Prevention and treatment of peri‐implant diseases—The EFP S3 level clinical practice guideline

Journal Of Clinical Periodontology, Год журнала: 2023, Номер 50(S26), С. 4 - 76

Опубликована: Июнь 1, 2023

Abstract Background The recently published Clinical Practice Guidelines (CPGs) for the treatment of stages I–IV periodontitis provided evidence‐based recommendations treating patients, defined according to 2018 classification. Peri‐implant diseases were also re‐defined in It is well established that both peri‐implant mucositis and peri‐implantitis are highly prevalent. In addition, particularly challenging manage accompanied by significant morbidity. Aim To develop an S3 level CPG prevention diseases, focusing on implementation interdisciplinary approaches required prevent development or their recurrence, treat/rehabilitate patients with dental implants following diseases. Materials Methods This was developed European Federation Periodontology, methodological guidance from Association Scientific Medical Societies Germany Grading Recommendations Assessment, Development Evaluation process. A rigorous transparent process included synthesis relevant research 13 specifically commissioned systematic reviews, evaluation quality strength evidence, formulation specific recommendations, a structured consensus involving leading experts broad base stakeholders. Results culminated recommendation various different interventions before, during after implant placement/loading. Prevention should commence when planned, surgically placed prosthetically loaded. Once loaded function, supportive care programme be structured, including periodical assessment tissue health. If detected, appropriate treatments management must rendered. Conclusion present informs clinical practice, health systems, policymakers and, indirectly, public available most effective modalities maintain healthy tissues, evidence at time publication.

Язык: Английский

---

Polymeric Scaffolds for Dental, Oral, and Craniofacial Regenerative Medicine

Molecules, Год журнала: 2021, Номер 26(22), С. 7043 - 7043

Опубликована: Ноя. 22, 2021

Dental, oral, and craniofacial (DOC) regenerative medicine aims to repair or regenerate DOC tissues including teeth, dental pulp, periodontal tissues, salivary gland, temporomandibular joint (TMJ), hard (bone, cartilage), soft (muscle, nerve, skin) of the complex. Polymeric materials have a broad range applications in biomedical engineering functioning as tissue scaffolds, carriers for cell-based therapies, devices delivery drugs biologics. The focus this review is discuss properties clinical indications polymeric scaffold extracellular matrix technologies medicine. More specifically, outlines key properties, advantages drawbacks natural polymers alginate, cellulose, chitosan, silk, collagen, gelatin, fibrin, laminin, decellularized matrix, hyaluronic acid, well synthetic polylactic acid (PLA), polyglycolic (PGA), polycaprolactone (PCL), poly (ethylene glycol) (PEG), Zwitterionic polymers. This highlights scaffolding and/or various tissues. Particularly, used procedures are discussed alveolar ridge preservation, vertical horizontal augmentation, maxillary sinus TMJ reconstruction, regeneration, periodontal/peri-implant plastic surgery, endodontics. In addition, scaffolds application whole tooth gland regeneration discussed.

Язык: Английский

---

Ultrasonographic tissue perfusion analysis at implant and palatal donor sites following soft tissue augmentation: A clinical pilot study

Journal Of Clinical Periodontology, Год журнала: 2021, Номер 48(4), С. 602 - 614

Опубликована: Янв. 19, 2021

ABSTRACT Aim To describe the application of power Doppler Ultrasonography (US) for evaluating blood flow at implant and palatal donor sites following soft tissue augmentation with connective graft (CTG). Materials Methods Five patients exhibiting a peri‐implant dehiscence received treatment coronally advanced flap corresponding CTG. Power US was used assessing volume baseline, 1 week, month, 6 months 12 post‐surgery blood‐flow dynamics sites. The speed‐weighted power‐weighted colour pixel density (CPPD) were computed from velocity (CV) (CP), respectively. Results A mean increase in CV 199.25% observed midfacial region after week compared to baseline. CP increased all month. At months, appeared lower than baseline CCPD great palatine foramen areas 1‐week 1‐month post‐operative evaluations. Conclusions is non‐invasive valuable tool estimating perfusion CPPD variation during different phases intra‐oral healing.

