Persson GR, Samuelsson E, Lindahl C, Renvert S. Mechanical non‐surgical treatment of peri‐implantitis: a single‐blinded randomized longitudinal clinical study. II. Microbiological results. J Clin ...Periodontol 2010; 37: 563–573. doi: 10.1111/j.1600‐051X.2010.01561.x
Background: Peri‐implantitis is common in patients with dental implants. We performed a single‐blinded longitudinal randomized study to assess the effects of mechanical debridement on the peri‐implant microbiota in peri‐implantitis lesions.
Materials and Methods: An expanded checkerboard DNA–DNA hybridization assay encompassing 79 different microorganisms was used to study bacterial counts before and during 6 months following mechanical treatment of peri‐implantitis in 17 cases treated with curettes and 14 cases treated with an ultrasonic device. Statistics included non‐parametric tests and GLM multivariate analysis with p<0001 indicating significance and 80% power.
Results: At selected implant test sites, the most prevalent bacteria were: Fusobacterium nucleatum sp., Staphylococci sp., Aggregatibacter actinomycetemcomitans, Helicobacter pylori, and Tannerella forsythia. 30 min. after treatment with curettes, A. actinomycetemcomitans (serotype a), Lactobacillus acidophilus, Streptococcus anginosus, and Veillonella parvula were found at lower counts (p<0.001). No such differences were found for implants treated with the ultrasonic device. Inconsistent changes occurred following the first week. No microbiological differences between baseline and 6‐month samples were found for any species or between treatment study methods in peri‐implantitis.
Conclusions: Both methods failed to eliminate or reduce bacterial counts in peri‐implantitis. No group differences were found in the ability to reduce the microbiota in peri‐implantitis.
Objectives: The aim of this study was to analyse the proportions of peri‐implant lesions at implants after 9–14 years of function.
Material and Methods: Two hundred and ninety‐four patients underwent ...implant therapy during the years 1988–1992 in Kristianstad County. These individuals were recalled to the speciality clinic 1 and 5 years after placement of the suprastructure. Between 2000 and 2002, 218 patients with 999 implants were examined clinically and radiographically.
Results: Forty‐eight per cent of the implants had probing depth 4 mm and bleeding on probing (peri‐implant mucositis). In 20.4% of the implants, the bone level was located 3.1 mm apical to the implant shoulder. Progressive bone loss (1.8 mm) during the observation period was found in 7.7% of the implants. Peri‐implantitis defined as bone loss 1.8 mm compared with 1‐year data (the apical border of the bony defect located at or apical to the third thread, i.e. a minimum of 3.1 mm apical to the implant shoulder), combined with bleeding on probing and or pus, were diagnosed among 16% of the patients and 6.6% of the implants.
Conclusion: After 10 years in use without systematic supportive treatment, peri‐implant lesions is a common clinical entity adjacent to titanium implants.
Renvert S, Lindahl C, Roos Jansåker A‐M, Persson R. Treatment of peri‐implantitis using Er:YAG laser or an air‐abrasive device: a randomized clinical trial. J Clin Periodontol 2011; 38: 65–73. doi: ...10.1111/j.1600‐051X.2010.01646.x
Background: Non‐surgical peri‐implantitis therapies appear to be ineffective. Limited data suggest that ER:YAG laser therapy improves clinical conditions. The present study aimed at comparing the treatment effects between air‐abrasive (AM) and Er:YAG laser (LM) mono‐therapy in cases with severe peri‐implantitis.
Materials and methods: Twenty‐one subjects in each group were randomly assigned to one time intervention by an air‐abrasive device or an Er:YAG laser. Clinical data were collected before treatment and at 6 months. Data analysis was performed using repeat univariate analysis of variance controlling for subject factors.
Results: No baseline subject characteristic differences were found. Bleeding on probing and suppuration decreased in both the groups (p<0.001). The mean probing depth (PPD) reductions in the AM and LM groups were 0.9 mm (SD 0.8) and 0.8 mm (SD ±0.5), with mean bone‐level changes (loss) of −0.1 mm (SD ±0.8) and −0.3 mm (SD ±0.9), respectively (NS). A positive treatment outcome, PPD reduction 0.5 mm and gain or no loss of bone were found in 47% and 44% in the AM and LM groups, respectively.
Conclusions: The clinical treatment results were limited and similar between the two methods compared with those in cases with severe peri‐implantitis.
Background: Peri‐implantitis is a frequent finding in patients with dental implants. The present study compared two non‐surgical mechanical debridement methods of peri‐implantitis.
