1,721,035 research outputs found
Is implant flossing a possible risk for the development of peri-implnat disease?
Full text linkBoth in animal experiments and clinical studies, it was established that biofilm deposition on the implant surface was the important etiologic factor for the initiation and the maintenance of peri-implant inflammation and possibly subsequent loss of marginal bone. Prevention of peri-implant infections is therefore of utmost importance for long-term dental implant survival. Maintaining a high standard of oral hygiene is consequently very important for an optimal longevity of oral implants. In that context, cleansing of implants using interproximal cleansing devices is a necessity. A frequently recommended oral hygiene aid is dental floss or superfloss. However, the unrestricted use of these oral hygiene devices in regions with exposed roughened implant surfaces has to be questioned, as new evidences show that pieces of the floss may become trapped in the peri-implant sulcus. The purpose of this communication is to present the possible risks of dental floss encountered with either already existing peri-implantitis lesions or possible connection discrepancies between fixture and abutment. A prime example with diagnosis, treatment and 6 years follow up will be presented by mean of pictures, endoscopic clips, radiographs, recordings and electron microscope examinations
Is impiant flossing a risk free procedure? A case report with a 6-year follow-up
No full textThis study reports a case of peri-implantitis correlated to floss fibers trapped by the implant-prosthetic macrostructure
Endoscopic-assisted non surgical periodontal therapy: radiographic evaluation of infrabony defect response. A pilot study.
No full textThe goal of non surgical therapy is to remove subgingival biofilm and a minimally invasive endoscopic treatment of subgingival areas allows a significant improvement of deposits removal.
The aim of this study is to analyze the radiographic response of infrabony defects after non surgical periodontal therapy performed with a periodontal endoscope.
Twenty-three sites, belonging to 13 patients (7 females and 6 males, mean ± SD = 50±11 years), were analyzed after endoscopic-assisted* non surgical periodontal therapy. All patients were affected by chronic periodontitis, with moderate (probing depth – PD: 5-6 mm) or deep (PD:≥7mm) pockets and vertical infrabony defects affecting single – rooted teeth.
All sites were treated with endoscopic-assisted scaling and root planing (S-RP) and standardized x-rays were taken before and one year after the treatment. Radiographs were scanned and evaluated using an image analyzer.
The following measurements were taken: the distance between interproximal cementoenamel junction (CEJ) and base of the defect (BD), the distance between bone crest (BC) and BD, the angle of the defect and the Infrabony Defect Fill (IDF) (measured as the difference between initial and final vertical distance from CEJ to BD).
Results, one year after the procedure, show a statistically significant (p=0.0001) mean reduction of CEJ-BD and BC-BD distances, respectively 1.13 (0.68-1.59) mm and 0.82 (0.42-1.22) mm, and a statistically significant (p=0.03) mean increase of the defect angle: 6.29 mm (0.67-11.92). Moreover, the mean value of IDF fill was 1.14 ± 0.22 mm, denoting an infrabony defect fill.
Bone remodeling, occurred after non surgical endoscopic-assisted periodontal therapy, led to a partial fill of the defect and an increase of the defect angle, due to a remineralization of the most apical part of the defect. Taking advantage of the regenerative potential present in the area, the vertical defect partially turned into a horizontal defect.
This procedure brings predictable improvements in the radiographic parameters of infrabony defects versus S-RP alone.
Periodontal endoscopic-assisted non surgical therapy achieves a statistically significant decrease of the vertical component of the bony defects and the opening of the defect angle.
