DOCSLIB.ORG

Peri Implant Disease

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Peri Implant Disease The Brown PDL tm I. Stephen Brown, D. D. S., Periodontics & Implant Dentistry Summer From Our Office Peri-Implant Disease: to Yours... Causes, Prevention and Treatment Peri-implant diseases are a grow- s with all periodontal dis- ber of years after restoration. Careful ing problem in implant dentistry. eases, early diagnosis of clinical monitoring of implants can Infectious in nature, they can be inflammation of the peri- find early changes in clinical parame- classified into two types: peri- A implant tissues adjacent to implants is ters. Clinical features of peri-implant implant mucositis and peri-implan- key to successful treatment. mucositis include, but are not limited titis. Peri-implant mucositis is an Radiographs should be taken at the to, bleeding on probing, swelling of inflammatory lesion residing only in the peri-implant mucosa, increased the mucosa. Peri-implantitis affects time of implant insertion to determine both the peri-implant soft tissues baseline alveolar bone levels. probing depths (mainly pseudo-pock- and the supporting bone. Radiographs should also be taken at ets), and/or erythema of the surround- Although restorations of endos- the time of prosthesis delivery and ing tissues. seous implants have demonstrated one year later. These can then be Peri-implantitis can be character- a very high success rate, one study compared to future radiographs to ized by bleeding or suppuration upon found 80 percent of patients had determine if crestal or peri-implant probing, increased pocket depth and peri-implant mucositis in half their bone loss has occurred. swelling or fistula formation; and implants; and 56 percent of Peri-implant diseases often do not additionally pain on chewing and patients also had peri-implantitis in become clinically evident for a num- radiographic bone loss. 43 percent of their implants. This current summer issue of The PerioDontaLetter addresses the Figure 1. If not caught causes, prevention and treatment of in its early stages, peri- peri-implant disease. As periodon- implant disease can tists, our focus is the treatment and progress and destroy the stabilization of these conditions. entire bone support for As always, we welcome your an implant. questions and comments in our col- laboration to manage these com- mon conditions. I. Stephen Brown, D. D. S. 220 South 16th Street, Suite 300 • Philadelphia, PA 19102 • (215) 735-3660 Figure 2. One year after implant Figure 3. On flap reflection, Figure 4. The cement was placement, a fistula is forming excess cement appears to be the removed and a bone graft and a on the buccal of the upper etiology of the bone destruction. barrier membrane were placed to second premolar. attempt to regenerate the lost bone support. Causes of Warrer et al found implants without than an attachment compared to the keratinized mucosa demonstrated connective tissue attachment seen with Peri-Implant Disease significantly more recession and natural teeth. slightly more attachment loss than Recent technological developments Local iatrogenic factors can play a implants with an adequate zone of in dental implant collar design and abut- significant role in the development of attached gingiva. ments have demonstrated the ability to peri-implant disease. These include: One study suggested that implant sur- maintain stable crestal bone and biolog- • excess cement face characteristics (smooth vs. tex- ical width. • bacterial biofilm tured) also influence the progression of • incompletely-seated abutments peri-implant disease. • open crown margins Preventing Lindhe J et al found that because • occlusal overload Peri-Implant Disease • over-contouring of restorations, and there are biologic differences between • poorly positioned implants teeth and implants, the progression of Preventing the development of a Several studies have shown chronic infection around implants is some- biofilm and eliminating it from the periodontitis increases the risk of peri- what different than it is around natural implant surface should be the first steps implant disease along with parafunc- teeth. The inflammatory cell infiltrate in the preservation of peri-implant soft tional habits (bruxism and malocclu- around implants was reported to be sion), systemic diseases such as dia- larger and extend more apically when tissue health. This requires thorough betes and osteoporosis, and