Magister Chirurgiae Dentium - MChD / Aim: To determine the prevalence of peri-implant mucositis and the association between systemic and local risk factors

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Made available in DSpace on 2014-12-17T15:43:54Z (GMT). No. of bitstreams: 1 KarynaMM_DISSERT.pdf: 1613458 bytes, checksum: 37ceb3c8bc9380fd82bea372ee1cedb7 (MD5) Previous issue date: 2014-02-20 / It has been shown that the development of peri-implant mucositis is associated with biofilm accumulation. It is believed that the therapeutic approaches used in periodontal disease may have a positive effect in the cases of peri-implant disease. The aim of this study was to evaluate the effectiveness of non-surgical treatment of peri-implant mucositis, with or without the use of chlorhexidine 0,12% in subjects rehabilitated with osseointegrated implants. Thus, patients were randomly divided into test group (chlorhexidine surgical therapy) and control (non-surgical treatment). This therapy consisted of an adaptation of the (Full Mouth scalling and Root Planing) nonoperative protocol FMSRP, but without the use of ultrasound. The visible plaque index (VPI), gingival bleeding index (GBI), probing depth (PD), bleeding on probing (BOP) and keratinized mucosa clinical parameters were evaluated at baseline and at different times after treatment. The data were not normally distributed and the implant was considered the sampling unit. Data were analyzed using Fri edman and Wilcoxon chi-square (&#61537;=5%), tests using the Statistical Package for Social Sciences 17.0 (SPSS). Thus, 119 implants were evaluated, 61 in the test group and 58 in the control group. The results showed statistically significant differences for the variables: average BTI implants in both groups (p<0,001), mean ISG implants both in the test group (p<0,001), and control (p= 0,006) of implants; PS for the test group (p< 0,001) and control (p = 0,015) and SS (p<0,001) in the two treatment groups. However, there was no statistically significant difference when the groups were compared. The PS and SS variables showed no statistically significant difference in any of independent interest to the study (age, sex, smoking, treatment group, keratinized mucosa at different times, peri-implant biotype, average VPI implants and GBI). Thus, it can be concluded that both the mechanical treatment isolated as its association with chlorhexidine mouthwash 0.12% can be used for the treatment of peri-implant mucositis. Moreover, the condition of oral h ygiene has improved between baseline and six months and the depth and bleeding on probing decreased after three and six months / Tem sido demonstrado que o desenvolvimento da mucosite peri-implantar est? associado ao ac?mulo de biofilme dent?rio. Acredita-se que as abordagens terap?uticas utilizadas nas doen?as periodontais podem apresentar efeito positivo nos casos de doen?as peri-implantares. O objetivo desse estudo foi avaliar a efic?cia do tratamento n?o cir?rgico da mucosite peri-implantar em 119 implantes, sendo 61 no grupo teste (digluconato de clorexidina a 0,12%) e 58 no grupo controle (placebo), em indiv?duos reabilitados com implantes. Desta forma, os pacientes foram divididos aleatoriamente em grupo teste (terapia n?o cir?rgica + clorexidina) e controle (terapia n?o cir?rgica). Esta terapia consistiu de uma adapta??o do protocolo n?o-cir?rgico FMSRP (Full Mouth Scalling and Root Planing), por?m, sem a utiliza??o do ultrassom. Os par?metros cl?nicos ?ndice de placa vis?vel (IPV), ?ndice de sangramento gengival (ISG), profundidade de sondagem (PS), sangramento ? sondagem (SS) e mucosa queratinizada foram avaliados no baseline e em diferentes per?odos ap?s o tratamento. Os dados n?o apresentaram distribui??o normal e o implante foi considerado a unidade amostral. Os dados foram analisados por meio dos testes de Friedman, Wilcoxon e Qui-quadrado (&#61537;=5%), utilizando o Statistical Package for Social Sciences 17.0 (SPSS). Os resultados mostraram que houve diferen?a estatisticamente significativa (p<0,05) para as vari?veis: m?dia do IPV dos implantes em ambos