periimplantitis

  • 文章类型: Journal Article
    简介:种植体周围炎是牙科种植的严重并发症,如果不及时治疗,可能导致植入物丢失和全身性疾病。种植体周围炎引起的骨缺损的有效再生对于维持牙种植体的功能至关重要。研究目的:该研究旨在比较细颗粒牙本质和Bio-Oss在重建由种植体周围炎引起的骨缺损中的有效性。材料和方法:该研究包括对骨密度随时间变化的综合放射学评估。使用Hounsfield单位(HU)评估骨密度作为骨衰减的量度,在愈合过程中以8周和12周的间隔进行放射学评估。该研究包括年龄在30至65岁之间的参与者。57例患者分为三组:22例患者接受小颗粒牙本质,15收到Bio-Oss,和20个没有骨替代材料的对照。结果:8周后,细牙组骨密度增加20%(p<0.05),而Bio-Oss组在12周后增加了15%(p<0.05)。对照组骨密度变化最小(12周后5%),这没有统计学意义。临床评估显示,在细牙本质组中95%的成功整合,Bio-Oss组的85%,对照组为70%。细牙本质组显示8周后骨密度增加20%(p<0.05),而Bio-Oss组在12周后增加了15%(p<0.05)。对照组骨密度变化最小(12周后5%),这没有统计学意义。临床评估显示,在细牙本质组中95%的成功整合,Bio-Oss组的85%,对照组为70%。结论:与对照组相比,细颗粒牙本质和Bio-Oss均显着改善了骨密度。细颗粒牙本质由于其快速的初始再生而适合于立即骨再生,虽然Bio-Oss提供长期支持,理想的维持植入物的稳定性在更长的时间。结果强调了根据临床情况选择合适的骨替代材料以改善牙种植体放置后患者预后的重要性。
    Introduction: Peri-implantitis is a serious complication in dental implantology that, if left untreated, may lead to implant loss and systemic diseases. Effective regeneration of bone defects resulting from peri-implantitis is crucial to maintaining the functionality of dental implants. Purpose of the Study: The study aimed to compare the effectiveness of fine-particle dentin and Bio-Oss in the reconstruction of bone defects caused by peri-implantitis. Materials and Methods: The study included a comprehensive radiological assessment of changes in bone density over time. Bone density was assessed using Hounsfield Units (HUs) as a measure of bone attenuation, with radiological assessments performed at 8- and 12-week intervals during the healing process. The study included participants ranging in age from 30 to 65 years. Fifty-seven patients were divided into three groups: 22 patients received small-particle dentin, 15 received Bio-Oss, and 20 controls without bone substitute material. Results: The fine-dentin group showed a 20% increase in bone density after 8 weeks (p < 0.05), while the Bio-Oss group showed a 15% increase after 12 weeks (p < 0.05). The control group showed minimal changes in bone density (5% after 12 weeks), which was not statistically significant. Clinical evaluations showed 95% successful integration in the fine dentin group, 85% in the Bio-Oss group, and 70% in the control group. The fine-dentin group showed a 20% increase in bone density after 8 weeks (p < 0.05), while the Bio-Oss group showed a 15% increase after 12 weeks (p < 0.05). The control group showed minimal changes in bone density (5% after 12 weeks), which was not statistically significant. Clinical evaluations showed 95% successful integration in the fine-dentin group, 85% in the Bio-Oss group, and 70% in the control group. Conclusions: Both fine-particle dentin and Bio-Oss significantly improved bone density compared to the control group. Fine-particle dentin is suitable for immediate bone regeneration due to its rapid initial regeneration, while Bio-Oss provides long-term support, ideal for maintaining implant stability over a longer period of time. The results highlight the importance of selecting appropriate bone replacement materials depending on the clinical scenario to improve patient outcomes after dental implant placement.
