• Title/Summary/Keyword: Peri-implant tissues

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Advanced peri-implantitis cases with radical surgical treatment

  • McCrea, Shane J.J.
    • Journal of Periodontal and Implant Science
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    • v.44 no.1
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    • pp.39-47
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    • 2014
  • Purpose: Peri-implantitis, a clinical term describing the inflammatory process that affects the soft and hard tissues around an osseointegrated implant, may lead to peri-implant pocket formation and loss of supporting bone. However, this imprecise definition has resulted in a wide variation of the reported prevalence; ${\geq}10%$ of implants and 20% of patients over a 5- to 10-year period after implantation has been reported. The individual reporting of bone loss, bleeding on probing, pocket probing depth and inconsistent recording of results has led to this variation in the prevalence. Thus, a specific definition of peri-implantitis is needed. This paper describes the vast variation existing in the definition of peri-implantitis and suggests a logical way to record the degree and prevalence of the condition. The evaluation of bone loss must be made within the concept of natural physiological bony remodelling according to the initial peri-implant hard and soft tissue damage and actual definitive load of the implant. Therefore, the reason for bone loss must be determined as either a result of the individual osseous remodelling process or a response to infection. Methods: The most current Papers and Consensus of Opinion describing peri-implantitis are presented to illustrate the dilemma that periodontologists and implant surgeons are faced with when diagnosing the degree of the disease process and the necessary treatment regime that will be required. Results: The treatment of peri-implantitis should be determined by its severity. A case of advanced peri-implantitis is at risk of extreme implant exposure that results in a loss of soft tissue morphology and keratinized gingival tissue. Conclusions: Loss of bone at the implant surface may lead to loss of bone at any adjacent natural teeth or implants. Thus, if early detection of peri-implantitis has not occurred and the disease process progresses to advanced peri-implantitis, the compromised hard and soft tissues will require extensive, skill-sensitive regenerative procedures, including implantotomy, established periodontal regenerative techniques and alternative osteotomy sites.

Influence of soft tissue and bone thickness on the dimensional change of peri-implant soft tissues;A clinical follow-up study (연조직 및 골 두께가 임플란트 주위 연조직 형태에 끼치는 영향에 관한 임상추적연구)

  • Chang, Moon-Taek
    • Journal of Periodontal and Implant Science
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    • v.35 no.1
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    • pp.187-197
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    • 2005
  • The aim of this study was to investigate the influence of peri-implant soft tissue and bone thickness on the early dimensional change of peri-implant soft tissue. Seventy-seven non-submerged implants of 39 patients which had been loaded more than 6 months were selected for the study. Following clinical parameters were measured; bucco-lingual bone width of the alveolar bone for implant placement before implant surgery; distance between implant shoulder and the first bone/implant contact at the surgery; presence of plaque, probing depth, bleeding on probing, width of keratinized mucosa, mucosa thickness, distance between implant shoulder and peri-implant mucosa, crown margin location at follow-up examination. The results showed that distance between implant shoulder and peri-implant mucosa (DIM) was correlated with probing depth and width of keratinized mucosa (p < 0.05). In addition, mucosa thickness was also correlated with probing depth (p<0.05). However, the bone width of alveolar bone and soft tissue thickness were not found to be correlated with DIM. It is important to understand the meaning of peri-implant tissue dimension in relation to dimensional changes of peri-implant soft tissue which designates appearance of implant-supported restorations. Future study is needed to elucidate the significance of the buccal bone thickness and soft tissue thickness with respect to the change of peri-implant soft tissue margin with the use of an instrument capable of measuring buccal bone thickness directly.

