adult U.S. population from the NHANES database. MATERIALS AND METHODS: Data from 10,676 subjects, representative of 143.8 millions of adults, were retrieved from the NHANES 2009-2014 database. GR prevalence was defined as the presence of at least one mid-buccal GR ≥1 mm. GRs were categorized following the 2018 World Workshop classification system (RT1, RT2, RT3) and according to different severity cut-offs. An analysis for GR risk indicators was also performed, selecting subjects without periodontitis. RESULTS: The patient-level prevalence of mid-buccal GRs (all types) was 91.6%, while it decreased to 70.7% when considering only the aesthetic zone. When focusing on RT1 GRs, the patient-level prevalence (whole mouth) was 12.4%, while it was 5.8% considering only the aesthetic zone. The majority of RT1 GRs were considered as mild (1-2 mm). The whole-mouth patient-level prevalence of RT2 and RT3 GRs was 88.8% and 55.0%, respectively. Age (35-49 years), gender (female), ethnicity (non-Hispanic Whites), last dental visit (>6 months before), tooth type (incisors) and the arch (mandible) resulted as risk indicators associated with the presence of RT1 GR. CONCLUSIONS: Mid-buccal GRs affect almost the entire US population. Age, gender, ethnicity, dental care exposure, tooth type and arch were identified as risk indicators for RT1 GRs.

The Biological Properties of OGI Surfaces Positively Act on Osteogenic and Angiogenic Commitment of Mesenchymal Stem Cells.

Osteogenesis process displays a fundamental role during dental implant osteointegration. In the present work, we studied the influence of Osteon Growth Induction (OGI) surface properties on the angiogenic and osteogenic behaviors of Mesenchymal Stem cells (MSC). MSC derived from dental pulp and HUVEC (Human Umbilical Vein Endothelial Cells) were grown in on OGI titanium surfaces, and cell proliferation and DNA synthesis were evaluated by MTT [3-(4,5-dimethylthiazol-2yl)-2,5-diphenyltetrazolium bromide] test and DNA quantification. Gene expression has been performed in order to evaluate the presence of mRNA related to endothelial and osteogenesis markers. Moreover, morphological and biochemical analyses of osteogenesis commitments has been performed. On OGI surfaces, MSC and HUVEC are able to proliferate. Gene expression profiler confirms that MSC on OGI surfaces are able to express endothelial and osteogenic markers, and that these expression are higher compared the expression on control surfaces. In conclusion On OGI surfaces proliferation, expression and morphological analyses of angiogenesis-associated markers in MSC are promoted. This process induces an increasing on their osteogenesis commitment.

What is the frequency of anatomical variations and pathological findings in maxillary sinuses among patients subjected to maxillofacial cone beam computed tomography? A systematic review

Background: When considering dental implant rehabilitation in atrophic posterior sectors, the maxillary sinuses must be evaluated in detail. Knowledge of the anatomical variations and of the potential lesions found in these structures conditions the outcome of sinus lift procedures and therefore of the dental implants. A systematic review is made to determine the frequency of anatomical variations and pathological findings in maxillary sinuses among patients subjected to cone beam computed tomography (CBCT). Material and Methods: A PubMed (MEDLINE) literature search was made of articles published up until 20 December 2015. The systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The quality of the studies included in the review was assessed using the Methodological Index for Nonrandomized Studies (MINORS). Results: The combinations of search terms resulted in a list of 3482 titles. Twenty-three studies finally met the inclusion criteria and were entered in the systematic review, comprising a total of 11,971 patients. The most common anatomical variations were pneumatization and sinus septa. The prevalence of maxillary sinus disease ranged from 7.5% to 66%. The most common pathological findings of the maxillary sinus were mucosal thickening, sinusitis and sinus opacification. Conclusions: Although the main indication of CBCT of the maxillary sinus in dentistry is sinus floor elevation/ treatment planning and evaluation prior to dental implant placement, this imaging modality is increasingly also used for endodontic and periodontal purposes. There is no consensus regarding the cutoff point beyond which mucosal thickening of the maxillary sinus should be regarded as pathological, and the definition of maxillary sinusitis moreover varies greatly in the scientific literature. In this regard, international consensus is required in relation to these concepts, with a clear distinction between healthy and diseased maxillary sinuses (AU)

No disponible