Probiotic treatment in the oral cavity : an update

Probiotics have been found to be beneficial to host health. Their primary use in medicine has been for the management of intestinal tract problems. In recent years, probiotics have been used as a treatment to promote oral health. The aim of the present study was to review published studies regarding probiotics and their effects on the oral cavity. Studies reporting the anticariogenic effects of probiotics, their use in the treatment of periodontal disease, a reduced crevicular fluid volume and cytokine content, as well as their use in the treatment of halitosis and Candida albicans were identified. Studies assessing residence time of probiotics in the oral cavity were also selected for retrieval. Most authors concluded that the use of oral probiotics was associated with an improvement in oral health, including a significantly reduced level of cariogenic and periodontal pathogens and a lower crevicular fluid volume and cytokine concentration

Bisphosphonates and dental implants: current problems

Osteonecrosis of the jaw has been described in patients taking bisphosphonates after oral surgery procedures, including the placement of dental implants. This review is an update of the relationship between bisphosphonates and dental implants.Results obtained by different authors are compared, contrasting earlier studies where an improvement in implant osseointegration using bisphosphonates was observed, with ones where statistically significant differences were found, and more recent studies disagreeing with the use of bisphosphonates for causing necrosis of the jaw. The differing results obtained between animal studies and the situation observed in humans may be due to a short medication and follow-up period, as well as to the existence of few research studies where dental implants are placed in the oral cavity.Currently, dental implants are contraindicated in patients being treated with intravenous bisphosphonates. In 2007, the American Association of Oral and Maxillofacial Surgeons suggested guidelines for patients treated with oral bisphosphonates, based on the clinical situation of the patient and the length of treatment with the drug, and that greater caution prior and subsequent to surgery should be taken for three years after treatment. All patients treated with bisphosphonates must have the risk of possible loss of implants and the risk of suffering a bony necrosis of the operated jaw explained to them, and give their informed consent prior to dental implant surgery

Osteonecrosis of the jaws in patients treated with bisphosphonates

The literature describes an increasing presence of bisphosphonate-induced osteonecrosis of the jaws (ONJ), characterized by the exposure for over 8 weeks of necrotic bone in the maxillofacial region, after bisphosphonate therapy, in the absence of prior maxillary radiotherapy. The present literature review examines the etiopathogenesis, risk factors, clinical forms, diagnosis, treatment and prevention of bisphosphonate-induced ONJ. In addition, a review is made of all the series involving over 15 patients diagnosed with this disorder between 1 January 2011 and 15 May 2011. A PubMed-Medline search was carried out with the following key words: 'bisphosphonates' and 'osteonecrosis'. The appearance of osteonecrosis is a serious complication, with an increasing incidence, that affects patient quality of life and causes important morbidity. All patients treated with bisphosphonates are at risk of developing osteonecrosis as a result of such medication. This potential complication therefore should be explained to the patient by both the prescribing physician and the dental surgeon in charge of oral treatment, with the obtainment of informed consent in all cases

Fracture and fatigue of cp titanium narrow dental implants. New trends in order to improve the mechanical response

Sixty-four fractured commercially pure titanium (cp-Ti) narrow dental implants (NDIs) with similar macrogeometry and connection designs were studied after di erent implantation times in humans in order to determine their reliability and to evaluate the causes of the fracture. These NDIs were compared with other similar implants, made with alloyed titanium with 15% Zr and with 12% strained titanium. Original implants were tested under static and fatigue conditions, simulating the tri-axial loads in the mouth by means of a Bionix hydraulic test machine. Fractography was studied using field-emission scanning electron microscopy (FSEM). The results showed that cp-Ti NDI exhibits low strength for mechanical cycling, and the alloyed Ti and strained titanium increase the mechanical strength, guaranteeing long term mechanical behavior. NDIs fractured due to fatigue, and, in some cases, the presence of cracks in the original NDIs quickly led to fracture. These cracks were attributed to plastic deformation during machining were found to be exacerbated due to acid etching in the passivation process. All cases of fracture were cp-Ti dental implants due to the low fatigue limit. The results show that, when titanium is alloyed or cold-worked, the fatigue limit is higher than cp-Ti. This in vitro research will help clinicians to select a better NDI system for safer treatment

Interleukins IL-6, IL-8, IL-10, IL-12 and periimplant disease. An update

Introduction: A study is made of the usefulness of cytokines (such as interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and interleukin-12 (IL-12)) as markers of periimplant disease (mucositis and periimplantitis). An increase in the levels of these cytokines in dental implant crevicular fluid may give rise to a lack of osteointegration, bbone loss or implant failure. Obbjective: To review the literature relating IL-6, IL-8, IL-10 and IL-12 levels to dental implant surgery and periimplantitis. Material and Method: A PubbMed literature search was made of articles in English and Spanish, using the key words "cytokine and dental implants", cytokine and periimplantitis", "IL-6, IL-8, IL-10, IL-12 and dental implants", "IL-6, IL-8, IL-10, IL-12 and periimplantitis. Fourteen articles were found and classified into two groups relating interleukin levels to: a) periimplant disease; and b) their influence upon dental implant osteointegration without periimplant disease. Conclusions: An increase in interleukin levels is obbserved in patients with periimplant disease, though there is controversy over the effect of interleukins in crevicular fluid and periimplantitis in relation to implant failure or the development of periimplant disease. © Medicina Oral S. L

