| 1. |
- Donati, Mauro, 1966, et al.
(författare)
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Immediate functional loading of implants in single tooth replacement: a prospective clinical multicenter study.
- 2008
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Ingår i: Clinical oral implants research. - : Wiley. - 1600-0501 .- 0905-7161. ; 19:8, s. 740-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of the present study was to evaluate the outcome of immediate functional loading of implants in single-tooth replacement using two different installation procedures. MATERIAL AND METHODS: One hundred and fifty-one subjects, who required single-tooth rehabilitation in the area of 15-25 and 35-45, were enrolled in eight private clinics in Italy. The implant sites were randomly allocated to one of the following treatment groups. In the control group, in which a standard preparation procedure for implant placement and submerged healing of the implant was used, abutment connection and loading of the implants were performed 3 months after installation. In the test group 1, a standard preparation procedure for the implant placement and immediate functional loading of implant was carried out. In the test 2 group, however, a modified implant installation procedure (osteotome technique) was used followed by immediate functional loading of the implant. Clinical and radiographic examinations were performed at 3 and 12 months of follow-up at all sites. RESULTS: Three implants (5.5%) from the test 2 group (osteotome preparation) and one (2%) from the test 1 group (conventional drill preparation) failed to integrate and were removed one and three months after implant installation. The mean marginal bone loss assessed at 12 months was 0.31 mm (test 1), 0.25 mm (test 2) and 0.38 mm (control) (no statistically significant differences were found between the three treatment groups.) CONCLUSION: It is suggested that immediate functional loading of implants that are placed with a conventional installation technique and with sufficient primary stability may be considered as a valid treatment alternative in a single-tooth replacement.
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| 2. |
- Berglundh, Tord, 1954, et al.
(författare)
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Are peri-implantitis lesions different from periodontitis lesions?
- 2011
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Ingår i: Journal of clinical periodontology. - 1600-051X. ; 38 Suppl 11, s. 188-202
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Forskningsöversikt (refereegranskat)abstract
- Aim:To compare histopathological characteristics of peri-implantitis and periodontitis lesions. METHODS: A search was conducted on publications up to July 2010. Studies carried out on human biopsy material and animal experiments were considered. RESULTS: While comprehensive information exists regarding histopathological characteristics of human periodontitis lesions, few studies evaluated peri-implantitis lesions in human biopsy material. Experimental peri-implantitis lesions were evaluated in 10 studies and three of the studies included comparisons to experimental periodontitis. Human biopsy material: the apical extension of the inflammatory cell infiltrate (ICT) was more pronounced in peri-implantitis than in periodontitis and was in most cases located apical of the pocket epithelium. Plasma cells and lymphocytes dominated among cells in both types of lesions, whereas neutrophil granulocytes and macrophages occurred in larger proportions in peri-implantitis. Experimental studies: placement of ligatures together with plaque formation resulted in loss of supporting tissues and large ICTs around implants and teeth. Following ligature removal, a "self-limiting" process occurred in the tissues around teeth with a connective tissue capsule that separated the ICT from bone, while in peri-implant tissues the ICT extended to the bone crest. CONCLUSION: Despite similarities regarding clinical features and aetiology of peri-implantitis and periodontitis, critical histopathological differences exist between the two lesions
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| 3. |
- Berglundh, Tord, 1954, et al.
(författare)
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Aspects of adaptive host response in periodontitis.
