Orientador: Elcio Marcantonio Junior / Resumo: O objetivo do presente estudo foi investigar a ocorrência das doenças peri-implantares e a influência de possíveis fatores de risco utilizando duas abordagens metodológicas diferentes. Inicialmente realizou-se um estudo retrospectivo para avaliar a sobrevivência e o sucesso de implantes com superfície tratada com ataque ácido após 8 a 10 anos de função. Quarenta e quatro pacientes e 183 implantes foram incluídos. Dados demográficos, sistêmicos e comportamentais foram obtidos seguidos da avaliação clínica periodontal, peri-implantar e radiográfica realizados em uma única sessão. Nesse estudo relatou-se, nos 183 implantes avaliados, um índice de sobrevivência e sucesso de 97,3% e 84,7%, respectivamente. Dos implantes sobreviventes, 51% apresentavam mucosite e 11% peri-implantite. Posteriormente investigou-se, em um estudo prospectivo, a incidência de mucosite e perda óssea peri-implantar após 1 ano em função. Foram incluídos 56 pacientes totalizando 180 implantes. O exame clínico periodontal e peri-implantar seguido de radiografias periapicais padronizadas foi realizado 15 dias após a instalação das próteses e após 3, 6 e 12 meses de função. Com essa abordagem, observou-se uma incidência de 44,8% de mucosite peri-implantar, porém nenhum caso de peri-implantite foi observado nos 180 implantes avaliados. Implantes com conexão hexagono interno apresentaram incidência de mucosite significativamente maior após 1 ano de acompanhamento. Ademais, uma média de perda óssea peri-implantar... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The purpose of this investigation was to assess the incidence of peri-implant diseases and how they can be associated to possible risk factors. Two different approaches were addressed. Through a retrospective study, survival and success rates of implants with acid-etched-treated surface were initially evaluated in 44 patients, with 183 implants, in function for 8 to 10 years. Analysis included demographic, systemic and behavioral data, followed by one-session radiographic, periodontal and peri-implant clinical evaluations. This first study yielded survival and success rates of 97.3% and 84.7%, respectively, for the 183 investigated implants. Among the surviving implants, 51% were affected by mucosite and 11%, by peri-implantitis. A second study was also carried out to prospectively investigate mucosite incidence as well as peri-implantar bone loss in 180 implants, placed in 56 patients, after 1 year of function, which were assessed by clinical periodontal and peri-implant examinations, followed by standardized peri-apical radiographs, carried out 15 days after installation of the prosthesis, and at 3, 6 and 12 months of function. This observation revealed a 44.8% rate of peri-implant mucosite; however, no case of peri-implantitis was found. Implants with an intern-hexagon platform were significantly more affected by mucositis after one year of observation. In addition, a mean peri-implant bone-loss of 0.35 ± 1.89 mm was detected, however none of the patient or implant-related... (Complete abstract click electronic access below) / Doutor

Syftet med studien var att undersöka det histopatologiska utseendet hos humana periimplantit-lesioner i relation till lesionens kliniska utseende. Periimplantit-vävnad lokaliserad runt 15 implantat avlägsnades kirurgiskt från 13 individer. De 15 kirurgiskt avlägsnade vävnadsproverna skiljde sig betydligt i utseende kliniskt och delades in i två grupper beroende på om de var inkapslade och välavgränsade mot omgivande vävnad eller mer diffust avgränsade. Vävnaderna preparerades histokemiskt (MAYERS HTX) och immunohistokemiskt (MACH 4 Universal HRP-Polymer Detection System). De celler som undersöktes med immunohistokemiska metoder var T-celler (CD3+), B-celler (CD20+), plasmaceller (CD138+), M1-makrofager (CD68+) och M2-makrofager (CD163+). Förekomsten av neutrofila granulocyter identifierades morfologiskt med rutininfärgning. Därefter scannades och analyserades proverna kvalitativt och kvantitativt. Ingen statistiskt signifikant skillnad kunde påvisas mellan tätheten av infiltrerade lymfocyter (P=0,613) och neutrofila granulocyter (P=0,336) samt arean av inflammationsinfiltratet (P=0,613) mellan de två studerade grupperna. Vidare kunde inget samband observeras mellan den histologiska sammansättningen av de studerade cellerna och det kliniska utseendet vilket dock kan förklaras av otydliga kliniska kriterier. Däremot