Microbial contamination dynamics in surgical treatment of patients using dental implants in a limited bone tissue volume

Author(s):  
A.M. Tsitsiashvili ◽  
A.M. Panin ◽  
Ye.N. Nikolayeva ◽  
A.A. Arutyunyan ◽  
M.S. Podporin ◽  
...  

The aim of the study was to evaluate the effectiveness of antibiotic chemotherapy regimens and the dynamics of the nature of microbial associations of the operating area at the surgical stages of treatment of patients using dental implants in conditions of limited bone tissue. The study involved 37 patients (17 m and 20 w, from 32 to 68 years). According to the tactics of the treatment and the type of antibacterial effect, the patients were divided into 3 groups. Per os was prescribed antibiotics as a step therapy: amoxicillin (flemoxin 500 mg 1 tablet 2 per day for 7 days) and amoxicillin / clavulanate (flemoclav 625 mg 1 table 2 per day 7 days), doxycycline (unidox 100 mg 1 table 1 per day 5 days). The 1st group of patients (n1=12; 31.9%) — a multi-stage approach (MA), where the 1st operation is bone grafting (BG) (Flemoxin 500 mg), after 6—9 months, the 2nd dental implantation (DI) (flemoklav 625 mg), after 3—6 months the 3rd — installation of gingival formers (GF) (unidox 100 mg). The 2nd group of patients (n2=14; 36.2%) — a one-stage approach (OA), where the 1st operation is BG with simultaneous DI (flemoxin 500 mg), after 6—9 months — the 2nd — installation of GF (flemoklav 625 mg). 3rd group — narrow/short implants (N/S) without BG were installed (n3=11; 31.9%). The 1st operation — DI (Flemoxin 500 mg), the 2nd — installation of GF (Flemoklav 625 mg). A bacteriological study with the identification of pure cultures of bacteria and determination of sensitivity to antibacterial drugs was performed for all patients before treatment and in dynamics. In MA, there was a suppression of the growth of certain types of bacteria and an increase in the number of species resistant to this antibiotic. In the framework of the OA, when prescribing antibiotics, the results were comparable. With N/S implants, growth inhibition of a number of species present at the beginning of treatment was noted. In multi-stage operations, we consider it reasonable to use beta-lactamase-protected drugs, or drugs of another group that include representatives of parodontopathogenic species and potential carriers of multiple resistance genes in their spectrum of action.

2020 ◽  
Vol 75 (5) ◽  
pp. 552-560
Author(s):  
Sergey Yu. Ivanov ◽  
Svetlana Yu. Kalinchenko ◽  
Nidjat A. Guseynov ◽  
Aleksander A. Muraev ◽  
Aigul Т. Safi ◽  
...  

Background.Due to the prevalence of Vitamin D deficiency as well as the frequency of reconstructive surgical interventions followed by dental implantation, the issue arises concerning the effect of Vitamin D on reparative regeneration of bone and osseointegration of dental implants.The purpose using literature data we are conducting an impact assessment of vitamin D on reparative regeneration of bone tissue, in particular, after oral reconstruction surgeries and dental implantation.Methods.Retrieval, systematization and analysis of scientific data on application of vitamin D supplementation and its effect on reparative regeneration of jaw bone tissue.The conclusions.For the most part, the positive effect exerted on reparative regeneration of jaw bone tissue and osseointegration of dental implants is due to the role of vitamin D in physiological processes evolving in bone tissue, namely maintenance of calcium and phosphate exchange through intestinal absorption and TNF, RANKL (Receptor activator of nuclear factor kappa-B ligand) and consequently differentiation of precursors to osteoclasts into osteoclasts through VDR stimulation (VitaminD Receptor) receptors for further osteogenesis. Also, according to literature data, FGF23 (Fibroblast Growth Factor) protein is a marker of osteoblasts differentiation into osteocytes, it is also known that FGF23 and 1,25(ОН)2D3 are genetically related. FGF23 is the main regulator of both phosphate exchange in bones and metabolism of vitamin D and its metabolites. Besides, indirect anti-inflammatory effect has been observed thanks to inhibition of pro-inflammatory cytokine secretion. Taking into account the abovementioned data, of particular relevance is the definition of serum concentration 25(ОН)D and development of schemes of vitamin D level pre-surgery correction in patients, who have to undergo oral reconstruction surgeries and dental implantation. Mass spectrometry is a promising diagnostic method for determining the level of vitamin D in a body, as it allows to identify the actual amount of vitamin D free from admixture of other steroid hormones. The introduction of this method into clinical practice will allow to monitor the level of vitamin D in patients, receiving reconstructive and rehabilitative treatment.


