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Languages : en
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A prospective case series was performed to examine the clinical andradiographic changes of peri-implant tissues 2 years after resective treatment ofperi-implantitis, including an apically positioned flap, osteoplasty andimplantoplasty. In total, 25 patients with 40 titanium implants from multiplebrands and advanced peri-implantitis were included in this study. After 2 years,all implants survived, mean probing pocket depth reduced from 8.7mm to3.3mm and bone level remained stable in 92.5% of the implants. Findingssuggest the approach of an apically positioned flap combined with osteoplastyand implantoplasty as an effective and reliable strategy against peri-implantitis.
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Languages : en
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Book Description
A prospective case series was performed to examine the clinical andradiographic changes of peri-implant tissues 2 years after resective treatment ofperi-implantitis, including an apically positioned flap, osteoplasty andimplantoplasty. In total, 25 patients with 40 titanium implants from multiplebrands and advanced peri-implantitis were included in this study. After 2 years,all implants survived, mean probing pocket depth reduced from 8.7mm to3.3mm and bone level remained stable in 92.5% of the implants. Findingssuggest the approach of an apically positioned flap combined with osteoplastyand implantoplasty as an effective and reliable strategy against peri-implantitis.
Author: Alberto Ortiz-Vigun
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Languages : en
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BackgroundDespite the significant body of evidence that shows importance of keratinized tissue in maintaining peri-implant health, there is not enough data regarding the role of soft tissue quantity and quality in the treatment of periimplantitis. Aim/HypothesisThe hypothesis of the study is that the collagen matrix of porcine origin is associated with lower patient morbidity, in comparison with autologous soft tissue graft, when used for the augmentation of the keratinized tissues simultaneously with the surgical treatment of peri-implantitisMaterials and MethodsA two-centre randomized controlled clinical trial was designed to test a study hypothesis. A sample of 40 patients was recruited basing upon the diagnosis of peri-implantitis and absent or insufficient peri-implant mucosa. 1 month after the non-surgical treatment, surgical procedure was performed.Peri-implant clinical and radiographic parameters, as well as patient perception of the therapy provided, will be evaluated before and at various stages (up to 26 weeks) after the surgical intervention. Also, change of vestibulum depth was analyzed, as well as the time spent for the procedure measured.Conclusions and clinical implicationsSuggested surgical modality resulted in the improvement of clinical parameters of peri-implant tissues at 6 months after the intervention. Both free gingival graft and collagen matrix provided increase of the peri-implant keratinized mucosa and vestibulum depth. Patients treated with the collagen matrix, reported lower difficulty of the surgical procedure and lower intrasurgical pain. However, longer follow-up is required to assess the stability of clinical parameters of peri-implant health.
Author: Francisco Caramelo
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Languages : en