Effect of ozone therapy upon clinical and bacteriological parameters of the oral cavity: an update

Objective: To review the literature on ozone therapy in oral health, as assessed by different clinical and bacteriological parameters. Material and methods: A PubMed literature search was made using the key words “ozone dental”, and establishing as limits “randomized controlled trial” and “dental journal”. Thirteen articles were identified, with access to only 6 of them. Results: Four studies used ozone for the treatment of caries. One study examined its effect upon dental hypersensitivity, while another evaluated the efficacy of ozone as a tooth whitening technique. Five studies explored the bacteriological actions of ozone therapy in reference to different types of bacteria. Conclusion: The reviewed literature yields a number of studies describing a high antimicrobial potential of ozone therapy in different dental areas, though very few in vivo studies have evidenced the success of such treatment. Further studies are therefore needed in this field

Radiological assessment of peri-implant bone loss: a 12-month retrospective study

Introduction: Following dental implant loading, marginal bone loss after one year must be evaluated to check correct maintenance of the bone levels. Objectives: To assess implant treatment success and quantify marginal bone loss 6 and 12 months after loading. Material and method: Sixty-one MIS® implants with a 1.8 mm machined neck were placed in 26 patients. Implant success was based on the criteria of Buser. Radiological controls were made 6 and 12 months after loading, measuring bone loss mesial and distal. Results: Twenty-two patients with 56 implants were included: 32 in the maxilla and 24 in the mandible. Two implants failed in two patients during the osseointegration phase (both in the maxilla), yielding an implant success rate of 96.4%. After 6 months, bone loss was 0.80±1.04 mm mesial and 0.73±1.08 mm distal, while after 12 months bone loss was 0.92±1.02 mesial and 0.87±1.01 distal. Conclusions: Bone loss 6 and 12 months after machined neck implant placement was within the normal ranges described in the literature

Peri-implantitis : associated microbiota and treatment

Introduction: Peri-implantitis is a late complication of dental implant treatment, induced by microbiological changes. Since the disorder is frequent, a review is indicated of the microorganisms that influence it and of the existing treatment options. Objective: To conduct a literature review of the microbiota associated to peri-implantitis and the existing treatment options. Material and Method: A PubMed literature search was made of the studies on the microbiota associated to dental implants in healthy patients and patients with peri-implantitis, as well as of the latest treatment developments, using the following key words: "peri-implantitis AND microbiota", "periimplantitis AND microbiota", "peri-implantitis AND treatment", and "periimplantitis AND treatment". Only clinical studies in humans were considered. The following criteria were applied for including articles in the analysis: a) for the peri-implant microbiota, the search limits were human studies after the year 2000; and b) for the treatment of peri-implantitis, the search limits were randomized and controlled clinical trials (RCTs) in humans, with a minimum follow-up of 4 months, and publication after the year 2000. Results: A total of 18 articles were selected in relation to peri-implant microbiota, and 13 in relation to the treatment of peri-implantitis (8 involving nonsurgical mechanical treatments and 5 surgical procedures). Conclusions: Evaluation of the literature has shown the microbiota associated to peri-implantitis to be more complex than that found under healthy peri-implant conditions - the main flora consisting of anaerobic gramnegative bacteria. No clear criteria have been identified for the diagnosis and treatment of peri-implantitis. © Medicina Oral S.L

The use of Lactobacillus reuteri DSM 17938 and ATCC PTA 5289 on oral health indexes in a school population: A pilot randomized clinical trial

To assess the effects of a probiotic upon oral health indices in adolescents and to establish relationships between these indices and dietary habits and oral hygiene. Twenty-seven adolescents between 12 and 18 years of age were randomized into two groups. The study group received tablets containing Lactobacillus reuteri DSM 17938/ATCC 5289 for 28 days, while the control group received tablets without any bacteria. Streptococcus mutans, Lactobacillus sp., and salivary pH were assessed at baseline and at 7, 14, 21, 28, and 45 days. The plaque, gingivitis, and bleeding indices were recorded at baseline and at 14, 28, and 45 days. Dietary and oral hygiene habits were also evaluated by means of a questionnaire. A less marked rise in S. mutans was recorded in the study group. Improvements were observed in terms of plaque, gingivitis, and bleeding, though statistical significance was not reached. Oral pH increased in the study group, though not to a significant degree. Poorer eating habits were significantly correlated to increased plaque. The study parameters decreased with the two strains of L. reuteri DSM 17938 and ATCC PTA 5289, though the results failed to reach statisticalOdontologí