smoking. compared to a corresponding lesion in oral hygiene instruction and strict One study found that the bacteria found the gingival tissue around natural teeth patient compliance. at implant sites affected with peri- due to the lack of cementum. Adequate periodontal disease control implantitis was almost identical to the In addition, the tissues around is also essential in the partially-edentu- bacteria found in periodontitis. implants are more susceptible to lous patient to prevent cross contamina- Other studies indicate the width of plaque-associated infections that tion from teeth to implants. Recent keratinized gingiva affects the health of spread into the alveolar bone primar- studies have found that the lack of pre- the supporting tissues around dental ily due to the lack of a periodontal ventive maintenance in individuals with implants. Bouri et al found implants ligament. pre-existing peri-implant mucositis was with narrow zones of keratinized tissue The routine soft tissue healing associated with a high incidence of peri- (less than 2mm) had more plaque and response to a majority of implant and implantitis. inflammation, were more prone to abutment surfaces is a parallel arrange- When restoring an implant, it is bleeding on probing, and presented ment of connective tissue fibers. This absolutely essential to ensure all excess with more bone loss. arrangement is described as a seal rather cement has been removed and the area is cleansable with an oral hygiene prod- local iatrogenic factors contributing to al steps, however minimal bone remod- uct such as an interproximal brush. the problem. eling is possible. Some success in well- Cement peri-implantitis is one of the If the disease has progressed to peri- contained four-wall defects has been most significant reasons for marginal implantitis and bone loss is evident, ini- achieved by removing the implant infection and bone loss. Studies by tial treatment is the same: mechanical crown and abutment and attempting Wilson, Cobb and Callan have debridement, anti-microbials and strict bone regenerative procedures after described pathological changes associ- oral hygiene protocols, including cover screw replacement, grafting and ated with excess cement. Shapoff and chlorhexidine mouthwash. primary closure. Lahey have discussed numerous factors Administration of systemic or local leading to excess cement and discussed antibiotics should also be considered to Bone Regeneration and strategies to identify, diagnose and pre- reduce the number of pathogens pre- vent excess cement around implants. sent. Adjunctive local or systemic Reosseointegration Adjusting the prosthesis to open the antibiotics have been shown to reduce embrasure space will allow the patient bleeding on probing and probing depths Comparison of the various decontam- easy access during home oral hygiene. in combination with mechanical ination methods or their combined use Pontic areas should be convex rather debridement. Culturing and / or DNA did not show any significant differences than concave in the area over gingival probes will identify the pathogenic bac- in terms of bone regeneration and tissues to ensure plaque and food debris teria and define which antibiotic will reosseointegration. is easily cleansable. likely have the best result. Once the implant surface has been The basic goal in the treatment of decontaminated, the clinician can then Treating peri-implantitis is decontamination of consider whether to attempt to regen- the infected abutment or implant sur- erate the bone around the implant Peri-Implant Disease face. Unfortunately, to date, studies based on the amount of bone loss, the suggest that nonsurgical treatment of defect morphology and the patient’s Peri-implant mucositis is often a peri-implantitis is unpredictable and motivation. reversible condition and requires only the use of chemical agents alone such Access flap surgery in combination minimal intervention to treat. Tho- as chlorhexidine has only limited with decontamination of the implant rough mechanical debridement of the effects on clinical and microbiological surface seems to be the treatment area along with local anti-microbials parameters. modality that provides the best such as Chlorhexidine irrigation or Numerous methods are used to improvement of inflammation. Ad- Dentomycin or Arestin is usually suffi- debride a plaque-contaminated abut- ditional osseous recontouring of the cient to resolve the problem. A tho- ment