Comparison of Azithromycin and Amoxicillin Before Dental Implant Placement: An Exploratory Study of Bioavailability and Resolution of Postoperative Inflammation

Background: Studies suggest that a single prophylactic dose of amoxicillin reduces early implant complications, but it is unclear whether other antibiotics are also effective. This study compared the local antimicrobial and anti‐inflammatory effects resulting from a single dose of azithromycin or amoxicillin before surgical placement of one‐stage dental implants. Methods: Healthy adult patients requiring one‐stage dental implant placement were allocated randomly to receive either 2 g amoxicillin (n = 7) or 500 mg azithromycin (n = 6) before surgery. Peri‐implant crevicular fluid (PICF) samples from the new implant and gingival crevicular fluid (GCF) from adjacent teeth were sampled on postoperative days 6, 13, and 20. Inflammatory mediators in the samples were analyzed by immunoassay, and antibiotic levels were measured by bioassay. Results: On day 6, azithromycin concentrations in GCF and PICF were 3.39 ± 0.73 and 2.77 ± 0.90 μg/mL, respectively, whereas amoxicillin was below the limit of detection. During early healing, patents in the azithromycin group exhibited a significantly greater decrease in GCF volume (P = 0.03, analysis of variance). At specific times during healing, the azithromycin group exhibited significantly lower levels of interleukin (IL)‐6 and IL‐8 in GCF than the amoxicillin group and exhibited significantly lower levels of granulocyte colony stimulating factor, IL‐8, macrophage inflammatory protein‐1β, and interferon‐gamma‐inducible protein‐10 in PICF. Conclusions: Azithromycin was available at the surgical site for a longer period of time than amoxicillin, and patients taking azithromycin exhibited lower levels of specific proinflammatory cytokines and chemokines in GCF and PICF. Thus, preoperative azithromycin may enhance resolution of postoperative inflammation to a greater extent than amoxicillin.     

Longitudinal Comparison of Cytokines in Peri‐Implant Fluid and Gingival Crevicular Fluid in Healthy Mouths

Background: Peri‐implant and gingival tissues provide important sealing and protective functions around implants and teeth, but comparisons of the immunologic responses of these tissues after implant placement have not been conducted. Cytokine levels were measured in peri‐implant crevicular fluid (PICF) and gingival crevicular fluid (GCF) as surrogate measures of immune function at subcrestally placed dental implants and healthy periodontal sites during a 1‐year monitoring period. Methods: A total of 27 dental implants were placed subcrestally in 21 periodontally healthy patients (mean age: 49.0 ± 13.4 years). Repeated clinical and cytokine measurements were obtained over 12 months. GCF and PICF samples were collected and analyzed by cytokine microarray. Data were examined by non‐parametric analysis of variance. Results: Plaque and bleeding indices were similar among all patients (P >0.05) at baseline. During 1 year of monitoring, the mean volumes of PICF and GCF were similar (P >0.05). The levels of interleukin (IL)‐4, ‐6, ‐10, and ‐12p70, tumor necrosis factor‐α, and interferon‐γ in GCF and PICF were not significantly different and did not vary over time (P >0.05). The levels of IL‐1α were higher in GCF than PICF at 1, 2, 6, and 12 months, as were the levels of IL‐8 at 1, 2, 4, 6, and 12 months (P <0.001). Transforming growth factor‐β1 in PICF and GCF exhibited time‐dependent increases, and vascular endothelial growth factor was reduced at 1 year without differences between PICF and GCF (P >0.05). Conclusion: Within the limitations of this study design, it can be concluded that after subcrestal implant placement, the immune response of peri‐implant and periodontal tissues, as assessed by cytokine levels in PICF and GCF, is similar.     

The Effect of Gingival Retraction Procedures on Periodontal Indices and Crevicular Fluid Cytokine Levels: A Pilot Study