kan det konstateras att en skillnad föreligger mellan proverna utifrån den histologiska bilden. Däribland varierar antalet plasmaceller avsevärt mellan proverna samt förekomst av fibrös bindvävszon mot benet. Ytterligare studier behövs för att förklara skillnaden i det kliniska och histologiska utseendet. / The purpose of this study was to examine the histopathological composition of human peri-implantitis lesions in relation to the clinical appearance of the lesion. Peri-implantitis tissue located around implants was surgically removed from 13 individuals. The surgically removed tissue samples differed significantly in appearance clinically and were divided into two groups, depending on whether they were encapsulated and well-bound to surrounding tissue or more diffusely delimited. The tissues were histochemically prepared (MAYERS HTX) and immunohistochemical (MACH 4 Universal HRP-Polymer Detection System). The cells examined by immunohistochemical methods were T cells (CD3 +), B cells (CD20 +), plasma cells (CD138 +), M1 macrophages (CD68 +) and M2 macrophages (CD163 +). The presence of neutrophilic granulocytes was examined morphologically by routine staining. The samples were then scanned and analyzed qualitatively and quantitatively. No statistically significant difference could be detected between the density of infiltrated lymphocytes (P = 0.613) and neutrophil granulocytes (P = 0.336) and the area of ​​the inflammatory infiltrate (P = 0.613) between the two studied groups. Furthermore, no relationship could be observed between the histological composition of the cells studied and the clinical appearance, which however, can be explained by unclear clinical criteria. The results indicated that there was a difference between the samples based on the histological composition, including the number of plasma cells which varied considerably between the samples and the presence of fibrous connective tissue zone close to the bone. Further studies are required to explain the difference in the clinical and histological appearance.

Little is known about the microbiome composition associated with peri-implantitis in developing countries. A recent study found a high prevalence of peri-implantitis in a group of Moroccan patients. We hypothesized that a distinct microbiome may be associated with this disease in Moroccan subjects, and the aim of this study was to investigate the composition of the microbiome in peri-implantitis sites and sites without peri-implantitis. The study material consisted of 35 dental patients with dental implants: 22 of these had peri-implantitis, and 13 were without peri-implantitis. Among these subjects, dental plaque samples were collected from 50 peri-implant sites as follows: in the peri-implantitis subjects, 22 samples were from peri-implantitis sites (peri-implantitis patient diseased sites) and 15 samples from sites without peri-implantitis (peri-implantitis patient control sites); and 13 samples from implants from subjects without peri-implantitis (non-peri-implantitis patient control sites). The samples were sequenced for the V1-V3 region of the 16S rRNA gene, and the resultant sequences were classified at the species level using a previously described Blastn-based algorithm. Downstream analysis of the data was performed with Phyloseq, Microbiome, Vegan and MaAsLin packages in R, using a false discovery rate (FDR) cutoff of 0.25. Fifty-six species and 30 genera were identified per sample on average. No significant differences were found between the groups in terms of species richness and alpha diversity. However, beta diversity analysis by PERMANOVA (Adonis) identified a statistically significant difference (FDR=0.024) between the peri-implantitis patient diseased sites and non-peri-implantitis patient control sites. Compared to non-peri-implantitis patient control sites, diseased but not control sites in patients with peri-implantitis showed significantly higher levels of Peptostreptococcus stomatitis and Mogibacterium spp. However, both diseased and control sites in patients with peri-implantitis had higher abundance of Olsenella uli, Atopobium spp. and Actinomyces spp. compared to non-peri-implantitis patient control sites. No differences at FDR ≤ 0.25 were found between diseased and control sites in patients with peri-implantitis, but Porphyromonas endodontalis tended to be elevated in diseased sites while Veillonella parvula tended to increase in control sites. These findings suggest a distinct dysbiotic microbiome is associated with peri-implantitis sites in Moroccan patients. / Oral Biology