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TitlePeri-implantitis surgical treatment with L-PRF: clinical cases. Background: Peri-implantitis (PI) has been defined has the presence of radiographic bone loss (RBL)u22653mm and/or probing depth (PD)u22656mm and profuse bleeding on probing (BoP). There are no evidence made recommendation regarding surgical treatment of PI. Leucocyte-platelet rich fibrin (L-PRF) improves the recruitment and proliferation of a variety of cells like endothelial cells and osteoblasts. Clinical benefits at bone regeneration and osseointegration healing are confirmed by systematic reviews.Aim: To present the 6 months clinical and radiographic results of peri-implantitis surgical treatment with L-PRF.Material and Methods: Five patients (1 implant/patient) were diagnosed with PI (RBLu22653mm; PDu22656mm; BOP). Mucosal recession (MR), PD, BoP, clinical attachment level (CAL)) and periapical X-Ray (RBL) were taken at baseline. After venipuncture L-PRF membranes were prepared (Choukrounu00b4s protocol). A mucoperiosteal flap was elevated and the presence of Cl Ie defects confirmed. The implant was rinsed with saline, calculus removed with a titanium curette (Deppeleru00ae, Switzerland), and implant cleaned with an air-flow system/glycine (Perio-mate, NSKu00ae, Japan). The peri-implant defects were totally filled and then covered with L-PRF membranes. Flaps were sutured. When possible implants were left submerged. Suture was removed after 10-15. At month 6 clinical and radiographic data were recorded.Changes between 0 and 6 months were analyzed (Wilcoxon test). Statistical analyses used SPSS v24 (SPSS Statistics for Windows, IBM). Significance level of P u2264 .05.Results: Two weeks post-operative one implant was lost. The implants had 7.4u00b13.5 years in function. The baseline clinical data were PD=7.23u00b12.50mm; MR=0.00u00b10.00mm; BoP=90.00u00b120.00 and CAL=7.23u00b12.50mm. Regarding radiographic data RBL=4.38u00b10.77mm. At the 6 months evaluation PD=3.75u00b11.42mm; MR=0.00u00b10.00mm; BoP=16.67u00b10.00 and CAL=3.75u00b11.42mm. Regarding radiographic data RBL=5.86u00b11.21mm. The variation between 6-0 months (treatment effect) was PD-2.79 u00b1 1.38mm ([-4.99; -0.59], p=0.068); MR=0.00u00b10.00mm ([0.00; 0.00], p=1.000); BoP=-0.54 u00b1 0.28 ([-0.99; -0.09], p=0.068) and CAL=-2.79 u00b1 1.38mm ([-4.99; -0.59], p=0.068), RBL=-0.58 u00b1 0.99mm ([-2.16; 1.00], p=0.273).Conclusion and Clinical implications: All peri-implant defects were circumferential Cl I e. This allowed to confine and stabilize the L-PRF membranes within the defect. This was also helped by the final membranes placed over the filled defect. The tested surgical treatment did not allowed to obtain clinical and radiographic statistical significant results, after a 6 months follow-up. Peri-implantitis surgical treatment with L-PRF seems not to have a positive treatment effect.
Author: Boyd J. Tomasetti
Publisher: Springer Nature
ISBN: 3030441997
Category : Medical
Languages : en
Pages : 334
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Book Description
This comprehensive guide to short implants will take the reader through their research and development, explain the clinical indications, evaluate the outcomes achieved with various implants, and explore restorative and laboratory considerations. Short implants have steadily gained greater market share in the last decade as practitioners sought alternatives to traditional length implants in order to avoid grafting procedures. Current manufacturers offer a variety of implant lengths and widths, allowing surgeons and restorative dentists the ability to select the best implant for each clinical circumstance. Cutting edge information is provided on the research and clinical results achieved utilizing a range of implants, specifically those developed by Nobel Biocare, Straumann, Jack Hahn, and Bicon. Readers will also find an extensive description of the role of ultra-short implants involving reconstruction in both cleft patients and cancer patients who have lost portions of their mandible and/or maxilla. This book is a must-have for those interested in learning how the use of short and ultra-short implants offers both surgeons and restorative dentists an opportunity to stand out from those that use only the traditional length implants.