Author(s):  
Henrique Esteves Magalhães ◽  
Priscilla Janaína de Lima Borelli Bovo ◽  
Luciano Rodrigues Neves ◽  
Marcelo Henrique Batista Santos ◽  
Rogério Luiz de Araújo Vian ◽  
...  

Introduction: In recent years, procedures with the use of dental implants have increased worldwide, reaching approximately one million dental implants per year. In recent years, a platelet concentrate called FRP (fibrin-rich plasma) has been the subject of clinical studies. Associated with this, the biomaterial Bio-Oss® (Geistlich), as it is biodegradable, biocompatible, non-toxic, and has low immunogenicity, and bio stimulators can act in the regeneration of bone tissue, as it establishes with the cells the appropriate biological niche (favorable microenvironment) for bone growth. Objective: Therefore, the present study aimed to evaluate, through a brief systematic review, the results that involve bone formation for dental implantation, with the use of biomaterials such as fibrin-rich plasma and Bio-Oss®. Methods: The model used for the review was PRISMA. Was used databases such as Scopus, Scielo, Lilacs, Google Scholar, PubMed. Results: Fibrin-rich plasma (FRP) as an autologous biomaterial for use in oral and maxillofacial surgery presents most leukocytes, platelets, and growth factors, forming a fibrin matrix, with three-dimensional architecture. The Bio-Oss® biomaterial (Geistlich), as it is biodegradable, biocompatible, non-toxic, and has low immunogenicity and bio stimulators can act in the regeneration of bone tissue, since it establishes with the adenomatous mesenchymal stem cells the appropriate biological niche for bone growth and, thus, allowing the dental implant to be as effective as possible. Conclusion: The use of FRP associated with Bio-Oss® seems to illustrate high success rates with minimal costs, which may reduce the amount of bone graft needed to fill the sinus cavity, reducing the costs of the procedure.


Author(s):  
A. V. Ivaschenko ◽  
A. E. Yablokov ◽  
I. I. Markov ◽  
V. A. Monakov ◽  
A. M. Nesterov

Relevance. The most important condition for a successful result of dental implantation is high-quality osseointegration of dental implants. In the literature, the issue of the quality of osseointegration is widely covered, which directly depends on the primary stability of dental implants. In the area of bone tissue remodeling, surrounding the installed dental implants, there are permanent processes of bone resorption and its restoration [1][2].The aim is to reveal the reactivity of alkaline phosphatase and osteocalcin in the biological fluid (saliva) in patients after dental implants.Materials and methods. The collection and analysis of clinical material was carried out on the basis of the Clinics of the Samara State Medical University of the Ministry of Health of Russia. Dental implantation surgery was performed in 184 patients aged 32 to 65 years. The gender ratio was 2:3 (40 men and 60 women). The teeth were lost due to poor oral hygiene and caries complications.Results and discussion. At the time of admission of patients to the department of the Department of Prosthetic Dentistry of the Clinics of the Samara State Medical University of the Ministry of Health of Russia, the bulk of the patients had a low hygienic status. The OHI-S index averaged 2.74 ± 0.33 conventional units. (control – 0.50 ± 0.07 c.u.). In order to reduce the negative influence of microorganisms in the supra- and subgingival dental deposits, all patients underwent professional oral hygiene, as well as antimicrobial therapy. At the time of installation of dental implants, the average OHI-S and Müllemann-Cowell index was 0.72 ± 0.06 and 0.57 ± 0.06 conventional units, respectively.Conclusions. 1. The increase in the titer of alkaline phosphatase and osteocalcin during dental implantation is not statistically significant. 2. TCRF in the oral fluid (saliva) exhibits maximum activity by the 14th day, exceeding the initial three times. This indicator remains at an increased level in the period up to six months from the beginning of the operation. 3. Revealing the values of the TRKF titer after the operation of dental implantation is advisable to use as an assessment of the state of trophic processes occurring in the bone tissue.


2021 ◽  
Vol 9 (4) ◽  
pp. 583-588
Author(s):  
Igor’ A. Moldovanov ◽  
◽  
Anna V. Podoprigora ◽  
Generik G. Adamyan ◽  
Mikhail A. Kryuchkov ◽  
...  