Os altos índice de sucesso dos implantes dentais e sua indicação crescente apresentam como limitação a contaminação bacteriana com a consequente doença peri-implantar. Os métodos de tratamento ainda não se apresentam claros e seguros, portanto, meios de prevenção que impeçam a formação de biofilme e inibam o crescimento bacteriano devem ser desenvolvidos e aplicados para impedir a falha dos implantes. O objetivo deste estudo foi avaliar a efetividade de um novo antimicrobiano nanoparticulado - o vanadato de prata (AgNO3) em diferentes concentrações (2,5%; 5% e 10%), aplicado sob a forma de filme superficial sobre diferentes substratos sugeridos para dispositivos da Implantodontia. Foram selecionados os materiais poliacetal, teflon e resina acrílica e os veículos glaze e esmalte para a aplicação do nanocomposto. Análises das propriedades físicas rugosidade superficial e dureza Rockwell superficial, assim como imagens obtidas por meio da Microscopia Eletrônica de Varredura (MEV), foram utilizadas para avaliar a resistência e alterações estruturais dos grupos e portanto, a viabilidade de aplicação clínica. A análise pelo método microbiológico do halo de inibição mostrou que as bactérias P. aeruginosa, E. coli, S mutans, E. faecalis e S. aureus tiveram inibição de crescimento; enquanto nas bactérias anaeróbias P. gingivalis e P. intermedia e na levedura C. albicans não foi demonstrada a atividade antibacteriana de AgNO3. O tipo de substrato utilizado e de veículo para a aplicação de AgNO3 não influenciaram nos resultados, com exceção do S. aureus que obteve maior diâmetro do halo de inibição quando aplicado com o glaze em comparação ao esmalte (p<0,05). A proporção do nanocomposto mostrou influência nos resultados, sendo que 10% se mostrou a mais eficaz em todas as bactérias, e de modo geral sem diferença estatística com a proporção de 5% (p<0,05). Apesar de proporções menores algumas vezes não mostrarem atividade antimicrobiana, estas provocaram menor alteração nas propriedades físicas dos materiais, sendo a proporção do AgNO3 proporcional ao aumento da rugosidade e dureza superficial. Os substratos e tipo de filme não influenciaram nos resultados da rugosidade superficial após a aplicação do tratamento superficial (p>0,05), entretanto a aplicação de 10% do nanocomposto causou a alteração superficial mais significativa (7,02 ± 2,99 Ra) (p<0,05). Na dureza superficial não foi encontrada alteração significativa com o aumento da concentração do AgNO3 no poliacetal e na resina acrílica (p>0,05), no entanto no teflon, 10% de AgNO3 não alterou significativamente os valores de resistência. Apesar dos filmes não influenciarem nos resultados, o substrato poliacetal demonstrou maior dureza com diferença estatística com os demais substratos (83,0 ±10,2 HR15Yadaptado) (p<0,05). As imagens obtidas no MEV comprovaram mudanças estruturais superficiais com a presença de mais picos e vales, em comparação a superfícies sem o tratamento antimicrobiano. Como conclusão, apesar de 10% ser a concentração do AgNO3 que atingiu um maior número de espécies, essa concentração deve ser ponderada sobre o seu uso, e avaliada em estudos futuros sobre a sua viabilidade de uso clínico em função das alterações nas propriedades físicas. / The high success rate of dental implants and their growing indications show the limitation of bacterial contamination with consequent peri-implant disease. The treatment methods have not yet clear and secure, thus means for preventing the deposition of biofilm and inhibit bacterial growth must be developed and implemented to prevent failure of implants. The aim of this study was to evaluate the effectiveness of a new nanoparticulate antimicrobial - vanadate silver (AgNO3) in different concentrations (2.5%, 5% and 10%), applied as a surface film on different substrates suggested for devices of Implantology. The materials polyacetal teflon and acrylic resin and vehicles enamel / glaze were selected for the application of nanocomposite. Analyzes of the physical properties surperficial roughness and superficial hardness Rockwell, as well as images obtained by scanning electron microscopy (SEM) were used to assess the strength and structural changes of the groups and therefore the feasibility of clinical application. A microbiological method for the analysis of inhibition zone shows growth inhibition on the