994 resultados para Ligature-induced peri-implantitis


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Background and objective: Stress during pregnancy may alter offspring susceptibility to diseases during adulthood. In the present study, female Lewis rats were subjected to chronic stress during the gestational period, and the effect of this stress was evaluated histometrically on the progression of ligature-induced bone loss in their adult offspring.Material and methods: After confirming pregnancy, half of the pregnant rats were randomly designated as control animals (no stress regimen was imposed), and the other half was submitted to a chronic stress model (immobilization at cold temperature) between the 7th and the 18th gestational day. After birth, 12 male rats delivered by stressed mothers - Group 1 (G1) - and 12 male rats delivered by non-stressed mothers - Group 2 (G2) - were selected. When birthed rats reached 250 g of body weight, a silk ligature was placed around their maxillary right second molar in order to induce bone loss. The non-ligated left side served as a control. Sixty days later, these animals were sacrificed by anaesthetic overdose. After routine laboratorial processing, images of the histological sections were digitized and submitted for histometric measurement using two parameters: histological attachment loss and bone loss.Results: on the ligated side, G1 presented with greater histological attachment and bone loss than G2 (p < 0.05). on the non-ligated control side, neither of the groups presented with alterations in these parameters (p > 0.05).Conclusion: The chronic stress regimen imposed on pregnant rats produced a greater progression of ligature-induced bone loss in their adult offspring. (C) 0 2011 Elsevier Ltd. All rights reserved.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Background. Periodontal disease in diabetic patients presents higher severity and prevalence; and increased severity of ligature-induced periodontal disease has been verified in diabetic rats. However, in absence of aggressive stimuli such as ligatures, the influence of diabetes on rat periodontal tissues is incompletely explored. The aim of this study was to evaluate the establishment and progression of periodontal diseases in rats only with diabetes induction. Methodology/Principal Findings. Diabetes was induced in Wistar rats (n = 25) by intravenous administration of alloxan (42 mg/kg) and were analyzed at 1, 3, 6, 9 and 12 months after diabetes induction. The hemimandibles were removed and submitted to radiographical and histopathological procedures. A significant reduction was observed in height of bone crest in diabetic animals at 3, 6, 9 and 12 months, which was associated with increased numbers of osteoclasts and inflammatory cells. The histopathological analyses of diabetic rats also showed a reduction in density of collagen fibers, fibroblasts and blood vessels. Severe caries were also detected in the diabetic group. Conclusions/Significance. The results demonstrate that diabetes induction triggers, or even co-induces the onset of alterations which are typical of periodontal diseases even in the absence of aggressive factors such as ligatures. Therefore, diabetes induction renders a previously resistant host into a susceptible phenotype, and hence diabetes can be considered a very important risk factor to the development of periodontal disease.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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The identification and treatment of peri-implant infections are an essential stage in the maintenance of dental implants, reflecting the longevity of rehabilitation. Therefore, the aim of the study was to conduct a literature review addressing peri-implantitis in dental implants in order to guide planning for the longevity of oral rehabilitation. It was conducted a detailed search strategy by the PubMed / Medline Dentistry and Oral Science, it was used as descriptors: “peri-implantitis” and “Dental Implant”, until July 2013. From 566 articles, after a review, according to the inclusion criteria, 34 articles were selected. The results were grouped together in topics (concept, etiology, diagnosis, surgical and nonsurgical, and aspects of oral rehabilitation) for further discussion and conclusions. Conclusions: The accumulation of plaque has been associated with a higher propensity to peri-implantitis. There is a higher incidence of the peri-implantitis disease among patients with previous history of periodontal disease. The local administration of antibiotics and association with mouthwashes / topical use are indicated as suitable for the treatment of moderate peri-implantitis.

