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Peri-Implant Diseases: Diagnostic Features, Microbiological Characteristics and Novel Surface Decontamination and Treatment Strategies

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A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 23595

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Special Issue Editors

Dr. Piero Papi

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Guest Editor

Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
Interests: peri-implantitis; biomaterials; antimicrobial surface decontamination, dental implants; biofilm; implant decontamination; antimicrobial mouthwash
Special Issues, Collections and Topics in MDPI journals

Dr. Pier Carmine Passarelli

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Guest Editor

Department of Head and Neck, Oral Surgery, and Implantology Unit, Institute of Clinical Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
Interests: oral surgery; implantology; oral health

Special Issue Information

Dear Colleagues,

It is a pleasure to invite you to contribute to this Special Issue on peri-implant diseases. Over the years, dental implants have shown excellent long-term survival and success rates; however, their massive use has been associated with an increased rate of implant-related complications, which can be classified as mechanical or biological. According to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions, implant-related biological complications can be divided into peri-implant mucositis and peri-implantitis. Another pathological condition, retrograde peri-implantitis, represents a radiolucent area surrounding only the apical part of the implant. Systemic oxidative stress together with up-regulation of inflammatory cytokines and presence of Gram-negative anaerobes, such as Porphyromonas gingivalis, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans, could exacerbate peri-implant diseases. The use of antibiotics is widespread among dentists for peri-implantitis patients: they are administered without proper scientific evidence, mostly on sn empirical case-by-case basis. This practice could lead to an increase in antibiotic resistance among patients, with effects particularly severe in the elderly population. Understanding bacterial and inflammatory activity may help us to target appropriate antibiotics for every patient, contributing to increasing the low success rate of currently adopted peri-implantitis treatment strategies. This Special Issue will publish papers related to clinical, radiographic, and microbiological analysis of peri-implantitis; implant surface decontamination and novel treatment strategies will be addressed.

Dr. Piero Papi
Dr. Pier Carmine Passarelli
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Peri-implantitis
mucositis
implant surface
biomaterials
antimicrobial surface decontamination
biofilm
implant decontamination
treatment
guided bone regeneration
implantoplasty
microbiome
bacterial decontamination
diagnosis
retrograde peri-implantitis
risk factors

Published Papers (6 papers)

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Research

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21 pages, 5471 KiB

Open AccessArticle

Methods of Topical Administration of Drugs and Biological Active Substances for Dental Implants—A Narrative Review

by Piotr Wychowański, Anna Starzyńska, Paulina Adamska, Monika Słupecka-Ziemilska, Bartosz Kamil Sobocki, Agnieszka Chmielewska, Bartłomiej Wysocki, Daniela Alterio, Giulia Marvaso, Barbara Alicja Jereczek-Fossa and Jan Kowalski

Antibiotics 2021, 10(8), 919; https://doi.org/10.3390/antibiotics10080919 - 28 Jul 2021

Cited by 10 | Viewed by 3556

Abstract

Dental implants are, nowadays, established surgical devices for the restoration of lost teeth. Considered as an alternative for traditional prosthetic appliances, dental implants surpass them in reliability and patient feedback. Local drug delivery around the implants promotes osseointegration and reduces peri-implantitis. However, there are currently no methods of a multiple, precise topical administration of drugs to the implant area. Engineering coatings on the implants, drug application on carriers during implantation, or gingival pockets do not meet all requirements of dental surgeons. Therefore, there is a need to create porous implants and other medical devices that will allow a multiple drug delivery at a controlled dose and release profile without traumatic treatment. Due to the growing demand for the use of biologically active agents to support dental implant treatment at its various stages (implant placement, long-term use of dental superstructures, treatment of the peri-implant conditions) and due to the proven effectiveness of the topical application of pharmacological biologically active agents to the implant area, the authors would like to present a review and show the methods and devices that can be used by clinicians for local drug administration to facilitate dental implant treatment. Our review concludes that there is a need for research in the field of inventions such as new medical devices or implants with gradient solid–porous structures. These devices, in the future, will enable to perform repeatable, controllable, atraumatic, and repeatable injections of active factors that may affect the improvement of osteointegration and the longer survival of implants, as well as the treatment of peri-implantitis. Full article

(This article belongs to the Special Issue Peri-Implant Diseases: Diagnostic Features, Microbiological Characteristics and Novel Surface Decontamination and Treatment Strategies)

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10 pages, 2491 KiB

Open AccessArticle

The Treatment of Peri-Implant Diseases: A New Approach Using HYBENX^® as a Decontaminant for Implant Surface and Oral Tissues

by Michele Antonio Lopez, Pier Carmine Passarelli, Emmanuele Godino, Nicolò Lombardo, Francesca Romana Altamura, Alessandro Speranza, Andrea Lopez, Piero Papi, Giorgio Pompa and Antonio D’Addona

