Surgical peri-implantitis treatment with and without guided bone regeneration. A randomized controlled trial

Objective: To evaluate the efficacy of reconstructive peri-implantitis treatment. Materials and Methods: Forty participants, with peri-implantitis and a contained intraosseous defect, were randomized to access flap (control) or access flap with xenograft and collagen membrane (test). All received systemic antimicrobials. Blinded examiners recorded probing depths (PD), bleeding and suppuration on probing (BOP & SOP), soft tissue levels, and marginal bone levels (MBL) at baseline and 12 months. Patient reported outcomes were recorded. The primary outcome was PD change. Results: All 40 participants (40 implants) completed the 12-month study. The mean (standard deviation) PD reduction (deepest site) was 4.2 (1.8) mm in the control and 3.7 (1.9) mm in the test group. MBL gain (deepest site) was 1.7 (1.6) mm in the control and 2.4 (1.4) mm in the test group. Absence of BOP & SOP was observed at 60% of both control and test implants. Buccal recession was 0.9 (1.6) mm in the control and 0.4 (1.1) mm in the test group. A successful outcome (absence of PD ≥ 5 mm with BOP, absence of SOP and absence of progressive bone loss) was achieved for 90% of the control and 85% of test group implants. No statistically significant differences in clinical or radiographic parameters were found between treatment groups. 30% of participants experienced mild gastro-intestinal disturbances. Reporting followed CONSORT guidelines. Conclusion: Similar clinical and radiographic improvements at 12 months were observed with high levels of patient satisfaction for both the access flap and xenograft covered by collagen membrane groups. Registered clinical trials.gov. ID:NCT03163602 (23/05/2017)

Using a psychosocial subgroup assignment to predict sickness absence in a working population with neck and back pain

<p>Abstract</p> <p>Background</p> <p>The overall objective was to evaluate the predictive validity of a subgroup classification based on the Swedish version of the MPI, the MPI-S, among gainfully employed workers with neck pain (NP) and/or low back pain (LBP) during a follow-up period of 18 and 36 months.</p> <p>Methods</p> <p>This is a prospective cohort study that is part of a larger longitudinal multi-centre study entitled Work and Health in the Process and Engineering Industries (AHA). The attempt was to classify individuals at risk for developing chronic disabling NP and LBP. This is the first study using the MPI-questionnaire in a working population with NP and LBP.</p> <p>Results</p> <p>Dysfunctional individuals (DYS) demonstrated more statistically significant sickness absence compared to adaptive copers (AC) after 36 months. DYS also had a threefold increase in the risk ratio of long-term sickness absence at 18 months. Interpersonally distressed (ID) subgroup showed overall more sickness absence compared to the AC subgroup at the 36-month follow-up and had a twofold increase in the risk ratio of long-term sickness absence at 18 months. There was a significant difference in bodily pain, mental and physical health for ID and DYS subgroups compared to the AC group at both follow-ups.</p> <p>Conclusions</p> <p>The present study shows that this multidimensional approach to the classification of individuals based on psychological and psychosocial characteristics can distinguish different groups in gainfully employed working population with NP/LBP. The results in this study confirm the predictive validity of the MPI-S subgroup classification system.</p

Implant Disease Risk Assessment IDRA-a tool for preventing peri-implant disease.

OBJECTIVE This treatment concept paper introduces a risk assessment tool, the Implant Disease Risk Assessment, (IDRA) which estimates the risk for a patient to develop peri-implantitis. MATERIALS AND METHODS The functional risk assessment diagram was constructed incorporating eight parameters, each with documented evidence for an association with peri-implantitis. RESULTS The eight vectors of the diagram include (1) assessment of a history of periodontitis (2) percentage of sites with bleeding on probing (BOP) (3) number of teeth/implants with probing depths (PD) ≥5 mm (4) the ratio of periodontal bone loss (evaluated from a radiograph) divided by the patient's age (5) periodontitis susceptibility as described by the staging and grading categories from the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases (Journal of Periodontology, 89 Suppl 1, S159-S172, 2018) (6) the frequency/compliance with supportive periodontal therapy (7) the distance in mm from the restorative margin of the implant-supported prosthesis to the marginal bone crest and (8) prosthesis-related factors including cleanability and fit of the implant-supported prosthesis. CONCLUSION The combination of these factors in a risk assessment tool, IDRA, may be useful in identifying individuals at risk for development of peri-implantitis

Surgical peri-implantitis treatment with and without guided bone regeneration. A randomized controlled trial

