• Journal of Periodontal and Implant Science
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• v.49 no.6
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• pp.397-405
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• 2019

Purpose: This study examined the prevalence and risk factors of peri-implant disease after at least 7 years of dental implant loading. Methods: A total of 111 patients with 218 dental implants were treated. The follow-up period for all implants was at least 7 years. The patients' dental records were collected and risk factors of peri-implant disease were investigated through logistic regression analysis. Results: The overall implant survival rate was 95.87%, because 9 of the 218 implants failed. The prevalence of peri-implant mucositis and peri-implantitis was 39.7% and 16.7%, respectively. As risk factors, smoking and prosthetic splinting showed significant associations with peri-implantitis (P<0.05). Conclusions: Within the limits of this study, no significant correlations were found between any risk factors and peri-implant mucositis, but a significantly elevated risk of peri-implantitis was observed in patients who smoked or had splinted prostheses in 2 or more implants.

• Journal of Periodontal and Implant Science
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• v.53 no.2
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• pp.145-156
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• 2023

Purpose: The significance of keratinized tissue for peri-implant health has been emphasized. However, there is an absence of clinical evidence for the use of a xenogeneic collagen matrix (XCM) to manage peri-implant mucositis and peri-implantitis. Therefore, the purpose of this study was to investigate outcomes after keratinized tissue augmentation using an XCM for the management of peri-implant diseases. Methods: Twelve implants (5 with peri-implant mucositis and 7 with peri-implantitis) in 10 patients were included in this study. Non-surgical treatments were first performed, but inflammation persisted in all implant sites. The implant sites all showed a lack of keratinized mucosa (KM) and vestibular depth (VD). Apically positioned flaps with XCM application were performed. Bone augmentation was simultaneously performed on peri-implantitis sites with an intrabony defect (>3 mm). The following clinical parameters were measured: the probing pocket depth (PPD), modified sulcular bleeding index (mSBI), suppuration (SUP), keratinized mucosal height (KMH), and VD. Results: There were no adverse healing events during the follow-up visits (18±4.6 months). The final KMHs and VDs were 4.34±0.86 mm and 8.0±4.05 mm, respectively, for the sites with peri-implant mucositis and 3.29±0.86 mm and 6.5±1.91 mm, respectively, for the sites with peri-implantitis. Additionally, the PPD and mSBI significantly decreased, and none of the implants presented with SUP. Conclusions: Keratinized tissue augmentation using an XCM for sites with peri-implant mucositis and peri-implantitis was effective for increasing the KMH and VD and decreasing peri-implant inflammation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.5
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• pp.220-224
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• 2014

Objectives: This study aimed to assess and compare the levels of interleukin-1beta (IL-$1{\beta}$) and interleukin-6 (IL-6) in the crevicular fluid around healthy implants, implants with peri-implantitis, and healthy teeth. Materials and Methods: This study evaluated 16 dental implants in 8 patients (4 males and 4 females). These patients had at least one healthy implant and one implant with peri-implantitis next to healthy teeth. The crevicular fluid was collected using absorbent cones and transferred to the laboratory. Specimens were evaluated by ELISA for interleukin levels. Data were analyzed using repeated measures ANOVA and Bonferroni tests (P<0.05). Results: Levels of IL-$1{\beta}$ in the crevicular fluid around implants with peri-implantitis were significantly higher than around healthy implants (P=0.002); the latter was significantly higher than around healthy teeth (P=0.015). A significant difference was found in the level of IL-6 in the crevicular fluid around implants with peri-implantitis and healthy implants (P=0.049) and also between implants with peri-implantitis and healthy teeth (P<0.001). Conclusion: Within the limitations of this study, significant differences exist in the levels of IL-$1{\beta}$ and IL-6 in the crevicular fluid of implants with peri-implantitis, healthy implants, and healthy teeth. More studies with larger sample sizes in different populations are necessary.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.416-424
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• 2019

Peri-implantitis appears in almost 20% of patients who received implant treatment, and increase in its number is inevitable as time goes by. Although it can be treated by both non-surgical and surgical procedures, in cases which include severe bone loss, explantation and rehabilitation may be necessary. Careful treatment planning and considerations to prevent recurrent peri-implantitis should be taken into account. In the following case presented, a patient with chronic periodontitis and peri-implantitis was successfully rehabilitated after removal of several implants. Extraction and explantation of multiple teeth and implants were followed by full mouth reconstruction with fixed implant prostheses on the mandible and implant retained overdenture on the maxilla. Surgical and prosthetic measures to prevent recurrent peri-implantitis were taken into consideration.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.4
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• pp.340-348
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• 2015

Peri-implantitis is the most common reason for a late failure and can occur even after years of successful osseointegration. The role of microbial plaque accumulation in the development of peri-implantitis has been well documented. On the other hand, the ideal method of implant surface decontamination to re-establish the health of peri-implant tissue remains to be determined. Removal of bacterial deposits is essential in the treatment of peri-implant infections, and various therapeutic approaches have been described in the literature, including mechanical debridement, disinfection with chemotherapeutic agents, and laser therapy. Recently, there has been a plenitude of scientific data regarding the use of laser irradiation to achieve titanium surface decontamination. Thus, research is focusing on lasers' potential use in the treatment of peri-implantitis. The aim of this literature review is to analyze and evaluate the efficacy of laser therapy for the treatment of peri-implantitis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.12.1-12.5
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• 2018

