Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
권호 표지
DOI QR코드

DOI QR Code

Microbiological and clinical effects of enamel matrix derivative and sustained-release micro-spherical minocycline application as an adjunct to non-surgical therapy in peri-implant mucosal inflammation

  • Faramarzi, Masumeh (Department of Periodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences) ;
  • Goharfar, Zahra (Department of Periodontics, Urmia University of Medical Sciences) ;
  • Pourabbas, Reza (Department of Periodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences) ;
  • Kashefimehr, Atabak (Department of Periodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences) ;
  • Shirmohmmadi, Adileh (Department of Periodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences)
  • Received : 2015.03.01
  • Accepted : 2015.05.03
  • Published : 2015.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: The purpose of this study was to compare the microbial and clinical effects of mechanical debridement (MD) alone or in combination with the application of enamel matrix derivative (EMD) and sustained-release micro-spherical minocycline (MSM) for treatment of peri-implant mucosal inflammation (PIMI). Materials and Methods: Subjects with at least one implant with PIMI were included and divided into control and two different test groups. In all three groups, MD was performed. In the MSM group, following MD, MSM was placed subgingivally around the implants. In the EMD group, after MD, EMD was placed in the sulcus around the implants. Sampling of peri-implant crevicular fluid for microbial analysis with real-time polymerase chain reaction and recording of probing depth (PD) and bleeding on probing (BOP) were performed prior to as well as two weeks and three months after treatment. Median values and interquartile range were estimated for each variable during the various assessment intervals of the study. Results: In all groups, at two weeks and three months, the counts of Porphyromonas gingivalis decreased significantly compared to baseline. Levels of P. gingivalis were significantly reduced in MSM (P<0.001) and EMD (P=0.026) groups compared to the control group. Also, clinical parameters improved significantly at two weeks and three months. Reduction of PD was significant in MSM (P<0.001) and EMD (P<0.001) groups. The decrease in BOP in the MSM, EMD, and control groups was 60%, 50%, and 20%, respectively. Conclusion: The use of MSM and EMD can be an adjunctive treatment for management of PIMI and improves clinical parameters and reduces P. gingivalis burden three months after treatment.