- 2005
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Ingår i: Journal of clinical periodontology. - 0303-6979. ; 32:Suppl 6, s. 87-107
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: To review host response in periodontitis with respect to cellular composition of lesions, T cell receptor (TCR) gene expression, cytokine profiles of T-helper (Th) cells and autoimmune components. MATERIAL AND METHODS: The studies included were confined to human material (biopsies, gingival crevicular fluid, blood from subjects with periodontitis). RESULTS AND CONCLUSIONS: In periodontitis lesions, plasma cells are the most common cell type and represent about 50% of all cells, while B cells comprise about 18%. The proportion of B cells is larger than that of T cells and Th cells occur in larger numbers than T cytotoxic cells. Polymorphonuclear cells and macrophages are found in fractions of less than 5% of all cells. Lesions in aggressive and chronic forms of periodontitis exhibit similar cellular composition. Differences in disease severity, however, may reflect increases in plasma cell and B cell densities. B cells serve as important antigen-presenting cells in periodontitis. The periodontitis lesion expresses a unique TCR gene repertoire that is different from that in blood. The role of superantigens in periodontitis is unclear. There are few studies using comparative designs and unbiased quantitative methods regarding Th-1 and Th-2 cells in periodontitis. The relative dominance of B cells and plasma cells in periodontitis lesions cannot entirely be explained by enhanced Th-2 functions but maybe because of an imbalance between Th-1 and Th-2. Autoimmune reactions are evident in periodontitis lesions. The role of auto-antibodies in the regulation of host response in periodontitis, however, needs to be clarified. Auto-reactive B cells occur in larger proportions in subjects with periodontitis than in healthy controls.
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| 4. |
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| 5. |
- Derks, Jan, 1977, et al.
(författare)
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Reconstructive surgical therapy of peri-implantitis: A multicenter randomized controlled clinical trial
- 2022
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Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 33:9, s. 921-944
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Tidskriftsartikel (refereegranskat)abstract
- Objective To evaluate the potential benefit of the use of a bone substitute material in the reconstructive surgical therapy of peri-implantitis. Methods In this multicenter randomized clinical trial, 138 patients (147 implants) with peri-implantitis were treated surgically, randomized by coin toss to either a control (access flap surgery) or a test group (reconstructive surgery using bone substitute material). Clinical assessments, including probing pocket depth (PPD), bleeding and suppuration on probing (BOP & SOP) as well as soft tissue recession (REC), were recorded at baseline, 6 and 12 months. Marginal bone levels (MBL), measured on intra-oral radiographs, and patient-reported outcomes (PROs) were recorded at baseline and 12 months. No blinding to group allocation was performed. The primary outcome at 12 months was a composite measure including (i) implant not lost, (ii) absence of BOP/SOP at all aspects, (iii) PPD <= 5 mm at all aspects and (iv) <= 1 mm recession of mucosal margin on the buccal aspect of the implant. Secondary outcomes included (i) changes of MBL, (ii) changes of PPD, BOP%, and buccal KM, (iii) buccal REC and (iv) patient-reported outcomes. Results During follow-up, four implants (one in the test group, three in the control group) in four patients were removed due to disease progression. At 12 months, a total of 69 implants in the test and 68 implants in the control group were examined. Thus, 16.4% and 13.5% of implants in the test and control group, respectively, met all predefined criteria of the composite outcome. PPD reduction and MBL gain were 3.7 mm and about 1.0 mm in both groups. Reduction in mean BOP% varied between 45% (test) and 50% (control), without significant differences between groups. Buccal REC was less pronounced in the test group (M = 0.7, SD = 0.9 mm) when compared to controls (M = 1.1, SD = 1.5 mm). PROs were favorable in both groups without significant differences. One case of allergic reaction to the antibiotic therapy was recorded. No other adverse events were noted. Conclusions Surgical therapy of peri-implantitis effectively improved the clinical and radiographic status at 12 months. While the use of a bone substitute material did not improve reductions of PPD and BOP, buccal REC was less pronounced in the test group. Patient satisfaction was high in both groups.
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| 6. |
- Donati, Mauro, 1966, et al.
(författare)
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Association of the -159 CD14 gene polymorphism and lack of association of the -308 TNFA and Q551R IL-4RA polymorphisms with severe chronic periodontitis in Swedish Caucasians.
