The purpose of this controlled double-blind, parallel, randomized clinical study was to determine the effect of antiseptic mouthrinse on parameters important to dental implant maintenance. Plaque, peri-implant gingivitis, gingival bleeding, probing depth, and attachment level were assessed over a 3-month test period. Twenty healthy adult patients each of whom had at least two dental implants, a modified gingival index > 1.5, and a modified Quigley-Hein plaque index score > 1.7 were enrolled into the study. After a thorough oral prophylaxis, patients were randomly assigned to either the antiseptic mouthrinse or a 5% hydroalcohol placebo mouthrinse group and instructed to rinse twice daily for 30 seconds with 20 ml of their assigned mouthrinse as an adjunct to their usual oral hygiene procedures. The baseline examination included plaque index, gingival index, bleeding index, probing depth measurement, and attachment level measurements. The plaque and gingival indices were rescored at 1, 2, and 3 months. Probing depths, attachment levels, and bleeding index were determined again at 3 months only. At the end of 3 months, the antiseptic mouthrinse group had statistically significant reductions in plaque index, gingival index, and bleeding index compared to the placebo group. There were no significant differences between groups in probing depth or attachment level. The results of this clinical study indicate that twice daily use of an antiseptic mouthrinse may provide benefits in the maintenance of dental implants.

Periodontitis is a chronic inflammatory disease characterized by tissue destruction. In the diseased oral environment, saliva has primarily been considered to act as a protectant by lubricating the tissue, mineralizing the bones, neutralizing the pH, and combating microbes. To understand the metabolic role that saliva plays in the diseased state, we performed untargeted metabolomic profiling of saliva from healthy and periodontitic individuals. Several classes of biochemicals, including dipeptide, amino acid, carbohydrate, lipids, and nucleotide metabolites, were altered, consistent with increased macromolecular degradation of proteins, triacylglycerol, glycerolphospholipids, polysaccharides, and polynucleotides in the individuals with periodontal disease. These changes partially reflected the enhanced host-bacterial interactions in the diseased state as supported by increased levels of bacterially modified amino acids and creatine metabolite. More importantly, the increased lipase, protease, and glycosidase activities associated with periodontitis generated a more favorable energy environment for oral bacteria, potentially exacerbating the disease state.

Immediate loading of a single implant placed in a fresh extraction site in periodontally compromised patients resulted in similar bone gain and soft tissue esthetic outcomes compared to delayed loading. Primary closure and delayed loading to ensure bone regeneration around implants were not critical in this study.

Both the immediate and delayed loading of immediately placed implants showed similar outcome with regards to treatment success rates and stability of radiographic bone level. Submerging an immediately placed implant and primary soft tissue closure did not show significant outcome advantages over the transmucosal approach.

The aim of this investigation was to determine the relationship between loss of radiographic crestal bone height and probing attachment loss. As part of this aim, we are introducing a new method for determination of a threshold for significant probing attachment loss which takes into account the error contributed by alteration in tissue tone. 57 adults with established periodontitis were selected. Radiographs were taken using the Rinn alignment system. Crestal change was determined from bone height measurements on digitized images of pairs of radiographs using the "side-by-side" technique of analysis developed recently by us. Probing attachment loss was measured using the Florida electronic probe system. Radiographic and probing measurements were made at baseline and after 1 year. No treatment was given during this period. A direct and significant relationship was observed between radiographic bone loss and probing attachment loss on a site basis (p = 0.0001, r2 = 0.018) and between subject means (p = 0.0014, r2 = 0.16). Radiographic and probing attachment change at all categories of sites, dichotomously classified as to not changing or loosing indicated 13% of sites were loosing by measurement of radiographic change and 9.6% were loosing by measurement of attachment change. Concordance in radiographic and attachment level change was found in 82% of sites examined. The relative diagnostic import of change in probing attachment or change in radiographic bone height requires treatment outcome studies based on use of diagnostic information of the 2 measuring techniques used singly and in combination.