or implant surface including bony architecture around the implant rough examination of the area should mechanical, sonic and ultrasonic could be helpful in arresting further also be completed to ensure there are no scalers; lasers; air-powder abrasion bone loss. Leonhardt et al found an and various chemical solutions such as citric acid, hydrogen peroxide and saline. Beneficial effects of laser therapy on peri-implantitis have been shown, but this treatment needs to be further evalu- ated. Schwarz et al found the Er:YAG laser only improved peri-implant prob- ing pocket depth and clinical attach- ment level for about six months. Another study using access flap surgery with the application of a chemical
Load more

Recommended publications
  • Combination of Bone Allograft, Barrier Membrane and Doxycycline in the Treatment of Infrabony Periodontal Defects: a Comparative Trial
    CORE Metadata, citation and similar papers at core.ac.uk Provided by Elsevier - Publisher Connector The Saudi Dental Journal (2015) 27, 155–160 King Saud University The Saudi Dental Journal www.ksu.edu.sa www.sciencedirect.com ORIGINAL ARTICLE Combination of bone allograft, barrier membrane and doxycycline in the treatment of infrabony periodontal defects: A comparative trial Ashish Agarwal a,*, N.D. Gupta b a Department of Periodontics, Institute of Dental Sciences, Bareilly, India b Department of Periodontics, DR. Z.A. Dental College, Aligarh Muslim University, Aligarh, India Received 1 March 2014; revised 4 December 2014; accepted 26 January 2015 Available online 27 May 2015 KEYWORDS Abstract Aim: The purpose of the present study was to compare the regenerative potential of Bone grafting; noncontained periodontal infrabony defects treated with decalcified freeze-dried bone allograft Doxycycline; (DFDBA) and barrier membrane with or without local doxycycline. Guided tissue regeneration Methods: This study included 48 one- or two-wall infrabony defects from 24 patients (age: 30–65 years) seeking treatment for chronic periodontitis. Defects were randomly divided into two groups and were treated with a combination of DFDBA and barrier membrane, either alone (combined treatment group) or with local doxycycline (combined treatment + doxycycline group). At baseline (before surgery) and 3 and 6 months after surgery, the pocket probing depth (PPD), clinical attachment level (CAL), radiological bone fill (RBF), and alveolar height reduction (AHR) were recorded. Analysis of variance and the Newman–Keuls post hoc test were used for sta- tistical analysis. A two-tailed p-value of less than 0.05 was considered to be statistically significant.
    [Show full text]
  • Modifications of Polymeric Membranes Used in Guided Tissue and Bone Regeneration
    polymers Review Modifications of Polymeric Membranes Used in Guided Tissue and Bone Regeneration Wojciech Florjanski 1 , Sylwia Orzeszek 1, Anna Olchowy 1, Natalia Grychowska 2, Wlodzimierz Wieckiewicz 2, Andrzej Malysa 1, Joanna Smardz 1 and Mieszko Wieckiewicz 1,* 1 Department of Experimental Dentistry, Faculty of Dentistry, Wroclaw Medical University, 50-367 Wroclaw, Poland; wojtek.fl[email protected] (W.F.); [email protected] (S.O.); [email protected] (A.O.); [email protected] (A.M.); [email protected] (J.S.) 2 Department of Prosthetic Dentistry, Faculty of Dentistry, Wroclaw Medical University, 50-367 Wroclaw, Poland; [email protected] (N.G.); [email protected] (W.W.) * Correspondence: [email protected] Received: 14 March 2019; Accepted: 28 April 2019; Published: 2 May 2019 Abstract: Guided tissue/bone regeneration (GTR/GBR) is a widely used procedure in contemporary dentistry. To achieve the required results of tissue regeneration, soft tissues that reproduce quickly are separated from the slow-growing bone tissue by membranes. Many types of membranes are currently in use, but none of them fulfil all of the desired features. To address this issue, further research on developing new membranes with better separation characteristics, such as membrane modification, is needed. Many of the current innovative modified materials are still in the phase of in vitro and experimental studies. A collective review on new trends in membrane modification to GTR/GBR is needed due to the widespread use of polymeric membranes and the constant development in the field of dentistry. Therefore, the aim of this review was to present an overview of polymeric membrane modifications to the GTR/GBR reported in the literature.