This procedure seems to be a reliable treatment for patients with a medical history or other psychological/economical concerns limiting a surgical approach
Preservation and reconstructive techniques of interdental papilla
No full textLa papilla interdentale, inizialmente considerata come una semplice parte della gengiva di forma piramidale, è un’entità anatomica dalla morfologia complessa, alla quale si riconoscono oggi sia finalità protettive verso il parodonto profondo e le superfici radicolari, sia funzioni estetiche e fonetiche; la sua perdita quindi deve essere valutata come l’alterazione dell’insieme delle sue specifiche funzioni. Analizzando i versanti papillari rivolti verso le superfici dentali in direzione corono-apicale, si trovano l’epitelio sulculare, l’epitelio giunzionale e l’attacco connettivale. L’attacco connettivale e l’epitelio giunzionale costituiscono un’unità fondamentale definita ampiezza biologica, la cui violazione porta a un’inesorabile e spontanea perdita di supporto di tessuto dentale finalizzata alla ricostruzione del corretto rapporto epitelio-connettivale. Molteplici sono le cause che possono portare alla perdita o al danneggiamento della papilla.
Tali fattori possono essere distinti in infettivi, come gengiviti e parodontiti, e traumatici, come l’uso scorretto dei dispositivi igienici domiciliari e la chirurgia parodontale. Dagli anni Sessanta in poi sono state elaborate numerose tecniche chirurgiche finalizzate a preservare i tessuti molli, compresi quelli interprossimali; particolare impulso a questa impostazione va attribuito non solamente a una cre- scente sensibilità estetica del parodontologo, ma anche all’introduzione di conoscenze di tipo rigenerativo/ricostruttivo.
Quando la perdita dei tessuti interdentali è già avvenuta possono essere attuate molteplici tecniche con finalità ricostruttive, che possono essere distinte in due categorie: chirurgiche e non chirurgiche. Le tecniche ricostruttive non chirurgiche mirano fondamentalmente a modificare le determinanti anatomiche non gengivali correlate con la presenza dei tessuti interdentali. Tra queste strategie si riconoscono trattamenti restaurativi, protesici e ortodontici; molto recente la proposta d’iniezione di fibroblasti.
Molteplici stratagemmi chirurgici sono stati descritti in letteratura, con finalità correttive verso deficit di tessuti interdentali; purtroppo nessuna ricerca specifica ha per ora verificato l’effettivo risultato e/o comparato tra loro tali tecnicismi. La conoscenza delle molteplici variabili che influenzano lo stato di salute e l’equilibrio dei tessuti compresi nell’area interdentale è alla base di una corretta gestione clinica dell’area; la rassegna del percorso scientifico che ha portato sino alle più recenti tecniche preservative e ricostruttive della papilla interdentale permette al clinico un razionale approccio terapeutico
Radiographic Response of Intrabony Defects After Endoscopic-assisted Non-surgical Periodontal Therapy
No full textObjectives: The primary goal of non-surgical periodontal therapy (NSPT) is to remove subgingival deposits. The recent introduction of endoscopy to this procedure has opened new opportunities. The aim of this work is to analyse the radiographic response of intrabony defects to endoscopic-assisted NSPT.
Methods: This was a prospective study on patients with chronic periodontitis. The main study outcome was radiographic bone changes. Twenty-three sites, belonging to 13 consecutive patients (7 females, 6 males, age =50±11) were studied. All patients were affected by chronic periodontitis presenting at least one vertical intrabony defect affecting a single–rooted tooth. Intrabony defects associated with perio-endo pathology were excluded. All sites were treated with one session of endoscopic-assisted (Dental View-DV2, CA, USA) NSPT and then maintained with 3-monthly supportive periodontal therapy. Standardized x-rays were taken before and one year after treatment. Radiographs were scanned and evaluated using an image analyser (Scion Image Analyzer, Scion, Frederick, MD, USA). The following measurements were registered: the distance between interproximal cement-enamel junction (CEJ) and base of the defect (BD), the distance between bone crest (BC) and BD and the angle of the defect defined by the previous two lines.
Results: Significant mean reduction of CEJ-BD and BC-BD distances were registered between baseline and 1-year follow-up: 1.13 ± 0.22 mm (95% CI:0.68-1.59) and 0.82 ± 0.19 mm (95% CI:0.42-1.22) respectively (Student T for paired data: p=0.0001). The defect angle showed a significant mean increase of 6.29 ± 2.71° (95% CI:0.67-11.92) (Student T for paired data: p=0.03).
