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Objectives: To assess the performance of clinical, microbiological, and immunological diagnosis of peri-implant health and the influence of professional hygiene measures on them., Material and Methods: Twenty-one edentulous patients with oral implants supporting a lower overdenture were followed up over 3 months beginning 1 week before their annual recall visit. Hygiene scores, probing depth, bleeding on probing (BOP), implant stability, gingival crevicular fluid (GCF) volume, sulcular interleukin-1beta (IL-1beta) and prostaglandin E2 (PGE2) concentrations, and relative concentrations of five bacterial species (polymerase chain reaction) were investigated. Measurement variation was assessed as a function of (a) intra- and (b) inter-examiner reliability, (c) inter-implant variation in each patient, (d) time, and (e) effect of hygiene measures by accuracy, repeatability, reproducibility, and visualization with the Bland and Altman Plot., Results: Measurement means and accuracy (in parentheses) were as follows: GCF volume 1.5 microl (1.5), Interleukin-1beta 8 ng/ml (26), PGE2 63 ng/ml (185), bacteria sum score 0.2 (0.7), plaque score 1 (1), BOP score 0 (1), Periotest value -4 (3), resonance frequency analysis ISQ 66 (11), and pocket probing depth 2.3 mm (0.7). No finding exhibited any statistically significant measurement variation as explained by accuracy, repeatability, or reproducibility. Bland and Altman Plots revealed insufficient agreement for replicated BOP assessments. A short post-treatment reduction in plaque and BOP scores was visually apparent. Still, professional oral hygiene measures exerted no sustained influence on the clinical and biochemical appearance of the peri-implant tissues., Conclusion: All findings except BOP showed statistically acceptable repeatability and moderate vulnerability to influences present 'chairside' in clinical practice.

Purpose: To evaluate, by means of the polymerase chain reaction (PCR), the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia in the mandibular arch of completely edentulous subjects before implant placement and 4 and 6 months after the placement of mandibular implant-supported fixed prostheses., Materials and Methods: Fifteen patients had bacterial plaque collected with sterile paper points before implant placement (ie, when they were completely edentulous) and at 3 sites on the peri-implant sulci displaying the largest probing depths after placement of 5 implants., Results: For the edentulous arch, A actinomycetemcomitans was detected in 13.3% of subjects, P intermedia was detected in 46.7% of subjects, and there was no detection of P gingivalis. After 4 and 6 months of implant placement, A actinomycetemcomitans was detected in 60% and 73.3% respectively; P intermedia in 46.7% and 53.3% respectively; and P gingivalis in 46.7% and 53.3%, respectively., Discussion: Future diagnosis should not be restricted to distinguishing individuals at risk of peri-implant disease. Such individuals should be identified by the employment of microbiologic methods and knowledge of the multifactorial nature of the host response to the action of microorganisms., Conclusions: The longer the implants were in the oral cavity, the higher the occurrence of A. actinomycetemcomitans, P. gingivalis, and P. intermedia in the peri-implant sulci of completely edentulous patients rehabilitated with mandibular implant-supported fixed prostheses was, without any clinical or radiographic evidence indicating peri-implant disease in the studied period.

Background: Long-term data on microbiological and clinical outcome as well as on patient satisfaction after implant therapy in the edentulous mandible are limited. Especially comparisons between fixed full prostheses (FFPs) and overdentures (ODs), or between anchoring systems for the latter are scarce., Aim: This study aimed to evaluate both of these parameters at the 10-year follow-up in a group of fully edentulous patients rehabilitated via an OD or a FFP (the latter to allow inter-group comparison)., Material and Methods: A total of 37 fully edentulous patients (25 ODs, 12 FFPs, age at implant installation ranged from 36 to 85 years) participated in this study. All subjects received their implants (Branemark System, Nobel Biocare AB, Gothenburg, Sweden) 10 years previously. For the ODs different attachment systems (bar, magnets, ball) had been applied that allowed a further intra-group comparison. At the follow-up visit, 10 years after the abutment insertion, a series of periodontal parameters were recorded, long-cone radiographs were taken and subgingival plaque samples were collected for analysis using checkerboard DNA-DNA hybridization. The clinical and radiographic data were recorded at abutment connection and after 1 and 10 years., Results: After 10 years of loading, mean plaque and bleeding indices and changes in attachment or marginal bone level were not significantly different, neither between the OD and FFP group, nor within the OD group. The marginal bone loss between abutment connection and year 10 was 0.86 and 0.73 mm for OD and FFP groups, respectively. The subgingival microbiota at implant sites from all (sub)-groups was comparable, with low numbers of DNA counts (+/-10 x 10(5)) but high detection frequencies of Actinobacillus actinomycetemcomitans (>90%), Porphyromonas gingivalis (>85%) and Tannerella forsythensis (30%). The composition of the subgingival microbiota was influenced by probing depth and bleeding tendency. Patient satisfaction was very high for both types of prosthetic rehabilitation. The FFP group scored only slightly better for chewing comfort and general satisfaction., Conclusion: These data indicate that from the clinical and microbiological standpoint, as well as patient satisfaction, both an OD and a FFP offer a favourable long-term outcome.

Objectives: This investigation sought intra-oral sources of species colonizing dental implants., Materials and Methods: Plaque samples were taken pre- and post-successful osseointegration from implants, teeth, and from tongues of 10 edentulous and 11 partially dentate subjects. Samples were assayed using whole genomic DNA probes in a checkerboard assay to 42 subgingival species., Results: Similar prevalences and mean levels (10(3) to 10(4)) of microorganisms colonized implants and teeth. Species levels from tongue samples were higher than those of teeth and implants, although species prevalence was similar, suggesting that larger samples were obtained from the tongue. No significant differences were observed between the microbiota from the tongue of edentulous and partially dentate subjects. Most implant species were detected on tongue pre-implantation. In individual edentulous subjects, there were positive associations between Capnocytophaga ochracea and Campylobacter rectus from tongue and implant samples. In individual partially dentate subjects, there were positive associations between Fusobacterium nucleatum subsp. vincentii from tongue and implant samples, and Treponema denticola from implant and tooth samples taken at the same visit., Conclusion: This study indicated that the tongue, in addition to teeth, can be a source for species colonizing new implants.