    [Show full text]
  • Iowa Section of the American Association for Dental Research
    Iowa Section of the American Association for Dental Research 67th Annual Meeting Moving Oral Health Research Forward Through Collaboration Our Keynote Speaker — Dr. Mary L. Marazita is professor and vice chair of the Department of Oral Biology in the University of Pittsburgh School of Dental Medicine and the Director of the Center for Craniofacial and Den- tal Genetics. With over 400 publications and almost 35 years of continuous NIH-funding, Dr. Marazita is a world leader in the use of statistical genetics and genetic epidemiology for understanding craniofacial birth defects and oral-facial development. In 1980, Dr. Marazita earned a Ph.D. in Genetics from the University of North Carolina, and in 1982, she completed post-doctoral train- ing in craniofacial biology at the University of Southern California. Before coming to Pittsburg, Dr. Marazita had faculty appointments at UCLA and the Medical College of Virginia. She is also a diplo- mate of the American Board of Medical Genetics and a Founding Fellow of the American College of Medical Genetics. At the University of Pittsburgh, Dr. Marazita has held numerous other appointments in the School of Dental Medicine, including assistant dean, associate dean for research, head of the Division of Mary L Marazita, Ph.D. Oral Biology, and chair of the Department of Oral Biology. Given her international reputation and commitment to the oral sci- ences, Dr. Marazita has held important roles in the National Institutes of Health (NIH), including the National Institute of Dental and Craniofacial Research (NIDCR), and the National Human Genome Research Institute (NHGRI). Dr. Marazita exemplifies the collaborative nature of scientific research, and embodies the theme of this conference.
    [Show full text]
  • Peri-Implantitis Regenerative Therapy: a Review
    biology Review Peri-Implantitis Regenerative Therapy: A Review Lorenzo Mordini 1,* , Ningyuan Sun 1, Naiwen Chang 1, John-Paul De Guzman 1, Luigi Generali 2 and Ugo Consolo 2 1 Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA 02111, USA; [email protected] (N.S.); [email protected] (N.C.); [email protected] (J.-P.D.G.) 2 Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, 41124 Modena, Italy; [email protected] (L.G.); [email protected] (U.C.) * Correspondence: [email protected] Simple Summary: Regenerative therapies are one of the options to treat peri-implantitis diseases that cause peri-implant bone loss. This review reports classic and current literature to describe the available knowledge on regenerative peri-implant techniques. Abstract: The surgical techniques available to clinicians to treat peri-implant diseases can be divided into resective and regenerative. Peri-implant diseases are inflammatory conditions affecting the soft and hard tissues around dental implants. Despite the large number of investigations aimed at identifying the best approach to treat these conditions, there is still no universally recognized protocol to solve these complications successfully and predictably. This review will focus on the regenerative treatment of peri-implant osseous defects in order to provide some evidence that can aid clinicians in the approach to peri-implant disease treatment. Keywords: peri-implant disease; peri-implant mucositis; peri-implantitis; re-osseointegration; regen- Citation: Mordini, L.; Sun, N.; Chang, erative therapy N.; De Guzman, J.-P.; Generali, L.; Consolo, U.
    [Show full text]
  • Treatment of Different Types of Bone Defects with Concentrated Growth Factor
    Gökmenoğlu et al. Int J Oral Dent Health 2016, 2:029 International Journal of Volume 2 | Issue 2 ISSN: 2469-5734 Oral and Dental Health Case Series: Open Access Treatment of Different Types of Bone Defects with Concentrated Growth Factor: Four Case Reports Ceren Gökmenoğlu1, Mustafa Cihan Yavuz1, Elif Sadik2, Varol Çanakçi1 and Cankat Kara1* 1Department of Periodontology, Faculty of Dentistry, Ordu University, Ordu, Turkey 2Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, Turkey *Corresponding author: Cankat KARA, DDS, PhD, Associate Professor, Department of Periodontology, Faculty of Dentistry, Ordu University, 52100 Ordu, Turkey, Tel: +90 452 212 1283, Email: [email protected] barrier to epithelium migration [4]. The purpose of these case series Abstract is to document the beneficial role of CGF mixed with bone graft and Various techniques have been attempted in the past to truly CGF barrier membrane to accelerate bone formation in the healing of regenerate the lost bone structures. Owing to its stimulatory effect different bone defect areas. on angiogenesis and epithelialization, concentrated growth factor (CGF) is an excellent material for enhancing bone healing. The Cases Report purpose of these case series is to document the beneficial role of CGF in the healing of different bone defect areas. This report This report describes four female patients presented with (lateral describes four female patients presented with (lateral cyst on cyst on tooth 22; periimplantitis on mandibular left first premolar tooth 22; periimplantitis on mandibular left first premolar area; area; furcation lesion on tooth 36, periapical abcess on teeth 11-21) furcation lesion on tooth 36, periapical abcess on teeth 11-21).