Язык: Английский

---

Wound healing dynamics, morbidity, and complications of palatal soft‐tissue harvesting

Periodontology 2000, Год журнала: 2022, Номер 92(1), С. 90 - 119

Опубликована: Дек. 30, 2022

Abstract Palatal‐tissue harvesting is a routinely performed procedure in periodontal and peri‐implant plastic surgery. Over the years, several surgical approaches have been attempted with aim of obtaining autogenous soft‐tissue grafts while minimizing patient morbidity, which considered most common drawback palatal harvesting. At same time, treatment errors during may increase not only postoperative discomfort or pain but also risk developing other complications, such as injury to greater palatine artery, prolonged bleeding, wound/flap sloughing, necrosis, infection, inadequate graft size quality. This chapter described complications techniques, together for reducing morbidity accelerating donor site wound healing. The role biologic agents, photobiomodulation therapy, local systemic factors, genes implicated healing are discussed.

Язык: Английский

---

Alveolar ridge preservation: Complications and cost‐effectiveness

Periodontology 2000, Год журнала: 2022, Номер 92(1), С. 235 - 262

Опубликована: Дек. 29, 2022

Abstract Alveolar ridge preservation is routinely indicated in clinical practice with the purpose of attenuating postextraction atrophy. Over past two decades numerous studies and reviews on this topic have populated literature. In recent years focus has primarily been analyzing efficacy outcomes pertaining to dimensional changes, whereas other relevant facets alveolar therapy remained unexplored. With premise, we carried out a comprehensive evidence‐based assessment complications associated different modalities modeled cost‐effectiveness therapeutic as function changes width height. We conclude that, among allogeneic xenogeneic bone graft materials, increased expenditure does not translate into effectiveness therapy. On hand, significant association between barrier membrane reduced horizontal vertical resorption was observed, though only certain degree, beyond which return investment significantly diminished.

Язык: Английский

---

The role of keratinized mucosa width as a risk factor for peri‐implant disease: A systematic review, meta‐analysis, and trial sequential analysis

Clinical Implant Dentistry and Related Research, Год журнала: 2022, Номер 24(3), С. 287 - 300

Опубликована: Март 17, 2022

Abstract Background Studies have examined the benefit of having keratinized peri‐implant mucosa width with mixed results. Purpose This study examines whether lack a prespecified (2 mm) amount (KMW) is risk factor for diseases. Methods A systematic electronic and manual search randomized or nonrandomized controlled noncontrolled clinical trials was conducted. Qualitative review, quantitative meta‐analysis, trial sequence analysis (TSA) implants inserted at sites <2 mm ≥2 KMW were analyzed to compare all predetermined outcome variables. The level evidence concerning role in health evaluated via Grading Recommendations, Assessment, Development Evaluation (GRADE) system guide. Results Nine studies included qualitative four meta‐analysis TSA. No significant inter‐group difference ( p > 0.05) low power found probing depth, soft‐tissue recession, marginal bone loss. favoring had lower mean plaque index (MD = 0.37, 95% CI: [0.16, 0.58], 0.002) (3 studies, 430 implants, low‐quality evidence). GRADE showed very quality other measures. Conclusion Based on available impact (either ≥ 2 as developing disease remains low. Future control proper sample size longer follow‐up are needed further validate current findings.

Язык: Английский

---

Comparing the Long-Term Success Rates of Tooth Preservation and Dental Implants: A Critical Review

Journal of Functional Biomaterials, Год журнала: 2023, Номер 14(3), С. 142 - 142

Опубликована: Март 3, 2023

Implant therapy is considered a predictable, safe, and reliable rehabilitation method for edentulous patients in most clinical scenarios. Thus, there growing trend the indications implants, which seems attributable not only to their success but also arguments such as more “simplified approach” based on convenience or belief that dental implants are good natural teeth. Therefore, objective of this critical literature review observational studies was discuss evidence concerning long-term survival rates treatment outcomes, comparing endodontically periodontally treated teeth with implants. Altogether, suggests decision between keeping tooth replacing it an implant should carefully consider condition (e.g., amount remaining degree attachment loss mobility), systemic disorders, patient preference. Although revealed high failures complications common. For reason, attempts be made first save maintainable over long-term, instead immediately