Material and ...Methods: Thirty‐seven subjects (mean age 61.5; S.D±12.4), with one implant each, demonstrating peri‐implantitis were randomized, and those treated either with titanium hand‐instruments or with an ultrasonic device were enrolled. Data were obtained before treatment, and at 1, 3, and 6 months. Parametric and non‐parametric statistics were used.
Results: Thirty‐one subjects completed the study. The mean bone loss at implants in both groups was 1.5 mm (SD ±1.2 mm). No group differences for plaque or gingival indices were found at any time point. Baseline and 6‐month mean probing pocket depths (PPD) at implants were 5.1 and 4.9 mm (p=0.30) in both groups. Plaque scores at treated implants decreased from 73% to 53% (p<0.01). Bleeding scores also decreased (p<0.01), with no group differences. No differences in the total bacterial counts were found over time. Higher total bacterial counts were found immediately after treatment (p<0.01) and at 1 week for ultrasonic‐treated implants (p<0.05).
Conclusions: No group differences were found in the treatment outcomes. While plaque and bleeding scores improved, no effects on PPD were identified.
Background: Peri‐implantitis is an inflammatory process caused by microorganisms affecting the tissues around an osseointegrated implant in function, resulting in a loss of supporting bone. Limited ...data exist regarding the treatment of peri‐implantitis. The aim of this study was to assess the clinical and microbiologic outcome of repeated local administration of minocycline microspheres, 1 mg, in cases of peri‐implantitis.
Methods: Thirty‐two subjects with at least one implant with a probing depth ≥4 mm combined with bleeding and/or exudate on probing and the presence of putative pathogenic bacteria were included in the study. At baseline, subjects were randomly assigned to receive local minocycline microspheres (17 subjects and 57 implants) or chlorhexidine gel (15 subjects and 38 implants) following debridement. Treatments were performed on three occasions: baseline and days 30 and 90. Follow‐up examinations were conducted at 10 days and at 1, 3, 6, 9, and 12 months.
Results: The use of minocycline resulted in significant improvements in probing depths compared to chlorhexidine at days 30, 90, and 180 (P = 0.5, P = 0.01, and P = 0.04, respectively). For the deepest sites of the minocycline‐treated implants, the mean probing depth reduction was 0.6 mm at 12 months. Regarding bleeding on probing, significant differences between groups, based on all four sites at the implants, were found at days 30, 90, 180, 270, and 360. Both treatments resulted in a marked reduction in the indicator bacteria.
Conclusions: The use of a repeated local antibiotic as an adjunct to the mechanical treatment of peri‐implantitis lesions demonstrated improvements in probing depths that were significantly different from controls and were sustained for 6 months. The adjunctive use of minocycline microspheres is beneficial in the treatment of peri‐implant lesions, but the treatment may have to be repeated.
Objectives: The aim of the present study was to evaluate the long‐term result of implant therapy, using implant loss as outcome variable.
Material and Method: Two hundred and ninty‐four patients had ...received implant therapy (Brånemark System®) during the years of 1988–1992 in Kristianstad County, Sweden. The patients were recalled to the speciality clinic 1 and 5 years after placement of the suprastructure. Between 2000 and 2002, 9–14 years after implant placements, the patients were again called in for a complete clinical and radiographic examination.
Results: Two hundred and eighteen patients treated with 1057 implants were examined. Twenty‐two patients had lost 46 implants and 12 implants were considered “sleeping implants”. The overall survival rate was 95.7%. Implant loss appeared in a cluster in a few patients and early failures were most common. Eight patients lost more than one fixture. A significant relationship was observed between implant loss and periodontal bone loss of the remaining teeth at implant placement. Maxillary, as opposed to mandibulary implants, showed more implant loss if many implants were placed in the jaw. A significant relationship between smoking habits and implant loss was not found.
Conclusion: A history of periodontitis seems to be related to implant loss.
Background: The purpose of this study is to assess clinical and microbiologic effects of the non‐surgical treatment of peri‐implantitis lesions using either an erbium‐doped:yttrium, aluminum, and ...garnet (Er:YAG) laser or an air‐abrasive subgingival polishing method.
Methods: In a 6‐month clinical trial, 42 patients with peri‐implantitis were treated at one time with an Er:YAG laser or an air‐abrasive device. Routine clinical methods were used to monitor clinical conditions. Baseline and 6‐month intraoral radiographs were assessed with a software program. The checkerboard DNA–DNA hybridization method was used to assess 74 bacterial species from the site with the deepest probing depth (PD) at the implant. Non‐parametric tests were applied to microbiology data.
