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Journal of Periodontology Oct 2013The number of placed implants has grown during the past decade, and the prevalence of peri-implantitis has increased. The purpose of the present study is to investigate...
BACKGROUND
The number of placed implants has grown during the past decade, and the prevalence of peri-implantitis has increased. The purpose of the present study is to investigate the treatment outcome of peri-implantitis and to identify factors influencing the treatment success rate.
METHODS
The study was conducted as a retrospective longitudinal study on a referral population. The material included 382 implants with peri-implantitis in 150 patients. Peri-implantitis was defined as presence of pocket depths ≥5 mm, bleeding at probing and/or suppuration, and the presence of implant radiographic bone loss ≥3 mm or bone loss comprising at least three threads of the implant. Variance analyses, χ(2) analyses, and logistic regression analysis were used for data analyses.
RESULTS
The mean age of the participants at baseline was found to be 64 years (range: 22 to 87 years). The mean ± SD follow-up time was 26 ± 20 months, and the mean time between implant installation and baseline was 6.4 years (range: 1 to 20 years). Periodontal flap surgery with osteoplasty was the most common type of therapy (47%), and regenerative surgery procedures with bone substitute materials were chosen in 20% of the cases. The mean success rate at patient level was 69%. The results of the logistic regression analyses showed that the success rate was significantly lower for individuals with the diagnosis of severe periodontitis, severe marginal bone loss around the implants, poor oral hygiene, and low compliance.
CONCLUSION
The effectiveness of the peri-implantitis therapy was impaired by severe periodontitis, severe marginal bone loss around the implants, poor oral hygiene, and low compliance.
Topics: Adult; Aged; Aged, 80 and over; Alveolar Bone Loss; Alveoloplasty; Bone Substitutes; Dental Implants; Dental Prosthesis, Implant-Supported; Female; Follow-Up Studies; Guided Tissue Regeneration, Periodontal; Humans; Longitudinal Studies; Male; Middle Aged; Oral Hygiene; Patient Compliance; Peri-Implantitis; Periodontal Index; Periodontal Pocket; Periodontitis; Retrospective Studies; Risk Factors; Stomatitis; Surgical Flaps; Treatment Outcome; Young Adult
PubMed: 23237584
DOI: 10.1902/jop.2012.120555 -
Advances in Clinical and Experimental... 2012Cleft of lip, alveolar process and palate is the most common congenital defect affecting the face. It occurs at the time of early embryogenesis as a result of disturbed... (Review)
Review
Cleft of lip, alveolar process and palate is the most common congenital defect affecting the face. It occurs at the time of early embryogenesis as a result of disturbed differentiation of the primordial cell layer and is associated with genetic and environmental factors. The most severe type of the defect is complete cleft of the lip, alveolar process and palate, unilateral or bilateral, which is accompanied by impaired breathing, sucking, swallowing, chewing, hearing and speaking. The treatment consists in the surgical reconnection (reconstruction) of the cleft anatomical structures and their formation to gain proper appearance, occlusal conditions and speech. The part of the surgical treatment is reconstruction of alveolar bone by means of autogenic spongy bone grafting (osteoplasty). The surgery performed at the stage of mixed dentition following an orthodontic treatment is a recognized standard management modality. Its effects provide stabilization of the dental arches fixed in the orthodontic treatment, possibility of growth of permanent teeth adjoining the cleft as well as separation of the nasal and oral cavities. The grafted bone becomes a platform for the collapsed base of the ala nasi and facilitates restoration of teeth loss. In the graft healing process the volume of the regenerated bone tissue is lower than the graft volume. Methods to augment the healed bone volume are being searched for, as this factor decides substantially on successful outcome of the surgery.
Topics: Alveolar Process; Alveoloplasty; Bone Transplantation; Child; Cleft Lip; Cleft Palate; Humans; Maxillofacial Development; Osseointegration; Recovery of Function; Surgical Flaps; Time Factors; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 23214291
DOI: No ID Found -
Plastic Surgery International 2012Objectives. To find clinical decisions on cleft treatment based on randomized controlled trials (RCTs). Method. Searches were made in PubMed, Embase, and Cochrane...