The influence of the implant-abutment complex on marginal bone and peri-implant conditions: A retrospective study

  • Tokgoz, Selen Ergin;Bilhan, Hakan
    • The Journal of Advanced Prosthodontics
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    • v.13 no.1
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    • pp.46-54
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    • 2021
  • Purpose. The design of the implant-abutment complex is thought to be responsible for marginal bone loss (MBL) and might affect the condition of the peri-implant tissues. This the present study aimed to evaluate the influence of the implant-abutment complex on MBL and the peri-implant tissues in partially edentulous patients treated with dental implants and determine the most advantageous design. Materials and Methods. A total of ninety-one endosseous implants with different designs of implant-abutment complex [tissue level-TL (n = 30), platform switch-PS (n = 18), and platform match-PM (n = 43)] were reviewed for MBL, Probing Pocket Depth (PPD) and Bleeding on Probing (BoP). MBL was calculated for first year of the insertion and the following years. Results. The median MBL for the PM implants (2.66 ± 1.67 mm; n = 43) in the first year was significantly higher than those for the other types (P=.033). The lowest rate of MBL (0.61 ± 0.44 mm; n = 18) was observed with PS implants (P=.000). The position of the crown-abutment border showed a statistically significant influence (P=.019) and a negative correlation (r=-0.395) on MBL. BoP was found significantly higher in PM implants (P=.006). The lowest BoP scores were detected in PS implants, but the difference was not significant (P=.523). The relation between PPD and connection type revealed no statistically significant influence (P>.05). Conclusion. Within the limitations of the present study, it may be concluded that PS implants seem to show better peri-implant soft tissue conditions and cause less MBL.

BLOOD VESSELS OF THE PERI-IMPLANT MUCOSA: A COMPARISON BETWEEN FLAP AND FLAPLESS PROCEDURES (피판과 무피판 임플란트 수술 후 임플란트 주위 점막의 혈관분포 비교)

  • Kim, Jung-In;Choi, Byung-Ho;Xuan, Feng;Kim, Ha-Rang;Mo, Dong-Yub
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.2
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    • pp.101-105
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    • 2009
  • Background: The vascularity of the peri-implant tissue is a very important parameter in establishment and maintenance of a healthy tissue after dental implant insertion. Objective: The purpose of this study was to compare the vascularity of the peri-implant mucosa between flap and flapless implant surgeries by using a canine mandible model. Study Design: In six mongrel dogs, bilateral, edentulated, flat alveolar ridges were created in the mandible. After 3 months of healing, two implants were placed in each side by either the flap or flapless procedures. After another healing period of 3 months, biopsies were obtained, prepared for light microscopy and exposed to morphometric measurements. Results: The supracrestal connective tissue lateral to the implant was found to be more richly vascularized in the flapless group than in the flap group. Conclusion: These results suggest that the flapless procedure may have an effect on increasing the vascularity of the peri-implant mucosa.

Treatment considerations in peri-implantitis (임프란트 주위염의 이해와 치료)

  • Kim, Bo-Bae;Ko, Young kyung;Park, Jun-Beom
    • The Journal of the Korean dental association
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    • v.53 no.5
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    • pp.318-325
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    • 2015
  • Peri-implantitis is defined as an inflammatory process affecting the tissues around an osseointegrated implant, resulting in the loss of the supporting bone. Microbial adherence and colonization appear to play a major role in the pathogenesis of periimplantitis. The decision regarding treatment strategies is based on the diagnosis. The severity of the peri-implant lesion and the treatment strategies must include mechanical cleaning (infection control) procedures. Mechanical instrumentation is widely used for the debridement of dental implants, but this may alter the titanium's surface properties. Therefore, selection of the type of instrumentation should be made depending on the type of surface to be debrided. Also, patients with dental implants must always be enrolled in a supportive therapy program.

The oral microbiome of implant-abutment screw holes compared with the peri-implant sulcus and natural supragingival plaque in healthy individuals