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  • 文章类型: Journal Article
    目的:本研究旨在使用种植体疾病风险评估图评估功能至少两年的牙种植体的风险状况评估与随访期间种植体周围边缘骨丢失之间的关系。材料和方法:本研究共纳入了70名患者和170名植入物,他们的功能负荷至少为两年,并参加了随访。全口菌斑指数(PI),牙龈指数(GI),探测深度(PD),探查时出血,临床依恋水平(CAL),和种植体周围改良菌斑指数,修正出血指数,PD,角化粘膜宽度(KMW),记录CAL和GR。根据IDRA风险图,参与者和牙科植入物被分为低,中度,和高危人群。在功能负荷(T0)和最后一次随访(T1)时获得的根尖X线片上测量边缘骨水平(MBL),中边缘和远端骨水平变化(ΔMBL)计算为T1-T0。结果:牙周炎病史与牙周炎易感性和患者级IDRA分类之间存在统计学上的显着相关性。全口胃肠道,PD,发现高危IDRA组的BOP在统计学上较高。在IDRA风险组之间的内侧和远端ΔMBL之间没有发现统计学上的显着结果。结论:在这项研究中,IDRA风险水平增加,尤其是牙周炎易感性和牙周炎史,但在ΔMBL方面,风险组之间没有发现显著差异。
    Purpose: This study aimed to evaluate the relationship between risk profile assessments of dental implants that have been in function for at least two-year and peri-implant marginal bone loss during the follow-up period using the Implant Disease Risk Assessment Diagram. Material and Methods: A total of 70 patients and 170 implants who had been functionally loaded for at least two years and who attended follow-up sessions were included in the study. Full-mouth plaque index (PI), gingival index (GI), probing depth (PD), bleeding on probing, clinical attachment level (CAL), and peri-implant modified plaque index, modified bleeding index, PD, keratinized mucosal width (KMW), CAL and GR were recorded. According to the IDRA risk diagram, participants and dental implants were divided into low, moderate, and high-risk groups. Marginal bone level (MBL) was measured on periapical radiographs obtained at functional loading (T0) and at the last follow-up session (T1), and mesial and distal marginal bone level changes (ΔMBL) were calculated as T1-T0. Results: A statistically significant correlation was found between the periodontitis history and periodontitis susceptibility and IDRA classification at the patient-level. Full-mouth GI, PD, and BOP were found to be statistically higher in the high-risk IDRA group. No statistically significant result was found between the mesial and distal ΔMBL between the IDRA risk groups.Conclusions: In this study, IDRA risk level increased especially by periodontitis susceptibility and periodontitis history, but no significant difference was found between risk groups in terms of ΔMBL.
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  • 文章类型: Journal Article
    牙周植入患者的微生物概况要求其中微生物的任何独特组成都是牙医感兴趣的。因此,我们评估了种植体周围炎患者的微生物概况,牙周炎患者和正常健康受试者。这项研究包括180名受试者。从60名牙周健康(PH)参与者中收集牙菌斑样本,60名牙周炎(PT)受试者,和60名种植体周炎(PI)受试者。获得了7种最常见的牙周病原体的最终浓度,即Aggregatibacter放线菌,具核梭杆菌,Denticola密螺旋体,牙龈卟啉单胞菌,中间介体普雷沃特拉,金黄色葡萄球菌和副流感嗜血杆菌。微生物的丰度以Log10CFU(x103)的形式表示。在这项研究中评估的周围病原体的丰度在种植周炎患者中是不同的,牙周炎患者和正常健康受试者,其周围病原体的丰度稍高。
    The microbial profile of patients with periimplantis to inqure any unique composition of microorganisms in them is of interest to dentists. Hence, we evaluated the microbial profile of patients with peri-implantitis, patients with periodontitis and normal healthy subjects. 180 subjects were included in this study. Plaque samples were collected from 60periodontically healthy (PH) participants, 60 periodontitis (PT) subjects, and 60 periimplantitis (PI) subjects. Final concentrations were obtained for seven most common periodontal pathogens namely Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia, Staphylococcus aureus and Haemophilus parainfluenzae. The abundance of microorganisms was represented in the form of Log10CFU (x103). The abundance of periopathogens evaluated in this research was different in periimplantitis patients, periodontitis patients and normal healthy subjects with slight greater abundance of peripathogens in patient with periimplantitis.