INTRODUCTION: The industry of temporary prosthetics for dental implantation in the postoperative period at the present stage of the development of dentistry has achieved significant results. However, up to now, there are still cases of insufficient effectiveness of temporary prosthetics, which is expressed in a reduced service life and a violation of the retention of temporary structures, the need for a relatively large number of corrections of their basis, as well as inflammatory and atrophic changes in the mucous membrane of the prosthetic bed and loss of bone tissue in the jaws in the projection of the mechanical pressure of the prosthesis. AIM: To determine the effectiveness of the use of polyetheretherketone for the manufacture of immediate prostheses based on temporary dental implants. MATERIALS AND METHODS: Dental implants in the upper jaw were installed in 76 patients with a diagnosis of full absence of teeth. For temporary rehabilitation for the period of osteointegration, temporary implants were installed in the amount of 2 pieces and temporary removable dentures were made. RESULTS: The use of polyetheretherketone revealed a 25% decrease in dentures breakdowns, an increase in the number of temporary implants viability by 37.5%, and a decrease in bone tissue atrophy by 19% to 22%. CONCLUSIONS: It is advisable to use polyetheretherketone for the manufacture of removable implant dentures.


2018 ◽  
pp. 38-42 ◽  
Author(s):  
S.P. Rubnikovich ◽  
I.S. Khomich

The aim was to study the nature of the morphological changes over time in the bone tissue around the implants under the influence of low-intensity pulsed ultrasound in the experiment. Materials and methods. Experimental studies were carried out on rabbits of the chinchilla breed, with dental implants installed in the tibia – two experimental groups with ultrasound and one control group. The animals were withdrawn from the experiment at 1, 2, 4 and 8 weeks and histological examination of the sections of peri-implant tissues was carried out. Results. The processes of osseointegration of dental implants in all groups of animals occurred without disrupting the normal process sequence. In the early stages granulation tissue is formed, later it is replaced by fibrous-reticular and coarse-fibrous bone tissue, and at the end – by a more mature lamellar bone tissue. However, the timing and degree of maturation of bone tissue, as well as osseointegration of implants in groups using low-frequency low-intensity pulsed ultrasound and without it differed significantly. The study showed that ultrasound exposure to implants and surrounding tissues induces osteoreparation processes, stimulating neoangiogenesis in granulation and newly formed bone tissue. Conclusion. Application of ultrasound to implants and subsequent application to the peri-implant tissues during and after dental implantation promotes the formation of bone tissue, identical by the histostructure to the maternal bone.


2021 ◽  
Vol 105 (1) ◽  
pp. 82-87
Author(s):  
O. Doroshenko ◽  
◽  
O. Bida ◽  

Resume. The high prevalence of periodontal disease causes the urgency of finding ways to improve methods of diagnosis, treatment and prevention of complications of this disease. The complex clinical picture requires a differentiated approach to the choice of orthopedic rehabilitation of such patients taking into account the patient's age, degree of pathological changes and activity of the pathological process with mandatory immobilization of movable teeth by different types of splints and splint dentures. Depending on the degree of pathological changes in periodontal tissues, the size and topography of dentition defects and the severity of destructive-resorptive processes in the alveolar bone, the replacement of dentition defects should be planned using dental implants and splinttype dentures. The aim of the study. Improving the effectiveness of orthopedic treatment of periodontal diseases, burdened by defects of the dentition through the differentiated use of dental implants and splinting structures. Materials and methods. A comprehensive clinical and laboratory examination of 237 patients with clinically diagnosed periodontitis I–III degree, burdened by partial loss of teeth. From the specified contingent of persons we carried out orthopedic treatment of 98 patients aged from 30 to 69 years with periodontal diseases of various severity, aggravated by defects of dentitions of various size and localization. Cone-beam computed tomography was used for objective quantitative and qualitative assessment of periodontal tissue and bone tissue of the edentulous jaw in individuals with various clinical forms of periodontal disease, to determine the relative densitometric density of bone tissue, when planning dental implantation and for control its results. The localization of supracontacts was determined by occlusion. Diagnosis and elimination of traumatic occlusion were performed according to Jenkelson and Schuller [3]. Evaluation of the stability of dental implants was performed by frequency – resonance analysis of the stability of dental implants using the Osstell ISQ device. Results. According to the results of examination of 237 people and the division of patients into three age groups, the clinical features of the pathological process in the age aspect were established. The results of computed tomography of the dental apparatus of the subjects showed that periodontal disease in the age aspect in the dynamics is accompanied by the severity of destructive-resorptive processes in the alveolar bone, which are manifested in a decrease in the relative densitometric density of bone marrow and bone loss. Orthopedic rehabilitation of this contingent of persons was performed with the use of biologically indifferent structural materials and splinting orthopedic structures, including splinting of abutment teeth, removable prosthetics and dental implantation, as well as accompanying physiotherapy of prostheses. In the case of periodontitis of I–II degree with sufficient volume and density of bone tissue in the area of the dentition defect, high clinical efficacy was shown by the use of dental implantation in the case of gradual loading of the dental implant using a superstructure of own development. In the presence of medium and large defects of the dentition on the background of periodontitis II–III severity in the presence of significant pathological mobility of abutment teeth and insufficient volume and density of bone tissue in the area of the defect sufficient clinical effectiveness showed the use of removable dentures own design. Conclusions. Periodontal diseases in the age aspect in the dynamics are accompanied by pronounced destructive-resorptive processes in the alveolar bone, which are manifested by a decrease in the relative densitometric density of bone tissue and progressive loss of height of the alveolar process. Timely application of dental implantation due to the dosed gradual occlusal load on the alveolar bone helps to preserve the structure of the alveolar bone and the height of the alveolar process. In the presence of medium and large defects of the dentition on the background of periodontitis II–III severity in the presence of significant pathological mobility of abutment teeth and insufficient volume and density of bone tissue in the area of the dentition defect, the use of removable dentures of splinttype design is shown. To prevent complications of prosthetics and prolong the use of orthopedic structures, it is advisable to use photodynamic maintenance therapy. Key words: periodontal tissue disease, dentition defect, dental implantation, splint-type denture.


