Managing variables in radiographic imaging for implant dentistry.
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Biomedical subjects
Publications and source records attributed to Donald P Callan.
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BACKGROUND: Currently, there is limited knowledge concerning the specific genus and species of bacteria that may colonize internal surfaces of the implant-abutment interface (IAI) of two-stage dental implants. The purpose of this study was to use DNA probe analysis to identify those periodontopathic bacteria that may inhabit the internal surfaces and healing abutment screw-threads of the IAI of dental implants in situ. METHODS: Following osseointegration, bacterial samples for DNA probe analysis were obtained from 54 two-stage hydroxyapatite plasma spray-coated implants in 32 patients. Using sterile paper points, samples were obtained from the IAI of 43 implants and the screw-threads of healing abutments in the other 11 implants. DNA probes were available to detect the following microbes: Actinobacillus actinomycetemcomitans, Tannerella forsythensis, Campylobacter rectus, Eikenella corrodens, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, and Treponema denticola. RESULTS: All samples taken from healing abutment screw-threads were negative for all target microbes. The aggregate percentage of positive results for each target microbe for samples from internal surfaces of the IAI were: 41.9%, A. actinomycetemcomitans, 60.5%, T. forsythensis; 44.2%, C rectus; 60.5%, E. corrodens; 48.8%, F. nucleatum; 46.5%, P. gingivalis; 55.8%, P. intermedia; and 51.2%, T. denticola. In addition, no significant differences were noted between colonization of individual microbial species when comparing anterior to posterior and maxillary to mandibular implant sites. CONCLUSIONS: Moderate to high levels of eight different periodontopathic microbes inhabiting the internal surfaces of the IAI of 43 two-stage implants in partially edentulous patients were identified by DNA probe analysis. The microbes colonized these surfaces within 25 days following the second stage surgery and placement of the healing abutment. In contrast, all samples obtained from screw-threads of 11 healing abutments were DNA probe negative. These findings appear to support those of other investigations demonstrating the translocation of bacteria from residual dentition to implants.
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BACKGROUND: Long-term evaluation of periodontal therapy is important for clinical decision making. METHODS: A synthetic cell-binding peptide (P-15) combined with anorganic bovine-derived hydroxyapatite bone matrix (ABM) was evaluated as a bone replacement graft in human periodontal osseous defects. Following initial preparation and reevaluation, flap surgery was performed. A variety of 1-, 2-, 3-wall bony defects were curetted and root surfaces subjected to mechanical debridement only. The bone defects were grafted with ABM/P-15, and the host flaps replaced or slightly coronally positioned. Weekly, then monthly deplaquing was performed until surgical reentry at 6 to 7 months. Patients were then followed on approximate 3-month recalls for 3 years. Twenty-five of the original 31 patients qualified for long-term evaluation in that their ABM/P-15 treated sites did not receive any additional therapy at the time of reentry. RESULTS: Significant clinical changes for the overall group of bony defects included improvement in mean clinical attachment level from 5.4 mm at surgery to 4.5 mm at the 6-month reentry to 3.8 mm at 3 years. There was also a decrease in mean probing depth from 5.3 mm at surgery to 3.1 mm at the 6-month reentry to 2.9 mm at 3 years. The mean gingival recession changed from +0.1 mm at surgery to 1.4 mm at the 6-month reentry to 0.9 mm at 3 years. All of these differences were at least P <0.05 from surgery to the 6-month reentry, and surgery to 3 years, but were not significant from reentry to 3 years via repeated measures analysis of variance. CONCLUSIONS: These favorable 3-year results with ABM/P-15 suggest that it may have a beneficial effect in the long-term clinical management of infrabony defects. Further long-term randomized controlled studies are needed to better assess the role of ABM/P-15 in long-term healing of periodontal osseous defects.
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