Keywords

References

  1. Misch CE, Perel ML, Wang HL, Sammartino G, Galindo-Moreno P, Trisi P, et al. Implant success, survival, and failure: the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. Implant Dent 2008;17:5-15.
  2. Esposito M, Hirsch JM, Lekholm U, Thomsen P. Biological factors contributing to failures of osseointegrated oral implants. (II). Etiopathogenesis. Eur J Oral Sci 1998;106:721-64. https://doi.org/10.1046/j.0909-8836..t01-6-.x
  3. Pjetursson BE, Tan K, Lang NP, Bragger U, Egger M, Zwahlen M. A systematic review of the survival and complication rates of fi xed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res 2004;15:667-76. https://doi.org/10.1111/j.1600-0501.2004.01120.x
  4. Heitz-Mayfi eld LJ. Peri-implant diseases: diagnosis and risk indicators. J Clin Periodontol 2008;35(8 Suppl):292-304. https://doi.org/10.1111/j.1600-051X.2008.01275.x
  5. Apse P, Ellen RP, Overall CM, Zarb GA. Microbiota and crevicular fl uid collagenase activity in the osseointegrated dental implant sulcus: a comparison of sites in edentulous and partially edentulous patients. J Periodontal Res 1989;24:96-105. https://doi.org/10.1111/j.1600-0765.1989.tb00863.x
  6. Serino G, Strom C. Peri-implantitis in partially edentulous patients: association with inadequate plaque control. Clin Oral Implants Res 2009;20:169-74. https://doi.org/10.1111/j.1600-0501.2008.01627.x
  7. Loe H, Theilade E, Jensen SB. Experimental gingivitis in man. J Periodontol 1965;36:177-87. https://doi.org/10.1902/jop.1965.36.3.177
  8. Renvert S, Roos-Jansaker AM, Claffey N. Non-surgical treatment of peri-implant mucositis and peri-implantitis: a literature review. J Clin Periodontol 2008;35(8 Suppl):305-15.
  9. Ericsson I, Persson LG, Berglundh T, Edlund T, Lindhe J. The effect of antimicrobial therapy on periimplantitis lesions. An experimental study in the dog. Clin Oral Implants Res 1996;7:320-8. https://doi.org/10.1034/j.1600-0501.1996.070404.x
  10. Mombelli A, Feloutzis A, Brägger U, Lang NP. Treatment of periimplantitis by local delivery of tetracycline. Clinical, microbiological and radiological results. Clin Oral Implants Res 2001;12:287-94. https://doi.org/10.1034/j.1600-0501.2001.012004287.x
  11. Buchter A, Meyer U, Kruse-Losler B, Joos U, Kleinheinz J. Sustained release of doxycycline for the treatment of peri-implantitis: randomised controlled trial. Br J Oral Maxillofac Surg 2004;42: 439-44. https://doi.org/10.1016/j.bjoms.2004.06.005
  12. Williams RC, Paquette DW, Offenbacher S, Adams DF, Armitage GC, Bray K, et al. Treatment of periodontitis by local administration of minocycline microspheres: a controlled trial. J Periodontol 2001;72:1535-44. https://doi.org/10.1902/jop.2001.72.11.1535
  13. Leung WK, Jin L, Yau JY, Sun Q, Corbet EF. Microfl ora cultivable from minocycline strips placed in persisting periodontal pockets. Arch Oral Biol 2005;50:39-48. https://doi.org/10.1016/j.archoralbio.2004.08.002
  14. Hammarstrom L, Heijl L, Gestrelius S. Periodontal regeneration in a buccal dehiscence model in monkeys after application of enamel matrix proteins. J Clin Periodontol 1997;24:669-77. https://doi.org/10.1111/j.1600-051X.1997.tb00248.x
  15. Casati MZ, Sallum EA, Nociti FH Jr, Caffesse RG, Sallum AW. Enamel matrix derivative and bone healing after guided bone regeneration in dehiscence-type defects around implants. A histomorphometric study in dogs. J Periodontol 2002;73:789-96. https://doi.org/10.1902/jop.2002.73.7.789
  16. Spahr A, Lyngstadaas SP, Boeckh C, Andersson C, Podbielski A, Haller B. Effect of the enamel matrix derivative Emdogain on the growth of periodontal pathogens in vitro. J Clin Periodontol 2002; 29:62-72. https://doi.org/10.1034/j.1600-051x.2002.290110.x
  17. Gutierrez MA, Mellonig JT, Cochran DL. Evaluation of enamel matrix derivative as an adjunct to non-surgical periodontal therapy. J Clin Periodontol 2003;30:739-45. https://doi.org/10.1034/j.1600-051X.2003.00374.x
  18. Haffajee AD, Socransky SS. Microbiology of periodontal diseases: introduction. Periodontol 2000 2005;38:9-12. https://doi.org/10.1111/j.1600-0757.2005.00112.x
  19. Kadkhodazadeh M, Amid R. Evaluation of peri-implant tissue health using a scoring system. J Implant Adv Clin Dent 2012;4:51-7.
  20. Research Randomizer [Internet]. Place unknown: Geoffrey C. Urbaniak and Scott Plous 1997-2015 [cited 2009 Aug 18]. Available from: https://www.randomizer.org.
  21. Lang NP, Berglundh T, Heitz-Mayfield LJ, Pjetursson BE, Salvi GE, Sanz M. Consensus statements and recommended clinical procedures regarding implant survival and complications. Int J Oral Maxillofac Implants 2004;19(Suppl):150-4.