bacterias P. aeruginosa, E. coli, S. mutans, E. faecalis and S. aureus; while the anaerobic bacteria P. gingivalis and P. intermedia and the yeast C. albicans has not been demonstrated antibacterial activity of AgNO3. The type of substrate used and the vehicle for the application of AgNO3 did not influence the results, with the exception of S. aureus with highest diameter of inhibition zone when applied with glaze compared to enamel (p<0.05). The proportion of the nanocomposite showed influence on the results, 10% proved the most effective in all bacteria, and generally no statistical difference in the proportion of 5% (p<0.05). Although smaller proportions sometimes do not show antimicrobial activity, these caused minor change in the physical properties of materials. The ratio of AgNO3 was proportional to the increase of roughness and hardness. The substrates and film type did not influence the results of the surface roughness after applying the surface treatment (p>0.05), however the application of 10% of the nanocomposite caused surface alteration more significant (7.02 ± 2.99 Ra) (p<0.05). In hardness was not found to significantly change with concentration of AgNO3 in the acrylic resin and the polyacetal (p> 0.05). However in teflon, 10% AgNO3 did not significantly alter the resistance values. Although the films do not influence the results, polyacetal substrate showed higher hardness with statistical difference with the other substrates (83.0 ± 10.2 HR15Yadaptado) (p <0.05). The SEM images proved superficial structural changes with the presence of more peaks and valleys compared to surfaces without antimicrobial treatment. In conclusion, despite 10% being the concentration of AgNO3 that reached the highest number of species, this concentration should be thought on its use, and evaluated in future studies on the feasibility of clinical use in accordance with changes in physical properties.

The prevalence of obesity is continually rising in developed countries like the United States. Based on the association between periodontitis and obesity and the relationship between periodontitis and peri-implantitis, it is important to understand the implications of obesity on peri-implant health. A potential relationship between obesity and peri-implant health has practical, biological and financial implications. The primary objective of this study was to determine the association between obesity as measured by the body fat indices (body mass index (BMI), waist circumference (WC), and body fat percent (fat %)) and the levels of inflammatory biomarkers in saliva. In addition, this study explored the correlations between the levels of these biomarkers in saliva versus their corresponding levels in peri-implant sulcular fluid (PISF) and gingival crevicular fluid (GCF) samples collected from the same subjects. Periodontal maintenance patients (N=73) were enrolled in this cross-sectional study. Anthropometric measurements (BMI, WC, and body fat %), intraoral assessment (full mouth plaque index, periodontal, and peri-implant comprehensive examinations) and unstimulated whole saliva samples were collected from the subjects. GCF and PISF were also collected. Levels of interleukin (IL)-1α, IL-1β, IL-4, IL-6, IL-8, IL-10, IL-12(p40), IL-17α, tumor necrosis factor (TNF)-α, osteoprotegerin (OPG), letpin and C-reactive protein (CRP) in saliva, GCF and PISF were analyzed using multiplex immunoassays. Statistical analyses were performed to explore the correlations of interest. Data from 63 subjects were included in the analysis. No statistically significant correlations were noted between any of the body fat indices and any of the biomarkers measured in saliva (p>0.05 in all instances). A significant positive correlation was noted between salivary and GCF levels of IL-1α (r=0.29, p=0.0232), IL-8 (r=0.29, p=0.0207) and between saliva and PISF levels of leptin (r=0.32, p=0.0284). The employed linear model also revealed the significant impact of tooth brushing frequency on the salivary levels of IL-1α, IL-1β and TNF-α (p<0.05). Based on this cross-sectional study of 63 patients, I conclude that there was no statistically significant correlation noted between salivary inflammatory biomarkers and any of the obesity measures. However, the levels of key inflammatory markers in saliva strongly correlated with their corresponding levels in GCF/PISF. In addition, frequency of tooth brushing was also related to levels of certain biomarkers in GCF/PISF.

