| 1. |
- Derks, Jan, 1977, et al.
(författare)
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Prevention and management of peri-implant mucositis and peri-implantitis: A systematic review of outcome measures used in clinical studies in the last 10 years
- 2023
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Ingår i: JOURNAL OF CLINICAL PERIODONTOLOGY. - : Wiley. - 0303-6979 .- 1600-051X. ; 50:Suppl 25, s. 55-66
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Forskningsöversikt (refereegranskat)abstract
- Objectives To evaluate outcome measures, methods of assessment, and analysis in clinical studies on the prevention and management of peri-implant mucositis and peri-implantitis. Methods Systematic electronic searches (CENTRAL/MEDLINE/SCOPUS) up to April 2021 were conducted to identify longitudinal clinical studies with >= 10 patients on either the prevention or management of peri-implant diseases. Outcome measures of this analysis were the choice of outcome measures, methods of assessment, and analytical methods. Risk of bias was evaluated according to study design. Data were extracted into evidence tables and outcomes were analysed in a descriptive manner. Results The analysis of the 159 selected studies revealed that probing pocket depth (PPD) and bleeding/suppuration on probing (BOP) were reported in 89% and 87% of all studies, respectively. Additional outcome measures included plaque scores (reported in 64% of studies), radiographic outcomes (49%), soft tissue dimensions (34%), and composite outcomes (26%). Adverse events (8%) and patient-reported outcomes (6%) were only rarely mentioned. A primary outcome measure was clearly defined only in 36% of studies. Data on PPD, radiographic outcomes, and soft tissue dimensions were primarily reported as mean values and rarely as frequency distributions. For radiographic outcomes and soft tissue dimensions, it was frequently unclear how clustered data were handled. Conclusions PPD and BOP were routinely reported in studies on the prevention and management of peri-implant mucositis and peri-implantitis, while composite outcomes, adverse events, and patient-reported outcomes were only infrequently described.
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| 2. |
- Derks, Jan, 1977, et al.
(författare)
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Prevention and management of peri-implant mucositis and peri-implantitis: A systematic review of outcome measures used in clinical studies in the last 10 years
- 2023
-
Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 34:Suppl. 25, s. 55-67
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Forskningsöversikt (refereegranskat)abstract
- Objectives To evaluate outcome measures, methods of assessment, and analysis in clinical studies on the prevention and management of peri-implant mucositis and peri-implantitis. Methods Systematic electronic searches (CENTRAL/MEDLINE/SCOPUS) up to April 2021 were conducted to identify longitudinal clinical studies with >= 10 patients on either the prevention or management of peri-implant diseases. Outcome measures of this analysis were the choice of outcome measures, methods of assessment, and analytical methods. Risk of bias was evaluated according to study design. Data were extracted into evidence tables and outcomes were analysed in a descriptive manner. Results The analysis of the 159 selected studies revealed that probing pocket depth (PPD) and bleeding/suppuration on probing (BOP) were reported in 89% and 87% of all studies, respectively. Additional outcome measures included plaque scores (reported in 64% of studies), radiographic outcomes (49%), soft tissue dimensions (34%), and composite outcomes (26%). Adverse events (8%) and patient-reported outcomes (6%) were only rarely mentioned. A primary outcome measure was clearly defined only in 36% of studies. Data on PPD, radiographic outcomes, and soft tissue dimensions were primarily reported as mean values and rarely as frequency distributions. For radiographic outcomes and soft tissue dimensions, it was frequently unclear how clustered data were handled. Conclusions PPD and BOP were routinely reported in studies on the prevention and management of peri-implant mucositis and peri-implantitis, while composite outcomes, adverse events, and patient-reported outcomes were only infrequently described.
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| 3. |
- 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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| 4. |
- Ichioka, Yuki, et al.
(författare)
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Changes in epigenetic pattern in osteoblasts in response to surface characteristics.
- 2020
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Ingår i: Virtual Osteology Symposium USA.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective: The overall aim of the current project was to investigate the influence of titanium and titanium surface characteristics on epigenetic mechanisms. Materials & Methods: An osteoblast-like cells (MG63) was incubated on glass, smooth titanium and rough titanium respectively for 0,1,6 and 24 h. The presence of double stranded DNA damage, DNA repair and epigenetic markers were investigated using immunofluorescence. Results: The percentage of total Chk2 positive cells, which indicate DNA repair, was 0% on the rough titanium surfaces at all time points, in comparison to glass and smooth titanium. Regarding DNA damage, total -H2AX positive cells on the rough titanium gradually decreased as incubation time increased, on the contrary to smooth titanium. For epigenetic markers related to the DNA damage/repair pathway, rough titanium surface showed the lower percentage of AcH3 positive cells compared to glass and smooth titanium surface. Conclusions: The findings in the current study show that titanium surface characteristics indeed influence DNA damage and the DNA repair pathway, including epigenetic factors.