Author: Maria Elisa Galarraga-Vinueza
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Languages : en
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Several surgical therapies have been proposed to counteract peri-implantitis (PI) and stop the progression of peri-implant bone loss. Implantoplasty has been claimed as a promising strategy to treat peri-implant disease and prevent progressive bone loss. The aim of the present retrospective study is to evaluate the success rate and clinical outcomes of 23 peri-implantitis cases treated through a combined surgical resective/implantoplasty therapy applying a novel u201cplatform switchu201d technique to preserve peri-implant tissues integrity and counteract progressive bone loss in a 2 year follow-up period.23 patients who underwent dental implant therapy, were diagnosed with peri-implantitis, and were treated through access flap surgery, a modified implantoplasty applying a platform switch design, bone recontouring, and surface decontamination. Implantoplasty success rate was determined by radiographic and clinical parameters recorded before and over the 2-year follow-up. Marginal bone loss (MBL) as the primary endpoint, presence of suppuration, pain, mobility, and implant fracture were evaluated through clinical and radiographic analysis before(T0), after the surgical treatment(T1), and after 2-years follow-up(T2). The 2-year follow-up exhibited peri-implant bone stability in 21 cases (91.3%) showing radiographically a MBL reduction(mean) of 0.2mm/SD:0.1 (mesial) and 0.04mm/SD:0.1 (distal). 3(13%) treated implants showed radiographically a mesial bone gain of (1.6 /SD: 0.1mm). Only one implant showed progressive bone loss (4.3%) of 1.5mm (mesial) after the 24-month follow- up, however the implant did not show any other clinical signs or symptoms. One implant was lost after one year of treatment due to mobility, presenting a failure rate of 4.3%. Pain and suppuration were resolved in 22 cases (96%) and none of the cases reported implant fracture or mobility after the modified implantoplasty was performed. Considering there is no u201cgold standardu201d treatment for PI, the relevant 2-year follow-up success rate of combined surgical resective and novel u201cplatform switchu201d implantoplasty therapy shows that this modified technique is promising since it counteracted progressive bone loss and eliminated PI signs and symptoms in more than 90% of the cases. Importantly, this therapy showed bone gain in smoothened surfaces in 13%, which is the desired goal of PI treatment. Consequently, further clinical studies are need to consolidate the efficiency and relevance of this novel technique for PI treatment.
Author: Paolo Morandi
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Languages : en
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Background : Peri-implantitis is a biofilm-related disease characterized by tissues inflammation and bone resorption. Despite the absence of accepted protocols, different therapeutic approaches were proposed as non-surgical therapy, access flap, resective and regenerative surgery associated to various decontamination methods of the implant surface. A beneficial effect was nevertheless reported as a result of implantoplasty in association with a resective or regenerative surgical approach.Aim/Hypothesis : The aim of this study was to observe the clinical effects of implantoplasty applied in different surgical approaches as resective surgery and regenerative surgery.Material and Methods : Fifteen patients with peri-implantitis were enrolled during a period of 30 months; the overall number of implants involved was 34. All patients were initially treated with non-surgical therapy in order to decrease peri-implant tissues inflammation and 6-8 weeks later the surgical treatment was performed. The surgical approach was chosen based on the anatomy of the bone defect. In bone defects with limited infra-bone portion (u2264 4mm) and where the peri-implant ostectomy was an acceptable biologic cost for adjacent teeth or implants a resective surgical approach was chosen and implantoplasty was performed on the resulting exposed implant surface. In deep infra bone defects (> 4mm) and in those defects where the resection of bone wouldnu2019t be acceptable a regenerative surgical approach was chosen. Six months after surgery all patients were reevaluated and probing depth, bone level and peri-implant soft tissues inflammation parameters (redness, bleeding-on-probing, swelling) were recorded.Results : Two implants in two different patients treated with a combination of regenerative surgery and implantoplasty failed due to a lack a primary closure after surgery: one was removed 4 months after surgery, the other implant needed a surgical re-entry three weeks and was then dropped out. Six months after surgery all the other implants showed no signs of peri-implant inflammation, probing depths u2264 5 mm and no further radiographic bone resorptions; mean probing depth (PD) gain was 2,27 mm. No negative side effects linked to the dispersion of metal filing were recorded.Conclusion and Clinical implications : The association of implantoplasty and a surgical treatment of peri-implantitis resulted in an improvement of all clinical parameters regarding the peri-implant tissues and could therefore be considered a safe and effective treatment option.