PURPOSE: The purpose of this study was to examine the effects of placement of retraction cord subgingivally upon periodontal indices including plaque index (PI), gingival index (GI), pocket depth (PD), bleeding on probing (BOP), and attachment level (AL), as well as gingival crevicular fluid (GCF) and TNF-alpha levels. METHODS: Ten teeth in 6 patients who were periodontally healthy were selected. These teeth had pocket depths of 3 mm or less, no evidence of significant loss of attachment, BOP, or plaque accumulation. The patients each received an oral prophylaxis. The following week, baseline measurements of periodontal indices and TNF-alpha were taken and the retraction cord was placed for 15 minutes. Following removal, the patients were dismissed. The periodontal indices measured included PI, GI, PD, BOP, and AL. In addition, the levels of TNF-alpha in GCF, were investigated. These measurements were made before gingival retraction as a baseline and on the 1st, 3rd, 7th, 14th, and 28th days post retraction. RESULTS: A repeated measures ANOVA showed that TNF-alpha levels in GCF were significantly increased at all five intervals after gingival retraction compared to the baseline. The mean TNF-alpha level peaked at Day 1 (0.90 +/- 0.62), then declined at Days 3 (0.53 +/- 0.16), 7 (0.43 +/- 0.08), 14 (0.47 +/- 0.10), and 28 (0.43 +/- 0.08) but was still elevated 54% above baseline at Day 28, p < 0.01. The GI was significantly elevated at Day 1 (0.9 +/- 0.49), p < 0.01; Day 3 (0.53 +/- 0.32); and Day 7 (0.33 +/- 0.33), p < 0.05. Unlike TNF-alpha, GI recovered to the baseline by day 14. Other periodontal parameters, PI, PD, BOP, and AL were not significantly altered by the gingival retraction procedure. CONCLUSION: This pilot study supports the previous research that gingival retraction causes an acute injury that heals clinically in 2 weeks as is indicated by the GI. It also provides the first evidence that gingival retraction results in an elevation of the proinflammatory cytokine, TNF-alpha, in GCF.     

TNF-alpha TGF-beta2 and IL-1beta levels in gingival and peri-implant crevicular fluid before and after de novo plaque accumulation

Aims: The aim of this split‐mouth study was to investigate levels of tumour necrosis factor alpha (TNF‐α), transforming growth factor beta (TGF‐β2) and interleukin‐1 beta (IL‐1β) in gingival crevicular fluid (GCF) and peri‐implant crevicular fluid (PICF) after a 21‐day‐period of de novo plaque accumulation in the same patient. Material and Methods: In 25 patients, samples of GCF and PICF were collected in the sulcus of the tooth and of the implant after professional hygiene. After the no‐hygiene phase (21 days), second samples of GCF and PICF were taken. Third samples were collected after 69 days of re‐establishment oral hygiene techniques. The crevicular fluids were used to determine the volume and the levels of TNF‐α, TGF‐β2 and IL‐1β. Results: The volume of the crevicular fluids increased significantly after 21 days of plaque accumulation around teeth and implants and decreased significantly by 69 days. TNF‐α and TGF‐β2 did not change significantly among the three different samples. A significant increase of IL‐1β was observed after plaque accumulation around the teeth GCF, whereas in the PICF the increase was not statistically significant. Conclusions: These data suggest that increased volumes of GCF and PICF could be useful markers of early inflammation in gingival and peri‐implant tissues. In the presence of de novo plaque, implants showed lower, and nearly significant, levels of IL‐1β compared with teeth.     

Acute‐phase proteins and immunoglobulin G against Porphyromonas gingivalis in peri‐implant crevicular fluid: a comparison with gingival crevicular fluid

This investigation had 2 aims: 1) to determine the levels of acute‐phase proteins and immunoglobulin G (IgG) against Porphyromonas gingivalis in peri‐implant crevicular fluid (PICF) and their association with the clinical condition of the peri‐implant mucosa; and 2) to compare the inflammatory and immunological responses at implants and teeth as reflected by the gingival crevicular fluid (GCF) and PICF levels of acute‐phase proteins and immunoglobulins. Thirty‐one partially edentulous subjects were recruited for this study. PICF was sampled from 1 healthy and 1 inflamed site from each patient; GCF was sampled from an additional 21 healthy and 27 inflamed tooth sites of the same patients. GCF and PICF were collected with paper strips (for 30 s) and analysed using enzyme‐linked immunosorbent assays for α2‐macroglobulin, α1‐antitrypsin, transferrin, lactoferrin and IgG against P. gingivalis . This investigation demonstrated that the absolute amounts of the acute‐phase proteins and IgG against P. gingivalis are higher in GCF and PICF from inflamed than healthy sites. No significant differences were observed between PICF and GCF components at either healthy or inflamed sites, suggesting that inflammatory and immune events are similar in the peri‐implant mucosa and gingiva in humans and that PICF and GCF production is governed by similar mechanisms.     