2021 ◽  
pp. 21-27
Author(s):  
Yu.O. Kinash ◽  
L.V. Kinash

Today, despite the progress made in dental implantology, the problem of rehabilitation of patients with significant bone atrophy in parodontal diseases has not been fully studied. The study aims to review the current views of various authors on the aetiology and treatment of parodontal diseases, which caused multiple tooth loss and bone atrophy in patients with occlusal pathology, based on the literature sources of scientific and medical information. Object and methods of study. Analytical study of scientific and medical literature on the treatment of multiple and partial tooth loss in patients with parodontal diseases in bone atrophy with impaired jaw relationships and orthopaedic rehabilitation using dental implantation and methods of bone augmentation of the mandible and maxilla. The use of implants in orthopaedic treatment expands the possibilities of using fixed prostheses, satisfying patients functionally and aesthetically. In case when the preservation of teeth becomes impossible or impractical to ensure proper treatment of the patient, they can be removed and replaced with dentures on dental implants. According to Misch C. [6], the masticatory load, which is exerted on the bone tissue of the jaws by an implant, increases the density of the bone structure. When teeth are lost due to parodontitis, there is atrophy of the alveolar ridge and a change in the structure of bone tissue, which is characterized by an increase in the porosity of the cancellous bone [4;5;7]. Sufficient bone volume and density in the area of the planned implantation are the main and important parameters for achieving normalized primary implant stabilization [11]. Partial and complete loss of teeth, as well as parodontal diseases, are always accompanied by the bone tissue of alveolar bone tissue of varying severity [1;4;5;13]. Signs of parodontal diseases in dentition defects are always more pronounced than in intact dental arch. The disease progresses rapidly, the dentition is destroyed if appropriate occlusal therapy is not performed [13;14]. Systemic factors and comorbidities in patients also play a significant role in reducing the bone volume of the jaws. The relationship between decreased bone density and age-related hormonal changes in women, as well as at the gender level, has been studied. Thus, women have changes in bone architecture and less dense arrangement of trabeculae in the jawbones than men [15].Bone tissue has a distinguishing feature – loss of multiple teeth or parodontal diseases lead to a redistribution of functional load, which causes its resorption [7;20]. In this regard, tooth extraction inevitably leads to a decrease in bone volume. The success of dental implantation on the maxilla became partially possible due to the introduction of sinus lifting with the use of osteoplastic materials [12;20;21]. According to some scientists[21], the autogenous bone graft is the gold standard in regenerative processes due to its osteoinductive, osteoconductive, and osteointegration properties, which are necessary for the restoration of lost bone tissue. The use of dentin in human teeth as an autograft was first described in a clinical case report in 2003 [23]. In recent experiments, these materials have proven to be a real alternative to the bone graft. Thanks to the work of a group of researchers [23;24], significant efforts were made in the basic and clinical study to find the best bone graft material for osseointegration of implants in the maxillary sinus. The autogenous dentin graft (AutoBT; Korea Tooth Bank, Seoul, Korea) was first developed in 2008, and several clinical studies have praised the use of AutoBT in the sinus compared to other grafts. Given the current development of advanced technologies in dental implantation, dentists use navigation templates in their practice, which are made using CAD CAM technology to improve the quality of care for patients who have indications for dental implantation. New diagnostic approaches allow us to virtually plan, simplify, and speed up surgery, to ensure accuracy. Thanks to this technology, dentists optimize the location of dental implants, taking into account the difficult conditions specific to patients with parodontal pathology.