- 2005
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Ingår i: Journal of clinical periodontology. - 0303-6979. ; 32:5, s. 474-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Severe forms of periodontitis are suggested to have a genetic basis. OBJECTIVE: The aim of the present investigation was to study the association of gene polymorphisms related to some immune regulation components (G-308A TNFA, Q551R IL-4RA and C-159T CD14) with severe chronic periodontitis. MATERIALS AND METHODS: Sixty patients (aged 36-74 years; mean 54.5+/-8.5) with severe and generalized chronic periodontitis were included. The patients exhibited bone loss >50% at all teeth. Thirty-nine periodontally healthy subjects between 35 and 78 years of age (mean 51.0+/-10.9) were recruited as controls. DNA was isolated from peripheral blood cells and genotyping was performed by combination of PCR and restriction endonuclease mapping. RESULTS: While gene polymorphisms for TNFA and IL-4RA did not show any association with severe chronic periodontitis, the analysis of the -159 CD14 gene polymorphism revealed significant differences between test and control groups. The proportion of subjects that exhibited the TT genotype was significantly smaller in the group with severe periodontitis than in periodontal healthy group (p=0.028; Fisher's exact test). The C allele carriage was 90% in the periodontitis group and significantly higher than in the healthy control group (72%). CONCLUSION: It is suggested that the -159 CD14 gene polymorphism is associated with chronic periodontitis in Caucasian subjects of a north European origin.
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| 7. |
- Donati, Mauro, 1966, et al.
(författare)
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B-1a cells and plasma cells in periodontitis lesions.
- 2009
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Ingår i: Journal of periodontal research. - : Wiley. - 1600-0765 .- 0022-3484. ; 44:5, s. 683-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND OBJECTIVE: Host response mechanisms in periodontal tissues are complex and involve numerous systems of interactions between cells. The B-cell lineage seems to predominate in chronic periodontitis lesions. The aim of the present investigation was to study the correlation between inflammatory cells and some functional markers in gingival lesions obtained from subjects with severe chronic periodontitis. MATERIAL AND METHODS: Thirty-eight Caucasian subjects volunteered to take part in the study. A gingival biopsy from one randomly selected diseased proximal site (probing pocket depth > 6 mm and bleeding on probing positive) was obtained from each patient. Immunohistochemical preparation was used to identify inflammatory cells and functional markers. Correlations between the different percentages of cell markers were analyzed by pairwise correlation. RESULTS: B cells (B-1a and B-2 cells) occurred in larger proportions than T cells and plasma cells. A statistically significant correlation was found between the percentage of B-1a cells and plasma cells and between all B lymphocytes and plasma cells. About 60% of B lymphocytes exhibited autoreactive features. CONCLUSION: It is suggested that B-1a cells constitute a significant part of the host response in periodontitis lesions and that plasma cells may develop from both B-2 and B-1a cells.
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| 8. |
- Donati, Mauro, 1966, et al.
(författare)
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B-1a cells in experimental gingivitis in humans.
- 2009
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Ingår i: Journal of periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 80:7, s. 1141-5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although previous studies revealed the presence of autoreactive B cells (B-1a cells) in periodontitis lesions, no evidence was provided for an active role of such cells in the host response to microbial challenge. The aim of the present investigation was to study the reaction of B-1a cells to de novo plaque formation in subjects who were treated for severe chronic periodontitis. METHODS: Fifteen white subjects with generalized, severe chronic periodontitis volunteered. Surgical periodontal therapy was performed in all quadrants of each subject after a period of infection control. After 6 months of healing (baseline), two gingival biopsies were harvested from each patient (probing depth <4 mm and no bleeding on probing; healed sites). The experimental gingivitis model was applied, and plaque accumulation was allowed for 3 weeks. Two additional biopsies were collected and prepared for immunohistochemical analysis on day 21. RESULTS: The biopsies retrieved after 3 weeks of plaque accumulation contained larger proportions of CD19+ and CD5+ cells (B-1a cells) than biopsies representing baseline (healed sites) (7.38% +/- 2.80% versus 5.96% +/- 2.48%). The tissue fraction of cells carrying the markers for CD3 (T cells), CD19 (B cells), and Bcl2 (apoptosis-associated marker) were significantly larger in tissue samples collected after 3 weeks of plaque accumulation than in specimens from baseline (healed sites). CONCLUSION: Autoreactive B cells (B-1a cells) are involved in the host response to microbial challenge in subjects with chronic periodontitis.