Objectives. To find clinical decisions on cleft treatment based on randomized controlled trials (RCTs). Method. Searches were made in PubMed, Embase, and Cochrane Library on cleft lip and/or palate. From the 170 articles found in the searches, 28 were considered adequate to guide clinical practice. Results. A scarce number of RCTs were found approaching cleft treatment. The experimental clinical approaches analyzed in the 28 articles were infant orthopedics, rectal acetaminophen, palatal block with bupivacaine, infraorbital nerve block with bupivacaine, osteogenesis distraction, intravenous dexamethasone sodium phosphate, and alveoloplasty with bone morphogenetic protein-2 (BMP-2). Conclusions. Few randomized controlled trials were found approaching cleft treatment, and fewer related to surgical repair of this deformity. So there is a need for more multicenter collaborations, mainly on surgical area, to reduce the variety of treatment modalities and to ensure that the cleft patient receives an evidence-based clinical practice.
PubMed: 23213503
DOI: 10.1155/2012/562892 -
SADJ : Journal of the South African... Apr 2012Osseointegrated dental implants are used routinely in dentistry in the confidence of predictable success. However, if the implant surfaces become colonised by pathogenic... (Review)
Review
Osseointegrated dental implants are used routinely in dentistry in the confidence of predictable success. However, if the implant surfaces become colonised by pathogenic bacteria, the plaque-induced inflammation around the implants may cause peri-implant tissue destruction. Peri-implant mucositis is a reversible, plaque-induced inflammatory lesion confined to the peri-implant soft tissue unit and clinically is characterised by redness, swelling and bleeding on gentle probing. Peri-implantitis is an extension of peri-implant mucositis to involve the bone supporting the implant: it is characterised by loss of osseointegration of the coronal part of the implant, by increased probing depth and by bleeding and/or suppuration on probing. Established peri-implantitis does not respond predictably to treatment. The best management of plaque-induced peri-implant inflammatory diseases is prevention. Regular personal and professional cleaning of the implant is mandatory to minimise bacterial load. Despite our best efforts, plaque-induced peri-implant inflammatory diseases will occur frequently, and as these diseases respond best to early treatment, early detection of peri-implant mucositis by regular assessment will permit timely treatment. Peri-implant mucositis is readily treated non-surgically. Peri-implantitis is more difficult to treat largely because of the problem of decontamination of the roughened, threaded surfaces of exposed implants. As a rule, surgical treatment will be necessary, and even then success is not assured.
Topics: Alveolar Bone Loss; Alveoloplasty; Animals; Anti-Bacterial Agents; Dental Implants; Dental Plaque; Dental Prophylaxis; Guided Tissue Regeneration, Periodontal; Humans; Mucositis; Peri-Implantitis; Periodontal Debridement; Stomatitis
PubMed: 23198360
DOI: No ID Found -
Oral Health & Preventive Dentistry 2012To test the value of submerging vital roots for the preservation of the residual ridge. (Comparative Study)
Comparative Study
PURPOSE
To test the value of submerging vital roots for the preservation of the residual ridge.
MATERIALS AND METHODS
The study sample consisted of 10 patients whose bone height on both submerged and control sites was measured with the help of OPG tracings and the use of grids, from the immediate post-operative period to 3 months, 6 months and 9 months post-operatively. Statistical analysis was performed using the t-test and one-way ANOVA.
RESULTS
The amount of bone loss was significantly greater in the control area in comparison to the submerged area from the immediate post-operative period to 3 months, 6 months and 9 months post-operatively.
CONCLUSION
Although the retained roots do not prevent the resorption of residual ridge, they aid in decreasing the resorptive pattern, thereby preserving the residual ridge to some extent. This may be an expedient and inexpensive way to preserve residual ridge, requiring minimal specialised training.