Язык: Английский

---

Impact of peri‐implant soft tissue characteristics on health and esthetics

Journal of Esthetic and Restorative Dentistry, Год журнала: 2023, Номер 35(1), С. 183 - 196

Опубликована: Янв. 1, 2023

Abstract Objective To review the impact of key peri‐implant soft tissue characteristics on health and esthetics. Main Considerations The keratinized mucosa width (KMW), mucosal thickness (MT), supracrestal height (STH) are essential components phenotype. An inadequate KMW (<2 mm) has been associated with local discomfort upon oral hygiene performance increased risk for onset diseases. A minimum buccal MT (≥2 is generally required to prevent esthetic issues related effect transmucosal prosthetic elements color can also contribute long‐term stability. STH directly marginal bone remodeling patterns during early healing process that follows connection components. Short STH, defined as <3 mm, consistently loss resulting from physiologic establishment seal. Insufficient may derive into fabrication unfavorable contours, which frequently results in unpleasing outcomes predisposes submarginal biofilm accumulation. Peri‐implant dehiscences (PISTDs) a type deformity often occur sites presenting KMW, MT, and/or deficiencies. PISTDs should be correctly diagnosed treated accordingly, usually by means multidisciplinary therapy. Conclusion Understanding different dimensional morphologic features fundamental make appropriate clinical decisions context tooth replacement therapy implant‐supported prostheses.

Язык: Английский

---

Do soft tissue augmentation techniques provide stable and favorable peri‐implant conditions in the medium and long term? A systematic review

Clinical Oral Implants Research, Год журнала: 2023, Номер 34(S26), С. 28 - 42

Опубликована: Сен. 1, 2023

Abstract Objectives To review the available literature on medium‐ and long‐term effects of soft tissue augmentation (STA) at implant sites to explore different approaches clinical‐, patient‐reported, health‐related parameters. Materials Methods A comprehensive electronic manual search was performed identify prospective clinical studies that assessed (≥36 months) outcomes following STA, including number maintaining peri‐implant health developing disease, incidence complications, stability clinical, volumetric, radiographic parameters, patient‐reported outcome measures (PROMs). Results Fifteen were included in qualitative analysis. STA with either a bilaminar‐ or an apically positioned flap (APF) approach, combination autogenous grafts (free gingival graft [FGG] connective [CTG]) substitutes (acellular dermal matrix [ADM] xenogeneic cross‐linked collagen [CCM]). An overall high survival rate observed. Most augmented maintained medium long term, mucositis peri‐implantitis ranging from 0% 50% 7.14%, respectively. The position margin APF + FGG bilaminar involving CTG CCM found be stable over time. No substantial changes reported for plaque score/index, bleeding probing/bleeding index, probing depth between early time points visits. CTG‐based procedures resulted increased dimension keratinized mucosa width (KMW) mucosal thickness (MT)/volumetric time, when compared follow‐ups. described marginal bone levels grafted professionally esthetic results points. Conclusions Implants received showed relatively low term. Augmented seem maintain level while non‐augmented implants may exhibit apical shift margin. favorable obtained are increase KMW MT expected CTG‐augmented sites.

Язык: Английский

---

Is alveolar ridge preservation an overtreatment?

Periodontology 2000, Год журнала: 2023, Номер 93(1), С. 289 - 308

Опубликована: Авг. 25, 2023

Abstract The morphology and dimensions of the postextraction alveolar ridge are important for surgical restorative phases implant treatment. Adequate new bone formation preservation following extraction will facilitate installation in a position, while soft tissue contour volume is essential an aesthetic implant‐supported restoration with healthy peri‐implant tissues. Alveolar (ARP) refers to any procedure that aims to: (i) limit dimensional changes after facilitating placement without additional extensive augmentation procedures (ii) promote healing alveolus, (iii) at entrance alveolus preserve contour. Although ARP clinically validated safe approach, certain clinical scenarios, benefit over unassisted socket has been debated it appears some clinicians may represent overtreatment. aim this critical review was discuss evidence pertaining four key objectives determine where can lead favorable outcomes when compared healing.

Язык: Английский

---