Pre- and post-operative management of dental implant placement. Part 2: management of early-presenting complications

Bryce, Graeme; Bomfim, Deborah I; Bassi, G. Steven

doi:10.1038/sj.bdj.2014.702

Cited by 24 publications

(16 citation statements)

References 64 publications

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“…With respect to dental implants, chlorhexidine has indications at several different stages: Pre-surgical mouth rinse (0.12% or 0.2% Chlorhexidine) to reduce oral microbial load for 7-10 days prior to surgery and immediately prior to surgery [ 64 , 65 ]; Post-operative protocols involving application of pressure for 30 minutes with gauze soaked in chlorhexidine [ 65 ] and rinse and during 7-14 days after surgery to aid healing [ 66 , 67 ] and for treatment of post-operative infections; Reduction of implant biofilm formation post-surgery [ 68 ] this may not necessarily relate to long improved outcomes in terms of preventing or managing longer term infections such as peri-implantitis As a mouth rinse during implant maintenance and for treatment of peri-implant disease, where high levels of plaque control are important. Including, irrigation with 0.12-0.2% chlorhexidine, plus topical chlorhexidine gel for 10 days, as an adjunct to mechanical debridement, may be beneficial [ 69 ].…”

Section: Uses For Oral Diseasementioning

confidence: 99%

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Current uses of chlorhexidine for management of oral disease: a narrative review

Brookes

Bescós

Belfield

et al. 2020

Journal of Dentistry

231

158

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Objectives Chlorhexidine (CHX) is a commonly used antiseptic mouthwash, used by dental practitioners and the public, due to its antimicrobial effects. The aim of this article was to provide a narrative review of current antimicrobial uses of CHX relevant to dentistry in the context of oral diseases, highlighting need for further studies to support its safe and appropriate use. Study selection, data and sources Randomised controlled trials, systematic reviews and national (UK and US) guidelines were consulted where available, with search terms for each subject category entered into MEDLINE, PubMed, Google Scholar and the Cochrane database. Results Some evidence existed to support adjunctive short-term use of CHX to manage dental plaque, and reduce clinical symptoms of gingivitis, dry socket, as well as reduce aerosolisation of bacteria. However, use must be weighed alongside the less desirable effects of CHX, including extrinsic staining of teeth, antimicrobial resistance to antiseptic agents and the rare, but fatal, allergic reactions to CHX. Conversely, evidence for the effectiveness of chlorhexidine to manage or prevent periodontitis, dental caries, necrotising periodontal diseases, peri-implantitis, and infections associated with extraction and aerosolised viruses remains less certain. Conclusions The use of CHX in dentistry and oral healthcare continues to be widespread and thus it is important that dental practitioners understand that, based on its differential mechanisms of action on different microbes, appropriate clinical and dental use of CHX should be oral disease specific. However, further scientific and clinical research is required before full recommendations can be made.

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Section: Uses For Oral Diseasementioning

confidence: 99%

“…Pre-surgical mouth rinse (0.12% or 0.2% Chlorhexidine) to reduce oral microbial load for 7-10 days prior to surgery and immediately prior to surgery [ 64 , 65 ];…”

Section: Uses For Oral Diseasementioning

confidence: 99%

Current uses of chlorhexidine for management of oral disease: a narrative review

Brookes

Bescós

Belfield

et al. 2020

Journal of Dentistry

231

158

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“…In our study, bone quality was assessed as being similar to mature bone 4-6 months after implant placement at all implant sites. Considering dental implant surgery can be associated with complications leading to patient morbidity and implant failure (5,6,43) including peri-implantitis in 34% of cases (44) and flap dehiscence in 19.1% (45), our preliminary result of the clinical study is encouraging. We have seen no complications and successful restoration of bone tissue in GBR by CelGro™ in 16 implants among 10 participants…”

Section: Discussionmentioning

confidence: 79%

“…Type I collagen is major protein component of the ECM in bone. It has been shown that undenatured type I collagen has a dynamic, bioactive structure with the ability to regulate cellular proliferation, differentiation and repair (43,44). We showed that CelGro™ is a predominantly Type I collagen bilayer membrane with two distinct sides of differently-aligned collagen fibers.…”

Section: Resultsmentioning

confidence: 99%

Collagen Membrane for Guided Cortical Bone Regeneration: Characterization, Preclinical and Proof of Concept Clinical Studies

