Preservação em próteses implantossuportadas: peri-implantite / reservation in implant-supported prostheses: Peri-implantitis

Resumo: A identificação e o tratamento da infecção ao redor do implante é uma etapa essencial na manutenção do implante osseointegrativo e isso reflete na vida útil da reabilitação. O principal objetivo do tratamento da peri-implantite é a utilização de métodos de descontaminação mecânica e química para eliminar a carga bacteriana na superfície do implante. O biofilme pode ser removido por métodos não cirúrgicos ou cirúrgicos. Nos casos mais graves, geralmente é necessário tratamento cirúrgico, cujo objetivo é corrigir o defeito ósseo existente, combinado com a aplicação do enxerto, para regenerar o tecido ósseo perdido no processo inflamatório. O propósito deste estudo é realizar uma revisão de literatura tendo como o tema preservação em próteses implantossuportadas: peri-implantite, a fim de guiar a conservação das reabilitações orais. Além de buscar maiores informações acerca do desenvolvimento da doença peri-implantar, bem como sua ligação com a doença periodontal e os fatores que contribuem para seu desenvolvimento. Para tanto, foram utilizados descritores como: “peri-implantite", "manutenção de implantes" e “ossointegração” nas bases de dados: Pubmed, Scielo, google acadêmico e Lilacs. Para possibilitar um melhor resultado, foram organizados tópicos para uma discussão final, sendo eles: conceito, etiologia, diagnóstico e tratamento. Foram encontradas dificuldades na manutenção dos implantes e a necessidade de se descrever o melhor planejamento para uma melhoria nos protocolos clínicos de preservação a fim de obter-se excelência nos desfechos clínicos.Abstract: The identification and treatment of infection around the implant is an essential step in the maintenance of the osseointegrative implant and this reflects on the lifetime of the rehabilitation. The main objective of peri-implantitis treatment is the use of mechanical and chemical decontamination methods to eliminate the bacterial load on the implant surface. Biofilm can be removed by non-surgical or surgical methods. In more severe cases, surgical treatment is usually necessary, the aim of which is to correct the existing bone defect, combined with the application of a graft, to regenerate the bone tissue lost in the inflammatory process. The purpose of this study is to conduct a literature review with the theme of preservation in implant-supported prostheses: peri-implantitis, in order to guide the conservation of oral rehabilitations. In addition to seeking more information about the development of peri-implant disease, as well as its connection with periodontal disease and the factors that contribute to its development. For this purpose, descriptors such as: “peri-implantitis”, “implant maintenance” and “bone integration” were used in the following databases: Pubmed, Scielo, academic Google and Lilacs. final discussion, namely: concept, etiology, diagnosis, and treatment. Difficulties were found in the maintenance of implants and the need to describe the best planning for an improvement in clinical preservation protocols in order to obtain excellence in clinical outcomes. Plaque control maintains the health of the soft tissue-implant interface.Keywords: Dental implants; Peri-implantitis; Bacterial plaque.

The Effect of Extrinsic Factors on the Mechanical Behavior and Structure of Elastic Dental Ligatures and Chains

Force provided by elastomers used in orthodontics can be affected by several factors present in the oral cavity. The aim of our study was to investigate the role of mouthwashes, toothbrushing, and smoking in the force decay of such elastomers. Tensile strength, changes in the force continuously exerted, and force decay of elastic chains (Ortho Organizer and Masel Short Power Chain) and elastic ligatures (Dentaurum and Masel) by two separate manufacturers were measured. Measurements were initially made on untreated elastics, followed by exposure to different environmental factors including cigarette smoke, toothbrushing (mechanical plaque control), and two different mouthwashes (chemical plaque control). Changes on the surface of the elastics were studied with scanning electron microscopy (SEM). Untreated Masel elastic ligature showed lower tensile strength than Dentaurum elastic ligature (2339 cN vs. 3660 cN), while significantly higher tensile strength was measured for Ortho Organizer elastic chains than Masel chains (2639 cN vs. 1324 cN). The decrease in the elastic force of Masel ligature was greater in response to all external factors compared to Dentaurum. Although brushing with toothpaste and toothbrush impacted the force of both Masel and Ortho organizer ligatures negatively, force degradation was more apparent in the case of the Ortho organizer. Surface changes were more visible when applying Curasept mouthrinse, however force decay was higher in the Corsodyl group. Mechanical and chemical plaque control can influence the tensile strength and force decay of orthodontic elastomers, which should be considered by selecting the elastomers or determining their changing interval for the practice.