Topics: Adult; Alveolar Bone Loss; Alveolar Process; Alveoloplasty; Denture, Complete; Female; Follow-Up Studies; Humans; Male; Middle Aged; Radiography, Panoramic; Surgical Flaps; Tooth Extraction; Tooth Root
PubMed: 23094269
DOI: No ID Found -
Archives of Plastic Surgery Sep 2012The bone graft for the alveolar cleft has been accepted as one of the essential treatments for cleft lip patients. Precise preoperative measurement of the architecture...
BACKGROUND
The bone graft for the alveolar cleft has been accepted as one of the essential treatments for cleft lip patients. Precise preoperative measurement of the architecture and size of the bone defect in alveolar cleft has been considered helpful for increasing the success rate of bone grafting because those features may vary with the cleft type. Recently, some studies have reported on the usefulness of three-dimensional (3D) computed tomography (CT) assessment of alveolar bone defect; however, no study on the possible implication of the cleft type on the difference between the presumed and actual value has been conducted yet. We aimed to evaluate the clinical predictability of such measurement using 3D CT assessment according to the cleft type.
METHODS
The study consisted of 47 pediatric patients. The subjects were divided according to the cleft type. CT was performed before the graft operation and assessed using image analysis software. The statistical significance of the difference between the preoperative estimation and intraoperative measurement was analyzed.
RESULTS
The difference between the preoperative and intraoperative values were -0.1±0.3 cm(3) (P=0.084). There was no significant intergroup difference, but the groups with a cleft palate showed a significant difference of -0.2±0.3 cm(3) (P<0.05).
CONCLUSIONS
Assessment of the alveolar cleft volume using 3D CT scan data and image analysis software can help in selecting the optimal graft procedure and extracting the correct volume of cancellous bone for grafting. Considering the cleft type, it would be helpful to extract an additional volume of 0.2 cm(3) in the presence of a cleft palate.
PubMed: 23094242
DOI: 10.5999/aps.2012.39.5.477 -
Journal of Oral and Maxillofacial... Feb 2013To compare the clinical and histologic healing of intraoral wounds closed using No. 3-0 silk suture with that obtained with isoamyl 2-cyanoacrylate glue. (Comparative Study)
Comparative Study Randomized Controlled Trial
PURPOSE
To compare the clinical and histologic healing of intraoral wounds closed using No. 3-0 silk suture with that obtained with isoamyl 2-cyanoacrylate glue.
MATERIALS AND METHODS
We performed alveoloplasty in 30 cases in the mandibular anterior region of edentulous arches; the length of incision in all cases was the same distance from the midline. The closure was performed on 1 side with No. 3-0 silk suture, and the other side was closed with isoamyl 2-cyanoacrylate. The surgical sites were evaluated on the first, seventh, fourteenth, and twenty-first postoperative days for tenderness and erythema. In 15 cases (group A), incisional biopsies on both sutured and glued sides were performed on the seventh postoperative day. In the other 15 patients, similar biopsies were executed on the fourteenth postoperative day (group B). All specimens were examined under a microscope for inflammatory cell infiltration, vascularity, and fibroblastic activity.
RESULTS
The incidence of tenderness and erythema was increased on the sutured side on the first, seventh, and fourteenth postoperative days but was similar to that on the glued side on the twenty-first postoperative day. In the patients biopsied on the seventh postoperative day, values of inflammatory cell infiltration and vascularity were higher on the sutured side, whereas in patients biopsied on the fourteenth postoperative day, only vascularity was higher on the sutured side.
CONCLUSION
On the seventh postoperative day, both clinical and histologic indicators of inflammation were higher on the sutured side, but these indicators had reached similar values on the fourteenth postoperative day on both the sutured and glued sides. This suggests that isoamyl 2-cyanoacrylate may aid initial healing.
