• The Journal of Korean Academy of Prosthodontics
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• v.34 no.3
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• pp.489-500
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• 1996

Pulsed Nd : YAG LASER has been applied to various fields in clinical dentistry including the treatment of peri-implantitis. However, LASER can affect properties of matter of dental implants which are important to maintaining the health of peri-implant tissue and can raise its temperature during lasing. So there have been warings of using LASER to treat peri-implantitis. But, the effects of laser on dental implants itself are not certain yet. So we measured the temperature rising, examined matter of properties by SEM and EDX before and after pulsed Nd : YAG lasing various intensity. 7 TPS implants and 7 HPS implants were used and pulsed Nd : YAG LASER was used in 0.3W, 1.0W, and 2.0W. 1. 2.0W LASER made polished neck portion of HPS implants reach $39.2^{\circ}C$ after 5 seconds lasing. 2. LASER made crater-like defects on plasma sprayed surface and surfaces were melted and divided by fragments after lasing. 3. There was no specific evidence of element change after lasing.

• Journal of Periodontal and Implant Science
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• v.45 no.6
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• pp.210-215
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• 2015

Purpose: The aim of this retrospective study was to investigate the cumulative success rate, the implant survival rate, and the occurrence of biological complications in implants supporting full-arch immediately loaded rehabilitations supported by upright and tilted implants. Methods: The clinical records and periapical radiographs of patients who attended follow-up visits were collected, and information was recorded regarding marginal bone loss resorption, the occurrence of peri-implant infectious diseases, and the implant survival rate. Implants were classified as successful or not successful according to two distinct classifications for implant success. Results: A total of 53 maxillary and mandibular restorations including 212 implants were analysed, of which 56 implants were studied over the full five-year follow-up period. After five years, the cumulative success rate was 76.04% according to the Misch classification and 56.34% according to the Albrektsson classification. The cumulative implant survival rate was 100%, although one implant was found to be affected by peri-implantitis at the second follow-up visit. Conclusions: The cumulative success rate of the implants dropped over time, corresponding to the progression of marginal bone resorption. The prevalence of peri-implantitis was very low, and the implant survival rate was not found to be related to the cumulative success rate.

• Journal of Periodontal and Implant Science
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• v.46 no.4
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• pp.266-276
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• 2016

Purpose: The aim of the present study was to retrospectively investigate the influence of potential risk indicators on the development of peri-implant disease. Methods: Overall, 103 patients referred for implant treatment from 2000 to 2012 were randomly enrolled. The study sample consisted of 421 conventional-length (>6 mm) non-turned titanium implants that were evaluated clinically and radiographically according to preestablished clinical and patient-related parameters by a single investigator. A non-parametric Mann-Whitney U test or Kruskal-Wallis rank test and a logistic regression model were used for the statistical analysis of the recorded data at the implant level. Results: The diagnosis of peri-implant mucositis and peri-implantitis was made for 173 (41.1%) and 19 (4.5%) implants, respectively. Age (${\geq}65$ years), patient adherence (professional hygiene recalls <2/year) and the presence of plaque were associated with higher peri-implant probing-depth values and bleeding-on-probing scores. The logistic regression analysis indicated that age (P=0.001), patient adherence (P=0.03), the absence of keratinized tissue (P=0.03), implants placed in pristine bone (P=0.04), and the presence of peri-implant soft-tissue recession (P=0.000) were strongly associated with the event of peri-implantitis. Conclusions: Within the limitations of this study, patients aged ${\geq}65$ years and non-adherent subjects were more prone to develop peri-implant disease. Therefore, early diagnosis and a systematic maintenance-care program are essential for maintaining peri-implant tissue health, especially in older patients.

• Journal of Periodontal and Implant Science
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• v.48 no.5
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• pp.326-333
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• 2018

Purpose: The present study investigated the outcomes of a newly-developed, simple, and practical nonsurgical treatment modality suitable for most forms of intrabony defects around failing dental implants using intrasulcular delivery of chlorhexidine solution and minocycline hydrochloride (HCl). Methods: Forty-five dental implants in 20 patients diagnosed with peri-implantitis were included. At baseline and the study endpoint, the probing pocket depth (PPD), clinical attachment level (CAL), and the presence of bleeding on probing (BOP) at 6 sites around each implant were recorded. The radiographic osseous defect morphology at the mesial or distal proximal aspect of each implant was classified as 1) narrow or wide and 2) shallow or deep. For a comparative analysis of bone changes according to the defect morphology, the distance from the implant shoulder to the most coronal bone-to-implant contact point (DIB) at the mesial and distal aspects of each implant was measured at baseline and the endpoint. Patients were scheduled to visit the clinic every 2-4 weeks for intrasulcular irrigation of chlorhexidine and delivery of minocycline HCl. Results: We observed statistically significant decreases in PPD, CAL, and BOP after treatment. At the endpoint, bone levels increased in all defects, regardless of the osseous morphology of the intrabony defect. The mean DIB change in deep defects was significantly greater than that in shallow defects. Although the mean bone gain in narrow defects was greater than in wide defects, the difference was not statistically significant. Conclusions: We propose that significant and sustainable improvements in both clinical and radiographic parameters can be expected when intrabony defects around dental implants are managed through a simple nonsurgical approach involving combined intrasulcular chlorhexidine irrigation and local delivery of minocycline HCl.