Allan

Ruan

Landao-Bassonga

et al. 2020

Preprint

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Background: Treatment of cortical bone defects is a clinical challenge. Guided bone regeneration (GBR), commonly used in oral in maxillofacial dental surgery, may show promise for orthopedic application in repair of cortical defects. However, a limitation in the use of GBR for cortical bone defects is the lack of an ideal scaffold that provides sufficient mechanical support to bridge the cortical bone with minimal interference in the repair process. We have developed a new collagen membrane, CelGroTM, for use in GBR. We report the material characterisation of CelGroTM, and evaluate the performance of CelGroTM in translational preclinical and clinical studies. Methods: Scanning electron microscopy (SEM), micro computed tomography (micro-CT) and transmission electron microscopy (TEM) were used to examine the structural morphology of CelGroTM. Purity and biochemical composition of CelGroTM was evaluated by Western-blot, immunohistochemistry and confocal microscopy. Physical and chemical properties of CelGroTM were examined and compared with another commercially available collagen membrane. The pre-clinical evaluation was conducted using a cortical bone defect model in the New Zealand white rabbit. Cortical bone regeneration in defects of the femoral diaphysis were evaluated at 30 days and 60 days after intervention, by micro-CT and histology. A clinical study to evaluate the performance of CelGroTM in GBR for treatment of bone augmentation surrounding dental implants was also performed. The clinical outcomes were evaluated by semi quantitative tissue condition assessments and cone-beam computed tomography (CBCT) scan. Results: CelGroTM has a bilayer structure of different fibre alignment and is composed almost exclusively of type I collagen. CelGroTM was found to be completely acellular and a clinically significant xenoantigen, α -gal, was not detected. CelGroTM displayed less deformity and better mechanical strength as compared to Bio-Gide ® . In the preclinical study, CelGroTM demonstrated enhanced bone-modelling activity and cortical bone healing. Micro-CT evaluation showed early bony bridging over the defect area 30 days post-operatively, and nearly complete restoration of mature cortical bone at the bone defect site 60 days post- operatively. Histological analysis at day 60 after surgery further confirmed that CelGroTM enables bridging of the cortical bone defect by induction of newly-formed cortical bone. It appears that CelGroTM showed better cortical alignment and reduced porosity at the defect interface compared to Bio-Gide®. Owning the fact that selection of orthopedic patients with cortical bone defects is complex, we conducted the proof of concept clinical study in a total of 16 dental implants which were placed in 10 participants receiving GBR. The results showed that there were with no complications or adverse events observed. CBCT evidenced efficiency of the CelGroTM scaffold for GBR for the dental implants, showing significantly decreased 2 distance from the implant shoulder to first bone/implant contact (DIB) and increased horizontal thickness of facial bone wall (HT). Conclusion: The findings of our study demonstrate that CelGroTM is an ideal membrane for GBR not only in oral maxillofacial reconstructive surgery but also in orthopedic applications. Details of clinical trial registration: “Single centre, open-label, pilot study of Celgro(tm) collagen membrane for guided bone regeneration around exposed implants in patients undergoing dental implant surgery”; Registration ID: ACTRN12615000027516; Date of registration: 19/01/2015; URL: https://anzctr.org.au/ACTRN12615000027516.aspx

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“…It has been recommended that the anti-bacteria treatment could be performed in the event compromised local and systematic conditions increase the infection possibility of the implantation sites. [21][22][23] We expect that this modied abutment might be used immediately aer implant placement as a prophylaxis treatment, in patients with complex bone augmentation, at susceptible sites of an immediately placed implant, suffering from previous periodontitis or periapical lesion, or compromised systematic conditions (such as diabetes). Thus, the special healing abutment might play a role in the prevention of peri-implantitis and early infection.…”

Section: Discussionmentioning

confidence: 99%

Roles of a new drug-delivery healing abutment in the prevention and treatment of peri-implant infections: a preliminary study

et al. 2018

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Pre- and post-operative management of dental implant placement. Part 2: management of early-presenting complications

Cited by 24 publications

References 64 publications

Current uses of chlorhexidine for management of oral disease: a narrative review

Current uses of chlorhexidine for management of oral disease: a narrative review

Collagen Membrane for Guided Cortical Bone Regeneration: Characterization, Preclinical and Proof of Concept Clinical Studies

Roles of a new drug-delivery healing abutment in the prevention and treatment of peri-implant infections: a preliminary study

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