Objective To evaluate the efficacy of reconstructive peri-implantitis treatment. Materials and Methods Forty participants, with peri-implantitis and a contained intraosseous defect, were randomized to access flap (control) or access flap with xenograft and collagen membrane (test). All received systemic antimicrobials. Blinded examiners recorded probing depths (PD), bleeding and suppuration on probing (BOP & SOP), soft tissue levels, and marginal bone levels (MBL) at baseline and 12 months. Patient reported outcomes were recorded. The primary outcome was PD change. Results All 40 participants (40 implants) completed the 12-month study. The mean (standard deviation) PD reduction (deepest site) was 4.2 (1.8) mm in the control and 3.7 (1.9) mm in the test group. MBL gain (deepest site) was 1.7 (1.6) mm in the control and 2.4 (1.4) mm in the test group. Absence of BOP & SOP was observed at 60% of both control and test implants. Buccal recession was 0.9 (1.6) mm in the control and 0.4 (1.1) mm in the test group. A successful outcome (absence of PD ≥ 5 mm with BOP, absence of SOP and absence of progressive bone loss) was achieved for 90% of the control and 85% of test group implants. No statistically significant differences in clinical or radiographic parameters were found between treatment groups. 30% of participants experienced mild gastro-intestinal disturbances. Reporting followed CONSORT guidelines. Conclusion Similar clinical and radiographic improvements at 12 months were observed with high levels of patient satisfaction for both the access flap and xenograft covered by collagen membrane groups

Supportive peri-implant therapy following anti-infective surgical peri-implantitis treatment: 5-year survival and success

OBJECTIVES: To evaluate clinical outcomes of supportive peri-implant therapy (SPIT) following surgical treatment of peri-implantitis. MATERIALS AND METHODS: Twenty-four partially dentate patients with 36 dental implants diagnosed with peri-implantitis were treated by an anti-infective surgical protocol followed by regular supportive therapy. SPIT included removal of supra- and submucosal biofilm at the treated implants using titanium or carbon fibre curettes, or ultrasonic devices. In addition, professional prophylaxis (calculus/biofilm removal) at other implants/teeth and oral hygiene reinforcement was provided. Clinical measurements and radiographs were obtained at 1, 3 and 5 years. A successful treatment outcome was defined as implant survival with the absence of peri-implant probing depths (PD) ≥ 5 mm with concomitant bleeding/suppuration and absence of progression of peri-implant bone loss. RESULTS: Twelve months after treatment, there was 100% survival of the treated implants and 79% of patients (19 of 24) had a successful treatment outcome according to the defined success criteria. At 3 years, 75% of the patients (18 of 24) had a successful treatment outcome, two patients (8%) were lost to follow-up (LTF), while 8% lost an implant, and two patients had recurrence of peri-implantitis. Between 3 and 5 years, an additional two patients were LTF, and an additional two patients each lost one implant. Thus, at 5 years 63% of patients (15 of 24) had a successful treatment outcome. Complete resolution of peri-implantitis, defined as absence of bleeding at all sites, was achieved in 42% of implants (N = 15) at 5 years. CONCLUSION: Five years following regular supportive therapy, the peri-implant conditions established following peri-implantitis surgery were maintained in the majority of patients and implants. Some patients had recurrence of peri-implantitis and some lost implants over the 5-year period

Supportive peri-implant therapy following anti-infective surgical peri-implantitis treatment: 5-year survival and success

OBJECTIVES: To evaluate clinical outcomes of supportive peri-implant therapy (SPIT) following surgical treatment of peri-implantitis. MATERIALS AND METHODS: Twenty-four partially dentate patients with 36 dental implants diagnosed with peri-implantitis were treated by an anti-infective surgical protocol followed by regular supportive therapy. SPIT included removal of supra- and submucosal biofilm at the treated implants using titanium or carbon fibre curettes, or ultrasonic devices. In addition, professional prophylaxis (calculus/biofilm removal) at other implants/teeth and oral hygiene reinforcement was provided. Clinical measurements and radiographs were obtained at 1, 3 and 5 years. A successful treatment outcome was defined as implant survival with the absence of peri-implant probing depths (PD) >/= 5 mm with concomitant bleeding/suppuration and absence of progression of peri-implant bone loss. RESULTS: Twelve months after treatment, there was 100% survival of the treated implants and 79% of patients (19 of 24) had a successful treatment outcome according to the defined success criteria. At 3 years, 75% of the patients (18 of 24) had a successful treatment outcome, two patients (8%) were lost to follow-up (LTF), while 8% lost an implant, and two patients had recurrence of peri-implantitis. Between 3 and 5 years, an additional two patients were LTF, and an additional two patients each lost one implant. Thus, at 5 years 63% of patients (15 of 24) had a successful treatment outcome. Complete resolution of peri-implantitis, defined as absence of bleeding at all sites, was achieved in 42% of implants (N = 15) at 5 years. CONCLUSION: Five years following regular supportive therapy, the peri-implant conditions established following peri-implantitis surgery were maintained in the majority of patients and implants. Some patients had recurrence of peri-implantitis and some lost implants over the 5-year period