Antibiotics 2021, 10(5), 512; https://doi.org/10.3390/antibiotics10050512 - 30 Apr 2021

Cited by 6 | Viewed by 2717

Abstract

Background: Peri-implantitis is a pathological condition characterized by an inflammatory process involving soft and hard tissues surrounding dental implants. The management of peri-implant disease has several protocols, among which is the chemical method HYBENX^®. The aim of this study is to demonstrate the efficacy of HYBENX^® in the treatment of peri-implantitis and to compare HYBENX^® with other chemical agents used in the surgical treatment of peri-implantitis. Methods: The present study included a population of ten subjects with severe peri-implantitis. The procedure used in the study involves the application of HYBENX^® after open-flap debridement. Each patient has been followed for 12 months after a single application of the decontaminant agent. Clinical and radiographical parameters were recorded at baseline, 3 months, and 12 months after treatment completion. Results: At baseline, a mean pocket probing depth (PPD) of 7.3 ± 0.5 mm and a mean clinical attachment level (CAL) of 8.8 ± 0.8 mm was recorded. An average residual PPD of 4.2 ± 0.5 mm and a mean CAL of 5.2 ± 0.8 mm were observed after 1 year. Additionally, the average of bone gain was about 3.4 mm, with a mean marginal bone level (MBL) change from 5.8 mm (baseline) to 2.4 mm (12 months). In total, 90% of the treated implants reached the success rate after the 1-year follow-up. Only in one case out of ten treated implants was resolution of the disease not achieved. Conclusion: Clinical improvements highlight that the procedure of open-flap debridement (OFD) + HYBENX^® may be considered an effective technique in the treatment of peri-implantitis. From the results obtained, it can be concluded that the use of HYBENX^® in the surgical treatment of peri-implantitis is promising. Overall, this protocol demands further studies to better understand the role and potential benefits of HYBENX^® in the treatment of peri-implantitis. Full article

(This article belongs to the Special Issue Peri-Implant Diseases: Diagnostic Features, Microbiological Characteristics and Novel Surface Decontamination and Treatment Strategies)

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9 pages, 254 KiB

Open AccessArticle

Microbiological Profiles of Dental Implants in Metabolic Syndrome Patients: A Case-Control Study

by Bianca Di Murro, Marta Moretti, Enrico De Smaele, Claudio Letizia, Carla Lubrano, Pier Carmine Passarelli, Antonio D’Addona, Giorgio Pompa and Piero Papi

Antibiotics 2021, 10(4), 452; https://doi.org/10.3390/antibiotics10040452 - 16 Apr 2021

Cited by 8 | Viewed by 1889

Abstract

There is a lack of knowledge on the possible influence of systemic conditions on peri-implantitis. The aim of this case-control study is to evaluate the difference in terms of oral pathogens’ concentrations in the peri-implant sulcus of a group of patients affected by metabolic syndrome (Mets) compared to healthy subjects. For each patient, peri-implant sulcular biofilm samples were obtained by inserting two sterile endodontic paper points in the deepest aspect of the peri-implant sulcus for 30 s. The quantitative real-time polymerase chain reaction was performed to evaluate total bacterial counts of six pathogens. Patients were screened for peri-implant diseases and clinical and radiographic parameters were recorded. A total of 50 patients was enrolled in the study, 25 affected by Mets and 25 healthy. Significantly higher bacterial counts were discovered for Aggregatibacter actinomycetemcomitans (p = 0.0008), Prevotella intermedia (p = 0.0477) and Staphylococcus aureus (p = 0.034) in MetS patients compared to healthy subjects. Performing a sub-group analysis, considering peri-implant status and dividing patients by MetS diagnosis, no statistically significant (p < 0.05) differences were found. For the first time, a correlation between MetS presence and a greater prevalence of some bacterial species in the peri-implant sulcus was reported, irrespectively from peri-implant status (health vs. disease). Full article

(This article belongs to the Special Issue Peri-Implant Diseases: Diagnostic Features, Microbiological Characteristics and Novel Surface Decontamination and Treatment Strategies)

11 pages, 1845 KiB

Open AccessArticle

Decontamination of Ti Oxide Surfaces by Using Ultraviolet Light: Hg-Vapor vs. LED-Based Irradiation

by Nagore Arroyo-Lamas, Unai Ugalde and Iciar Arteagoitia

Antibiotics 2020, 9(11), 724; https://doi.org/10.3390/antibiotics9110724 - 22 Oct 2020

