La peri-implantitis puede poner en riesgo la integridad funcional de un implante dental, ya que dependiendo de la severidad del daño, éste puede ocasionar la pérdida irremediable del implante. Dicho padecimiento está asociado directamente con la formación de la placa dento-bacteriana sobre la superficie del implante.En este trabajo de tesis se estudiarón, por un lado las propiedades de superficie de 6 tipos diferentes de tratamientos utilizados en implantes dentales (tales como: la rugosidad, la mojabilidad y la energía superficial (Capítulo 2) y su influencia en el comportamiento de adhesión de dos cepas bacterianas Streptococcus sanguinis y Lactobacillus salivarius. La primera de ellas muy importante en la formación de la placa dento-bacteriana por ser una de las bacterias que colonizan la superficie del implante inmediatamente después de ser colocado, facilitando la incorporación de otras bacterias periodontopatogénicas, la segunda, tiene la función de mantener el equilibrio de la placa dento-bacteriana. Y por otro lado, la repercusión que tiene la adhesión y colonización de estas bacterias sobre las superficies de titanio.Para esto, se realizaron dos tipos de ensayos de manera general, los primeros en sus medios rutinarios de cultivo para cada cepa bacteriana (Capítulo 3) y los segundos en una saliva artificial modificada (Capítulo 4). Los resultados observados en ambos casos evidenciaron, el daño ocasionado por la presencia de bacterias en contacto directo con las superficies de titanio, los cuales fueron evaluados detalladamente en el capítulo 5. / Peri-implantitis is a soft tissue dental implant inflammation, which may increase implant failure risk, depending direct on severity illness. This device affection is correlated with implant surface bacterial plaque formation. In this thesis work we studied in one hand, titanium surface properties of 6 different kind of treatments commonly used on dental dental implants (such as: roughness, wettability and surface energy) and its adhesion influence on 2 bacteria strains Streptococcus sanguinis and Lactobacillus salivarius (the first one is implied on dental plaque formation, because these bacteria colonize implant surface immediately after implantation, leading and facilitating the periodontopatogenic bacteria coaggregation, whereas the second strain, has to maintain dental plaque equilibrium). And in the other hand, the last part of this work was focused on the bacterial adhesion effect on titanium surfaces. In general we made two sort of experiments: in rutinary culture media (specific for each strain) and in modified artificial saliva (Chapters 3 and 4 respectively). Our results showed a titanium surface damage because of bacterial attachement on that, which were detailly studied in chapter 5

Dentistry has come a long way from its humble beginnings. Like all other healthcare specialties, dentistry has evolved through the years. The understanding of physiology of dental health and disease has evolved allowing us to treat dental diseases much more efficiently. However not all dental problems are fully understood. Diseases that affect the bone and soft tissue around teeth and dental implants, also known as “periodontal” and peri-implant” diseases respectively, have proven to be among the least understood and challenging dental diseases to treat. Recent advancements in microbiology and immunology have revealed that periodontal and peri implant disease have a plethora of interactions between the invading bacteria, the defensive human cells, and signaling micro molecules that control inflammation. Those interactions have opened up a new frontier for researchers in dentistry, microbiology, immunology, pharmacology and dental materials to understand these interactions and explore possible new treatments. Simvastatin is a commonly prescribed drug used to control blood cholesterol. Recent research has revealed that simvastatin also possesses potent anti-inflammatory properties, and research has shown that topical application simvastatin is effective at controlling inflammation around teeth with periodontitis. However it has not yet been tested around dental implants with peri-implant disease. Thus the purpose of the current study is to investigate the effect of topical simvastatin on implants with peri-implant inflammation

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No description available.