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| 9. |
- Donati, Mauro, 1966, et al.
(författare)
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Effect of immediate functional loading on osseointegration of implants used for single tooth replacement. A human histological study.
- 2013
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Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161. ; 24:7, s. 738-45
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Tidskriftsartikel (refereegranskat)abstract
- Objective To analyze hard tissue reactions to immediate functionally loaded single implants that were installed either with a conventional drill preparation procedure or with an osteotome preparation technique. Materials and methods Thirteen subjects with two sites requiring single tooth rehabilitation by means of implants volunteered for the study. Each subject received one test (immediate functionally loaded) and one control (non-loaded) implant. In six subjects (group 1) the implants were placed using a conventional drilling procedure, whereas in the remaining seven subjects (group 2) an osteotome preparation procedure was performed. Block biopsies containing test and control implants and peri-implant bone tissues were collected at 1month in four of the subjects in group 1 and in five subjects of group 2. The remaining implant sites were sampled at 3months after implant placement. The biopsies were prepared for histological examination. Results Two implants of the test-2 group (osteotome preparation) representing 1month of healing and another test-2 implant representing 3months of healing failed to integrate. A multilevel multivariate statistical analysis demonstrated that no differences in bone-to-implant contact (BIC)% were found in between test and control implants, the density of newly formed peri-implant bone was significantly higher around test than control implants at 1 and 3months of healing. Sections representing osteotome technique sites showed fractured trabeculae and large amounts of bone particles. Conclusions It is suggested that immediate loading of implants does not influence the osseointegration process, whereas the density of newly formed peri-implant bone at such sites appears to be increased in relation to unloaded control implants. The use of an osteotome preparation technique during installation results in damage of peri-implant bone and enhances the risk for failure in osseointegration.
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| 10. |
- Donati, Mauro, 1966
(författare)
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Gene Polymorphisms and Related Cell Markers in Periodontitis Lesions
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Inflammatory and immune reactions to microbial plaque are the predominant features of periodontitis. Epidemiological studies revealed that differences in periodontitis among individuals could not be explained by differences in oral hygiene alone and that not everybody is equally susceptible. Periodontitis is considered to be a multifactorial disease where the interaction of multiple genetic and environmental components results into disease expression. The objectives of the present series of studies were (i) to investigate the association of gene polymorphisms related to some immune regulation components (IL10, TNFA, IL4RA CD14) with severe chronic periodontitis (studies I-II), (ii) to study the local expression of some immune regulation components in relation to gene polymorphisms in subjects with chronic periodontitis (study III), (iii) to study the correlation between inflammatory cells and functional markers in gingival lesions obtained from subjects with severe chronic periodontitis (study IV) (iv) and to study the reaction of B-1a cells to de novo plaque formation in subjects who were treated for severe chronic periodontitis (study V). It was demonstrated that the proportion of subjects that exhibited the –1087 IL10 GG genotype was significantly larger in the group with severe periodontitis than in the group of healthy controls (study I), that the proportion of subjects that exhibited the –159 CD14 TT genotype was significantly smaller in the group of subjects with severe periodontitis than in the periodontally healthy group (study II) and that the proportion of IL-10 positive cells in the peripheral area of periodontitis lesions was significantly larger in subjects with the – 1087 IL10 GG genotype than in subjects with AG or AA genotypes (study III). It was also observed that B cells (B-1a cells and B-2 cells) occurred in larger proportions than T cells, plasma cells and neutrophils in periodontitis lesions and a significant correlation was found between percentages of B-1a cells and plasma cells and between densities of B-lymphocytes and plasma cells (study IV). Further, biopsies retrieved after 3 weeks of plaque accumulation contained larger proportions of B-1a cells than biopsies representing healthy sites (study V).
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