4.19.23_Hoda CIDRR Flashcards
What study examined antibiotic prophylaxis in dental implant surgery?
Momand CIDRR
474 patients having implant(s) placed
* 2g amoxicillin 1 hour before surgery
* Placebo tablets 1 hr before surgery
Result: NSSD between groups = abx prophylaxis is not required for implant surgeries
Claus Lang - did a meta-analysis to perform antibiotic prophylaxis prior to implant placement. Found that the prophylaxis group did better. (1% vs 2% is twice as much)
What study looked at the impact of local predisposing / precipitating factors and systemic drivers for peri-implant diseases?
Monje CIDRR
Predisposing factors
Soft tissue related:
* KM< 2 mm: More discomfort during brushing, inflammation and mucosal recession
* Shallow vestibulum (< 4 mm): Poorer access for plaque control measures and mobile mucosa
* Thin crestal phenotype (< 2 mm): More physiological/early bone resorption and mucosal recession
Hard tissue related:
* Highly dense bone: More physiological/early bone resorption (explanation: cortical bone has more peri-implantitis due to distance osteogenesis, osteoclastogenesis is expected)
Surgical factors:
* Inadequate implant position: More buccolingual and/or vertical bone resorption
* High insertion torque (>50 Ncm): More physiological/early bone resorption
Prosthetic factors:
* Inadequate emergence profile (>30): Plaque and debris accumulation/impaction
* Uncleansible prosthesis: Inability to access for plaque control
Implant position:
* Insufficient BBT (< 1.5 mm): Esthetic failure
* Too apical (≥6 mm from adjacent CEJ): Greater proinflammatory profile
* To shallow (equi-/supra- crestal implant position): Convex crown
* Too close to each other: Uncleansible prosthetic rehabilitation
Dr. Wang always places the implant as 45 Ncm.
Sometimes when placing implant - reverse, go in, reverse, go in - try 3 times - if doesn’t work, then redrill and try again
Why 1.5 min distance from implant to bone? = 0.5 mm for PDL, 1 mm for bone to prevent remodeling bone loss. Ideal is 3 mm (by Tarnow) based on Tal’s article. Tarnow used 3i implants with polished collar that caused saucerization and bone loss causes papillae loss.
What Michigan study looked at thread exposures and peri-implantitis risk?
Ravida - thread exposure increases risk of peri-implantitis (OR = 7.8X)
What is the role of KT as a risk factor for peri-implant disease? A systematic review & meta-analysis
Ravida CIDRR
Aim:
* To examine whether the lack of a prespecified (2 mm) amount of keratinized mucosa width (KMW) is a risk factor for peri-implant diseases.
* Systematic review & MA. 685 implants analyzed (178 in the < 2mm group, and 507 in the ≥ 2 mm group)
Results: Significant data heterogeneity. Most analyses only have 2 or 3 articles
What are the soft tissue features of peri-implant diseases and related treatments?
Galarraga-Vinueza & Tavelli
Aims: To investigate the role of inflammatory mechanisms in the soft tissue compartment during peri-implant diseases.
* PMN’s, M1/M2 macrophage ratio, T & B lymphocytes exhibit elevated values in peri-implantitis
* If < 2 mm KT, have to do a staged FGG + xenograft (or ADM).
* If > 2mm KT, can use straight away a xenograft (or ADM)
What are the prognostic factors associated with implant loss, disease progression, or favorable outcomes after peri-implantitis surgical therapy?
Ravida CIDRR
Aim: To examine the key local and systemic factors associated with implant loss, disease progression, or favorable outcomes after surgical peri-implantitis therapy.
Factors affecting long-term survival:
* Moderate bone loss 25-50% = OR: 15X compared to < 25% bone loss
* Severe bone loss (>50%) = OR: 20x compared to < 25% bone loss
* Frequency of supportive maintenance care
What are the prognostic factors associated with implant loss, disease progression, or favorable outcomes after peri-implantitis surgical therapy?
Ravida CIDRR
Aim: To examine the key local and systemic factors associated with implant loss, disease progression, or favorable outcomes after surgical peri-implantitis therapy.
Factors affecting long-term survival:
* Moderate bone loss 25-50% = OR: 15X compared to < 25% bone loss
* Severe bone loss (>50%) = OR: 20x compared to < 25% bone loss
* Frequency of supportive maintenance care