Yes / Peri-implantitis remains the major impediment to the long-term use of dental implants. With increasing concern over the growth in antibiotic resistance, there is considerable interest in the preparation of antimicrobial dental implant coatings that also induce osseointegration. One such potential coating material is fluorapatite (FA). The aim of this study was to relate the antibacterial effectiveness of FA coatings against pathogens implicated in peri-implantitis to the physicochemical properties of the coating. Ordered and disordered FA coatings were produced on the under and upper surfaces of stainless steel (SS) discs, respectively, using a hydrothermal method. Surface charge, surface roughness, wettability, and fluoride release were measured for each coating. Surface chemistry was assessed using X-ray photoelectron spectroscopy and FA crystallinity using X-ray diffraction. Antibacterial activity against periodontopathogens was assessed in vitro using viable counts, confocal microscopy, and scanning electron microscopy (SEM). SEM showed that the hydrothermal method produced FA coatings that were predominately aligned perpendicular to the SS substrate or disordered FA coatings consisting of randomly aligned rodlike crystals. Both FA coatings significantly reduced the growth of all examined bacterial strains in comparison to the control. The FA coatings, especially the disordered ones, presented significantly lower charge, greater roughness, and higher area when compared to the control, enhancing bacteria−material interactions and therefore bacterial deactivation by fluoride ions. The ordered FA layer reduced not only bacterial viability but adhesion too. The ordered FA crystals produced as a potential novel implant coating showed significant antibacterial activity against bacteria implicated in peri-implantitis, which could be explained by a detailed understanding of their physicochemical properties. / This work was partially funded through WELMEC, a Centre of Excellence in Medical Engineering funded by the Wellcome Trust and EPSRC, under grant number WT 088908/Z/09/Z.

A micro infiltração de fluidos bucais e bactérias na interface implante e o intermediário são discutidos na literatura através de várias pesquisas pontuando e determinando que o espaço existente entre os componentes e as conexões dos implantes, chamados de GAP, que parece ser a fonte da infiltração de microorganismos, quer a partir de meio externo para meio interno ou vice versa, resultando em reações inflamatórias nos tecidos periodontais. Portanto, este estudo teve como objetivo analisar um método para evitar e ou pelo menos diminuir micro infiltração na interface implante-intermediário utilizando um material de vedação chamado Loctite® 222 (Henkel Ltda). Este é um material monocomponente, anaeróbico, tixotrópico, de baixa resistência à desmontagem sendo utilizado industrialmente para ajustar os parafusos. Os implantes testados neste estudo foram de três diferentes sistemas de conexão protética: hexágono externo (n = 10), hexágono interno (n = 10) e cone morse (n = 10) e estes foram todos fabricados pela mesma empresa (SIN - Sistema de Implantes). Inicialmente, esses implantes foram utilizados como grupo controle, não recebendo a aplicação do selante na área de conexão. Mini intermediários cônicos foram sentados sobre os corpos dos implantes e o torque foi aplicado seguindo recomendação dos fabricantes. Cada implante foi imerso em um criotubo de 2ml contendo 1,5 ml de BHI estéril. Todos foram inoculados com 250l de Enterecoccus faecalis (ATCC - 29212) no interior do criotubo. Os implantes foram limpos, esterilizados e divididos em 3 grupos testes. Uma fina camada do selante foi aplicada com microbrush sobre a área de conexão antes de encaixar os pilares e logo foi aplicado o torque conforme as recomendações do fabricante. Períodos de avaliação, de 7, 14, 21, 35, 49 e 63 dias foram realizados para analisar a presença de micro infiltração do meio interno dos implantes, seguindo regulamentações específicas no fluxo laminar. Os resultados mostraram a eficácia do material selante quando se compara o grupo controle com os grupos testes. Uma eficácia de 100% foi encontrada para todos os sistemas de implantes estudados, o hexágono externo, hexágono interno e cone morse. / Microbial and fluidic leakage in the implant-abutment interface are shown in literature through a variety of studies, accusing the space that exists between the components of the implant, called \"GAP\", which seems to be the source of the microorganism infiltration, either from the external to the internal environment or the inverse, resulting in inflammatory reactions of the periodontal tissues. Therefore, this study aimed to analyze a method to avoid or at least reduce microleakage at the implant-abutment interface by using a sealing material named Loctite ® 222 (Henkel Ltda). This is a single component, anaerobic, thixotropic, lowstrength threadlocker material industrially used to adjust screws. The implants tested in this study were of three different implant-abutment systems: external hexagon (n=10), internal hexagon (n=10) and morse cone connection (n=10) and these were all manufactured by the same company (SIN - Implant System). Initially, these implants were used as the control group, not receiving the sealant application at the connection area. Mini conical abutments were seated over the implant bodies and torque-tightened to 20 Ncm. Each implant was immersed in a 2ml cryotube containing 1.5 ml of sterile BHI. All implants were inoculated with 250l of Enterecoccus faecalis (ATCC - 29212) inside the cryotube. The same implants were then cleaned, sterilized and divided into 3 test groups. A thin layer of the sealant was applied on the connection area before seating the abutments and proceeding as described before. Evaluation periods of 7, 14, 21, 35, 49 and 63 days were performed to analyze the presence of external contamination of the internal environment, following specific regulations in laminar flow. The results showed the effectiveness of the sealant material when comparing the control group to the test groups. An efficacy of 100% was found for all implant systems studied, the external hexagon, internal hexagon and Morse cone connection.