Results: PD reductions (mean ± SD) were 0.9 ± 0.8 mm and 0.8 ± 0.5 mm in the laser and air‐abrasive groups, respectively (not significant). No baseline differences in bacterial counts between groups were found. In the air‐abrasive group, Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus anaerobius were found at lower counts at 1 month after therapy (P <0.001) and with lower counts in the laser group for Fusobacterium nucleatum naviforme (P = 0.002), and Fusobacterium nucleatum nucleatum (P = 0.002). Both treatments failed to reduce bacterial counts at 6 months. Porphyromonas gingivalis counts were higher in cases with progressive peri‐implantitis (P <0.001).
Conclusions: At 1 month, P. aeruginosa, S. aureus, and S. anaerobius were reduced in the air‐abrasive group, and Fusobacterium spp. were reduced in the laser group. Six‐month data demonstrated that both methods failed to reduce bacterial counts. Clinical improvements were limited.
Aim: This randomized clinical trial presents a 12‐month follow‐up of the clinical and microbiological results after application of minocycline microspheres as an adjunct to mechanical treatment of ...incipient peri‐implant infections compared with an adjunctive treatment using 1% chlorhexidine gel application.
Material and Methods: Thirty‐two subjects with probing depth 4 mm, combined with bleeding and/or exudate on probing and presence of putative pathogenic bacteria were given oral hygiene instructions and mechanical treatment of infected areas adjacent to implants. The subjects were then randomly assigned adjunctive subgingival antimicrobial treatment using either chlorhexidine gel or minocycline microspheres. Sixteen patients in the minocycline group and 14 in the chlorhexidine group completed the study. Follow‐up examinations were carried out after 10 days, 1, 2, 3, 6, 9 and 12 months.
Results: The adjunctive use of minocycline microspheres resulted in improvements of probing depths and bleeding scores, whereas the adjunctive use of chlorhexidine only resulted in limited reduction of bleeding scores. For the deepest sites of the treated implants in the minocycline group, the mean probing depth was reduced from 5.0 to 4.4 mm at 12 months. This study could not show any significant difference in the levels of bacterial species or groups at any time point between the two antimicrobial agents tested. The present findings encourage further studies on adjunctive use of minocycline microspheres in the treatment of peri‐implant lesions.
Conclusions: The use of a local antibiotic as an adjunct to mechanical treatment of incipient peri‐implantitis lesions demonstrated improvements in probing depths that were sustained over 12 months.
AimTo determine the prevalence and development of peri-implant mucositis and peri-implantitis and to assess risk factors over time. Materials and MethodsThe study is a longitudinal case series ...assessing the occurrence and diagnosis of peri-implant mucositis and peri-implantitis. ResultsA total of 218 of 294 patients who had received dental implants between 1988 and 1992 were examined between 2000 and 2002 (examination II; 9-14years after the first examination). At examination III (20-26years after examination I, on average 23.3years), 86 individuals were re-examined. The diagnosis of peri-implant mucositis and peri-implantitis at examination III was 54.7% and 22.1%, respectively. Surgical treatment of peri-implantitis after examination II resulted in a bone gain for two of 12 individuals. Individuals with 3 implants at examination II were at risk for peri-implantitis at examination III (P< 0.05). Radiographic evidence of periodontitis (p=0.40), a diagnosis of peri-implant mucositis (p=.77) or smoking (p=.86) at examination II were not predictive of peri-implantitis at examination III. ConclusionsThe diagnosis and occurrence of peri-implantitis and peri-implant mucositis were high. Healthy conditions at implants after 9-14years were predictive of future implant health.
Aim
To determine the prevalence and development of peri‐implant mucositis and peri‐implantitis and to assess risk factors over time.
Materials and Methods
The study is a longitudinal case series ...assessing the occurrence and diagnosis of peri‐implant mucositis and peri‐implantitis.
Results
A total of 218 of 294 patients who had received dental implants between 1988 and 1992 were examined between 2000 and 2002 (examination II; 9–14 years after the first examination). At examination III (20–26 years after examination I, on average 23.3 years), 86 individuals were re‐examined. The diagnosis of peri‐implant mucositis and peri‐implantitis at examination III was 54.7% and 22.1%, respectively. Surgical treatment of peri‐implantitis after examination II resulted in a bone gain for two of 12 individuals. Individuals with ≥3 implants at examination II were at risk for peri‐implantitis at examination III (P< 0.05). Radiographic evidence of periodontitis (p = 0.40), a diagnosis of peri‐implant mucositis (p = .77) or smoking (p = .86) at examination II were not predictive of peri‐implantitis at examination III.
Conclusions
The diagnosis and occurrence of peri‐implantitis and peri‐implant mucositis were high. Healthy conditions at implants after 9–14 years were predictive of future implant health.
