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1. Peri-implantitis and periodontitis. Experimental and clinical studies

Author

Carcuac, Olivier

Subjects
histology, dental implant, peri-implant disease, systemic antibiotics, treatment, inflammation, animal experiment, immunohistochemistry, periodontal disease, antiseptics, biopsy, radiology
Abstract

Peri-implantitis is an increasing problem in implant dentistry. The current series of studies employed a translational approach with the aim to compare peri-implantitis and periodontitis lesions and evaluate the influence of implant surface characteristics and the adjunctive use of systemic antibiotics/local antiseptics on healing following surgical treatment of peri-implantitis. Tissue reactions following ligature removal in experimental periodontitis and peri-implantitis were analyzed in a dog model (Study I). Histopathological characteristics in human peri-implantitis and periodontitis lesions were evaluated in 80 patients (Study II). Labrador dogs were used to analyze the effect of surgical treatment of experimental peri-implantitis at implants with different surface characteristics using different anti-infective procedures (Study III). 100 patients with severe peri-implantitis were treated surgically with or without adjunctive systemic antibiotics or the local use of chlorhexidine for implant surface decontamination. Treatment outcomes were evaluated after 1 year. A binary logistic regression analysis was performed to identify factors influencing the probability of treatment success (Study IV). It was demonstrated that : the amount of bone loss that occurred during the period following ligature removal was significantly larger at implants with a modified surface than at implants with a non-modified surface and at teeth. The histological analysis revealed that peri-implantitis sites exhibited inflammatory cell infiltrates that were larger, extended closer to the bone crest and contained larger proportions of neutrophil granulocytes and osteoclasts than in periodontitis. (Study I) peri-implantitis lesions were more than twice as large and contained significantly larger area proportions, numbers, and densities of CD138-, CD68-, and MPO-positive cells than periodontitis lesions. (Study II) the local use of chlorhexidine has minor influence on resolution of peri-implantitis following surgical treatment. (Study III) treatment outcome was influenced by implant surface characteristics. (Study III and IV) the adjunctive use of systemic antibiotics increased the probability for treatment success at implants with modified surfaces but not at implants with a non-modified surface. (Study IV)

Published
2015

2. Peri-implantitis in a specialist clinic of periodontology. Clinical features and risk indicators.

Author

Carcuac O and Jansson L

Subjects
Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Humans, Jaw, Edentulous, Partially rehabilitation, Male, Middle Aged, Periodontal Index, Retrospective Studies, Risk Factors, Smoking adverse effects, Young Adult, Alveolar Bone Loss etiology, Dental Implantation adverse effects, Periodontitis etiology
Abstract

Implant therapy has become a widely recognized treatment alternative for replacing missing teeth. Several long term follow-up studies have shown that the survival rate is high. However, complications may appear and risk indcators associated with early and late failures have been identified. The purpose of the present retrospective clinical study was to describe some clinical features of patients with clinical signs of peri-implantitis and to identify risk indicators of peri-implantitis in a population at a specialist clinic of Periodontology. In total,the material consisted of 377 implants in 111 patients with the diagnosis peri-implantitis. The mean age at the examination was found to be 56.3 years (range 22-83) for females and 64.1 years (range 27-85) for males. The mean number of remaining teeth was found to be 10.5 (S.D. 8.89) and the mean number of implants was 5.85 (S.D. 3.42). For a majority of the subjects, more than 50% of the remaining teeth had a marginal bone loss of more than 1/3 of the root length. Forty-sex percent of the patients visited regularly dental hygienists for supportive treatment. The percentage of implants with peri-implantitis was significantly increased for smokers compared to non-smokers (p = 0.04). In the group of non-smokers, 64% of the implants had the diagnosis peri-implantitis, while the corresponding relative frequency for smokers was 78%. A majority of the individuals had a Plaque index and Bleeding on probing index >50%. The median of the follow-up time after implant placement was 7.4 years and the observation period was not significantly correlated to the degree of bone loss around the implants. Among the subjects with a mean bone loss >6 mm at implants with peri-implantitis, more than 70% had a mean marginal bone loss > 1/3 of the root length of the remaining teeth. A positive and significant correlation was found between the degree of marginal bone loss in remaining teeth and the degree of bone loss around implants with peri-implantitis. In conclusion, the results of the present study indicate that smoking as well as previous history of periodontitis are associated with peri-implantitis and may represent risk factors for this disease.

Published
2010

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