Introduction: Periodontal disease is one of the most common inflammatory diseases in the world. A possible autoimmune aspect behind the local tissue destruction in periodontal disease, as a result of the invasion of oral pathogens over time has been reported in previous studies, but the correlation is yet unclear. Purpose: The aim of this literature review was to shed light on the topic if autoantibodies and autoimmune reactions are associated with gingivitis, periodontitis or peri-implantitis and the progression of these inflammatory diseases. Material and methods: A search in the Pubmed database was done resulting in 138 hits. To follow a systematic approach for selecting the studies to include, we used predefined inclusion and exclusion criteria Results: 26 articles studying a broad variety of different autoantibodies was included for this literature review. A vast majority of the included studies were of case-control design and, because of the broad variety and different variables and data, we decided that a meta-analysis could not be performed. Conclusion: Many studies where results could be compared due to similar comparisons, regarding the incidence of periodontal disease and the prevalence of certain autoantibodies, showed opposite results which makes it hard to reach a conclusion. The main part of the included studies were of small size and therefore more comparable studies are needed to clarify the possible association between periodontal disease and an autoimmune reaction mediated by autoantibodies.

BACKGROUND: Implant therapy has been the gold standard in the past decade when it comes to replacing partially or complete edentulous oral cavities. Patients favor this line of treatment since it does mimic their natural teeth in esthetic, function and phonetics. Unfortunately, some initially integrated implants end up diagnosed with peri-implantitis, which threatens the longevity of those implants in their respective alveolar bone. Several methods have been discussed aiming to either salvage the diseased implant or prolong the life of it in patients’ oral cavities. In this protocol we studied the efficacy of one of the suggested protocols that has been used frequently in periodontal practices aiming to decontaminate the surface of previously diseased implants. MATERIALS AND METHODS: This study looked at the efficacy through two analyses, a descriptive and a quantitative. In the descriptive, several peri-implantitis diagnosed implants were collected and distributed over 4 groups: Test, Negative Control, Positive control and compared to pristine implants. Osteoprogenitor cells were prepared in-vitro and seeded over these implants after applying the protocol on Test group only. The quantitative analysis used the EDX analysis to study the percentages of Titanium and Oxygen on contaminated implants before and after applying the protocol on. Deposits removal was tested as well to ensure efficacy of decontamination protocol. RESULTS: Descriptive analysis showed that osteoprogenitor cells had higher attachment and proliferation on implants that followed the decontamination protocol vs. other groups. Quantitative analysis showed statistically significant higher titanium percentages after decontamination. Oxygen levels were higher as well but not statistically significant. Deposits were statistically significant in removal after decontamination protocol. CONCLUSION: Decontamination of previously diseased implants following the mentioned protocol has efficiently increased the chances of re-establishment of osseointegration in previously contaminated implants.

