• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.4
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• pp.181-189
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• 2015

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.

• Imaging Science in Dentistry
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• v.54 no.2
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• pp.171-180
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• 2024

Purpose: This study was conducted to identify the typical sites and patterns of peri-implant bone defects on cone-beam computed tomography (CBCT) images, as well as to evaluate the detectability of the identified bone defects on panoramic images. Materials and Methods: The study population included 114 patients with a total of 367 implant fixtures. CBCT images were used to assess the presence or absence of bone defects around each implant fixture at the mesial, distal, buccal, and lingual sites. Based on the number of defect sites, the presentations of the peri-implant bone defects were categorized into 3 patterns: 1 site, 2 or 3 sites, and circumferential bone defects. Two observers independently evaluated the presence or absence of bone defects on panoramic images. The bone defect detection rate on these images was evaluated using receiver operating characteristic analysis. Results: Of the 367 implants studied, 167 (45.5%) had at least 1 site with a confirmed bone defect. The most common type of defect was circumferential, affecting 107 of the 167 implants(64.1%). Implants were most frequently placed in the mandibular molar region. The prevalence of bone defects was greatest in the maxillary premolar and mandibular molar regions. The highest kappa value was associated with the mandibular premolar region. Conclusion: The typical bone defect pattern observed was a circumferential defect surrounding the implant. The detection rate was generally higher in the molar region than in the anterior region. However, the capacity to detect partial bone defects using panoramic imaging was determined to be poor.

• Imaging Science in Dentistry
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• v.49 no.4
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• pp.265-272
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• 2019

Purpose: To compare the diagnostic accuracy of cone-beam computed tomography (CBCT) with that of parallel(PPA) and oblique projected periapical(OPA) radiography for the detection of different types of peri-implant bone defects. Materials and Methods: Forty implants inserted into bovine rib blocks were used. Thirty had standardized bone defects(10 each of angular, fenestration, and dehiscence defects), and 10 were defect-free controls. CBCT, PPA, and OPA images of the samples were acquired. The images were evaluated twice by each of 2 blinded observers regarding the presence or absence and the type of the defects. The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were determined for each radiographic technique. The 3 modalities were compared using the Fisher exact and chi-square tests, with P<0.05 considered as statistical significance. Results: High inter-examiner reliability was observed for the 3 techniques. Angular defects were detected with high sensitivity and specificity by all 3 modalities. CBCT and OPA showed similar AUC and sensitivity in the detection of fenestration defects. In the identification of dehiscence defects, CBCT showed the highest sensitivity, followed by OPA and PPA, respectively. CBCT and OPA had a significantly greater ability than PPA to detect fenestration and dehiscence defects(P<0.05). Conclusion: The application of OPA radiography in addition to routine PPA imaging as a radiographic follow-up method for dental implantation greatly enhances the visualization of fenestration and dehiscence defects. CBCT properly depicted all defect types studied, but it involves a relatively high dose of radiation and cost.

• Imaging Science in Dentistry
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• v.46 no.3
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• pp.173-178
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• 2016

Purpose: Optical coherence tomography (OCT) has been investigated as a novel diagnostic imaging tool. The utilisation of this equipment has been evaluated through several studies in the field of dentistry. The aim of this preliminary study was to determine through basic experiments the effectiveness of OCT in implant dentistry. Materials and Methods: To assess detection ability, we captured OCT images of implants in each of the following situations: (1) implants covered with mucosae of various thicknesses that were harvested from the mandibles of pigs; (2) implants installed in the mandibles of pigs; and (3) implants with abutments and crowns fixed with temporary cement. The OCT images were captured before cementation, after cementation, and after removing the excess submucosal cement. Results: If the thickness of the mucosa covering the implant body was less than 1 mm, the images of the implants were clearly detected by OCT. In the implants were installed in pigs' mandibles, it was difficult to capture clear images of the implant and alveolar bone in most of the samples. Remnants of excess cement around the implants were visible in most samples that had a mucosa thickness of less than 3 mm. Conclusion: Currently, OCT imaging of implants is limited. Cement remnants at the submucosal area can be detected in some cases, which can be helpful in preventing peri-implant diseases. Still, though there are some restrictions to its application, OCT could have potential as an effective diagnostic instrument in the field of implant dentistry as well.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.4
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• pp.307-314
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• 2014

