Purpose This is a systematic review and meta‐analysis to estimate the overall prevalence of proximal contact loss (PCL) and determine the distribution and clinical features of PCL. Methods This systematic review was conducted following the preferred reporting items for systematic reviews and meta‐analyses (PRISMA) guidelines. As this was a systematic review of prevalence, the condition, context, and population framework was followed. The focus question was: What is the prevalence and distribution of PCL in implant‐supported restorations? Two investigators independently examined the literature in four databases (Medline, Scopus, Web of Science, and Cochrane) for suitable articles published before November 11, 2020, with no start‐date restriction; an additional search was conducted by hand. A standardized data extraction chart was utilized to extract the relevant information from the selected studies. Results Fifteen studies met the inclusion criteria. A total of 11,699 restorations were evaluated in the final sample. The overall prevalence was 20% at the implant restoration level (among 4984 implants) and 26.6% at the contact point level (among 2603 contact points). The frequency of PCL was higher on the mesial side, both at the implant restoration level (13.8%) and at the contact point level (21.9%), than on the distal side, where the prevalence was 3.3% and 11.0%, respectively. The event rate in the maxilla and in the mandible at the contact level was 21.4% and 21.9%, respectively. Conclusions PCL is a frequent complication. Approximately 29% of contact points develop this condition, which may cause food impaction and damage to the interproximal tissues.
Background: Peri-implantitis is an inflammatory disease with an increasing diffusion rate which can affect the long-term survival of a prosthetic rehabilitation. The present study focused on the decontaminating efficacy of chlorhexidine and air polishing system with sodium bicarbonate powder against Candida albicans, a microorganism which seems to have a superinfecting opportunistic role in the pathology. The aim of the authors was to investigate and compare the effectiveness of these treatments, commonly used in clinical practice. Methods: An in vitro study was conducted to analyze the effects of two widely used therapeutic aids for the disinfection of affected titanium implants: chlorhexidine (CHX) and air polishing with sodium bicarbonate powder (P). A qualitative and quantitative comparative analysis of the residual biofilm was carried out using a colorimetric assay (XTT) and scanning electron microscopy (SEM) observation. The experiment was conducted both on machined titanium surfaces and on rough sandblasted ones with the aim of bringing out differences in the therapeutic outcomes concerning the superficial texture of the implant. The null hypothesis was that no difference could be detected between the samples, regarding both the treatments performed and the nano-structural features of titanium. Results: The best results (on both types of implant surfaces) were obtained when combining the use of chlorhexidine and air polishing (C + P). A linear decrease in the optical density (OD) values recorded at three different time points (30 s, 1 min, 5 min) was also observed passing from the first to the last one. When observed under scanning electron microscope rough surfaces showed an extensive and highly structured biofilm, more complex if compared to the one encountered when analyzing machined implants. Conclusions: the present pilot study showed that rough surfaces can promote fungal adhesion and eventually hinder the outcome of a decontaminating treatment. For this purpose, the physio-chemical technique is always more efficient if compared to a single-technique approach regardless of the surface characteristics.
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