  • MinKee Son;Yuri Song;Yeuni Yu;Si Yeong Kim;Jung-Bo Huh;Eun-Bin Bae;Won-Tak Cho;Hee Sam Na;Jin Chung
    • Journal of Periodontal and Implant Science
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    • v.53 no.3
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    • pp.233-244
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    • 2023
  • Purpose: An implant-supported prosthesis consists of an implant fixture, an abutment, an internal screw that connects the abutment to the implant fixture, and the upper prosthesis. Numerous studies have investigated the microorganisms present on the implant surface, surrounding tissues, and the subgingival microflora associated with peri-implantitis. However, there is limited information regarding the microbiome within the internal screw space. In this study, microbial samples were collected from the supragingival surfaces of natural teeth, the peri-implant sulcus, and the implant-abutment screw hole, in order to characterize the microbiome of the internal screw space in healthy subjects. Methods: Samples were obtained from the supragingival region of natural teeth, the peri-implant sulcus, and the implant screw hole in 20 healthy subjects. DNA was extracted, and the V3-V4 region of the 16S ribosomal RNA was sequenced for microbiome analysis. Alpha diversity, beta diversity, linear discriminant analysis effect size (LEfSe), and network analysis were employed to compare the characteristics of the microbiomes. Results: We observed significant differences in beta diversity among the samples. Upon analyzing the significant taxa using LEfSe, the microbial composition of the implant-abutment screw hole's microbiome was found to be similar to that of the other sampling sites' microbiomes. Moreover, the microbiome network analysis revealed a unique network complexity in samples obtained from the implant screw hole compared to those from the other sampling sites. Conclusions: The bacterial composition of the biofilm collected from the implant-abutment screw hole exhibited significant differences compared to the supra-structure of the implant. Therefore, long-term monitoring and management of not only the peri-implant tissue but also the implant screw are necessary.

Amlodipine-induced gingival overgrowth around dental implants (Amlodipine으로 인한 임플란트 주위 조직의 비대)

  • Yoo, Jang-Bae;Kim, Il-Kyu;Choi, Jin-Ho;Lee, Jae-Kwan;Um, Heung-Sik;Chang, Beom-Seok
    • Journal of Periodontal and Implant Science
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    • v.35 no.3
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    • pp.591-596
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    • 2005
  • Amlodipine, nifedipine, and felodipine are calcium channel blocking agents, which are cause of unwanted gingival overgrowth around natural teeth. Many studies has been performed about this unwanted effects. However, the exact etiology remains uncertain.Few reports and investigations can be found in the literature on drug-induced gingival overgrowth around dental implants. The present case reports that amlodipine-induced gingival overgrowth occurred in peri-implant sites, confirms clinical and histological features in hyperplastic peri-implant tissues. Clinical and histological features of amlodipine-induced gingival overgrowth around dental implants were similar to that of tissue around natural teeth.

Considerations in implant crestal module to preserve peri-implant tissue (임플란트 주위 조직 보존을 위한 임플란트 경부의 디자인에 관한 고찰)

  • Kim, Hong-Jun;Kim, Jee-Hwan;Kim, Sung-Tae;Lee, Jae-Hoon;Park, Young-Bum
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.4
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    • pp.346-353
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    • 2011
  • Purpose: The peri-implant soft tissue is remodeled by the initial marginal bone resorption affecting the prognosis and esthetic result of treatment. Thus various designs on implant neck design are studied to preserve peri-implant bone. The purpose of this study is to review on the causes of initial marginal bone resorption, the configuration of peri-implant soft tissue, and the implant crestal module favorable in preserving peri-implant tissue. Materials and methods: The studies on the causes of initial marginal bone resorption and the implant crestal modules are researched and reviewed using Pubmed database. The implant crestal modules including one piece and two-piece implant, internal and external hex abutment, taper and butt joint connection, scalloped design abutment, and platform switching concept are reviewed. Results: A number of clinical and experimental studies preferred one piece implant to two-piece in preserving initial peri-implant tissue. For two piece implants, internal hex abutment and taper joint connection appear more favorable than external hex abutment and butt joint connection relatively. Controversial issues still exist on scalloped design requiring more studies on it. Although the rationale is not certain, the concept of platform switching seems favorable in preserving initial peri-implant tissue based on clinical and experimental studies. Conclusion: Each implant crestal module contains its own advantages and disadvantages with various controversial issues. In the aspect of preservation of initial peri-implant tissue, however, one-piece implant seems beneficial. In cases when two-piece implant is more appropriate due to prosthodontic concerns or any other problems, the application of platform switching concept, internal connection abutment, and taper joint connection may be favorable for the preservation of peri-implant tissues.