Author(s):  
Nigman Lukmanovich Khabilov ◽  
Tatyana Olegovna Mun ◽  
Farkhodjon Komiljonovich Usmonov ◽  
Iskander Mukhamedovich Baybekov

The widespread introduction of dental implant in the dental practice will determine progress and the future of prosthetic dentistry. At the same time, like any new direction dental implantation has generated a lot of questions and unsolved problems. On many of these issues and problems can be answered only by using morphological methods. Therefore, after the development of a new construction of the dental implant one of the main issues was the question of its interaction with the jawbone and soft tissues of the oral cavity.We performed the experiment on 24 long snout dogs of both sexes, weighing 30-35 kg, with normal bite, at the age of 20-24 months. Animals were divided into 2 groups, according to samples of screw dental implants used in the experiment: basic group - 12 dogs in which were used samples of the new construction of dental implant “Implant.uz” (Uzbekistan); control group – 12 dogs in which were applied screw dental implant system “Dentium” (South Korea). Terms of derivation of animals from experiments were 1, 3, and 6 months.By using morphological techniques were studied implants “Implant.uz” from medical titanium BT-1.00 brand, their interaction with bone of alveolar ridge. “Implant.uz” did not cause pathological changes in the bone tissue of alveolar ridges of jaws and could be an alternative to known dental implants.


2017 ◽  
Vol 6 ◽  
pp. 28-35
Author(s):  
Galina Prots ◽  
Mykola Rozhko ◽  
Vasyl Pjuryk ◽  
Irina Prots

Aim: To Improve the treatment of patients with partial edentia and chronic generalized periodontitis by including dental implantation to the complex of therapeutic measures. Materials and methods: There have been presented the results of 240 patients with varying severity degrees of generalized periodontitis who underwent surgery on periodontal tissues with dental implantation. The research was conducted at the OCH of Ivano-Frankivsk 2007–2017.To improve the efficiency for dental implants and periodontal surgical intervention is necessary to determine the quality of bone remodeling, identifying markers of bone tissue metabolism. Results: It was established that in 40,81 % patients the results of research showed markers of bone remodeling indicating a high rate of bone formation (25,12±2,23 ng / ml) and a slight increase in rate of resorption marker, which results in low rates of bone resorption (8,54±1,23 nmol/L). These patients were not prescribed with osteotropic drugs. 50,83 % of patients with osteopenia were noticed to manifest the formation of bone possible raise of bone resorption (10.82±1.34n/mole), which was the indication for antiresorptive medication prescription. In 8,36 % of patients with osteoporosis was observed inhibition of bone formation processes (18,05±2,08 ng / ml) and increased resorption indices (15,34±1,87 nmol/L). Medications that stimulate osteogenesis and prevent bone resorption were prescribed. Conclusions: When planning dental implants and periodontal surgical intervention it is necessary to identify markers of bone remodeling to assess the structural and functional state of bone tissue and prescribe osteotrophic drugs that promote positive postoperative period.


Author(s):  
S. P. Rubnikovich ◽  
I. S. Khomich ◽  
Yu. L. Denisova

The article presents the results of a histological study of morphological changes in bone tissue around established dental implants after exposure to low-intensity, low-frequency ultrasound during dental implantation. Histological studies of tibia bone blocks were conducted in three groups of laboratory animals around installed dental implants, which were subjected to different modes of ultrasonic exposure. In the course of studies, it was found that the processes of osseointegration of dental implants in animals of all groups occurred without staging. In the early stages, granulation tissue was formed, which was subsequently replaced by reticulofibrotic bone tissue, and then by more mature lamellar tissue. The timing and degree of bone maturation, as well as the indicators of osseointegration in groups using low-intensity pulsed ultrasound and without it, were significantly different. It was shown that the ultrasound effect on peri-implant tissues induces osteoreparative processes, stimulating neoangiogenesis in granulation and newly formed bone tissue. It has been established that ultrasonic exposure of implants, and then peri-implant tissues during dental implantation, promotes the formation of bone tissue, the histostructure of which is similar to the histostructure of the maternal bone at earlier stages.


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