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| 5. |
- Ichioka, Yuki, et al.
(författare)
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Decontamination of biofilm-contaminated implant surfaces: An in vitro evaluation
- 2023
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Ingår i: Clinical Oral Implants Research. - 0905-7161. ; 34:10, s. 1058-1072
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of the present study was to evaluate the cleaning efficacy of two mechanical and two chemical protocols in the decontamination of implant surfaces.Methods: In total, 123 commercially available implants were mounted in plastic models mimicking peri-implant circumferential intra-bony defects. A multispecies biofilm was grown on implant surfaces. Mechanical (air-polishing (AP), rotating titanium brush (TiB)) and chemical decontamination (alkaline electrolyzed water, N-acetyl-L-cysteine) protocols were used. Cleaning efficacy in terms of residual biofilm area, chemical surface properties, and bacterial counts were analyzed by scanning electron microscopy, energy-dispersive X-ray spectroscopy, and quantitative polymerase chain reaction.Results: Surface decontamination protocols including use of an AP device or a rotating TiB were superior in terms of biofilm removal and in reducing atomic% of Carbon on implant surfaces when compared to methods restricted to wiping with gauze. The use of chemical agents as adjuncts to the mechanical cleaning protocols provided no relevant overall benefit over saline. No treatment modality, however, resulted in complete biofilm removal.Conclusion: Air-polishing and rotating TiB were more effective implant surface decontamination protocols than wiping with gauzes. Use of chemical agents did not improve cleaning efficacy.
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| 6. |
- Ichioka, Yuki
(författare)
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Decontamination of implant surfaces
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Peri-implantitis is a pathological condition occurring in tissues around dental implants. It is caused by microorganisms and characterized by inflammation in the peri-implant connective tissue and progressive loss of supporting bone. The goal of treatment of peri-implantitis is to resolve inflammation and to arrest further loss of supporting bone. Removal of the bacterial biofilm from the implant surface is a prerequisite to achieve this goal. The aim of the present series of studies was to evaluate the efficacy in biofilm removal of different implant surface decontamination methods. In Studies I and II, different mechanical and chemical decontamination protocols on biofilm-coated titanium discs were evaluated. It was demonstrated that air-polishing and rotating titanium brush were the superior mechanical methods, while alkaline electrized water (AEW) and N-acetyl-L-cysteine were the most effective chemical agents. In Study III, different combinations of mechanical protocols and chemical agents were examined using commercially available implants covered with a multispecies biofilm. Decontamination protocols including an air-polishing device or a rotating titanium brush were superior in terms of biofilm removal and in reducing atomic% of Carbon on implant surfaces when compared to methods restricted to wiping with gauzes. The use of chemical agents as adjuncts to the mechanical cleaning protocols provided no relevant benefit over saline. Study IV evaluated the cleaning efficacy of air-polishing and a combination of air-polishing and AEW in surface decontamination of explanted peri-implantitis-affected implants. SEM analysis revealed that both treatment protocols were effective in biofilm removal. While differences between treatment protocols were small, implant thread geometry, implant surface characteristics and gender influenced results. In addition, EDS analysis showed that target zones of the implant (apical, middle, coronal) influenced the atomic% of Carbon and Calcium and that implant surface characteristics affected the atomic% of Titanium. The present series of in vitro studies demonstrated that both air-polishing and rotating titanium brush are effective tools in removing biofilm from implants. Clinical studies are needed to assess the efficacy of the implant surface decontamination protocols during surgical treatment of peri-implantitis.
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| 7. |
- Ichioka, Yuki, et al.
(författare)
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Epigenetic changes of osteoblasts in response to titanium surface characteristics.
- 2021
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Ingår i: Journal of biomedical materials research. Part A. - : Wiley. - 1552-4965 .- 1549-3296. ; 109:2, s. 170-180
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to investigate the influence of titanium surface characteristics on epigenetic mechanisms and DNA damage/repair pathways. Osteoblast-like cells (MG63) were incubated on glass, smooth titanium, and minimally rough titanium discs, respectively, for 0, 1, 6, and 24hr. The presence of double-stranded DNA damage (γH2AX), DNA repair (Chk2), and epigenetic markers (AcH3 & DNMT1) were investigated using immunofluorescence. There were no Chk2-positive cells on the minimally rough titanium surfaces at all-time points, in comparison to glass and smooth titanium. Total γH2AX-positive cells on minimally rough titanium gradually decreased as incubation time increased, on the contrary to smooth titanium. Minimally rough titanium surfaces induced cytoplasmic staining of DNMT1 up to 99% at 24hr. For epigenetic markers related to the DNA damage/repair pathway, minimally rough titanium surfaces showed the lower percentage of AcH3-positive cells compared to glass and smooth titanium surface. The findings in the current study show that titanium surface characteristics indeed influence DNA damage and the DNA repair pathway, including epigenetic factors.