Microgrooves on titanium surface affect peri-implant cell adhesion and soft tissue sealing; an in vitro and in vivo study

  • Lee, Hyo-Jung;Lee, Jaden;Lee, Jung-Tae;Hong, Ji-Soo;Lim, Bum-Soon;Park, Hee-Jung;Kim, Young-Kwang;Kim, Tae-Il
    • Journal of Periodontal and Implant Science
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    • v.45 no.3
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    • pp.120-126
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    • 2015
  • Purpose: With the significance of stable adhesion of alveolar bone and peri-implant soft tissue on the surface of titanium for successful dental implantation procedure, the purpose of this study was to apply microgrooves on the titanium surface and investigate their effects on peri-implant cells and tissues. Methods: Three types of commercially pure titanium discs were prepared; machined-surface discs (A), sandblasted, large-grit, acid-etched (SLA)-treated discs (B), SLA and microgroove-formed discs (C). After surface topography of the discs was examined by confocal laser scanning electron microscopy, water contact angle and surface energy were measured. Human gingival fibroblasts (hGFs) and murine osteoblastic cells (MC3T3-E1) were seeded onto the titanium discs for immunofluorescence assay of adhesion proteins. Commercially pure titanium implants with microgrooves on the coronal microthreads design were inserted into the edentulous mandible of beagle dogs. After 2 weeks and 6 weeks of implant insertion, the animal subjects were euthanized to confirm peri-implant tissue healing pattern in histologic specimens. Results: Group C presented the lowest water contact angle ($62.89{\pm}5.66{\theta}$), highest surface energy ($45{\pm}1.2mN/m$), and highest surface roughness ($Ra=22.351{\pm}2.766{\mu}m$). The expression of adhesion molecules of hGFs and MC3T30E1 cells was prominent in group C. Titanium implants with microgrooves on the coronal portion showed firm adhesion to peri-implant soft tissue. Conclusions: Microgrooves on the titanium surface promoted the adhesion of gingival fibroblasts and osteoblastic cells, as well as favorable peri-implant soft tissue sealing.

Receptor activator of nuclear factor kappa-B gene polymorphisms in Iranian periodontitis and peri-implantitis patients

  • Kadkhodazadeh, Mahdi;Baghani, Zahra;Ebadian, Ahmad Reza;Kaghazchi, Zahra;Amid, Reza
    • Journal of Periodontal and Implant Science
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    • v.44 no.3
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    • pp.141-146
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    • 2014
  • Purpose: Peri-implantitis and periodontitis are inflammatory and infectious diseases of implant and tooth-supporting tissues. Recently, the role of gene polymorphisms of immune response components in the relevant pathogenesis has been investigated. The present study was the first to evaluate the relationship between two known single nucleotide polymorphisms (SNPs) of the receptor activator of nuclear factor kappa-${\beta}$ (RANK) gene (rs3018362 and rs35211496) in chronic periodontitis and peri-implantitis patients in an Iranian population. Methods: Eighty-one periodontally healthy patients, 38 patients with peri-implantitis, and 74 patients with chronic periodontitis were enrolled in this study. DNA was extracted from blood arm vein samples by using Miller's salting out technique according to the manufacturer's instructions given in the extraction kit. The concentration of DNA samples was measured using a spectrophotometer. The genetic polymorphisms of the RANK gene were evaluated using a competitive allele specific polymerase chain reaction (KBioscience allele specific PCR) technique. Differences in the frequencies of genotypes and alleles in the diseased and healthy groups were analyzed using chi-squared statistical tests (P<0.05). Results: Analysis of rs35211496 revealed statistically significant differences in the expression of the TT, TC, and CC genotypes among the three groups (P=0.00). No statistically significant difference was detected in this respect between the control group and the chronic periodontitis group. The expression of the GG, GA, and AA genotypes and allele frequencies (rs3018362) showed no statistically significant difference among the three groups (P=0.21). Conclusions: The results of this study indicate that the CC genotype of the rs35211496 RANK gene polymorphism was significantly associated with peri-implantitis and may be considered a genetic determinant for peri-implantitis, but this needs to be confirmed by further studies in other populations.