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Oral Biofilms and Their Implication in Oral Diseases
Published in Chaminda Jayampath Seneviratne, Microbial Biofilms, 2017
Georgios N. Belibasakis, Nagihan Bostanci
The periodontal and the peri-implant pocket potentially share similar microenvironmental conditions (e.g. anaerobic). The initial form of peri-implant infection is peri-implant mucositis, characterised by inflammation of the soft peri-implant mucosa, but with no evidence of destruction of the supporting bone. Progression of inflammation deeper into the implant-supporting bone manifests as peri-implantitis. Peri-implant mucositis and peri-implantitis are considered as the peri-implant variants of gingivitis and periodontitis. Yet, the clinical features of peri-implantitis are much more aggressive, rapidly progressing and difficult to treat, compared to periodontitis. In this sense, the patho-mechanisms of peri-implantitis may be distinct to those of periodontitis, even though they display qualitative similarities [40]. A good description of the relationship between peri-implantitis and periodontitis is that they are ‘fraternal’ infections [41].
Dental Implant Infection: Typical Causes and Control
Published in Huiliang Cao, Silver Nanoparticles for Antibacterial Devices, 2017
As the worldwide volume of implants increases, the number of patients/implants affected by peri-implant diseases increase markedly. Peri-implant disease, one of the most common complications that may lead to failure of dental implant treatment, has aroused increasingly more attention. The disease refers to the inflammatory lesions that develop in the soft and hard tissues around dental implants, including peri-implant mucositis and peri-implantitis (Figure 14.2). Peri-implant mucositis is recognised as reversible inflammatory reactions in the mucosa adjacent to an implant, whereas peri-implantitis is characterised as an inflammatory process affecting the tissues around an osseointegrated implant in function, resulting in loss of supporting bone (Albrektsson and Isidor 1994). Peri-implant diseases are considered to be infection diseases, which have been shown to have a close association with bacterial contamination (Costerton et al. 1999; Glinel et al. 2012).
Whitening, Therapeutic Esthetics, and Oral Health Improvement
Published in Linda Greenwall, Tooth Whitening Techniques, 2017
The incidence of peri-implantitis is increasing as more implants are placed. There is a wide range of treatment options, most of which are unsatisfactory and involve improved oral hygiene techniques around the implant, the placement of CHX gel around the abutment connection, an intense course of antibiotics, removal of the implant, raising a flap for pocket reduction to salvage the implant, and using ultrasonics and air abrasion around the exposed threads and into the pocket. Sometimes the deterioration can be rapid with severe consequences involving bone loss around the implant. A simple maintenance strategy of placing 10% carbamide peroxide in a specially made therapeutic tray may be a sensible strategy to prevent this from occurring. The patient would wear this tray overnight, depending on the severity of the peri-implantitis. The wear schedule can vary depending on the severity of the peri-implantitis. A maintenance regimen could involve use of CHX once per week overnight, or daily nighttime placement of 10% carbamide peroxide or nightly use if there is suppurative exudate from the pocket. The problem with the standard treatment (i.e., CHX gel or mouthrinse) is that patients can develop a resistance to CHX over time. In addition, allergy to CHX has been reported in the literature to be increasing. For maintenance treatment, patients are shown in detail how to apply the gel and place the tray in the mouth with the gel in place. A specific wear routine will be given to the patient to improve maintenance (see Figure 24.5).
Pain and morbidity after non-surgical and surgical treatment of peri-implantitis
Published in Acta Odontologica Scandinavica, 2019
Thomas Åge Norum, Anne Merete Aass, Odd Carsten Koldsland
Surgical treatment of peri-implantitis was reported as more painful than non-surgical treatment. This was as expected, although it was probably less inflammation in the tissue before the surgical treatment compared to the non-surgical treatment, due to the curettage and administration of antibiotics with the surgical treatment. This might also be attributed to the fact that the surgical treatment is more invasive and gives a greater mechanical trauma with exposed bone margins, longer operating time, and suturing that can subsequently give more discomfort. These findings are in accordance with findings in other studies of pain, comparing non-surgical and surgical periodontal treatment [32–35]. For practical reasons, surgery was performed one week after non-surgical treatment. The patients’ perception and assessment of pain after surgical treatment might have been influenced by the pain experienced after the non-surgical treatment.
The effect of a decontamination protocol on contaminated titanium dental implant surfaces with different surface topography in edentulous patients
Published in Acta Odontologica Scandinavica, 2019
Mohammad Alotaibi, Gary Moran, Brendan Grufferty, Stefan Renvert, Ioannis Polyzois
A small number of in vivo studies evaluating implant decontamination during surgical or non-surgical peri-implantitis treatment have been performed. In a study by de Wall et al., 30 patients with peri-implantitis were surgically treated. The treatment included bone re-contouring, debridement and chemical decontamination of the exposed implant surfaces. Microbiological samples were taken during surgery (before and after implant decontamination) by rubbing a sterilized brush across the implant surface [35]. There is a good possibility that the brush used in this study or cotton pellets used for taking microbiological samples in similar studies [36,37] were not specifically designed to go between the threads of the implants or robust enough to rub off a significant amount of bacteria. In the study herein, specimen vortexing and centrifuging, in addition to the mechanical debridement must have contributed on bacterial loosening and as a result, in to more accurate way of measuring the number of bacteria present.
Graphene onto medical grade titanium: an atom-thick multimodal coating that promotes osteoblast maturation and inhibits biofilm formation from distinct species
Published in Nanotoxicology, 2018
Nileshkumar Dubey, Kassapa Ellepola, Fanny E. D. Decroix, Julien L. P. Morin, AH Castro Neto, Chaminda J. Seneviratne, Vinicius Rosa
One of the most relevant long-term failure modes of titanium implants is the bacterial colonization of their surfaces by different pathogenic organisms. The infection of the surrounding bone can cause peri-implantitis, which can affect up to 16% of all dental implants (Daubert et al. 2015). It impairs osteogenesis and induces bone loss leading to weaker anchorage and decreased stability of the implants (Robitaille et al. 2016). The management of peri-implantitis focuses on infection control, detoxification of implant surface, and antibiotic therapy. Nonetheless, the low effectiveness of systemic and local antibiotic prophylaxis, problems associated with antibiotic-resistant bacteria, and risk of superinfection are causes of deep concern (Heitz-Mayfield et al. 2012; Verdugo, Laksmana, and Uribarri 2016). Moreover, biofilms on the surface of implants protect the organisms from the activity of antimicrobial agents and host defense mechanisms (Mombelli et al. 1987).