Conclusions: The present work shows a clear improvement of infrabony defects one year after therapy. The endoscopic-assisted NSPT therefore seems a promising therapeutic approach, leading to significant radiographic benefits in a minimally invasive way. Randomized controlled studies are strongly required to test this treatment against other NSPT modalities
Evaluation of Floss Remnants After Implant Flossing in Three Different Implant Conditions: A Preclinical Study
No full textPurpose: The aim of this preclinical study was to evaluate whether implant flossing could leave floss residues in three different implant-prosthetic conditions. Materials and Methods: Using an anatomical model, three different conditions were studied: correct connection between the implant and abutment and complete insertion of the implant threads into the plaster (control group); misfit of approximately 220 to 230 μm between the implant platform and abutment in the absence of any thread exposure (misfit group); partial exposure of implant threads but absence of misfit (thread group). Twenty-one microstructured tapered threaded implants were divided among the three groups. Each sample was subjected to a flossing procedure using spongy floss, standardized in terms of movement, frequency, time, and pressure. Subsequently, a stereomicroscope examination with a standardized magnification of 10× was performed in order to highlight the possible presence of floss residues on the implant surface. Results: No floss residue was ever detected for the control group. Both misfit and thread groups showed floss residues that were discernible in two different types: microfilaments and amorphous particles. Statistical analysis showed a significant difference for the presence of floss remnants between the control group and the other two experimental groups (P = .005). No difference was observed between the misfit and thread groups. Conclusion: This study shows that exposed threads and misfit can induce the release of floss residues during maintenance procedures
Permanent mucosal discoloration correlated to magnesium-enriched hydroxyapatite: a case report.
No full textPurpose: To describe a clinical case where magnesiumenriched hydroxyapatite (MHA) (SintLife®) used for socket preservation has induced a permanentmucosal discoloration.
Methods and materials: After a minimally traumatic extraction of a first maxillary right molar, MHA particulate was inserted into the socket for bone contour preservation.
The surgical procedure as the healing process was uneventful. Two months later, the soft tissue areas corresponding to the vestibular sockets of the extracted roots displayed asymptomatic bluish discoloration. The rehabilitation of the area was suspended and the discoloration monitored. Six years later, the pigmentation was still present and the radiographic evaluation of the area showed residual biomaterial particles. The histomorphological evaluation of the soft and hard tissues was consequently performed in order to better comprehend the origin of the mucosal alteration.
Results: Histological examination confirmed the presence of residual MHA particles, mainly in direct contact with bone tissue, but partly embedded into the subepithelial fibrotic chorion (see the enclosed picture). There was no melanosis or melanocytic hyperplasia in the epithelium. Mild inflammatory infiltrate was observed, without deposits of haemosiderin. These findings suggest that biomaterial represents the source of discoloration. Since the MHA preparation is white, it can be speculated that, one time into the organic environment, it has gone to a chromatic modification visible through the overlying soft tissues. However this hypothesis did not find a confirmation in the intraoperative observations, where the few particles of biomaterial seen coming out from the surgical areas were all white coloured. Alternatively an explanation of the discoloration can be found in the Tyndall effect, which refers to the fact that different wavelengths of light do not scatter depending on size of substances they encounter: longer redder wavelengths can penetrate more deeply into the soft tissues than shorter blue wavelength before reflecting out. So the light reflecting from tissue over the biomaterial contains less red light than blue, giving the biomaterial a bluish cast. For instance, a similar principle governs why veins appear blue in the skin, despite the red colour of transported blood.