Author: Marc Quirynen
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Languages : en
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Background: Non-surgical treatment of peri-implantitis is targeted at mechanical and/or chemical disinfection of the implant and its suprastructures, to allow inflamed peri-implant tissues to heal. Many different surgical and non-surgical techniques for the treatment of peri-implantitis have been investigated, with varying results. However, a combination of various non-surgical techniques in a single treatment session in a full-mouth disinfection protocol has not been investigated yet.Aim: To determine if a combination of various non-surgical techniques in a single treatment session, comprised of using hand curettes and carbon-tipped ultrasonic, air-abrasion, and Er:YAG-laser therapy in a full-mouth disinfection protocol, leads to short-term resolution of peri-implantitis.Materials and methods: 27 patients with one or more dental implants with clinical and radiographic signs of peri-implantitis were randomly allocated to 2 groups. The test group (11 patients, 31 implants) received debridement of the affected implants, using hand curettes, carbon-tipped ultrasonics, air-abrasion with glycine powder and Er:YAG-laser irradiation. Additionally, full-mouth disinfection was performed on all teeth with pockets >4 millimetres. The control group (16 patients, 30 implants) received debridement of the implants by hand curettes only. This group did not undergo a full-mouth disinfection. For both groups, all treatments were performed in a single session. Bleeding on probing (BoP) scores, peri-implant probing depths (PPD), clinical attachment levels (CAL), interproximal bone levels (BL) and full-mouth plaque scores (FMPS) were recorded at intake and at 3 and 6 months after treatment.Results: The test group showed statistically significantly more reduction in bleeding on probing scores at the 3 and 6 months of follow-up despite of an increase of scores in the test group in between 3 and 6 months after treatment. Both groups showed a statistically significant decrease in PPD after 3 months (p= 0.009 and p= 0.0008 for the control and test groups, respectively). The difference in decrease between both groups was statistically significant in favour of the test group (p= 0.0001). At 6 months an increase in PPD was observed for both groups. The difference at 6 months was no longer statistically significant. Changes in bone level from intake to 3 months and 6 months after treatment were not statistically significant. Conclusions: A more thorough debridement protocol can result in greater resolution of inflammation in the peri-implant tissues and the effects can be sustained up to 6 months after treatment. Clinically this implicates that a more comprehensive mechanical and/or chemical disinfection protocol is beneficial for the treatment of implants affected by peri-Implantitis.
Author: Georgios E. Romanos
Publisher: John Wiley & Sons
ISBN: 1119807018
Category : Medical
Languages : en
Pages : 596
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Book Description
Comprehensive, multidisciplinary approach to all aspects of dental implant maintenance, based on treatment outcomes Saving Dental Implants offers a complete reference to all factors in long-term success in dental implants. Taking an interdisciplinary approach, each chapter is written by leading experts in the field. The book examines treatment outcomes, provides advice on how to manage implants for long-term success, and supports clinicians in avoiding and managing peri-implant complications. The text presents global treatment approaches and concepts—established philosophies in practice for the last 20 years—and also looks to possible future management strategies. Designed to help clinicians apply the concepts in practice, the text also covers the pros and cons of implant therapy and the specifics of pre-implant diagnostics, treatment methodology, prosthetic concepts, and further maintenance visits. Featuring hundreds of high-quality color photographs to support the text, Saving Dental Implants covers topics such as: The anatomic features of peri-implant tissues, including clinical and histological information, and an evaluation of the studies using different implant systems and prosthetic concepts Diagnostic tools and procedures to make the proper diagnosis of peri-implant conditions, and microbiota of the peri-implant tissues and diagnostic opportunities for bacterial diagnosis Nanoparticles found in the peri-implant tissues from the implant placement, their loading, and their impact on peri-implant diseases The significance, applications, and limitations of bone grafting techniques to optimize the shape of the alveolar ridge New technologies for better treatment of peri-implant complications Examining the most current information and research on diagnosing, preventing, and managing peri-implant complications, Saving Dental Implants is a must-have practical reference for dental practitioners, specialists, and students who wish to help patients reach the best functional and esthetic outcomes.