Topics: Adult; Aged; Alveoloplasty; Biopsy; Connective Tissue; Cyanoacrylates; Epithelium; Erythema; Female; Follow-Up Studies; Humans; Inflammation; Jaw, Edentulous; Male; Mandible; Microvessels; Middle Aged; Pain, Postoperative; Postoperative Complications; Prospective Studies; Silk; Suture Techniques; Sutures; Tissue Adhesives; Wound Closure Techniques; Wound Healing
PubMed: 23089654
DOI: 10.1016/j.joms.2012.08.032 -
The Journal of Evidence-based Dental... Sep 2012A procedure using 4 dental fixtures with an immediate-loaded prosthesis for totally edentulous patients is the focus of an evidence-based analysis that uses modern... (Review)
Review
CONTEXT
A procedure using 4 dental fixtures with an immediate-loaded prosthesis for totally edentulous patients is the focus of an evidence-based analysis that uses modern methodologies to review an innovative clinical technique. The long-term outcomes for this surgical and prosthetic treatment for previously or newly edentulated patients by clinical teams worldwide, as well as the author's clinical personal data in a referral-based private practice, are reported in this investigation.
EVIDENCE ACQUISITION
An independent research dentist performed the literature review using terms that would identify articles commensurate with this article. The search years for keywords were limited to 2010 and 2011 because the purpose of the article was limited to current thinking and evidence on this specific technique. In this article, the author elected to restrict the literature search to journals that are commonly read and received in his clinical practice on a monthly basis. Because of the specific nature of this procedure, all historical references to the "all-on-4" procedure were also included in the database inquiries.
EVIDENCE SYNTHESIS
The literature search revealed that the investigated technique has been reported worldwide by multiple authors using retrospective clinical analyses. In the maxillary jaw, the range of implants placed was 27 to 980 fixtures with 1 to 7 years of follow-up, demonstrating a cumulative implant success rate range of 92.5% to 100%. The mandibular arch demonstrated cumulative success rates of 93.8% to 100% with 1 to 10 years of follow-up with a range of 18 to 980 fixtures being placed. The investigator's own personal clinical statistics compared favorably with other clinical teams, with a total of 120 fixtures being placed in both jaws with 6 years of follow-up with a cumulative survival implant success rate of 100%. Continuous stability of the definitive final prosthesis was above 99% in the largest reported review and 100% for this author's private practice.
CONCLUSION
Based on extensive reporting by multiple clinicians, the technique investigated is grounded in good bioengineering basic science, and demonstrates long-term clinical outcomes that can provide highly predictable long-term prosthetic stability for the edentulous patient. This highly focused critically appraised review of individual articles using 4 implants to support a fixed dental prosthesis provides clinicians and patients with a protocol that conservatively and immediately reduces the morbidity associated with the loss of teeth and removable prostheses traditional used to negate edentulism.
Topics: Alveoloplasty; Dental Prosthesis Design; Dental Prosthesis Retention; Dental Prosthesis, Implant-Supported; Evidence-Based Dentistry; Humans; Longitudinal Studies; Mouth, Edentulous
PubMed: 23040347
DOI: 10.1016/S1532-3382(12)70031-3 -
Journal of Pharmacy & Bioallied Sciences Aug 2012Pre-prosthetic surgery is that part of oral and maxillofacial surgery which restores oral function and facial form. This is concerned with surgical modification of the...
Pre-prosthetic surgery is that part of oral and maxillofacial surgery which restores oral function and facial form. This is concerned with surgical modification of the alveolar process and its surrounding structures to enable the fabrication of a well-fitting, comfortable, and esthetic dental prosthesis. The ultimate goal of pre-prosthetic surgery is to prepare a mouth to receive a dental prosthesis by redesigning and smoothening bony edges.
PubMed: 23066301
DOI: 10.4103/0975-7406.100312 -
Journal of the American Dental... Oct 2012
Socket preservation of implant sites: A critical summary of Ten Heggeler JMAG, Slot DE, Van der Weijden GA. Effect of socket preservation therapies following tooth extraction in non-molar regions in humans: a systematic review (published online ahead of print Nov. 22, 2010). Clin Oral Implants Res...
Topics: Alveoloplasty; Humans; Tooth Extraction; Tooth Socket
PubMed: 23024312
DOI: 10.14219/jada.archive.2012.0045