• Journal of Periodontal and Implant Science
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• v.35 no.4
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• pp.907-919
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• 2005

Porphyromonas gingivalis is a gram negative. black-pigmented anaerobe, associated with periodontitis & peri-implantitis. Fimbriae(fimA) of P. gingivalis are filamentous components on the cell surface and important in the colonization and invasion of periodontal tissue. But all P. gnigivalis strains don't have equal pathogenicity, inequality among strains originates from different fimA genotype. P. gnigivalis fimA gene encoding fimbrillin(structural subunit of fimbriae) has been classified into 5 genotypes(types I to V) based on the nucleotide sequences. In the present study, we examined the prevalence of these fimA genotypes in patients with dental implant and the relationship between prevalence of these genotypes and a condition of peri-implant tissue. Dental plaque specimens obtained from 189 peri-implant sulci of 97 patients with dental implants were analyzed by 16S rRNA fimA gene-directed PCR assay. P. gingivalis were detected in 86.2% of the alll samples. Among the P. gingivalis-positive samples, a significant difference in the occurrence of typeII was observed between test and the two control groups. In two control groups, typeII fimA were detected in 6.3%(PD<5mm/BOP-). 18.7%(PD<5mm/BOP+). In the test $group(PD{\geqq}5mm/BOP+)$, type II fimA genotype were detected most frequently in 50.0% . And a correlation between specific fimA types and peri-implantitis was found in $typeII(R^2=l.105)$. These results suggest that P. gingivalis strains that possess typeII fimA are gradually increased, as a condition of peri-implant tissue is getting complicated and are closely associated with peri-implant health status. We speculate that these organisms be involved in peri-implantitis

• Imaging Science in Dentistry
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• v.40 no.3
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• pp.123-129
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• 2010

Purpose : To evaluate the effect of surgical treatment of ligature-induced peri-implantitis in dogs using fractal analysis. Also, the capabilities of fractal analysis as bone analysis techniques were compared with those of histomorphometric analysis. Materials and Methods : A total of 24 implants were inserted in 6 dogs. After a 3-months, experimental periimplantitis characterized by a bone loss of about 3 mm was established by inducing with wires. Surgical treatment involving flap procedure, debridement of implants surface with chlorhexidine and saline (group 1), guided bone regeneration (GBR) with absorbable collagen membrane and mineralized bone graft (group 2), and $CO_2$ laser application with GBR (group 3) were performed. After animals were sacrificed in 8 and 16 weeks respectively, bone sections including implants were made. Fractal dimensions were calculated by box-counting method on the skeletonized images, made from each region of interest, including five screws at medial and distal aspects of implant, were selected. Results : Statistically significant differences in the fractal dimensions between the group 1($0.9340{\pm}0.0126$) and group 3($0.9783{\pm}0.0118$) at 16 weeks were found (P<0.05). The fractal dimension was statistically significant different between 8($0.9395{\pm}0.0283$) and 16 weeks in group 3 (P<0.05). These results were similar with the result of the evaluation of new bone formation in histomorphometric analysis. Conclusions : Treatment of experimental peri-implantitis by using $CO_2$ laser with GBR is more useful than other treatments in the formation of new bone and also the tendency of fractal dimension to increase relative to healing time may be a useful means of evaluating.

• Journal of Periodontal and Implant Science
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• v.53 no.4
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• pp.295-305
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• 2023

Purpose: Various methods have been proposed to achieve the nearly complete decontamination of the surface of implants affected by peri-implantitis. We investigated the in vitro debridement efficiency of multiple decontamination methods (Gracey curettes [GC], glycine air-polishing [G-Air], erythritol air-polishing [E-Air] and titanium brushes [TiB]) using a novel spectrophotometric ink-model in 3 different bone defect settings (30°, 60°, and 90°). Methods: Forty-five dental implants were stained with indelible ink and mounted in resin models, which simulated standardised peri-implantitis defects with different bone defect angulations (30°, 60°, and 90°). After each run of instrumentation, the implants were removed from the resin model, and the ink was dissolved in ethanol (97%). A spectrophotometric analysis was performed to detect colour remnants in order to measure the cumulative uncleaned surface area of the implants. Scanning electron microscopy images were taken to assess micromorphological surface changes. Results: Generally, the 60° bone defects were the easiest to debride, and the 30° defects were the most difficult (ink absorption peak: 0.26±0.04 for 60° defects; 0.32±0.06 for 30° defects; 0.27±0.04 for 90° defects). The most effective debridement method was TiB, independently of the bone defect type (TiB vs. GC: P<0.0001; TiB vs. G-Air: P=0.0017; TiB vs. GE-Air: P=0.0007). GE-Air appeared to be the least efficient method for biofilm debridement. Conclusions: T-brushes seem to be a promising decontamination method compared to the other techniques, whereas G-Air was less aggressive on the implant surface. The use of a spectrophotometric model was shown to be a novel but promising assessment method for in vitro ink studies.