    [Show full text]
  • Endodontic Recommended Reading List 2018 A. ความรู้วิทยาศาสตร์พื้นฐาน 1
    1 Endodontic Recommended Reading List 2018 A. ความรู้วิทยาศาสตร์พื้นฐาน 1. Gross, microscopic และ ultrastructural anatomy of soft and hard tissue (tooth and surrounding) 2. Embryology, histology, bone biology 3. Microbiology 4. Oral infection & immunology 5. Oral medicine, Oral pathology 6. Inflammation & healing 7. ชีวสถิติ 8. ความรู้กฎหมายวิชาชีพ เจตคติ และจรรยาบรรณแห่งวิชาชีพทันตกรรม B. วิทยาศาสตร์การแพทย์ที่เกี่ยวข้องกับสาขา 1. Embryology, histology, physiology of pulp and periapical tissue 2. Biology of dental pulp 1. Bennett CG, Kelln EE, Biddington WR. Age changes of the vascular pattern of the human dental pulp. Arch Oral Biol. 1965;10(6):995-8. 2. Bernick S. Effect of aging on the nerve supply to human teeth. J Dent Res. 1967;46(4):694- 9. 3. Bernick S. Lymphatic vessels of the human dental pulp. J Dent Res. 1977;56(1):70-7. 4. Brannstrom M. The hydrodynamic theory of dentinal pain: sensation in preparations, caries, and the dentinal crack syndrome. J Endod. 1986;12(10):453-7. 2 5. Brannstrom M, Linden LA, Johnson G. Movement of dentinal and pulpal fluid caused by clinical procedures. J Dent Res. 1968;47(5):679-82. 6. Byers MR, Neuhaus SJ, Gehrig JD. Dental sensory receptor structure in human teeth. Pain. 1982;13(3):221-35. 7. Carrigan PJ, Morse DR, Furst ML, Sinai IH. A scanning electron microscopic evaluation of human dentinal tubules according to age and location. J Endod. 1984;10(8):359-63. 8. DENTISTRY AAOP. Guideline on Pulp Therapy for Primary and Immature Permanent Teeth. Pediatr Dent. 2016;38(6):280-8. 9. Fitzgerald M, Chiego DJ, Jr., Heys DR. Autoradiographic analysis of odontoblast replacement following pulp exposure in primate teeth.
    [Show full text]
  • Bioresorbable Collagen Membranes for Guided Bone Regeneration
    6 Bioresorbable Collagen Membranes for Guided Bone Regeneration Haim Tal, Ofer Moses, Avital Kozlovsky and Carlos Nemcovsky Department of Periodontology and Implantology, Tel Aviv University Israel 1. Introduction Localized lack of bone volume in the jaws may be due to congenital, post-traumatic, postsurgical defects or different disease processes. Increasing the bone volume has long been an attractive field of basic and clinical research. The introduction of implant therapy, and the proven relationship between long-term prognosis of dental implants and adequate bone volume at the implant site (Lekholm et al. 1986), dramatically increased the interest of both clinicians and scientists in this field, making augmentation procedures an important part of contemporary implant therapy. Basically, four methods have been described to augment bone volume: a. osteoinduction, using appropriate growth factors (Reddi 1981; Urist 1965); b. osteoconduction, using grafting materials that serve as scaffolds for new bone growth (Buch et al. 1986; Reddi et al. 1987); c. distraction osteogenesis, by which a surgically induced bone fracture enables slow controlled pulling apart of the separated bone fragments (Ilizarov 1989a,b); d. guided bone regeneration, which allows selective bone tissue growth into a space maintained by tissue barriers (Dahlin et al. 1988, 1991a; Kostopoulos & Karring 1994; Nyman & Lang 1994). Among the different methods, guided bone regeneration (GBR) is the most popular and best documented for the treatment of localized bone defects in the jaws, probably due to its relative simplicity of use while allowing the placement of endosseous implants in areas of the jaw with bony defects and/or insufficient bone volume. Highly predictable success rates can be achieved using GBR; in fact, it has been shown that success rates of implants placed at GBR treated sites and sites without bone augmentation are comparable (Hammerle et al.