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  • 文章类型: Journal Article
    本系统综述研究了质子泵抑制剂(PPI)对牙周病,种植体周围炎和种植体存活的严重程度的可能影响。我们在PubMed进行了文献检索,Scopus,直到2024年4月,科克伦中央图书馆。两位综述作者独立筛选了标题和摘要,然后筛选了检索到的研究的全文。包括评估PPI使用与牙周病严重程度和种植体周围炎或种植体存活之间关系的观察性和临床试验研究。从纳入的研究中提取数据由两个独立的综述完成。在最初从在线搜索中检索到的940项研究中,7项研究符合纳入标准。三项研究检查了牙周炎,而四个人专注于种植体周围炎和种植体寿命。相反,关于PPI使用对种植体周围和种植体存活影响的证据是相互矛盾的.因此,更精心设计的RCT有必要得出明确的结论。由于质子泵抑制剂改变了肠道微生物组,影响骨骼,加上牙周病的发病机制和病因受牙周袋内细菌的影响,据推测,它们可能会影响牙周的发病机制。
    This systematic review investigates the probable effect of proton pump inhibitor (PPI) use on the severity of periodontal disease and peri-implantitis and implant survival. We conducted a literature search in PubMed, Scopus, and Cochrane Central Library up to April 2024. Two review authors independently screened the title and abstracts and then the full texts of retrieved studies. Observational and clinical trial studies that assessed the association between PPIs use and periodontal disease severity and peri-implantitis or implant survival were included. Data extraction from the included studies was done by two reviews independently. Of 940 studies initially retrieved from online searching, 7 research met the inclusion criteria. Three studies examined periodontitis, while four focused on peri-implantitis and implant longevity. On the contrary, evidence regarding the impact of PPIs use on peri-implantits and implant survival is conflicting. Therefore, more well-designed RCTs are warranted to come to a definite conclusion. Since proton pump inhibitors alter the gut microbiome, and affect bone, plus the pathogenesis and etiology of periodontal disease are affected by bacteria within the periodontal pocket, it is hypothesized that they may affect periodontal pathogenesis.
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  • 文章类型: Journal Article
    需要肾脏替代治疗的慢性肾脏病(CKD)患者数量正在增加,通常表现出口腔表现,包括牙周病,牙龈增生,唾液成分改变,和尿毒症性口腔炎。尿毒症性口腔炎,口干症,念珠菌病非常频繁,特别是在接受透析或肾移植的患者中。CKD患者还经历了钙稳态固有的骨代谢的深刻改变,磷,维生素D,甲状旁腺激素,和成纤维细胞生长因子(FGF)。这些改变导致颌骨的去矿化,骨小梁减少,皮质骨厚度减少,纤维囊性骨病变,骨折,拔牙后伤口愈合延迟。因此,老年血液透析患者的口腔健康管理存在严重的临床问题。本文对CKD或透析患者的口腔健康和康复进行了综述。
    The number of chronic kidney disease (CKD) patients requiring renal replacement therapy is increasing, often exhibiting oral manifestations including periodontal disease, gingival hyperplasia, altered saliva composition, and uremic stomatitis. Uremic stomatitis, xerostomia, and candidiasis are very frequent, particularly among patients undergoing dialysis or kidney transplant recipients. CKD patients also experience profound alterations in bone metabolism inherent in the homeostasis of calcium, phosphorus, vitamin D, parathyroid hormone, and fibroblast growth factor (FGF). These alterations lead to demineralization of the jaw bones, reduced bone trabeculae, reduced cortical bone thickness, fibrocystic bone lesions, bone fractures, and delayed wound healing post-tooth extraction. Consequently, oral health management of elderly hemodialysis patients poses serious clinical problems. This review focused on the oral health and rehabilitation of patients with CKD or on dialysis.