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Purpose: A recent in vivo study has shown considerable contamination of internal implant and suprastructure components with great biodiversity, indicating bacterial leakage along the implant-abutment interface, abutment-prosthesis interface, and restorative margins. The goal of the present study was to compare microbiologically the peri-implant sulcus to these internal components on implants with no clinical signs of peri-implantitis and in function for many years. Checkerboard DNA-DNA hybridization was used to identify and quantify 40 species. Material and Methods: Fifty-eight turned titanium Brånemark implants in eight systemically healthy patients (seven women, one man) under regular supportive care were examined. All implants had been placed in the maxilla and loaded with a screw-retained full-arch bridge for an average of 9.6 years. Gingival fluid samples were collected from the deepest sulcus per implant for microbiological analysis. As all fixed restorations were removed, the cotton pellet enclosed in the intra-coronal compartment and the abutment screw were retrieved and microbiologically evaluated. Results: The pellet enclosed in the suprastructure was very similar to the peri-implant sulcus in terms of bacterial detection frequencies and levels for practically all the species included in the panel. Yet, there was virtually no microbial link between these compartments. When comparing the abutment screw to the peri-implant sulcus, the majority of the species were less frequently found, and in lower numbers at the former. However, a relevant link in counts for a lot of bacteria was described between these compartments. Even though all implants in the present study showed no clinical signs of peri-implantitis, the high prevalence of numerous species associated with pathology was striking. Conclusions: Intra-coronal compartments of screw-retained fixed restorations were heavily contaminated. The restorative margin may have been the principal pathway for bacterial leakage. Contamination of abutment screws most likely occurred from the peri-implant sulcus via the implant-abutment interface and abutment-prosthesis interface.

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To perform a literature review on peri-implant metastases and primary malignoma and report a case of a pulmonary metastasis around dental implants of the anterior mandibular jaw that mimicked peri-implantitis.

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The similarity of periodontitis and peri-implantitis demands for the utilization of similar principles for the treatment. Different decontamination methods were available cleaning of implant surfaces contaminated with bacteria. The aim of the present study was to evaluate the effects of various decontamination methods on reosseointegration on contaminated implants. Six mongrel dogs were used. The mandibular 1st molars and all premolars were removed bilaterally. Three months later, experi- mental implants with different surface characters were installed in each sides of the mandible. The implant consisted of two parts; the implant body and an exchangeable intraosseous implant cylinder. After osseointegration, experimental peri-implantitis was induced by cotton ligatures until the bone loss reached the junction of the two segments of the implant. After debridement of the bone defects, three treatment models were performed; (i) contaminated cylinders were removed, pristine cylinders were placed; (ii) contaminated cylinders were cleaned in situ with saline and (iii) contaminated cylinders was removed, cleaned with saline, sterilized by autoclaving. All implants were covered with membranes. After 3 months, histological evaluations were accomplished. The results indicated that in situ saline therapy demonstrated a significant difference at SLA surfaces in bone-implant-contact. Treatment of contaminated implants in situ with saline resulted in resolution of peri-implantitis and bone fill in defects.

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OBJECTIVE Recent review articles have shown that open debridement is more effective in the treatment of peri-implantitis than closed therapy. However, surgery may result in marginal recession and compromise esthetics. The purpose of this study was to assess the efficacy of nonsurgical antimicrobial photodynamic therapy (aPDT) in moderate vs severe defects. METHOD AND MATERIALS The study encompassed 16 patients with a total of 18 ailing implants. Ten of these implants showed moderate bone loss (< 5 mm; Group 1) and eight implants severe defects (5 through 8 mm; Group 2). All implants received aPDT without surgical intervention. At baseline and 2 weeks, 3 months, and 6 months after therapy, peri-implant health was assessed including sulcus bleeding index (SBI), probing depth (PD), distance from implant shoulder to marginal mucosa (DIM), and clinical attachment level (CAL). Radiographic evaluation of distance from implant to bone (DIB) allowed comparison of peri-implant hard tissues after 6 months. RESULTS Baseline values for SBI were comparable in both groups. Three months after therapy, in both groups, SBI and CAL decreased significantly. In contrast, after 6 months, CAL and DIB increased significantly in Group 2, not in Group 1. However, DIM-values were not statistically different 6 months after therapy in both groups. CONCLUSION Within the limits of this 6-month study, nonsurgical aPDT could stop bone resorption in moderate peri-implant defects but not in severe defects. However, marginal tissue recession was not significantly different in both groups at the end of the study. Therefore, especially in esthetically important sites, surgical treatment of severe peri-implantitis defects seems to remain mandatory.