    [Show full text]
  • Clinical and Experimental Studies of Bone Substitutes and Dental Implants in Compromised Bone Sites
    Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1515 Clinical and experimental studies of bone substitutes and dental implants in compromised bone sites AMELA TRBAKOVIC ACTA UNIVERSITATIS UPSALIENSIS ISSN 1651-6206 ISBN 978-91-513-0501-1 UPPSALA urn:nbn:se:uu:diva-364437 2018 Dissertation presented at Uppsala University to be publicly examined in Skoogsalen, Ing. 78/79, Akademiska sjukhuset, Uppsala, Friday, 14 December 2018 at 09:15 for the degree of Doctor of Philosophy (Faculty of Medicine). The examination will be conducted in Swedish. Faculty examiner: Professor Christer Dahlin (Göteborgs Universitet, Avd för biomaterialvetenskap). Abstract Trbakovic, A. 2018. Clinical and experimental studies of bone substitutes and dental implants in compromised bone sites. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1515. 82 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN 978-91-513-0501-1. Background: With an ageing population, an increase of more challenging implant treatments is expected. In this thesis, we evaluate the outcome of two faster implant protocols, in patients with compromised alveolar bone. We examine the bone integrating abilities of two new synthetic bone substitute materials and in another paper, we discuss the effects of nonsteroidal anti- inflammatory drugs (NSAID) on bone healing. Aim: In paper I we investigate implant survival and effect of reduced implant-tooth distance. In paper II we evaluate the long-term implant survival and function of immediately loaded implants. In paper III & IV, we analyse if added NSAID reduce postoperative pain and if it has a reduced effect on new bone formation in a rabbit sinus lift model.
    [Show full text]
  • Surgical Periodontics: Regenerative Procedures – Dental Clinical Policy
    UnitedHealthcare® Dental Clinical Policy Surgical Periodontics: Regenerative Procedures Policy Number: DCP014.08 Effective Date: April 1, 2021 Instructions for Use Table of Contents Page Related Dental Policies Coverage Rationale ....................................................................... 1 • Dental Barrier Membrane Guided Tissue Definitions ...................................................................................... 2 Regeneration Applicable Codes .......................................................................... 3 • Full Mouth Debridement Description of Services ................................................................. 3 • Implants Clinical Evidence ........................................................................... 4 • Non-Surgical Periodontal Therapy U.S. Food and Drug Administration ............................................. 9 References ..................................................................................... 9 • Provisional Splinting Policy History/Revision Information ........................................... 11 • Surgical Endodontics Instructions for Use ..................................................................... 11 • Surgical Periodontics: Mucogingival Procedures • Surgical Periodontics: Resective Procedures Coverage Rationale Bone Replacement Grafts for Retained Natural Teeth Bone Replacement Grafts for retained natural teeth are indicated for the following: Infrabony/Intrabony vertical defects Class II Furcation involvements Bone Replacement Grafts for
    [Show full text]
  • Because Implant Placement Involves Drilling Into Bone, Clinicians Rely on Highly Specialized Instruments. Mentor Offers Sales Re
    ORAL LANDSCAPING Because implant placement involves drilling into bone, clinicians rely on highly specialized instruments. Mentor offers sales reps an in-depth view of the kinds of tools that are critical to implant surgery By Rebecca Stone ental implants were introduced in the anatomy in three dimensions, so we know how much bone there is. We also know how far we are from vital structures United States in the early 1980s, and such as the mandibular nerve, maxillary sinus or adjacent teeth. It since then their popularity has lets us evaluate not only the quantity of bone before we do implant surgery, continued to grow. Made of but also bone quality and whether any pathology is present.” This makes a lot of sense when you consider that one Dbiocompatible materials, they are surgically placed in of the most common reasons for dentists to be hesitant the jaw, forming a scaffold for the attachment of about adding implants to their list of services abutments that accommodate crowns or other is fear of nicking a nerve or damaging adjacent structures. With 3D radiogra - prosthetics. Used to replace a single tooth or to phy and the ability to virtually plan populate an entire edentulous ridge, implant therapy implant surgery before the blade touches the gingival crest, such fears are calls for highly specialized tools to help ensure success. becoming increasingly unfounded. After extracting the tooth in question, the clinician may employ a And when a clinician can charge number of instruments. But in the view of many operators, including more than $3000 for a basic implant procedure, that’s Michael Tischler, DDS, who has a general, implant and cosmetic prac - a fear worth conquering.
