39 research outputs found
The Effect of Keratinized Mucosa on Peri-Implant Health and Patient-Reported Outcome Measures: A Systematic Review and Meta-Analysis
Objectives: The aim of this systematic review was to analyze the effect of keratinized mucosa (KM) on different peri-implant health-related parameters and on patient-reported outcome measures (PROMs). Material and methods: Randomized controlled trials, cohort, cross-sectional and case-control human studies with a follow-up period of at least 6 months comparing two groups of patients with presence or absence of KM, or with KM < 2 mm or & GE;2 mm were included. Primary outcomes were implant failures, PROMs and BoP (BoP/mBI). Additional outcomes were PPD, plaque accumulation (mPI/PI), gingival inflammation (GI/mGI), marginal bone loss (MBL), soft tissue recession (REC) and biological complications. Results: Fifteen studies were included (one RCT, two cohort prospective and twelve cross-sectional). Meta-analysis was performed for cross-sectional studies. Implant failure and complications were not presented as outcome measures, and five studies analyzed PROMs. Results from the meta-analysis reported no evidence of any statistical significant difference between groups in PPD, BoP and MBL, while a statistical significant difference in GI/BI, PI and REC was present in favor of the group with KW & GE; 2 mm. More biological complications were present in the group with no KM/KM < 2 mm but few cases were present to draw any conclusions. Although a meta-analysis could not be performed, a consistent trend toward the worst pain/discomfort in KM < 2 mm was observed. Conclusions: No clear evidence was found supporting the role of KM in peri-implant health and PROMs, even if more plaque and marginal inflammation were present in the KM < 2 mm group. Clinical relevance: KM could have a role in patients with erratic maintenance and patient comfort
The Microbiologic Profile Associated with Peri-Implantitis in Humans: A Systematic Review
International audiencePURPOSE: To qualitatively investigate the microbiologic profile in peri-implantitis by systematically reviewing the published literature on peri-implant infection.MATERIALS AND METHODS: Searches of the US National Institutes of Health free digital archives of the biomedical and life sciences journal literature (PubMed) and The Cochrane Library of the Cochrane Collaboration (CENTRAL), as well as a hand search of other literature, were conducted to identify articles potentially relevant for the review. Randomized clinical trials, prospective cohort studies, longitudinal studies, case-control studies, and cross-sectional studies in humans reporting microbiologic findings in patients with diagnosed peri-implantitis were considered eligible for this review. Screening, data extraction, and quality assessment were conducted independently and in duplicate.RESULTS: Twenty-one articles were eligible for inclusion in this review. Early studies focused on the identification of target periopathogens, whereas more recent studies used advanced molecular techniques for comprehensive overview of the peri-implantitis-associated microbiome. In summary, the microbiologic profile in peri-implantitis (1) is complex and variable, (2) consists of gram-negative anaerobic periopathogens and opportunistic microorganisms in almost the same ratio, (3) is frequently associated with the Epstein-Barr virus and nonsaccharolytic anaerobic gram-positive rods, (4) is not so strictly associated with Staphylococcus aureus, and (5) is different from that of periodontitis. A meta-analysis could not be performed because of the heterogeneity of the reviewed studies.CONCLUSION: Although a comparison of the published results was limited because of the inhomogeneity of the studies, it is clear that the microbiologic profile of peri-implantitis consists of aggressive and resistant microorganisms and is distinct from that of periodontitis. It seems that the quantitative characteristics of the microflora cohabitants represent the key determinant of disease, rather than the qualitative composition, which is very similar in healthy and peri-implantitis states