Conclusion: In spite of the excellent characteristics of MHA as bone substitute, the potential appearance of permanent mucosal discoloration represents a relevant drawback for oral cavity, especially for those areas with clear aesthetic demand. More investigations are needed in order to confirm the present observations and better comprehend the eventual origin of the mucosal discoloration
The electric toothbrush: analysis of filaments under stereomicroscope
No full textThe use of manual and electric toothbrushes has a fundamental role in primary prevention in oral hygiene. However, aggressive use of the toothbrushs, especially those with non-rounded filaments, can result in lesions in both soft and hard oral tissue. Without doubt, the electric toothbrush is a useful aid for the patient, and it is therefore intersting to evaluate not only its effectiveness in plaque removal, but also the relationship between morphology of filaments and incidence of muco-gingival pathologies. Objective: The aim of this research was to evaluate various forms of bristles of elctric toothbrushes under a stereomicroscope vision.
Data sources: brusshes tested included two samples of toothbrushes from isx different types. Tufts from the same position on the toothbrush head were removed and examined under stereomicroscope. In this study the percentage of rounded filaments that is considered acceptable and non-traumatic was evaluated according to the Silverstone and Featherstone classification. Conclusion: Morphological analysis of electric toothbrush filaments revealed a low percentale of rounded filaments. In only 4 of 12 electric toothbrushes tested there were more than 50% of the filaments rounded in appearance
Recognition and treatment of peri-implant mucositis: Do we have the right perception? A structured review
Full text linkPeri-implant mucositis is a common inflammatory lesion of the soft tissues surrounding endosseous implants, with no loss of the supporting bone. Its prevention or early diagnosis are vital for dental implant success.The aim of this review was to investigate knowledge strengths and gaps in clinicians'perceptions of periimplant mucositis prevalence and evidence for successful treatment.A literature search for articles published until 2020, reporting on the prevalence of peri-implant mucositis and its treatment was performed in standard online databases. The inclusion criteria were as follows: studies in English; studies with an available abstract; studies on humans with at least 1 dental implant; and studies reporting on the prevalence and/or treatment of peri-implant mucositis. Sixty-five studies fulfilled the inclusion criteria. The included papers were analyzed to identify data on the prevalence and treatment of peri-implant mucositis. The prevalence statistics for peri-implant mucositis had wide ranges in both the patient-based (PB) analysis and the implant-based (IB) analysis; the possible reasons for these wide ranges are discussed. Treatment methods for peri-implant mucositis were analyzed individually and compared to the management of gingivitis.It was determined that the currently available information on the prevalence rates and the standardized therapeutic protocols for peri-implant mucositis are insufficient. Since the mean gingivitis and peri-implant mucositis prevalence rates in the PB analysis were similar, it is possible that peri-implant mucositis is under estimated due to variables related to implant rehabilitation itself
In‐vitro comparison of two different toothbrush bristles about peri‐implant sulcus penetration
No full textObjective: The aim of this preclinical study was to compare the ability of tapered and cylindrical bristles to penetrate the peri-implant sulcus. Methods: A full mandibular dental arch was reproduced in plaster cast. In site #3.6 a hollow glass cylinder was positioned simulating a 4 mm diameter implant and the gingival component was recreated by using dedicated silicone. A Bass brushing technique was performed from the vestibular side in humid environment. During it, the penetration of the bristles between the gum and the implant was recorded by mean of an optic fibre fixed inside the cylinder. The protocol included 5 toothbrushes per group and 10 tests per toothbrush, for a total of 50 assessments for each of the two groups. A scale of 5 grades for bristle penetration was defined: grade 0 (× < 2 mm), grade 1 (2 ≤ × < 3 mm), grade 2 (3 ≤ × < 4 mm), grade 3 (4 ≤ × < 5 mm) and grade 4 (5 ≤ × < 8 mm). From the video recordings the highest value of penetration was identified for each test. Results: The tapered bristles showed an 8 times greater penetration capacity (p = 0.001) in respect to the cylindrical bristles (multilevel analysis). The percentage of tests reaching depths ≥3 mm was 86% for tapered group and 28% for the cylindrical group. Conclusion: This preclinical study shows a clear and superior penetration capacity of the tapered bristles in respect to traditional cylindrical ones. For tapered bristles, a potentially greater hygienic efficacy around dental implants is suggested
- …