A micro infiltração de fluidos bucais e bactérias na interface implante e o intermediário são discutidos na literatura através de várias pesquisas pontuando e determinando que o espaço existente entre os componentes e as conexões dos implantes, chamados de GAP, que parece ser a fonte da infiltração de microorganismos, quer a partir de meio externo para meio interno ou vice versa, resultando em reações inflamatórias nos tecidos periodontais. Portanto, este estudo teve como objetivo analisar um método para evitar e ou pelo menos diminuir micro infiltração na interface implante-intermediário utilizando um material de vedação chamado Loctite® 222 (Henkel Ltda). Este é um material monocomponente, anaeróbico, tixotrópico, de baixa resistência à desmontagem sendo utilizado industrialmente para ajustar os parafusos. Os implantes testados neste estudo foram de três diferentes sistemas de conexão protética: hexágono externo (n = 10), hexágono interno (n = 10) e cone morse (n = 10) e estes foram todos fabricados pela mesma empresa (SIN - Sistema de Implantes). Inicialmente, esses implantes foram utilizados como grupo controle, não recebendo a aplicação do selante na área de conexão. Mini intermediários cônicos foram sentados sobre os corpos dos implantes e o torque foi aplicado seguindo recomendação dos fabricantes. Cada implante foi imerso em um criotubo de 2ml contendo 1,5 ml de BHI estéril. Todos foram inoculados com 250l de Enterecoccus faecalis (ATCC - 29212) no interior do criotubo. Os implantes foram limpos, esterilizados e divididos em 3 grupos testes. Uma fina camada do selante foi aplicada com microbrush sobre a área de conexão antes de encaixar os pilares e logo foi aplicado o torque conforme as recomendações do fabricante. Períodos de avaliação, de 7, 14, 21, 35, 49 e 63 dias foram realizados para analisar a presença de micro infiltração do meio interno dos implantes, seguindo regulamentações específicas no fluxo laminar. Os resultados mostraram a eficácia do material selante quando se compara o grupo controle com os grupos testes. Uma eficácia de 100% foi encontrada para todos os sistemas de implantes estudados, o hexágono externo, hexágono interno e cone morse. / Microbial and fluidic leakage in the implant-abutment interface are shown in literature through a variety of studies, accusing the space that exists between the components of the implant, called \"GAP\", which seems to be the source of the microorganism infiltration, either from the external to the internal environment or the inverse, resulting in inflammatory reactions of the periodontal tissues. Therefore, this study aimed to analyze a method to avoid or at least reduce microleakage at the implant-abutment interface by using a sealing material named Loctite ® 222 (Henkel Ltda). This is a single component, anaerobic, thixotropic, lowstrength threadlocker material industrially used to adjust screws. The implants tested in this study were of three different implant-abutment systems: external hexagon (n=10), internal hexagon (n=10) and morse cone connection (n=10) and these were all manufactured by the same company (SIN - Implant System). Initially, these implants were used as the control group, not receiving the sealant application at the connection area. Mini conical abutments were seated over the implant bodies and torque-tightened to 20 Ncm. Each implant was immersed in a 2ml cryotube containing 1.5 ml of sterile BHI. All implants were inoculated with 250l of Enterecoccus faecalis (ATCC - 29212) inside the cryotube. The same implants were then cleaned, sterilized and divided into 3 test groups. A thin layer of the sealant was applied on the connection area before seating the abutments and proceeding as described before. Evaluation periods of 7, 14, 21, 35, 49 and 63 days were performed to analyze the presence of external contamination of the internal environment, following specific regulations in laminar flow. The results showed the effectiveness of the sealant material when comparing the control group to the test groups. An efficacy of 100% was found for all implant systems studied, the external hexagon, internal hexagon and Morse cone connection.

Although the infectious initiation of peri-implantitis is commonly accepted, differences in microbial composition in peri-implantitis and periodontitis has been the subject of some debate. The presence of periodontal pathogens at sites with peri-implantitis has been documented by many studies. However, other studies have revealed that sites with peri-implantitis harbour high levels of microorganisms which have not primarily been associated with periodontitis, such as Candida-, Staphylococcus- and Enterobacteriaceae species. These findings suggest that peri-implantitis may display a flora distinct from that of periodontitis. The aim of the present study was to evaluate the presence of three known periodontal pathogens, Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis) and Treponema denticola (T. denticola) at healthy and diseased (peri-implantitis) sites. A second aim was to evaluate the presence of Candida-, Staphylococcus- and Enterobacteriaceae-species at the same sites. The hypothesis was that A. actinomycetemcomitans, P. gingivalis, T. denticola, Candida-, Staphylococcus- and Enterobacteriaceae-species would be detected at higher levels in peri-implantitis samples than healthy controls. Samples of peri-implant crevicular fluid (PICF) were obtained from peri-implant pockets in 13 subjects, of which 5 subjects had both healthy and diseased implants, 4 subjects had healthy implants only and the remaining 4 had only diseased implants. Microbial analyses were carried out using Real Time PCR and microbial culture techniques. A. actinomycetemscomitans, P. gingivalis and T. denticola were detected at higher levels at sites with peri-implantitis compared to healthy sites. Furthermore, Klebsiella oxytoca was detected in one peri-implantitis sample whereas Candida- and Staphylococcus species were not detected in any of the samples. Higher counts of periodontal pathogens were detected around implants with peri-implantitis. The suggestion that Candida and Staphylococcus may be present at higher levels in peri-implantitis was not supported by this study as these bacteria could not be detected in any of the samples.