Os altos índice de sucesso dos implantes dentais e sua indicação crescente apresentam como limitação a contaminação bacteriana com a consequente doença peri-implantar. Os métodos de tratamento ainda não se apresentam claros e seguros, portanto, meios de prevenção que impeçam a formação de biofilme e inibam o crescimento bacteriano devem ser desenvolvidos e aplicados para impedir a falha dos implantes. O objetivo deste estudo foi avaliar a efetividade de um novo antimicrobiano nanoparticulado - o vanadato de prata (AgNO3) em diferentes concentrações (2,5%; 5% e 10%), aplicado sob a forma de filme superficial sobre diferentes substratos sugeridos para dispositivos da Implantodontia. Foram selecionados os materiais poliacetal, teflon e resina acrílica e os veículos glaze e esmalte para a aplicação do nanocomposto. Análises das propriedades físicas rugosidade superficial e dureza Rockwell superficial, assim como imagens obtidas por meio da Microscopia Eletrônica de Varredura (MEV), foram utilizadas para avaliar a resistência e alterações estruturais dos grupos e portanto, a viabilidade de aplicação clínica. A análise pelo método microbiológico do halo de inibição mostrou que as bactérias P. aeruginosa, E. coli, S mutans, E. faecalis e S. aureus tiveram inibição de crescimento; enquanto nas bactérias anaeróbias P. gingivalis e P. intermedia e na levedura C. albicans não foi demonstrada a atividade antibacteriana de AgNO3. O tipo de substrato utilizado e de veículo para a aplicação de AgNO3 não influenciaram nos resultados, com exceção do S. aureus que obteve maior diâmetro do halo de inibição quando aplicado com o glaze em comparação ao esmalte (p<0,05). A proporção do nanocomposto mostrou influência nos resultados, sendo que 10% se mostrou a mais eficaz em todas as bactérias, e de modo geral sem diferença estatística com a proporção de 5% (p<0,05). Apesar de proporções menores algumas vezes não mostrarem atividade antimicrobiana, estas provocaram menor alteração nas propriedades físicas dos materiais, sendo a proporção do AgNO3 proporcional ao aumento da rugosidade e dureza superficial. Os substratos e tipo de filme não influenciaram nos resultados da rugosidade superficial após a aplicação do tratamento superficial (p>0,05), entretanto a aplicação de 10% do nanocomposto causou a alteração superficial mais significativa (7,02 ± 2,99 Ra) (p<0,05). Na dureza superficial não foi encontrada alteração significativa com o aumento da concentração do AgNO3 no poliacetal e na resina acrílica (p>0,05), no entanto no teflon, 10% de AgNO3 não alterou significativamente os valores de resistência. Apesar dos filmes não influenciarem nos resultados, o substrato poliacetal demonstrou maior dureza com diferença estatística com os demais substratos (83,0 ±10,2 HR15Yadaptado) (p<0,05). As imagens obtidas no MEV comprovaram mudanças estruturais superficiais com a presença de mais picos e vales, em comparação a superfícies sem o tratamento antimicrobiano. Como conclusão, apesar de 10% ser a concentração do AgNO3 que atingiu um maior número de espécies, essa concentração deve ser ponderada sobre o seu uso, e avaliada em estudos futuros sobre a sua viabilidade de uso clínico em função das alterações nas propriedades físicas. / The high success rate of dental implants and their growing indications show the limitation of bacterial contamination with consequent peri-implant disease. The treatment methods have not yet clear and secure, thus means for preventing the deposition of biofilm and inhibit bacterial growth must be developed and implemented to prevent failure of implants. The aim of this study was to evaluate the effectiveness of a new nanoparticulate antimicrobial - vanadate silver (AgNO3) in different concentrations (2.5%, 5% and 10%), applied as a surface film on different substrates suggested for devices of Implantology. The materials polyacetal teflon and acrylic resin and vehicles