Although a laser has been introduced to implant dentistry for decades, its efficacy is still open debate. The aim of this literature review is to analyze and evaluate the efficacy of laser therapy for the treatment of dentinal hypersensitivity and periodontal conditions.

• Journal of Periodontal and Implant Science
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• v.53 no.3
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• pp.233-244
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• 2023

Purpose: An implant-supported prosthesis consists of an implant fixture, an abutment, an internal screw that connects the abutment to the implant fixture, and the upper prosthesis. Numerous studies have investigated the microorganisms present on the implant surface, surrounding tissues, and the subgingival microflora associated with peri-implantitis. However, there is limited information regarding the microbiome within the internal screw space. In this study, microbial samples were collected from the supragingival surfaces of natural teeth, the peri-implant sulcus, and the implant-abutment screw hole, in order to characterize the microbiome of the internal screw space in healthy subjects. Methods: Samples were obtained from the supragingival region of natural teeth, the peri-implant sulcus, and the implant screw hole in 20 healthy subjects. DNA was extracted, and the V3-V4 region of the 16S ribosomal RNA was sequenced for microbiome analysis. Alpha diversity, beta diversity, linear discriminant analysis effect size (LEfSe), and network analysis were employed to compare the characteristics of the microbiomes. Results: We observed significant differences in beta diversity among the samples. Upon analyzing the significant taxa using LEfSe, the microbial composition of the implant-abutment screw hole's microbiome was found to be similar to that of the other sampling sites' microbiomes. Moreover, the microbiome network analysis revealed a unique network complexity in samples obtained from the implant screw hole compared to those from the other sampling sites. Conclusions: The bacterial composition of the biofilm collected from the implant-abutment screw hole exhibited significant differences compared to the supra-structure of the implant. Therefore, long-term monitoring and management of not only the peri-implant tissue but also the implant screw are necessary.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.451-463
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• 2001

Following the extensive use of implant, the incidence of peri-implantitis increases. Guided bone regeneration has been used for the optimal treatment of this disease. Because implant surface was contaminated with plaque and calculus, cleaning and detoxification were needed for the reosseointegration when guided bone regeneration was performed. Various mechanical and chemical methods have been used for cleaning and detoxification of implant surface, air-powder abrasive and oversaturated citrate were known to be most effective among these methods. However, these methods were incomplete because these could not thoroughly remove bacteria of implant surface, moreover deformed implant surface. Recent studies for detoxification of the implant surface using laser were going on, $CO_2$ laser and Soft Diode laser were known to be effective among these methods. The purpose of this study was to obtain clinical guide by application these laser to implant surface. 15 experimental machined pure titanium cylinder models were fabricated. The $CO_2$ laser treatment under dry, wet and hydrogen peroxide condition or the Soft Diode laser treatment under Toluidine blue O solution condition was performed on the each of models. Each groups were examined with SPM and SEM to know whether their surface was changed. The results were as follows : 1. Surface roughness and surface form weren't changed when $CO_2$ laser was usedunder dry condition(P>0.05). 2. Surface roughness and surface form weren't changed when $CO_2$ laser was used under wet condition(P>0.05). 3. Surface roughness and surface form weren't changed when $CO_2$ laser was used under hydrogen peroxide condition(P>0.05). 4. Surface roughness and surface form weren't changed when Soft Diode laser was used under toluidine blue O solution condition(P>0.05). From the result of this study, it may be concluded that the $CO_2$ laser having relatively safe pulse mode and the Soft Diode laser used with photosensitizer can be used safely to treat peri-implantitis.