Author: Francisco Caramelo
Publisher:
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Languages : en
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Title:Peri-implantitis surgical treatment with L-PRF/xenograft block: clinical cases. Background: Peri-implantitis (PI) has been defined has the presence of radiographic bone loss (RBL)u22653mm and/or probing depth (PD)u22656mm and profuse bleeding on probing (BoP). Evidence regarding surgical treatment of PI does not allow any specific recommendation. Leucocyte-platelet rich fibrin (L-PRF) retains cytokines and growth factors being released for a period of 7-11 days. Systematic reviews confirmed the clinical benefits of L-PRF at periodontal wound healing, bone regeneration and osseointegration.Aim: To present the clinical and radiographic results after 6 months of peri-implantitis surgical treatment with L-PRF/xenograft block.Material and Methods: Five patients (5 implants) were diagnosed with PI (RBLu22653mm; PDu22656mm; BOP). Mucosal recession (MR), PD, BoP, clinical attachment level (CAL)) and periapical X-Ray (RBL) were taken at baseline. L-PRF membranes were prepared (Choukrounu00b4s protocol) and chopped/mixed with xenograft (Creosu00ae Xenogain, Nobel Biocare, Switzerland). Fibrinogen was added to form a block. A mucoperiosteal flap was elevated, the implant rinsed with saline, calculus removed with a titanium curette (Deppeleru00ae, Switzerland) and implant cleaned with an air-flow system/glycine (Perio-mate, NSKu00ae, Japan). The peri-implant defects (no Cl Ie) were filled with L-PRF/xenograft block and covered with L-PRF membranes. Flaps were sutured. When possible implants were left submerged. Suture was removed after 10-15. At month 6 clinical and radiographic data were recorded.Changes between 0 and 6 months were analyzed (Wilcoxon test). Statistical analyses used SPSS v24 (SPSS Statistics for Windows, IBM). Significance level of P u2264 .05.Results: One female patient was a smoker (7 cigarettes/day). There were no healing complications. The baseline clinical data were PD=8.43u00b11.65mm; MR=0.00u00b10.00mm; BoP=73.33u00b124.95 and CAL=8.43u00b11.65mm. Regarding radiographic data RBL=5.86u00b11.21mm. At the 6 months evaluation PD=3.63u00b10.71mm; MR=0.07u00b10.25mm; BoP=16.67u00b10.00 and CAL=3.70u00b10.69mm. Regarding radiographic data RBL=1.75u00b11.08mm. The variation between 6-0 months (treatment effect) was PD=-4.80u00b11.12mm ([-6.19; -3.41], p=0.042); MR=0.07u00b10.09mm ([-0.05; 0.18], p=0.157); BoP=-0.57u00b10.28 ([-0.91; -0.22], p=0.041) and CAL=-4.73u00b11.17mm ([-6.19; -3.28], p=0.043), RBL=-4.11u00b11.39mm ([-5.84; -2.39], p=0.043).Conclusion and Clinical implications: Our clinical cases refer to peri-implantitis biologically more demanding defects (other than circumferential Cl Ie). Both clinical and radiographic statistical significant results were obtained with glycine decontamination and peri-implant defect fill with L-PRF/xenograft block, after a 6 months follow-up. Peri-implantitis surgical treatment with a block of L-PRF/xenograft may have a positive clinical effect.
Author: Mark R. Stevens
Publisher: Springer Nature
ISBN: 3030757501
Category : Medical
Languages : en
Pages : 480
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Book Description
This book examines the latest technologies and developments in oral and maxillofacial surgery. It presents information in an easy-to-read format and meticulously details each surgical technique. Thorough and accurate chapters comprehensively present procedures and treatments step-by-step procedures objectively. Each chapter follows a consistent format of which includes the scientific documentation of the procedure through clinical studies, objective benefits for the patient, detailed explanations of the procedure, levels of treatment complexity according to the SAC (simple -advanced complex) classification, and cost-effectiveness of the procedure for the patient and clinician. Extensive images, figures, and tables supplement select chapters to aid in visual learning. Extensive and unique, Innovative Perspectives in Oral and Maxillofacial Surgery is a vital tool for all dental specialists ranging from undergraduate students to established oral maxillofacial surgeons.