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Antimicrobial photodynamic therapy (PDT) has attracted much attention for the treatment of pathogenic biofilm associated with peridontitis and peri-implantitis. However, data from randomized controlled clinical studies (RCTs) are limited and, to some extent, controversial, making it difficult to provide appropriate recommendations. Therefore, the aims of the present study were (a) to provide an overview on the current evidence from RCTs evaluating the potential clinical benefit for the additional use of PDT to subgingival mechanical debridement (ie, scaling and root planing) alone in nonsurgical periodontal therapy; and (b) to provide clinical recommendations for the use of PDT in periodontal practice.

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AIM To systematically assess the efficacy of patient-administered mechanical and/or chemical plaque control protocols in the management of peri-implant mucositis (PM). MATERIAL AND METHODS Randomized (RCTs) and Controlled Clinical Trials (CCTs) were identified through an electronic search of three databases complemented by manual search. Identification, screening, eligibility and inclusion of studies was performed independently by two reviewers. Studies without professional intervention or with only mechanical debridement professionally administered were included. Quality assessment was performed by means of the Cochrane Collaboration's tool for assessing risk of bias. RESULTS Eleven RCTs with a follow-up from 3 to 24 months were included. Definition of PM was lacking or heterogeneously reported. Complete resolution of PM was not achieved in any study. One study reported 38% of patients with complete resolution of PM. Surrogate end-point outcomes of PM therapy were often reported. The choice of control interventions showed great variability. The efficacy of powered toothbrushes, a triclosan-containing toothpaste and adjunctive antiseptics remains to be established. High quality of methods and reporting was found in four studies. CONCLUSIONS Professionally- and patient-administered mechanical plaque control alone should be considered the standard of care in the management of PM. Therapy of PM is a prerequisite for the prevention of peri-implantitis.

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Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

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Introdução: A colocação de implantes dentários tornou-se um procedimento de rotina para a reabilitação de pacientes parcial ou totalmente desdentados. As doenças periimplantares constam atualmente como uma importante complicação biológica. Sendo as doenças periimplantares de origem infeciosa, podem ser classificadas em mucosite periimplantar, uma condição caracterizada por uma inflamação reversível e sem perda de suporte ósseo, e em peri-implantite, que é uma inflamação irreversível que afeta o osso de suporte em implantes osteointegrados. Ao longo dos últimos anos diferentes estratégias de tratamento para a peri-implantite têm sido sugeridas, no entanto, continua por estabelecer qual a abordagem terapêutica mais eficaz. Objetivo: Realizar uma revisão narrativa sobre as doenças periimplantares, abordando os aspetos epidemiológicos, a etiologia, o diagnóstico e avaliar, de entre as diferentes abordagens terapêuticas disponíveis para o tratamento da peri-implantite, qual ou quais as mais efetivas. Matérias e Métodos: Foi realizada uma pesquisa bibliográfica recorrendo à base de dados da “MEDLINE/Pubmed”, com as seguintes palavras e expressões-chave: “Peri-implantitis and Diagnosis”, “Peri-implantitis and Treatment”. Deu-se especial ênfase a revisões sistemáticas e a meta-análises. Apenas foram pesquisados artigos em inglês, não tendo sido empregues quaisquer limites temporais. Conclusão: Sendo as doenças periimplantares bastante frequentes, é da responsabilidade do clinico examinar e monitorizar os pacientes que foram reabilitados com implantes. O clinico deve informar sobre as complicações biológicas e a necessidade das consultas de manutenção. Atualmente não existe nenhum protocolo ideal estabelecido para o tratamento da peri-implantite. Nesse sentido, a prevenção da doença é fundamental.