The management of peri-implant breakdown around functioning osseointegrated dental implants.
ABSTRACT Peri-implant tissue breakdown can be the result of microbial action as well as of biomechanical and occlusal overload. The long-term goal of the treatment of peri-implant breakdown is to arrest the progression of the disease and to achieve a maintainable site for the patient. Peri-implant bony defects around functioning implants can be treated with either non-surgical or surgical (resective or regenerative) techniques. Bone regeneration is possible in selected peri-implant bony defects of functioning implants if appropriate surgical techniques are utilized and the etiologic cause is eradicated.
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ABSTRACT: Dental implants have become increasingly common for the management of tooth loss. Despite their placement in a contaminated surgical field, success rates are relatively high. This article reviews dental implants and highlights factors leading to infection and potential implant failure. A literature search identified studies analysing the microbial composition of peri-implant infections. The microflora of dental peri-implantitis resembles that found in chronic periodontitis, featuring predominantly anaerobic Gram-negative bacilli, in particular Porphyromonas gingivalis and Prevotella intermedia, anaerobic Gram-negative cocci such as Veillonella spp. and spirochaetes including Treponema denticola. The role of Staphylococcus aureus and coagulase-negative staphylococci that are typically encountered in orthopaedic infections is debatable, although they undoubtedly play a role when isolated from clinically infected sites. Likewise, the aetiological involvement of coliforms and Candida spp. requires further longitudinal studies. Currently, there are neither standardised antibiotic prophylactic regimens for dental implant placement nor universally accepted treatment for peri-implantitis. The treatment of infected implants is difficult and usually requires removal. In the UK there is no systematic post-surgical implant surveillance programme. Therefore, the development of such a project would be advisable and provide valuable epidemiological data.The Journal of hospital infection 04/2009; 72(2):104-10. · 3.01 Impact Factor
Article: Diagnosis and treatment of a large periapical implant lesion associated with adjacent natural tooth: a case report.[show abstract] [hide abstract]
ABSTRACT: A possible cause for dental implant failure is the periapical implant lesion (PIL). In this case report we describe an apical periodontitis on a tooth adjacent to a dental implant that may have communicated with the apical region of the dental implant, and causing retrograde peri-implantitis. To our knowledge this is the first report demonstrating the concomitant successful treatment of the periapical implant pathology and the adjacent natural tooth without the removal of the implant. The presence of large bony defect at the apical region of the natural tooth and the implant, resulting in a sinus tract and a deep periodontal pocket, was also confirmed with computerized tomography. The treatment procedure included root canal treatment followed by the debridement of the apical bone lesion, and guided bone regeneration. An uneventful healing with acceptable esthetic was observed.Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 07/2006; 101(6):e132-8. · 1.50 Impact Factor
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ABSTRACT: Different techniques have been used for the treatment of peri-implant defects. However, there are always questions about the issue of reosseointegration. The present paper explores the recent literature on the topic of peri-implantitis therapy, and presents a surgical protocol for implant surface decontamination using the CO(2) laser, grafting of the defect, and coverage with a membrane according to a clinical case. The results appear to be promising and may improve the long-term clinical outcomes of failing dental implants.Photomedicine and laser surgery 07/2009; 27(3):381-6. · 1.76 Impact Factor