• The Journal of Korean Academy of Prosthodontics
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• v.62 no.2
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• pp.123-130
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• 2024

There are various methods for restoring the dentition of completely edentulous patients. Removable complete dentures have the advantage of being relatively economical, but they can be uncomfortable to wear. With the introduction of implant prosthodontics, various options such as implant-supported overdentures and hybrid prostheses have become available. If there is inadequate remaining ridge or limited financial resources, an overdenture supported by a few implants with additional attachments may be more suitable. In this case, due to severe peri-implantitis and other complications, the implants were removed. Subsequently, four implants (two on each side) were placed in the maxilla and a milled-bar with attachment was fabricated for each side of the maxilla.

• Journal of Periodontal and Implant Science
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• v.48 no.2
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• pp.103-113
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• 2018

Purpose: The purpose of this retrospective study with 4-12 years of follow-up was to compare the marginal bone loss (MBL) between external-connection (EC) and internal-connection (IC) dental implants in posterior areas without periodontal or peri-implant disease on the adjacent teeth or implants. Additional factors influencing MBL were also evaluated. Methods: This retrospective study was performed using dental records and radiographic data obtained from patients who had undergone dental implant treatment in the posterior area from March 2006 to March 2007. All the implants that were included had follow-up periods of more than 4 years after loading and satisfied the implant success criteria, without any peri-implant or periodontal disease on the adjacent implants or teeth. They were divided into 2 groups: EC and IC. Subgroup comparisons were conducted according to splinting and the use of cement in the restorations. A statistical analysis was performed using the Mann-Whitney U test for comparisons between 2 groups and the Kruskal-Wallis test for comparisons among more than 2 groups. Results: A total of 355 implants in 170 patients (206 EC and 149 IC) fulfilled the inclusion criteria and were analyzed in this study. The mean MBL was 0.47 mm and 0.15 mm in the EC and IC implants, respectively, which was a statistically significant difference (P<0.001). Comparisons according to splinting (MBL of single implants: 0.34 mm, MBL of splinted implants: 0.31 mm, P=0.676) and cement use (MBL of cemented implants: 0.27 mm, MBL of non-cemented implants: 0.35 mm, P=0.178) showed no statistically significant differences in MBL, regardless of the implant connection type. Conclusions: IC implants showed a more favorable bone response regarding MBL in posterior areas without peri-implantitis or periodontal disease.

• Imaging Science in Dentistry
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• v.52 no.3
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• pp.267-273
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• 2022

Purpose: The aim of this study was to assess the influence of kilovoltage- peak (kVp) and the metal artifact reduction (MAR) tool on the detection of buccal and lingual peri-implant dehiscence in the presence of titanium-zirconia (Ti-Zr) and zirconia (Zr) implants in cone-beam computed tomography (CBCT) images. Materials and Methods: Twenty implant sites were created in the posterior region of human mandibles, including control sites (without dehiscence) and experimental sites (with dehiscence). Individually, a Ti-Zr or Zr implant was placed in each implant site. CBCT scans were performed using a Picasso Trio device, with variation in the kVp setting (70 or 90 kVp) and whether the MAR tool was used. Three oral radiologists scored the detection of dehiscence using a 5-point scale. The area under the receiver operating characteristic (ROC) curve, sensitivity, and specificity were calculated and compared by multi-way analysis of variance (α=0.05). Results: The kVp, cortical plate involved (buccal or lingual cortices), and MAR did not influence any diagnostic values (P>0.05). The material of the implant did not influence the ROC curve values(P>0.05). In contrast, the sensitivity and specificity were statistically significantly influenced by the implant material (P<0.05) with Zr implants showing higher sensitivity values and lower specificity values than Ti-Zr implants. Conclusion: The detection of peri-implant dehiscence was not influenced by kVp, use of the MAR tool, or the cortical plate. Greater sensitivity and lower specificity were shown for the detection of peri-implant dehiscence in the presence of a Zr implant.