Aim: To assess whether the use of deproteinized bovine bone mineral (DBBM) and native bilayer collagen membrane (NBCM) improved healing of peri-implantitisrelated bone defects at 12 months. Materials and methods: In a multi-centre, randomized clinical trial, 32 individuals received surgical debridement (control group [CG]), and 34 received adjunct use of DBBM and NBCM (test group [TG]). Radiographic defect fill (RDF), probing pocket depth (PPD), bleeding on probing (BOP)
30 periodontally compromised adult subjects with mandibular buccal class II furcation defects were recruited for this study. All selected defects were treated according to the biological principles of guided tissue regeneration. The subjects were randomly assigned to 2 parallel groups. The test group (n=15) received a bioabsorbable polyglycolic-polylactic membrane (PGA/PLA group); the control group (n=15) received a non-resorbable expanded polytetrafluoroethylene membrane (ePTFE group). After initial therapy, baseline measurements were recorded including plaque index, gingival index, vertical and horizontal probing depths, clinical attachment level and depth of the recession. Recall visits were made at 1, 2, 4, 6, 8, 12, and 24 weeks. At 12 months, all baseline clinical parameters were again measured. The data analysis did not demonstrate a significant difference between the 2 groups. The vertical probing depth and attachment level changes were statistically significant in each group. The postoperative recession was 0.6 mm in the ePTFE group (p<0.05) and 0.8 mm (p<0.05) in the PGA/PLA group. Compared to the initial measurements, the mean changes in horizontal probing depth were 2.7 mm and 2.5 mm (p<0.001), corresponding to mean reductions of 41.5% and 40.9% for the ePTFE and the PGA/PLA groups respectively. The results of this study suggest that 12 months after initial surgery, similar clinical improvements can be obtained in GTR therapy of buccal class II furcation lesions, regardless of whether bioabsorbable PGA/PLA membranes or non-resorbable ePTFE membranes are used.
In implant dentistry, plaque control and oral hygiene practices are essential to limit the risk of complication and failure in the long term. All conditions around an implant in function that influence the load and pathogenicity of the microbiota are considered local risk indicators. They concern the prosthetic suprastructure design and the possibility for the patient to easily access each implant for plaque removal. Use of cemented prostheses should be limited to avoid excess cement acting as a foreign body and leading to peri‐implant disease. The crown margins should be supramucosal, and the connection should be precise to avoid a gap between the implant and the suprastructure. Every implant system is characterised by a specific design, surface texture and connection type. These features may influence peri‐implantitis development and progression, and the clinician should consider the risk of infection when selecting an implant. The soft‐tissue conditions around the implant, the width of keratinised mucosa, and the phenotype and thickness of the mucosa are also considered major risk indicators, as the presence of any mucosal defect around an implant can increase plaque accumulation and result in tissue inflammation. The pathogenicity of the microbiota around an implant is primarily dependent on pocket depth. Deep pockets around implants should be avoided and, if present, closely monitored and/or reduced. Proximity to natural teeth presenting endodontic and/or periodontal lesions may result in implant contamination, but the influence of the type of edentulism on perio‐pathogen presence is still unclear. These local conditions around an implant have a clear influence on peri‐implant diseases development and progression, but there is still only limited evidence regarding their role as true risk indicators.
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