Interleukin-1beta,tumor necrosis factor-alpha levels and neutrophil elastase activity in peri-implant crevicular fluid

The aim of this study was to determine interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha) levels and neutrophil elastase (NE) activity in peri-implant crevicular fluid (PICF) of smoker and nonsmoker patients, and to investigate their relationships with clinical parameters. A total of 42 endosseous root-form dental implants of 14 patients were clinically examined by modified Plaque index (PI), modified Gingival index (GI) and probing depth (PD). Smoking habits of the patients were recorded. PICF of implants were collected by Periopaper strips and IL-1beta, TNF-alpha levels were determined by enzyme-linked immunosorbent assay (ELISA). NE was analyzed with a neutrophil specific chromogenic substrate, N-methoxysuccinyl-Ala-Ala-Pro-Val-p-nitroanilide. The cytokine and enzyme levels in PICF were expressed as total amount/activity and as concentrations. NE activity in PICF significantly correlated with GI and PD, and IL-1beta levels with GI and PICF volume (P < 0.05). The correlations were stronger when the PICF levels were expressed as total IL-1beta amount and as total NE activity. The implants with inflamed gingiva (GI > 1) had higher levels of IL-1beta and NE activity than implants with noninflamed or slightly inflamed gingiva (GI 3 mm) was greater than the implants with shallow pockets (PD 相似文献   

种植义齿排龈后种植体周围软组织损伤愈后的动物实验研究

目的 通过观察比格犬种植义齿排龈后牙龈指数、龈沟液量和龈沟液中炎症细胞因子肿瘤坏死因子-α（TNF-α）等指标的变化,探讨排龈所致种植义齿周围软组织损伤愈后情况。方法 拔除8只比格犬左侧下颌第四前磨牙（n=8）,严格控制口腔菌斑,2个月后行骨水平种植体植入,3个月后行全冠粘接固位。全冠粘接前使用排龈线排龈5 min,排龈前和排龈后1、3、7、14、28、56 d,分别记录种植体的牙龈指数,测量龈沟液量并用酶联免疫吸附试验检测龈沟液中TNF-α的变化。 结果 种植体牙龈指数、龈沟液量、TNF-α在排龈后第1、3、7天均大于排龈前和排龈后第14、28、56天（P<0.05）,第14、28、56天恢复至排龈前水平,差异无统计学意义（P>0.05）。结论 保持良好口腔卫生的情况下,骨水平种植义齿周围软组织排龈线造成的排龈损伤是可逆性损伤,牙龈指数、龈沟液量、TNF-α在第14天恢复至排龈前水平。     

种植体周围龈沟液中白细胞介素-8含量的测定

目的　测定种植体周围炎患者龈沟液(GCF)中白细胞介素-8(IL-8)水平,探讨IL-8与种植体周围炎的关 系。方法　选择健康种植体和种植体周围炎患者各35例,测定种植体周GCF量并运用双抗体夹心酶联免疫吸附 法检测GCF中IL-8总量及浓度;同时检测种植体周临床指标,包括菌斑指数、探诊深度、牙龈指数和松动度。结果 　种植体周围炎GCF量、IL-8总量和浓度均高于健康种植体(P<0·01);GCF量、IL-8总量与临床指标之间有正相关 关系(P<0·01)。结论　种植体周围GCF量及GCF中IL-8水平的变化与种植体周围炎的发生有关,临床检测GCF 中IL-8水平可作为诊断种植体周围炎的客观指标之一。     

Tissue inhibitor of metalloproteinases-1, matrix metalloproteinases-1 and -8, and collagenase activity levels in peri-implant crevicular fluid after implantation