Analysis of the Effect on Denture Base Metal of Cleaning with Denture Cleanser Using the Quartz Crystal Microbalance Method

Denture plaque control for the prevention of aspiration pneumonia is very important. The pellicle is the major cause of denture plaque adhesion. Few basic studies have evaluated the effectiveness of denture cleansers for pellicles composed of salivary proteins. The adhesion of salivary proteins formed on denture base metal and the removal rate were quantitatively analyzed using the QCM method after denture cleanser injection. This is the first study to compare the cleaning effects of denture cleanser on denture base metal using the QCM method. Au and Ti sensors were employed as the denture base metals. Albumin was used for the adsorption of salivary proteins. The results showed that no significant difference was found between Au and Ti in the amounts of albumin adsorbed, and the rate of albumin removal from Ti was significantly higher than that of Au. In this study, the cleaning effectiveness of denture cleanser was confirmed based on the adsorbed amount and the removal rate of salivary proteins adsorbed onto denture base metals. Thus, the QCM method was suggested to be a useful tool for removing the effects of salivary proteins from denture cleaning agents on denture base metal.

Adjunctive Effect of Green Tea Mouthwash Prepared at Different Steeping Temperatures on Gingivitis: A Triple-Blind Randomized Controlled Clinical Trial

Purpose: To compare the effect of green tea mouthwashes prepared at different steeping temperatures as adjuncts to mechanical plaque control on gingivitis. Methods: Forty-five women with gingivitis participated in this 4-week randomized controlled clinical trial. They received professional mechanical plaque control and rinsed daily with either warm green tea, hot–cold green tea or placebo. Dental plaque control record (PCR) and gingival bleeding indices (GBI) were recorded at baseline and 7, 14 and 28 days after. Results: Participants’ mean age was 20.7 ± 2 years. The mean scores for the PCR and GBI at baseline were 82.4 ± 19 and 85.8 ± 7, respectively. All groups showed significant reduction in PCR and GBI between Days 0 and 28 (p < 0.01). No significant differences in PCR were observed between the groups at any of the examinations (p > 0.01). The warm green tea group demonstrated significantly lower GBI at all examinations compared to the hot–cold group (p < 0.01). Conclusions: Within study limits, green tea-made mouthwashes significantly reduced plaque and gingivitis when used as adjuncts to mechanical plaque control. The green tea mouthwash prepared in warm water demonstrated significantly higher efficacy in lowering gingivitis compared to that prepared in hot water followed by ice.

Tooth Loss During Supportive Periodontal Care in a Strict Non-surgically Treated Cohort – a Retrospective Data Analysis

Background: This retrospective study aimed to evaluate tooth loss (TL) within a strict non-surgically treated patient cohort after supportive periodontal care (SPC) of 2.5-10.7 years.Methods: Data for non-surgically treated patients were checked for: complete periodontal examination data at baseline (T0), after active periodontal therapy (T1), and after ≥2.5 years of SPC (T2); Smoking, diabetes mellitus, age (at least 18 years), plaque and gingival indices, bleeding on probing (BOP), percentage of residual pockets, SPC adherence, and number of SPCs were assessed as risk factors for TL.Results: 132 patients were included (76 female, mean age 56.7±10.3 years), mean T1–T2: 4.5±1.6 years. 26.5% of all patients lost 118 teeth (0.5 teeth/patient, 0.12 teeth/patient/year). Plaque and bleeding parameters: mean plaque control record (PCR): 59.77±28.07%, mean papilla bleeding index (PBI): 47.46±34.12%, mean BOP: 33.46±21.52%. SPC duration (p=0.013) and T2 BOP (p=0.048) were identified as patient-related risk factors for TL.Conclusion: The strictly non-surgical approach within the reported cohort was characterized by elevated BOP, PBI, and PCR scores, possibly highlighting the lack of surgical intervention and regular SPC as negative effect. An apparently low TL rate could be observed. Duration of SPC and BOP (T2) were identified as risk factors for TL.