  22. Mombelli A, van Oosten MA, Schurch E Jr, Land NP. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol 1987;2:145-51. https://doi.org/10.1111/j.1399-302X.1987.tb00298.x
  23. Schou S, Holmstrup P, Keiding N, Fiehn NE. Microbiology of ligature-induced marginal inflammation around osseointegrated implants and ankylosed teeth in cynomolgus monkeys (Macaca fascicularis). Clin Oral Implants Res 1996;7:190-200. https://doi.org/10.1034/j.1600-0501.1996.070301.x
  24. Holt SC, Kesavalu L, Walker S, Genco CA. Virulence factors of Porphyromonas gingivalis. Periodontol 2000 1999;20:168-238. https://doi.org/10.1111/j.1600-0757.1999.tb00162.x
  25. Lang NP, Wilson TG, Corbet EF. Biological complications with dental implants: their prevention, diagnosis and treatment. Clin Oral Implants Res 2000;11(Suppl 1):146-55. https://doi.org/10.1034/j.1600-0501.2000.011S1146.x
  26. Kato T, Kusakari H, Hoshino E. Bactericidal efficacy of carbon dioxide laser against bacteria-contaminated titanium implant and subsequent cellular adhesion to irradiated area. Lasers Surg Med 1998;23:299-309. https://doi.org/10.1002/(SICI)1096-9101(1998)23:5<299::AID-LSM10>3.0.CO;2-K
  27. Sahm N, Becker J, Santel T, Schwarz F. Non-surgical treatment of peri-implantitis using an air-abrasive device or mechanical debridement and local application of chlorhexidine: a prospective, randomized, controlled clinical study. J Clin Periodontol 2011;38:872-8. https://doi.org/10.1111/j.1600-051X.2011.01762.x
  28. Park JB, Jang YJ, Koh M, Choi BK, Kim KK, Ko Y. In vitro analysis of the effi cacy of ultrasonic scalers and a toothbrush for removing bacteria from resorbable blast material titanium disks. J Periodontol 2013;84:1191-8. https://doi.org/10.1902/jop.2012.120369
  29. Renvert S, Lessem J, Lindahl C, Svensson M. Treatment of incipient peri-implant infections using topical minocycline microspheres versus topical chlorhexidine gel as an adjunct to mechanical debridement. J Int Acad Periodontol 2004;6(4 Suppl):154-9.
  30. Persson GR, Salvi GE, Heitz-Mayfi eld LJ, Lang NP. Antimicrobial therapy using a local drug delivery system (Arestin) in the treatment of peri-implantitis. I: microbiological outcomes. Clin Oral Implants Res 2006;17:386-93. https://doi.org/10.1111/j.1600-0501.2006.01269.x
  31. Renvert S, Lessem J, Dahlén G, Lindahl C, Svensson M. Topical minocycline microspheres versus topical chlorhexidine gel as an adjunct to mechanical debridement of incipient peri-implant infections: a randomized clinical trial. J Clin Periodontol 2006;33:362-9. https://doi.org/10.1111/j.1600-051X.2006.00919.x
  32. Gestrelius S, Andersson C, Lidstrom D, Hammarström L, Somerman M. In vitro studies on periodontal ligament cells and enamel matrix derivative. J Clin Periodontol 1997;24:685-92. https://doi.org/10.1111/j.1600-051X.1997.tb00250.x
  33. Bosshardt DD. Biological mediators and periodontal regeneration: a review of enamel matrix proteins at the cellular and molecular levels. J Clin Periodontol 2008;35(8 Suppl):87-105. https://doi.org/10.1111/j.1600-051X.2008.01264.x
  34. Wennstrom JL, Lindhe J. Some effects of enamel matrix proteins on wound healing in the dento-gingival region. J Clin Periodontol 2002;29:9-14. https://doi.org/10.1034/j.1600-051x.2002.290102.x
  35. Mombelli A, Brochut P, Plagnat D, Casagni F, Giannopoulou C. Enamel matrix proteins and systemic antibiotics as adjuncts to nonsurgical periodontal treatment: clinical effects. J Clin Periodontol 2005;32:225-30. https://doi.org/10.1111/j.1600-051X.2005.00664.x
  36. Sculean A, Windisch P, Auschill TM, Dori F. Treatment of peri-implantitis with EDTA decontamination and application of an enamel matrix protein derivate-a report of 3 case. Periodontal Practice Today 2004;1:237-45.
  37. Boutaga K, van Winkelhoff AJ, Vandenbroucke-Grauls CM, Savelkoul PH. Comparison of real-time PCR and culture for detection of Porphyromonas gingivalis in subgingival plaque samples. J Clin Microbiol 2003;41:4950-4. https://doi.org/10.1128/JCM.41.11.4950-4954.2003
  38. Boutaga K, van Winkelhoff AJ, Vandenbroucke-Grauls CM, Savelkoul PH. The additional value of real-time PCR in the quantitative detection of periodontal pathogens. J Clin Periodontol 2006;33: 427-33. https://doi.org/10.1111/j.1600-051X.2006.00925.x
  39. Sakamoto M, Takeuchi Y, Umeda M, Ishikawa I, Benno Y. Rapid detection and quantification of five periodontopathic bacteria by real-time PCR. Microbiol Immunol 2001;45:39-44. https://doi.org/10.1111/j.1348-0421.2001.tb01272.x