The integrity of connective tissues surrounding dental implants may be influenced by a balance between matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). The purpose of this study was to provide an overall assessment of TIMP-1, MMP-1 and -8 levels as well as collagenase activities during the wound healing process after implantation and in peri-implantitis lesions. Peri-implant crevicular fluid (PICF) was sampled with sterile paper strips from 10 osseointegrated implants of 6 subjects. Ten implants from 6 patients affected with peri-implantitis were also assessed. Gingival crevicular fluid (GCF) from 11 periodontitis-affected patients and 10 healthy volunteers served as controls. TIMP-1 and MMP-1 and -8 protein levels in the PICF were measured by ELISA, and active and APMA-activatable collagenase activities were determined by functional assays using image-analysis after SDS-PAGE. The experiment showed a significant increase in the TIMP-1 level at 1 week after implantation as compared with that in GCF from healthy periodontium. Four weeks after implantation it had reached the same level as that in the GCF of healthy subjects. The data has also disclosed a higher post-implantation collagenase activity level at 1 week than at weeks 2, 4, and 12. This may be due to the increase in MMP-1 and -8. Furthermore, peri-implantitis and periodontitis were shown to be similar inflammatory lesions in respect to MMP-1 and -8 and collagenase activities, even though the TIMP-1/MMP-1 + MMP-8 ratio was significantly lower in peri-implantitis than in periodontitis. In conclusion, the overproduction of TIMP-1 in the wound area after implantation could, to some extent, inhibit excessive tissue destruction and degradation of the neo-matrix in wound repair due to MMPs.     

Expression of HMGB1 and HMGN2 in gingival tissues, GCF and PICF of periodontitis patients and peri-implantitis

Background and objective

High mobility group chromosomal protein B1 (HMGB1) and N2 (HMGN2), two members of high mobility group (HMG) family, play important role in inflammation. The purpose of this study was to investigate the expression of HMGB1 and HMGN2 in periodontistis.

Materials and methods

The expression of HMGB1 and HMGN2 mRNA in gingival tissues and gingival crevicular fluid (GCF) in chronic periodontitis (CP), generalised aggressive periodontitis (G-AgP) patients and healthy subjects was detected by real-time PCR. The protein level of HMGB1 and HMGN2 in peri-implant crevicular fluid (PICF), peri-implant crevicular fluid of peri-implantitis (PI-PICF) and normal patients was determined by Western blotting. Furthermore, IL-1β, IL-6, IL-8, TNF-α and HMGB1 levels in GCF, PI-PICF and healthy-PICF samples from different groups were determined by ELISA.

Results

HMGN2 expression was increased in inflamed gingival tissues and GCF from CP and G-ApG groups compared to control group. HMGB1 expression was the highest in the gingival tissues and GCF from CP patients and was accompanied by increased concentrations of IL-1β, IL-6, IL-8 proinflammaory cytokines.

Conclusion

To our knowledge, this is the first study reporting that the expression of HMGB1 and HMGN2 was increased in the gingival tissues and GCF in CP and G-AgP and the PICF in PICF. Our data suggest that HMGB1 may be a potential target for the therapy of periodontitis and PI.     

复方黄芩含漱液与复方氯己定含漱液治疗慢性龈炎的疗效比较

目的:比较复方黄芩含漱液与复方氯己定含漱液治疗慢性牙龈炎的临床疗效及龈沟液中TNF-α的变化.方法:纳入慢性龈炎患者90例,按随机数表法将研究对象分为生理盐水(A)组、复方氯己定组(B)和复方黄芩组(C),每组30例,常规进行口腔洁治,分别在治疗前及治疗后1、2周和1个月记录菌斑指数、牙龈指数,检测龈沟液中TNF-α的含量.结果:4个时间点综合比较,3组患者菌斑指数有统计学差异(F =3.506,P=0.034),B组低于A、C组,而A组和C组无统计学差异(P=0.611);3组患者牙龈指数的差异有统计学意义(F =6.359,P=0.003),A组高于B、C组,而B和C组无统计学差异(P=0.911);3组患者龈沟液中TNF-α的浓度有统计学差异(F =3.780,P=0.027),A组高于B、C组,而B和C组无统计学差异(P=0.923).结论:复方黄芩含漱液与复方氯己定含漱液缓解慢性牙龈炎炎症的效果相当.     

Effects of Topical Antibiotic Prophylaxis on Wound Healing After Flapless Implant Surgery: A Pilot Study