Background: Subcutaneous emphysema refers to swelling caused by the presence of air or gas in the interstices of loose connective tissue. In the head and neck area, it may follow the fascial planes and is characterized by sudden swelling, crepitus on palpation, infrequent pain, and air emboli on radiography. It usually occurs as a complication in dental treatment. Some reports have described subcutaneous emphysema caused by dental procedures; however, severe emphysema related to peri-implantitis after treatment has not been documented. Accordingly, the current report describes a rare case of subcutaneous cervical emphysema resulting from the use of an air-powder abrasive device to treat peri-implantitis. Case presentation: Based on a review of the existing literature and the present case, nine cases of subcutaneous emphysema due to air-powder abrasive device have been reported. In most cases, the emphysema resolved over time after treatment with prophylactic antibiotics; among these, two were related to peri-implantitis management. Conclusion: Considering the frequent use of air-powder abrasive devices to treat peri-implantitis, the potential risk of iatrogenic emphysema related to this procedure needs to be addressed more extensively.

• The Journal of the Korean dental association
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• v.52 no.7
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• pp.408-415
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• 2014

Peri-implant diseases are inflammatory lesions, which include peri-implant mucositis and peri-implantitis. Peri-implant mucositis is described as the presence of inflammation in the mucosa around implants without any bone loss. By contrast, in peri-implantitis, besides the inflammation in the peri-implant mucosa, loss of supporting bone is also seen. Diagnosis of peri-implant diseases require the use of gentle probing(0.2 ~ 0.3N) to identify the presence of bleeding on probing, probing depth and suppuration, both signs of clinical inflammation. Radiographs are required to detect loss of supporting bone. Baseline probing measurements and high quality, long cone periapical radiographs should be obtained once the restoration of the implant is completed to make possible longitudinal monitoring of peri-implant tissue.

• The Journal of the Korean dental association
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• v.51 no.12
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• pp.637-642
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• 2013

Because the implant is regarded as a common treatment. It is clinically important that systemic and local risk factor of threatening peri implant mucosa should be considered during the process. The most risk factors are detected in clinical diagnosis, but it might be difficult and not clear to recognize systemic or combined factors. This article reviews risk factors of peri-implantitis. Local factors are biomechanics, periodontal soft tissue characteristics, infected site and oral hygiene. Systemic factors are alcohol, smoking and genetic traits.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.31-41
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• 2005

Fimbriae (fimA) of Porphyromonas gingivalis are filamentous components on the cell surface and are thought to play an important role in the colonization and invasion of periodontal tissue. P. gnigivalis fimA gene encoding fimbrillin, a 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 peri-implantitis. Dental plaque specimens obtained from 80 peri-implant sulci of 50 patients with dental implants were analyzed by 16S rRNA fimA gene-directed PCR assay. P. gingivalis were detected in 74.4% of the samples of the control group (healthy peri- implant sulci; probing depth<5mm) and in 92.0% of the samples of the test group (peri-implant sulci with peri-iimplantitis; probing $depth{\geqq}5mm$). Among the P. gingivalis-positive samples of the control group, the most prevalent fimA type was type I (29.3%), followed by type II (26.8%). In contrast, a majority among the P. gingivalis-positive samples of the test group was type II (56.S%), followed by type I (43.5%). TypeII fimA genotype organisms were detected more frequently in the test group and a significant difference in the occurrence of type II was observed between test and the control groups. A correlation between specific fimA types and peri-implant health status was found in type II (OR 3.545) and only a weak relationship was revealed in typeIV(OR 3.807). These findings indicate that P. gingivalis strains that possess type II fimA are predominant in peri-implant sulci with peri-implantitis and are closely associated with peri-implant health status. P. gingivalis with type II fimA may be involved in peri-implantitis.

• Journal of Periodontal and Implant Science
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• v.44 no.3
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• pp.141-146
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• 2014

Purpose: Peri-implantitis and periodontitis are inflammatory and infectious diseases of implant and tooth-supporting tissues. Recently, the role of gene polymorphisms of immune response components in the relevant pathogenesis has been investigated. The present study was the first to evaluate the relationship between two known single nucleotide polymorphisms (SNPs) of the receptor activator of nuclear factor kappa-${\beta}$ (RANK) gene (rs3018362 and rs35211496) in chronic periodontitis and peri-implantitis patients in an Iranian population. Methods: Eighty-one periodontally healthy patients, 38 patients with peri-implantitis, and 74 patients with chronic periodontitis were enrolled in this study. DNA was extracted from blood arm vein samples by using Miller's salting out technique according to the manufacturer's instructions given in the extraction kit. The concentration of DNA samples was measured using a spectrophotometer. The genetic polymorphisms of the RANK gene were evaluated using a competitive allele specific polymerase chain reaction (KBioscience allele specific PCR) technique. Differences in the frequencies of genotypes and alleles in the diseased and healthy groups were analyzed using chi-squared statistical tests (P<0.05). Results: Analysis of rs35211496 revealed statistically significant differences in the expression of the TT, TC, and CC genotypes among the three groups (P=0.00). No statistically significant difference was detected in this respect between the control group and the chronic periodontitis group. The expression of the GG, GA, and AA genotypes and allele frequencies (rs3018362) showed no statistically significant difference among the three groups (P=0.21). Conclusions: The results of this study indicate that the CC genotype of the rs35211496 RANK gene polymorphism was significantly associated with peri-implantitis and may be considered a genetic determinant for peri-implantitis, but this needs to be confirmed by further studies in other populations.