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  • 文章类型: Journal Article
    目的:纳米技术在牙科科学中不断进步,推进旨在改善牙科植入物的几个功能。牙科植入物表面处理的替代方法是电化学阳极氧化,这可以产生具有抗菌潜力和骨诱导特征的纳米管表面(TiO2纳米管)。本系统综述和荟萃分析旨在阐明与未经处理的钛表面相比,所讨论的表面可能具有抗菌性能。
    方法:为此,在PubMed基地进行了系统的搜索,丁香花,Embase,网络科学,Cinahl,和CochraneCentral,还有,手动搜索和灰色文献。
    方法:搜索产生了742篇文章,其中156个如下全文阅读。然后,37例纳入系统评价,8例纳入荟萃分析。
    结果:15项研究揭示了使用TiO2纳米管表面的显著抗菌保护,而15项研究发现对照和纳米纹理表面之间没有统计学差异。体外研究的荟萃分析表明,仅在6小时内研究金黄色葡萄球菌的研究中,相关的细菌减少。体内研究的荟萃分析显示,在TiO2纳米管表面上的细菌粘附和增殖降低了三倍。
    结论:在临床前研究中,TiO2纳米管作为牙科植入物的表面与抗菌性能呈正相关。然而,诸如阳极氧化协议等因素,细菌菌株,应考虑单培养方法,因此,需要进一步的研究来促进临床可翻译性。
    OBJECTIVE: Nanotechnology is constantly advancing in dental science, progressing several features aimed at improving dental implants. An alternative for surface treatment of dental implants is electrochemical anodization, which may generate a nanotubular surface (TiO2 nanotubes) with antibacterial potential and osteoinductive features. This systematic review and meta-analysis aims to elucidate the possible antibacterial properties of the surface in question compared to the untreated titanium surface.
    METHODS: For that purpose, was performed a systematic search on the bases PubMed, Lilacs, Embase, Web Of Science, Cinahl, and Cochrane Central, as well as, manual searches and gray literature.
    METHODS: The searches resulted in 742 articles, of which 156 followed for full-text reading. Then, 37 were included in the systematic review and 8 were included in meta-analysis.
    RESULTS: Fifteen studies revealed significant antibacterial protection using TiO2 nanotube surfaces, while 15 studies found no statistical difference between control and nanotextured surfaces. Meta-analysis of in vitro studies demonstrated relevant bacterial reduction only for studies investigating Staphylococcus aureus in a period of 6 h. Meta-analysis of in vivo studies revealed three times lower bacterial adhesion and proliferation on TiO2 nanotube surfaces.
    CONCLUSIONS: TiO2 nanotube topography as a surface for dental implants in preclinical research has demonstrated a positive relationship with antibacterial properties, nevertheless, factors such as anodization protocols, bacteria strains, and mono-culture methods should be taken into consideration, consequently, further studies are necessary to promote clinical translatability.
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  • 文章类型: Journal Article
    植入物表面的多微生物生物膜去除和净化是治疗植入物周炎的最重要目标。本研究的目的是评估四种不同的去污方法在体外去除鲍曼不动杆菌和金黄色葡萄球菌生物膜的功效。75个种植牙被细菌悬液污染,随机分为5组(n=15):阴性对照组,未接受治疗;阳性对照组,用0.2%氯己定治疗;第1组,用壳聚糖刷(LabridaBioCleanTM,LabridaAS,奥斯陆,挪威);第2组,用壳聚糖刷和0.2%氯己定处理;和第3组,用基于电解清洁方法的装置处理(GalvoSurge,GalvoSurge牙科公司,Widnau,瑞士)。菌落形成单位(CFU)计数用于评估每个样品中活细菌的数量,并进行统计分析。与阴性对照组相比,所有的净化方法都减少了CFU计数。电解清洁方法比其他三种方法更有效地净化了植入物表面,而壳聚糖刷效果最差。需要在更现实的环境中进行进一步的研究,以评估本研究中描述的去污程序的功效。
    Polymicrobial biofilm removal and decontamination of the implant surface is the most important goal in the treatment of periimplantitis. The aim of this study is to evaluate the efficacy of four different decontamination methods for removing Acinetobacter baumannii and Staphylococcus aureus biofilms in vitro. Seventy-five dental implants were contaminated with a bacterial suspension and randomly divided into five groups (n = 15): the negative control group, which received no treatment; the positive control group, treated with 0.2% chlorhexidine; group 1, treated with a chitosan brush (Labrida BioCleanTM, Labrida AS, Oslo, Norway); group 2, treated with a chitosan brush and 0.2% chlorhexidine; and group 3, treated