    [Show full text]
  • A Guide to the Endodontic Literature Success & Failure
    A Guide to the Endodontic Literature Success & Failure: Authors Description European Soc. Definition of Success: Clinical symptoms originating from an endodontically-induced apical periodontitis should neither persist nor develop after RCT Endodontology (1994 IEJ): and the contours of the PDL space around the root should radiographically be normal. AAE Quality Assurance Objectives of NSRCT (= nonsurgical root canal treatment) Guidelines · Prevent adverse signs or symptoms · Remove RC contents · Create radiographic appearance of well obturated RC system · Promote healing and repair of periradicular tissues · Prevent further breakdown of periradicular tissues The Mantra: · Apical periodontitis (=AP; = periapical radiolucency =PARL) is caused primarily by bacteria in RC systems (Sundqvist 1976; Kakehashi 1965; Moller 1981) · If bacteria in canal systems are reduced to levels that are not detected by culturing, then high success rates are observed (Bystrom 1987; Sjogren 1997) · Best documented results for canal disinfection are chemomechanical debridement with Ca(OH)2 for at least 1week (Sjogren 1991) · Mechanical instrumentation alone (C&S) reduces bacteria by 100-1,000 fold. But only 20-43% of cases show complete elimination (Bystrom 1981; Bystrom & Sundqvist 1985) · Do C&S and add 0.5% NaOCl produces complete disinfection in 40-60% of cases (Bystrom 1983) · Do C&S with 0.5% NaOCl and add one week Ca(OH)2: get complete disinfection in 90-100% of cases (Bystrom 1985; Sjogren 1991). Problems with the Mantra · Koch’s postulates cannot be applied
    [Show full text]
  • Current Knowledge and Future Perspectives of Barrier Membranes: a Biomaterials Perspective
    REVUE DE LA LITTÉRATURE / LITERATURE REVIEW Parodontologie / Periodontology CURRENT KNOWLEDGE AND FUTURE PERSPECTIVES OF BARRIER MEMBRANES: A BIOMATERIALS PERSPECTIVE Carole Chakar * | Sara Khalil** | Nadim Mokbel*** | Abdel Rahman Kassir**** Abstract: Periodontal regenerations and bone augmentations are common procedures practiced on a daily basis worldwide. This had led to the introduction of a wide number of barrier membranes, all aiming at regenerating a sufficient amount of bone while being safe, cost effective and easy to handle. Membranes have different characteristics that may influence their clinical properties and the result obtained. The article aims at presenting an overview of the different barrier membranes commonly used in the oral surgery field, while shedding light on the new advances in the third generation membranes. Keywords: Barrier membrane – periodontal regeneration – bone augmentation. IAJD 2020;11(1):43-50. CONNAISSANCES ACTUELLES ET PERSPECTIVES D'AVENIR DES MEMBRANES BARRIÈRES Résumé La régénération parodontale et les chirurgies d’augmentation osseuse sont des procédures courantes pratiquées quotidiennement dans le monde entier. Cela a conduit à l’introduction d’un grand nombre de membranes barrières, toutes visant à régénérer une quantité suffisante d’os tout en étant sûres, rentables et faciles à manipuler. Les membranes ont des caractéristiques différentes qui peuvent influencer leurs propriétés cliniques et le résultat obtenu. L’article vise à présenter un aperçu des différentes membranes barrières couramment utilisées dans le domaine de la chirurgie buccale, tout en mettant en lumière les nouvelles avancées des membranes de troisième génération. Mots-clés: membrane - régénération parodontale - augmentation osseuse. IAJD 2020;11(1):43-50. * Ass. Prof. ** Masters in Periodontics, Head of Department of Periodontology Department of Periodontology Saint Joseph University, Beirut, Lebanon Saint Joseph University, Beirut, Lebanon [email protected] *** Ass.
    [Show full text]