enamel / glaze were selected for the application of nanocomposite. Analyzes of the physical properties surperficial roughness and superficial hardness Rockwell, as well as images obtained by scanning electron microscopy (SEM) were used to assess the strength and structural changes of the groups and therefore the feasibility of clinical application. A microbiological method for the analysis of inhibition zone shows growth inhibition on the bacterias P. aeruginosa, E. coli, S. mutans, E. faecalis and S. aureus; while the anaerobic bacteria P. gingivalis and P. intermedia and the yeast C. albicans has not been demonstrated antibacterial activity of AgNO3. The type of substrate used and the vehicle for the application of AgNO3 did not influence the results, with the exception of S. aureus with highest diameter of inhibition zone when applied with glaze compared to enamel (p<0.05). The proportion of the nanocomposite showed influence on the results, 10% proved the most effective in all bacteria, and generally no statistical difference in the proportion of 5% (p<0.05). Although smaller proportions sometimes do not show antimicrobial activity, these caused minor change in the physical properties of materials. The ratio of AgNO3 was proportional to the increase of roughness and hardness. The substrates and film type did not influence the results of the surface roughness after applying the surface treatment (p>0.05), however the application of 10% of the nanocomposite caused surface alteration more significant (7.02 ± 2.99 Ra) (p<0.05). In hardness was not found to significantly change with concentration of AgNO3 in the acrylic resin and the polyacetal (p> 0.05). However in teflon, 10% AgNO3 did not significantly alter the resistance values. Although the films do not influence the results, polyacetal substrate showed higher hardness with statistical difference with the other substrates (83.0 ± 10.2 HR15Yadaptado) (p <0.05). The SEM images proved superficial structural changes with the presence of more peaks and valleys compared to surfaces without antimicrobial treatment. In conclusion, despite 10% being the concentration of AgNO3 that reached the highest number of species, this concentration should be thought on its use, and evaluated in future studies on the feasibility of clinical use in accordance with changes in physical properties.

Made available in DSpace on 2014-06-11T19:28:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2000-04-17Bitstream added on 2014-06-13T20:17:45Z : No. of bitstreams: 1 shibli_ja_me_arafo.pdf: 739694 bytes, checksum: 57c9b17fc168fc0329fc6f5001a03672 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A microbiota presente na peri-implantite induzida por ligadura, em diferentes superfícies de implantes osseointegrados, foi analisada em 6 cães adultos machos. 36 implantes osseointegrados (9 Ticp: titânio comercialmente puro; 9 TPS: titânio plasma spray; 9 HA: hidroxiapatita; 9 superfícies tratadas com ácidos) foram inseridos e distribuídos igualmente 3 meses após exodontia de todos os pré-molares inferiores. Após um período de 3 meses de osseointegração, os implantes receberam os cicatrizadores. Decorridos 45 dias de cicatrização, amostras peri-implantares foram colhida, utilizando pontas de papel, no período 0 e após a colocação de ligaduras com fio de algodão, nos períodos 20, 40 e 60 dias. A contagem total de microrganismos (CTM) e a proporação de A. actinomycetemcomitans, Bacteroides forsythus, P. gingivalis, P. intermedia, Campylobacter sp, Capnocytophaga sp., Fusobacterium sp., Peptostreptococcus micros, bastonetes anaeróbios Gram-negativos, Streptococcus beta-hemolíticos, Eikenella corrodens e Candida sp. foram analisadas. Não houve diferença da CTM entre as diferentes superfícies (p>0,05). A Pg não foi detectada no tempo 0; nos tempos 20 e 40 foi detectada em 12 implantes (4 Ticp, 4 HA, 2 TPS e 1 Sup. Trat. com ácidos) e no