• Journal of Periodontal and Implant Science
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• v.53 no.1
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• pp.69-84
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• 2023

Purpose: The objective of this study was to analyze the microbial profile of individuals with peri-implantitis (PI) compared to those of periodontally healthy (PH) subjects and periodontitis (PT) subjects using Illumina sequencing. Methods: Buccal, supragingival, and subgingival plaque samples were collected from 109 subjects (PH: 30, PT: 49, and PI: 30). The V3-V4 region of 16S rRNA was sequenced and analyzed to profile the plaque microbiota. Results: Microbial community diversity in the PI group was higher than in the other groups, and the 3 groups showed significantly separated clusters in the buccal samples. The PI group showed different patterns of relative abundance from those in the PH and PT groups depending on the sampling site at both genus and phylum levels. In all samples, some bacterial species presented considerably higher relative abundances in the PI group than in the PH and PT groups, including Anaerotignum lactatifermentans, Bacteroides vulgatus, Faecalibacterium prausnitzii, Olsenella uli, Parasutterella excrementihominis, Prevotella buccae, Pseudoramibacter alactolyticus, Treponema parvum, and Slackia exigua. Network analysis identified that several well-known periodontal pathogens and newly recognized bacteria were closely correlated with each other. Conclusions: The composition of the microbiota was considerably different in PI subjects compared to PH and PT subjects, and these results could shed light on the mechanisms involved in the development of PI.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.3
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• pp.186-195
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• 2018

Purpose: We performed quantitative and qualitative analysis of typical periodontal bacteria using real time PCR method to investigate the microbiological difference according to the severity of peri-implant disease in Koreans. Materials and Methods: Total of 60 implants were divided into three groups (healthy group, peri-implant mucositis group, peri-implantitis group) through periapical radiographs and clinical indices. The evaluated clinical parameters were pocket depth, plaque index, suppuration and bleeding on probing. Using a sterilized curette instrument, microbial samples were collected from the subgingival plaque and real-time PCR was performed on five periodontal bacteria. The relative expression levels of microorganisms were compared by comparative delta-CT method. Results: The relative expression levels of E. corrodens and T. denticola were significantly higher in the peri-implantitis group (P < 0.017). On the other hand, the relative expression level of F. nucleatum and P. gingivalis was relatively high in the healthy implant group regardless of the severity of disease. P. intermedia was significantly lower in the healthy implant group (P < 0.017). Conclusion: Periodontal bacteria were detected in Koreans with peri-implant diseases, but there was no microbiological distribution similar to periodontitis.

• Journal of Periodontal and Implant Science
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• v.34 no.1
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• pp.71-81
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• 2004

Peri-implantitis could be the result of biomechanical and occlusal overload as well as microbiologic invasion. The dental implant may be more susceptible to dental plaque than the natural tooth, as the predictability of a stable soft tissue attachment complex has not yet been confirmed. With the development of peri-implantitis, the implant surface would be exposed to the oral environment and becomes coated with bacteria. The objective of therapy for this condition is to regain integration of the implant with bone. Since fibroblast adherence to surfaces is impeded by endotoxin, it would seem that decontamination would be desirable to obtain maximum osseointegration. The purpose of this study was to determine whether various chemotherapeutic and mechanical treatments(distilled water, air-powder abrasive, hypersaturated citric acid, tetracycline) can detoxify contaminated titanium implant surface by means of kinetic LAL test. Experimental rough surface titanium disks were fabricated. All of them were divided into two groups(A.a group and P.g group) and each contaminated by A. actinomycetemcomitans and P. gingivalis suspension. Contaminated disks were treated with distilled water, air-powder abrasive, citric acid and tetracycline, and then all disks were placed into LPS-free water for elution. The results were as follows : 1. In A.a group, LPS elute level of all test groups were significantly lower than control group(p<0.05). 2. In A.a group, LPS elute level of test 2, test 3 and test4 groups were significantly lower than that of control group(p<0.05). But, among the test 2, test 3, test4 groups, the significant differences were not detected. 3. In P.g group, LPS elute level of test 2, test 3 and test 4 groups were lower than that of control group(p<0.05). But, among the test groups, the significant differences were not detected. From the result of this study, it would be concluded that air-powder abrasive, hypersaturated citric acid and tetracycline treatments may be effective at reducing endotoxin level on rough titanium implant surfaces, and can be clinically used. But the treatments in peri-implantitis differentially impact osseointegration making one method clinically superior. To gain this knowledges, further molecular biologic and histopathologic studies should be developed.