os grupos; m?dia do ISG dos implantes tanto no grupo teste, como controle dos implantes; PS para o grupo teste e controle e SS dentro dos dois grupos de tratamento. No entanto, n?o houve diferen?a estatisticamente significativa quando os grupos foram comparados. As vari?veis PS e SS n?o mostraram diferen?a estatisticamente significativa com nenhuma vari?vel independente de interesse para este estudo (idade, sexo, fumo, grupo de tratamento, mucosa ceratinizada nos diferentes tempos, bi?tipo peri-implantar, m?dia do IPV e ISG nos implantes). Desta forma, pode-se concluir que tanto a terapia mec?nica isolada como sua associa??o com bochechos de digluconato de clorexidina a 0,12% podem ser usados para o tratamento da mucosite peri-implantar. Al?m disso, a condi??o de higiene bucal melhorou entre o baseline e seis meses e a profundidade e sangramento ? sondagem reduziram ap?s tr?s e seis meses

Aim: To evaluate different parameters potentially affecting the efficacy of air-polishing devices in disinfecting implant surfaces in a non-surgical treatment approach of peri-implantitis lesions. Material and method: Altogether, 56 turned and 56 moderately rough implants were coated with a simulated biofilm. The implants were mounted in customized resin models simulating peri-implant 30° bone-defects, 3- and 5-mm deep; soft tissues were simulated with ballistic gelatin. Each implant was cleaned for 30 or 90 seconds in total (6 sites pr. implant; 5 or 15 seconds pr. site) with one of two different air-polishing devices (W&amp;H and EMS). Implants were photographed in three different angulations and the amount of residual biofilm on the implant surface was measured digitally. Beta-regression models were used to assess the outcome. Results: Implant surface, treatment time and air-polishing device significantly affected the amount of residual biofilm. Turned implant surface, longer treatment time, and using the EMS device resulted in significantly less residual biofilm. In the most apical part of the defect, both air-polishing devices performed similarly, however, this was also the area with most biofilm left compared to more coronal aspects. Defect depth had no significant effect.  Conclusion: Superior biofilm removal is achieved at implants with turned surface, and when applying longer treatment time. At the deepest aspect of the defect, implant decontamination is compromised. / Syfte: Syftet med denna laborativa studie är att utvärdera olika parametrar som potentiellt kan påverka effekten av air-polishing maskiner vid icke-kirurgisk rengöring av implantat för behandling av peri-implantit. Material och metod: Sammanlagt, 56 turned (maskin bearbetade) och 56 moderately rough (måttlig ytråhet) implantat var belagda med en biofilmimitation. Implantaten var placerade i en specialgjord resin-modell som simulerar en 30° bendefektmodell med 3- respektive 5 mm defektdjup; mjukvävnaden simulerades med ballistiskt gelatin. Varje implantat rengjordes i totalt 30 eller 90 sekunder (6 sidor per implantat; 5 eller 15 sekunder per sida) med en av två air-polishing maskiner (W&amp;H och EMS). Implantaten fotograferades sedan ur tre olika vinklar för att digitalt bedöma kvarstående biofilm. Implantatyta, tillverkare, defektdjup och behandlingstid analyserades som prediktionsvariabler för kvarstående biofilm (%). Beta-regressionsanalys användes för att bedöma resultatet. Resultat: Implantat-yta, tillverkare och behandlingstid påverkade mängden kvarvarande biofilmsimulation signifikant. Maskinbearbetade implantatytor, en längre behandlingstid, användande av EMS maskinen, resulterade alla i signifikant mindre kvarvarande biofilm. De två tillverkarna presterade endast lika i de mest apikala delarna av defekten, men detta var också det område med mest kvarvarande biofilm jämfört med mer koronala aspekter. Defekt djup hade ingen signifikant effekt på resultatet. Slutsats: Man kan förvänta sig bättre borttagning av biofilm när man behandlar maskinbearbetade implantatytor samt när man använder en längre behandlingstid.Vid den djupaste aspekten av defekten, äventyras dekontaminering av implantat