Cited by 5 | Viewed by 2024

Abstract

C-range Ultraviolet (UVC) mercury (Hg)-vapor lamps have shown the successful decontamination of hydrocarbons and antimicrobial effects from titanium surfaces. This study focused on surface chemistry modifications of titanium dental implants by using two different light sources, Hg-vapor lamps and Light Emitting Diodes (LEDs), so as to compare the effectivity of both photofunctionalization technologies. Two different devices, a small Hg-vapor lamp (λ = 254 nm) and a pair of closely placed LEDs (λ = 278 nm), were used to irradiate the implants for 12 min. X-ray Photoelectron Spectroscopy (XPS) was employed to characterize the chemical composition of the surfaces, analysing the samples before and after the lighting treatment, performing a wide and narrow scan around the energy peaks of carbon, oxygen and titanium. XPS analysis showed a reduction in the concentration of surface hydrocarbons in both UVC technologies from around 26 to 23.4 C at.% (carbon atomic concentration). Besides, simultaneously, an increase in concentration of oxygen and titanium was observed. LED-based UVC photofunctionalization has been suggested to be as effective a method as Hg-vapor lamps to remove the hydrocarbons from the surface of titanium dental implants. Therefore, due to the increase in worldwide mercury limitations, LED-based technology could be a good alternative decontamination source. Full article

(This article belongs to the Special Issue Peri-Implant Diseases: Diagnostic Features, Microbiological Characteristics and Novel Surface Decontamination and Treatment Strategies)

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10 pages, 650 KiB

Open AccessArticle

Attitude in Radiographic Post-Operative Assessment of Dental Implants among Italian Dentists: A Cross-Sectional Survey

by Bianca Di Murro, Piero Papi, Pier Carmine Passarelli, Antonio D’Addona and Giorgio Pompa

Antibiotics 2020, 9(5), 234; https://doi.org/10.3390/antibiotics9050234 - 7 May 2020

Cited by 8 | Viewed by 2416

Abstract

There is a lack of evidence in the attitude and prescribing practice of implantologists in dental implant post-operative assessment; therefore, the aims of this cross-sectional study were to investigate these habits and the knowledge about radiographic aspect of retrograde peri-implantitis (RPI) among Italian implantologists. A questionnaire was sent via email to dentists randomly selected from the register of implantology and oral surgery societies. It included three questions: the preferred X-ray after implant placement, the timing of post-operative assessment and the knowledge of the RPI radiographic representation. A final sample of 434 implantologists was included in the study. The majority of them (84.3%) perform a periapical X-ray as control radiograph and picked the correct radiographic representation of RPI (74.3%), without statistically significant differences (p > 0.05) for sex, age, years of working practice and number of implants placed per year. Just 47.7% of dentists perform a control radiograph at prostheses delivery, to establish a proper baseline. A statistically significant difference (p < 0.05) was detectable only for the number of implants placed per year, with dentists placing > 80 implants selecting the correct choice. To the best of authors’ knowledge, this is the first study to report data on attitude of implantologists in radiographic imaging after implant placement. Full article

(This article belongs to the Special Issue Peri-Implant Diseases: Diagnostic Features, Microbiological Characteristics and Novel Surface Decontamination and Treatment Strategies)

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Review

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19 pages, 2267 KiB

Open AccessReview

Peri-Implant Diseases: Diagnosis, Clinical, Histological, Microbiological Characteristics and Treatment Strategies. A Narrative Review

by Ioannis Kormas, Chantal Pedercini, Alessandro Pedercini, Michail Raptopoulos, Hatem Alassy and Larry F. Wolff

Antibiotics 2020, 9(11), 835; https://doi.org/10.3390/antibiotics9110835 - 22 Nov 2020

Cited by 36 | Viewed by 9983

Abstract

Since the use of dental implants is continuously increasing, it is imperative for dental practitioners to understand the nature and treatment of peri-implant diseases. The purpose of this manuscript is to comprehensively review peri-implant diseases, their characteristics, as well as their non-surgical and surgical treatment. To that end, the current literature was searched and a narrative review was conducted. It is essential that the case definitions described in the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions are used to diagnose and classify peri-implant health, peri-implant mucositis and peri-implantitis. While recent epidemiologic studies on peri-implant diseases exist, there is great heterogeneity in the definition of these conditions. Several risk factors and indicators are reported in the literature, with smoking and diabetes being the most universally accepted. In peri-implant mucositis, non-surgical treatment seems to be sufficient. However, for the treatment of peri-implantitis, a surgical approach, which includes open-flap debridement, apically positioned flap and guided bone regeneration, is considered more appropriate. A great variety of adjuncts to mechanical treatment have been reported with controversial results. Finally, studies comparing results from different peri-implantitis treatments are warranted in randomized controlled clinical trials in order to provide stronger evidence-based approaches. Full article

(This article belongs to the Special Issue Peri-Implant Diseases: Diagnostic Features, Microbiological Characteristics and Novel Surface Decontamination and Treatment Strategies)

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