período 60 dias, em 9 (2 Ticp, 3 HA, 2 TPS e 1 Sup. Trat. com ácidos), tendo menor afinidade à superfície tratada com ácidos. Pi foi detectada em 5 implantes (2 Ticp, 2 HA e 1 Sup. Trat. com ácidos) no período 0 e em 100% dos implantes nos demais períodos. Fusobacterium sp. foi detectado em todos os períodos, tendo uma maior afinidade à HA. Streptococcus beta-hemolíticos foi detectado em 6 implantes (3 Ticp, 1 TPS e 2 HA) no período 0 e 30, 26 e 24 implantes respectivamente nos períodos 20, 40 e 60. Campylobacter sp. e Candida sp. foram detectadas em baixas proporções. Os demais microrganismos não... . / The microbiota associated with ligature-induced peri-implantitis, in different dental implants surfaces, was investigated by cultivation on enriched non-selective and various selective solid media, in 6 mongrel dogs. 36 dental implants (9 Ticp: titanium commercially pure; 9 TPS: titanium plasma spray; 9 HA: hidroxiapatite; 9 surfaces acid-etched) were placed in a similar distribution in all dogs 3 months after extraction of all premolars in mandible. Following a healing period of 3 months, healing abutments were installed and 45 days after cotton ligatures were placed and oral-cleaning procedures abolished for 2 months to induce vertical bone loss of about 40%. Microbial samples were with paper points on day of ligature placement and after 20, 40 and 60 days. The total number of cultivable bacteria and proportions of A. actinomycetemcomitans, Bacteroides forsythus, P. gingivalis, P. intermediate, Campylobacter sp., Capnocytophaga sp., Fusobacterium sp., Peptostreptococcus micros, Enteric Gram-negative rods, beta-hemolytic Streptococcus, Eikenella corrodens and Candida sp. were analyzed. No significant microbiological differences were observed among the different surfaces (p>0,05). Pg was not detected in the time 0; already in the times 20 and 40 were detected in 12 dental implants (4 Ticp, 4 HA, 2 TPS and 1 acid-etched surface) and in the period 60 days, in 9(2 Ticp, 3 HA, 2 TPS and 1 acid-etched surface), tends smaller affinity to eh surface with acids-etched surface. Pi was detected in 5 implants (2 Ticp, 2 HA and 1 acid-etched surface) in the period 0 and in 100% of implants in other periods. Fusobacterium sp. was detected in all the periods, tends a larger affinity to HA. Beta-hemolytic Streptococcus was detected in 6 implants (3 Ticp, 1 TPS and 2 HA) in the period 0 and 30, 26 and 24... (Complete abstract, click electronic address below).

Made available in DSpace on 2014-06-11T19:28:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2000-04-26Bitstream added on 2014-06-13T20:27:59Z : No. of bitstreams: 1 martins_mc_me_arafo.pdf: 1209084 bytes, checksum: 7b11e93ab4898fd54b0df7617be967e1 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Foram avaliados, clínica e radiograficamente, as reações de quatro diferentes superfícies de implante frente ao desenvolvimento e progressão da peri-implantite: Ticp: titânio comercialmente puro; TPS: titânio revestido com plasma spray de titânio; HA: hidroxiapatita; Ost. Superfícies tratadas com ácidos. Para tanto, foram utilizados seis cães, cujos pré-molares inferiores e superiores foram extraídos. Decorridos 90 dias, os implantes foram aleatoriamente colocados, e iniciou-se o controle químico e mecânico do biofilme bacteriano; após o período de osseointegração (90 dias) foram colocados os conectores, e após 45 dias da colocação dos conectores, iniciou-se a indução da peri-implantite por meio de ligaduras de fio de algodão (suspensão do controle do biofilme bacteriano), e os primeiros exames clínicos (profundidade de sondagem, sangramento à sondagem, índices de placa e sangramento, e mobilidade) e radiográficos (perda óssea) foram realizados. Esses parâmetros foram novamente avaliados após 20, 40 e 60 dias, quando da troca das lidaguras. A análise dos resultados não demonstrou diferença significante entre as superfícies, em