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| 8. |
- Ichioka, Yuki, et al.
(författare)
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Factors influencing outcomes of surgical therapy of peri-implantitis: A secondary analysis of 1-year results from a randomized clinical study
- 2023
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Ingår i: JOURNAL OF CLINICAL PERIODONTOLOGY. - 0303-6979. ; 50:10, s. 1282-1304
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To identify predictors of treatment outcomes following surgical therapy of peri-implantitis.Materials and Methods: We performed a secondary analysis of data from a randomized controlled trial (RCT) comparing access flap with or without bone replacement graft. Outcomes at 12 months were probing pocket depth (PPD), bleeding on probing (BOP), soft-tissue recession (REC) and marginal bone level (MBL) change. Multilevel regression analyses were used to identify predictors. We also built an explanatory model for residual signs of inflammation.Results: Baseline PPD was the most relevant predictor, showing positive associations with final PPD, REC and MBL gain, and negative association with probability of pocket closure. Smokers presented higher residual PPD. Absence of keratinized mucosa at baseline increased the probability of BOP but was otherwise not indicative of outcomes. Plaque at 6 weeks was detrimental in terms of residual PPD and BOP. Treatment allocation had an effect on REC. Final BOP was explained by residual PPD & GE;6 mm and plaque at more than two sites.Conclusions: Baseline PPD was the most relevant predictor of the outcomes of surgical therapy of peri-implantitis. Pocket closure should be a primary goal of treatment. Bone replacement grafts may be indicated in aesthetically demanding cases to reduce soft-tissue recession. The importance of smoking cessation and patient-performed plaque control is also underlined.
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| 9. |
- Ichioka, Yuki, et al.
(författare)
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In vitro evaluation of chemical decontamination of titanium discs
- 2021
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Peri-implant diseases are caused by bacterial biofilm colonizing implant surfaces. Prevention and management of peri-implant mucositis and peri-implantitis rely on effective biofilm removal. This study aimed to evaluate biofilm removal and cytocompatibility following chemo-mechanical surface decontamination of biofilm-coated titanium discs. Biofilm-coated (Streptococcus gordonii) discs, with either non-modified (smooth) or modified (rough) surfaces, were instrumented using a sterile gauze soaked in one out of four solutions: saline (NaCl), alkaline electrized water (AEW), citric acid (CA) or N-acetyl-l-cysteine (NAC). Non-contaminated, untreated titanium discs served as controls (C). Residual deposits (bacteria and gauze fibers) and cytocompatibility for osteoblast-like cells were evaluated using SEM and immunofluorescence. Cytotoxicity was assessed using WST-8 assay and immunofluorescence. All protocols were equally effective in removing bacteria from smooth surfaces, while AEW and CA were found to be superior at rough surfaces. AEW and NAC were superior in promoting cytocompatibility over NaCl. NAC and CA had a strong cytotoxic effect on osteoblast-like and fibroblast cells. In conclusion, AEW may be beneficial in the decontamination of implant surfaces, effectively removing bacterial biofilm and restoring cytocompatibility.
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| 10. |
- Ichioka, Yuki, et al.
(författare)
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Mechanical removal of biofilm on titanium discs: An in vitro study
- 2022
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Ingår i: Journal of Biomedical Materials Research Part B-Applied Biomaterials. - : Wiley. - 1552-4973 .- 1552-4981. ; 110:5, s. 1044-1055
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this in vitro study was to evaluate surface cleanness and cytocompatibility following mechanical instrumentation of biofilm-contaminated titanium surfaces. Titanium discs (non-modified [Ti(s)] and shot-blasted surfaces [Ti(r)]) contaminated with Streptococcus gordonii were instrumented using four different techniques: (i) gauze soaked in saline (GS), (ii) ultra-sonic device (US), (iii) rotating nickel-titanium brush (TiB), or (iv) air-polishing device (AP). Non-contaminated, untreated titanium disks were used as controls (C). Residual deposits and cytocompatibility for osteoblast-like cells were evaluated using scanning electron microscopy, immunofluorescence, and reverse transcriptase polymerase chain reaction. While the number of residual bacteria on Ti(s) discs was close to 0 in all treatment groups, significantly higher mean numbers of residual bacteria were observed on Ti(r) discs for GS (152.7 +/- 75.7) and TiB (33.5 +/- 22.2) than for US (0) and AP (0). Instrumentation with US resulted in deposition of foreign material (mean area% of foreign material: 3.0 +/- 3.6% and 10.8 +/- 9.6% for Ti(s) and Ti(r) discs, respectively). AP was the most effective decontamination procedure in reducing bacteria without depositing residual foreign material on Ti(r) discs. TiB and AP were superior methods in restoring cytocompatibility, although no method of mechanical decontamination resulted in pristine levels of cytocompatibility.
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