This study evaluated the presence of cytokines (IL-1β, IL-2, IL-4, IL-6, MCP-1, MIP-1α, MIP-1β, and TNF-α) and human herpesvirus (HSV1, HSV2, EBV, CMV, VZV, HHV6, HHV7, and HHV8) in saliva samples taken from subjects with and without peri-implantitis. Forty-two periodontally healthy subjects were divided according to peri-implant condition: healthy and peri-implantitis groups. The clinical parameters as probing depth, clinical attachment level, plaque index, gingival bleeding, bleeding on probing, and suppuration were evaluated. For cytokine detection, multiplex analysis was performed, and PCR assay was used to identify herpesviruses. No significant differences were found in cytokine levels between groups (p > 0.05). The presence of herpesvirus was 1.97-fold higher in patients with peri-implantitis (odds ratio, CI 0.52–7.49). The association of the presence or absence of herpesvirus with the salivary markers was statistically significant for MIP-1β (p = 0.0087) and TNF-α (p = 0.0437) only in the peri-implantitis group. The presence of herpesviruses in patients with peri-implantitis suggests the development of a proinflammatory environment, which is characterized by increased expression of MIP-1β and TNF-α in saliva.
Background and ObjectivesThe aim of this study was to examine the salivary microbiome in healthy peri-implant sites and those with peri-implantitis.MethodsSaliva samples were collected from 21 participants with healthy peri-implant sites and 21 participants with peri-implantitis. The V4 hypervariable region of the 16S rRNA gene was sequenced using the Ion Torrent PGM System (Ion 318™ Chip v2 400). The NGS analysis and composition of the salivary microbiome were determined by taxonomy assignment. Downstream bioinformatic analyses were performed in QIIME (v 1.9.1).ResultsClinical differences according to peri-implant condition status were found. Alpha diversity metrics revealed that the bacterial communities of participants with healthy peri-implant sites tended to have a richer microbial composition than individuals with peri-implantitis. In terms of beta diversity, bleeding on probing (BoP) may influence the microbial diversity. However, no clear partitioning was noted between the salivary microbiome of volunteers with healthy peri-implant sites or volunteers with peri-implantitis. The highest relative abundance of Stenotrophomonas, Enterococcus and Leuconostoc genus, and Faecalibacterium prausnitzii, Haemophilus parainfluenzae, Prevotella copri, Bacteroides vulgatus, and Bacteroides stercoris bacterial species was found in participants with peri-implantitis when compared with those with healthy peri-implant sites.ConclusionDifferences in salivary microbiome composition were observed between patients with healthy peri-implant sites and those with peri-implantitis. BoP could affect the diversity (beta diversity) of the salivary microbiome.
HighlightsProsthetic planning prior to surgical treatment is crucial for the success of implant-supported prostheses.Poor rehabilitation planning can lead to gingival retraction and fracture of prosthetic components.A multidisciplinary approach is of utmost importance to achieve the desired results.
Digital workflow is increasingly accessible in daily dental practice. It has several benefits in implantology, such as the possibility of precise planning, which results in faster and safer surgery and, consequently, reduced prosthetic complications. There are also disadvantages that must be taken into consideration for successful treatment, such as deviations between the planned and placed implant position and intraoral scanning inaccuracies. We report a clinical case in implantology in which digital workflow was used throughout the process, pointing out its facilities and complications in the daily practice of dental surgeons. The patient had grade II mobility and external root resorption of tooth 11. After virtual planning, a surgical guide was fabricated by a CAD/CAM system, with immediate placement of a dental implant using the guided surgery technique. At the end of the osseointegration period, intraoral scanning was performed for fabrication of the final prosthesis also by a CAD/CAM system. After placement, the patient approved the aesthetic and functional results of the implant. We observed advantages such as simplification of clinical steps and safety of the proposed planning, but there were also disadvantages such as the complexity of digital tools, deviations of the placed implant, and inaccuracy in color selection. It was concluded that digital workflow is a reality that can be integrated into daily dental practice, resulting in greater safety, predictability of results, and ease of use in all clinical stages. However, it should be noted that there are still inaccuracies in digital tools and that a steep learning curve is needed in this area, which, if neglected, may lead to unsatisfactory results.
Dental surgeons need in-depth knowledge of the bone tissue status and gingival morphology of atrophic maxillae. The aim of this study is to describe preoperative virtual planning of placement of five implants and to compare the plan with the actual surgical results. Three-dimensional planning of rehabilitation using software programs enables surgical guides to be specially designed for the implant site and manufactured using 3D printing. A patient with five teeth missing was selected for this study. The patient’s maxillary region was scanned with CBCT and a cast model was produced. After virtual planning using ImplantViewer, five implants were placed using a printed surgical guide. Two weeks after the surgical procedure, the patient underwent another CBCT scan of the maxilla. Statistically significant differences were detected between the virtually planned positions and the actual positions of the implants, with a mean deviation of 0.36 mm in the cervical region and 0.7 mm in the apical region. The surgical technique used enables more accurate procedures when compared to the conventional technique. Implants can be better positioned, with a high level of predictability, reducing both operating time and patient discomfort.
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