with a device based on the electrolytic cleaning method (GalvoSurge, GalvoSurge Dental AG, Widnau, Switzerland). The colony-forming unit (CFU) count was used to assess the number of viable bacteria in each sample, and statistical analyses were performed. When compared to the negative control group, all the decontamination methods reduced the CFU count. The electrolytic cleaning method decontaminated the implant surface more effectively than the other three procedures, while the chitosan brush was the least effective. Further research in more realistic settings is required to assess the efficacy of the decontamination procedures described in this study.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Meta-Analysis
    目的:评估哪种净化方法用于对被细菌污染的钛表面(圆盘和牙种植体)进行清创,最有效地消除细菌生物膜。
    方法:在2010年1月1日至2022年10月31日之间在四个电子数据库中进行了系统搜索。搜索策略遵循PICOS格式,仅包括在牙科植入物或钛盘样品上完成的体外研究。评估的结果变量包括最有效的方法-化学或机械-从钛表面去除细菌生物膜。进行了荟萃分析,数据通过单水平和多水平随机效应模型进行汇总(p<0.05)。
    结果:删除重复项后,初始搜索产生了5260篇文章。按标题评定后,abstract,和全文回顾,共有13篇文章符合本次审查的纳入标准.评估了不同的去污方法,包括机械和化学,研究中最常见的方法是氯己定(CHX)。在纳入的研究中注意到显著的异质性。当CHX处理与PBS比较时,荟萃分析仅鉴定了生物膜减少的显著差异。其余的比较没有发现各种去污方法之间的显著差异。
    结论:本结果没有证明一种去污方法在从钛盘和植入物表面消除细菌生物膜方面是优越的。
    To assess which decontamination method(s) used for the debridement of titanium surfaces (disks and dental implants) contaminated with bacterial, most efficiently eliminate bacterial biofilms.
    A systematic search was conducted in four electronic databases between January 1, 2010 and October 31, 2022. The search strategy followed the PICOS format and included only in vitro studies completed on either dental implant or titanium disk samples. The assessed outcome variable consisted of the most effective method(s)-chemical or mechanical- removing bacterial biofilm from titanium surfaces. A meta-analysis was conducted, and data was summarized through single- and multi-level random effects model (p < .05).
    The initial search resulted in 5260 articles after the removal of duplicates. After assessment by title, abstract, and full-text review, a total of 13 articles met the inclusion criteria for this review. Different decontamination methods were assessed, including both mechanical and chemical, with the most common method across studies being chlorhexidine (CHX). Significant heterogeneity was noted across the included studies. The meta-analyses only identified a significant difference in biofilm reduction when CHX treatment was compared against PBS. The remaining comparisons did not identify significant differences between the various decontamination methods.
    The present results do not demonstrate that one method of decontamination is superior in eliminating bacterial biofilm from titanium disk and implant surfaces.
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  • 文章类型: Journal Article
    种植体周围黏膜炎和种植体周围炎是种植牙的常见并发症。本文全面概述了2017年世界研讨会的新定义,临床和影像学表现,发病机制,危险因素,和种植体周围疾病的分类。此外,作者讨论了各种类型的仪器,材料,以及通常用于治疗非手术和手术种植体周围炎的技术。最后,作者包括围绕这个主题的一些有争议的话题。
    Periimplant mucositis and periimplantitis are common complications of dental implant. This article provides a comprehensive overview of the 2017 World Workshop\'s new definition, clinical and radiographic presentation, pathogenesis, risk factors, and classification of periimplant diseases. Also, the authors discuss various types of instruments, materials, and techniques commonly used for treatment of nonsurgical and surgical periimplantitis. Lastly, the authors include some controversial topics surrounding this subject.
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