Effects of health-promoting school strategy on dental plaque control and preventive behaviors in schoolchildren in high-caries, rural areas of Taiwan: a quasi-experimental design

Background We evaluated the effects of health-promoting school (HPS) strategy on plaque control and behavior change in high-caries schoolchildren in Taitung, Taiwan. Methods A quasi-experimental design was adopted; six intervention schools (intervention group [IG]) and six comparison schools (comparison group [CG]) were selected from elementary schools with higher-than-average caries rates (> 68%). The IG was selected using cluster sampling, and the CG was selected to match the IG. In total, the IG and CG groups included 166 and 174 children each. The selected schools implemented the HPS framework for 3 months in the 2019 academic year. An oral examination of dental plaque was administered, and a self-administered questionnaire regarding knowledge, attitude, self-efficacy, and behaviors was distributed at baseline and at 2-week follow-up. A linear and logistic regression model using generalized estimating equations (GEEs) was used to analyze the differences between baseline and the follow-up data. Results Compared with the CG, the IG had a greater reduction in plaque index among second graders (β = − 0.36) and plaque control record scores among second, fourth, and sixth graders (β = − 27.48, − 26.04, and − 18.38, respectively). The IG also exhibited a greater increase at follow-up with respect to oral health–related knowledge among second graders and fourth graders (β = 1.46 and β = 0.92, respectively), attitude toward oral hygiene behaviors among sixth graders (β = 1.78), and self-efficacy regarding flossing for sixth graders (β = 1.43). Sixth graders in the IG were significantly more likely to brush before sleeping (adjusted odds ratio [aOR] = 2.99) and use fluoride toothpaste (aOR = 5.88) than those in the CG. Conclusions The HPS strategy was effective in reducing dental plaque and promoting preventing behaviors in rural high-caries schoolchildren.

A 10 Day Tooth Brushing Pilot Study- Report

A major dental problem in persons with mental retardation/developmental disabilities is poor dental hygiene resulting in poor plaque control which leads to gingivitis, periodontal disease and dental caries. The most obvious reason for poor oral hygiene of such persons is their inability to clean the oral cavity adequately. Caregivers face many challenges in providing good oral care for such individuals. The electric toothbrush has been shown to be effective in plaque removal and gingivitis in both healthy and disabled/ special needs people. They are more superior at removing plaque and reducing gingivitis in both short- and long-term clinical trials. This study assessed the effectiveness of using electric toothbrushes as a means of plaque control in a 10-day pilot program. It was implemented as part of a life skills program at a special needs school in South Auckland. A total of 11 children participated in the program. Informed consent was obtained from parents/caregivers prior to the study. Electric toothbrushes and toothpastes were provided by the author of the study along with and oral hygiene instructions to the teachers/caregivers. The study was evaluated by comparing photos of the teeth before and after the pilot study. Plaque disclosing tablets were used to aid this process as it dyes the plaque making it visible to the eyes. Evaluation /feedback forms were also completed by teachers/caregivers of the special needs unit to ascertain the efficacy of the program. The findings of the study showed that using electric toothbrushes improved both the general plaque distribution and boosted children’s motivation to brush their teeth. The conclusion drawn from this study indicates that while electric toothbrushes are effective at plaque control, a longer intervention period is postulated to obtain clinically significant results or see a significant change in behavior.

Effect of Pudilan Keyanning antibacterial mouthwash on dental plaque and gingival inflammation in patients during periodontal maintenance phase: study protocol for double-blind, randomised clinical trial

IntroductionPlaque control plays a critical role in the prevention and treatment of periodontitis. Antibacterial mouthwash is one of the most important tools for plaque control. Pudilan, including extracts of Scutellaria baicalensis root, Taraxacum mongolicum, Bunge corydalis herb and Isatis indigotica, was reported playing the role of anti-inflammatory and anti-bacterial. However, its effect on dental plaque and periodontal inflammation remains unknown. We aimed to assess the efficacy of Pudilan Keyanning antibacterial mouthwash which contains the active essence of Pudilan and 0.03%–0.06% cetylpyridinium chloride, as well as Pudilan active essence for plaque control and gingival anti-inflammation in patients during periodontal maintenance phase.Methods and analysisIn this double-blind, randomised, placebo-controlled clinical trial, a total of 120 participants during periodontal maintenance phase will be enrolled. After supragingival scaling, they will be randomly assigned into three groups in a 1:1:1 ratio: the Pudilan Keyanning antibacterial mouthwash group, a chlorhexidine acetate mouthwash (0.12%) group or a placebo group with mouthwash containing the same components as the Pudilan Keyanning mouthwash except for Pudilan active ingredients. They will rinse with mouthwash, respectively, two times per day for 6 weeks. Clinical parameters (such as plaque index, bleeding index) and the level of volatile sulfide in the breath will be measured and analysed. The subgingival plaque will be collected and analysed microbiologically. Questionnaire feedback will be analysed.Ethics and disseminationThe study protocol (V.4) was reviewed and approved by the Medical Ethical Committee of Peking University School and Hospital of Stomatology (Ethics Approval No. PKUSSIRB-201950153b). All participants signed a written consent form.Trial registration numberChiCTR2000041253.