nenhum dos parâmetros analisados, com exceção da mobilidade (avaliada pelo PeriotestÒ) e perda óssea, que foram menores nos implantes TPS. Concluiu-se que as superfícies apresentam comportamento semelhante durante a indução da peri-implantite, com exceção no parâmetros mobilidade e perda óssea, que apresentaram os implantes TPS com comportamento superior. / The reactions of four different implant surfaces were evaluated in regard to the development and progression of peri-implantitis: titanium commercially pure (Ticp), titanium plasma spray (TPS) hidroxiapatite coated (HA) and acid attached surfaces (Ost). Six dogs had their premolars extracted. After 90 days, the implants were ramdonly placed and the dogs receive soft diet, chemical and mechanical plaque control; after the osseointegration period (90 days), the healing abutments were placed. After the healing period (45 days), the plaque control was suspended, and cotton ligatures were installed when the first clinical (probing depth, bleeding on probing, plaque index, bleeding index, and mobility) and radiographic (bone loss) exams were taken. These parameters were re-exanimate after 20, 40 and 60 days, when the ligatures were changed. The results did not show significant differences between the surfaces in any parameter observed except for the mobility (evaluated with PeriotestÒ), and bone loss. These two parameters had the TPS surface with the lower rates. It was conclude that the surfaces show similar behavior during the induction of peri-implantitis, except for the mobility and bone loss parameters witch the TPS implants had better behavior.

Purpose: This practice-based cross-sectional study aimed to investigate whether common risk indicators for peri-implant diseases were associated with peri-implant mucositis and peri-implantitis in patients undergoing supportive implant therapy (SIT) at least 5 years after implant restoration. Methods: Patients exclusively restored with a single implant type were included. Probing pocket depth (PPD), bleeding on probing (BOP), suppuration, and radiographic bone loss (RBL) were assessed around implants. The case definitions were as follows: peri-implant mucositis: PPD ≥4 mm, BOP, no RBL; and peri-implantitis: PPD ≥5 mm, BOP, RBL ≥3.5 mm. Possible risk indicators were compared between patients with and without mucositis and peri-implantitis using the Fisher exact test and the Wilcoxon rank-sum test, as well as a multiple logistic regression model for variables showing significance (P<0.05). Results: Eighty-four patients with 169 implants (observational period: 5.8±0.86 years) were included. A patient-based prevalence of 52% for peri-implant mucositis and 18% for peri-implantitis was detected. The presence of 3 or more implants (odds ratio [OR], 4.43; 95 confidence interval [CI], 1.36–15.05; P=0.0136) was significantly associated with an increased risk for mucositis. Smoking was significantly associated with an increased risk for peri-implantitis (OR, 5.89; 95% CI, 1.27–24.58; P=0.0231), while the presence of keratinized mucosa around implants was associated with a lower risk for peri-implantitis (OR, 0.05; 95% CI, 0.01–0.25; P<0.001). Conclusions: The number of implants should be considered in strategies to prevent mucositis. Furthermore, smoking and the absence of keratinized mucosa were the strongest risk indicators for peri-implantitis in patients undergoing SIT in the present study.:1. Einführung 1.1 Definition und Erkrankungen peri-implantärer Gewebe 1.2 Prävalenz peri-implantärer Entzündungen 1.3 Einfluss- bzw. Risikofaktoren 1.4 Prävention peri-implantärer Erkrankungen 1.5 Zielsetzung und Fragestellung 2. Publikationsmanuskript 3. Zusammenfassung der Arbeit 4. Literatur 5. Wissenschaftliche Präsentationen 6. Darstellung des eigenen Beitrags 7. Erklärung über die eigenständige Abfassung der Arbeit 8. Danksagung

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