Background: The purpose of this pilot study is to investigate the effects of local application of minocycline hydrochloride ointment (MHO) and erythromycin eye ointment (EEO) on wound healing after flapless implant surgery. Methods: Forty patients with flapless implant surgery were enrolled and assigned randomly to three groups: 1) MHO group (n = 17); 2) EEO group (n = 18); and 3) control group (n = 5). All of them took systemic antibiotics; the control group did not receive the application of topical antibiotics. Three days after the surgical operation, clinical parameters, peri‐implant crevicular fluid volume, and crevicular lipopolysaccharide (LPS) levels of all patients were collected, measured, and analyzed. Results: Clinical outcomes of the two treatment groups were superior to results of the control group, indicating the effectivity of local antibiotics application in promoting early wound healing after flapless implant surgery. There was no obviously different effect between EEO and MHO in the early stages of healing. In addition, there were significant correlations between LPS level and all clinical parameters. Conclusions: The local application of antibiotics along with the systemic antibiotics could reduce the inflammatory response in wound healing after implant surgery. The EEO and MHO were equally effective in early wound healing. Compared to the MHO, the EEO has advantages of higher cost efficiency and convenience. Therefore, it is recommended to use the EEO in topical antibiotic prophylaxis for wound healing after flapless implant surgery.     

Osmotic pressure of periimplant sulcular and gingival crevicular fluids: a split-mouth, randomized study of its measurement and clinical significance

Objectives: This study comparatively investigated periimplant sulcular fluid (PISF) and gingival crevicular fluid (GCF) by means of the osmotic pressure (OP) levels of PISF (PISFOP) and GCF (GCFOP). It was a preliminary research that aimed to quantify PISFOP and GCFOP as well as to evaluate their clinical significances around implants and teeth. Material and methods: Partially edentulous implant patients treated by the same clinicians and using the same implant system were randomized in a split‐mouth trial design. Fifty‐four implants and teeth from these patients were selected in the same mouth and jaw as matched pairs of samples, i.e. as symmetrical or corresponding implant and tooth. PISFOP/GCFOP measurement was performed by an osmometer following PISF/GCF sampling procedures. Clinical significance was evaluated by the correlations between PISFOP/GCFOP and some clinical examination parameters of periimplant/periodontal soft tissues. These parameters included Silness–Löe plaque index (PI), Löe–Silness gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD) and probing attachment level (PAL). Results: PISFOP was higher than GCFOP, and GI, BOP, PPD and PAL were higher in the implant group than in the tooth group (P<0.05). PISFOP positively correlated with the clinical parameters of implants (P<0.01 for PI, GI and BOP; P<0.05 for PPD and PAL), and GCFOP positively correlated with the clinical parameters of teeth (P<0.01 for PPD; P<0.05 for PI, GI, BOP and PAL). Conclusions: The results reveal that PISFOP and GCFOP may be measured by osmometer, and their levels may be related with the clinical conditions of periimplant/periodontal soft tissues. To cite this article:
Sakallιo?lu U, Lütfio?lu M, Sakallιo?lu EE, Sert S, Ceylan G. Osmotic pressure of periimplant sulcular and gingival crevicular fluids: a split‐mouth, randomized study of its measurement and clinical significance.
Clin. Oral Impl. Res. 22 , 2011; 706–710
doi: 10.1111/j.1600‐0501.2010.02044.x     

Plasma and gingival crevicular fluid phenytoin concentrations as risk factors for gingival overgrowth

BACKGROUND: Gingival enlargement is one of the side effects associated with the administration of phenytoin. The mechanism by which phenytoin induces gingival enlargement is not well understood. This study was conducted to investigate the relationship between plasma and gingival crevicular fluid (GCF) phenytoin concentrations and the degree of gingival overgrowth in patients with similar gingival and plaque indices and also to determine the risk factors for gingival enlargement. METHODS: Eighteen patients taking phenytoin in regular doses > or =6 months prior to the investigation participated in the study. Gingival enlargement was evaluated with two indices to score vertical and horizontal overgrowth. The gingival index (GI), plaque index (PI), gingival bleeding time index (GBTI), probing depth (PD), and clinical attachment level (CAL) were also evaluated. GCF and plasma phenytoin concentrations were determined by using high-performance liquid chromatography (HPLC). RESULTS: There was no significant difference between responders and non-responders for PD, CAL, PI, GI, and GBTI. Phenytoin was detected in all of the GCF and plasma samples using the HPLC analysis method. The mean concentration of phenytoin in GCF was significantly greater than the concentration of phenytoin in plasma. No significant difference was observed for the concentration of GCF phenytoin between responders and non-responders. However, the concentration of plasma phenytoin was significantly higher in responders than non-responders. CONCLUSION: This study showed that plasma phenytoin level appeared to be a risk factor for phenytoin-induced gingival overgrowth.     

Associations of alveolar bone loss and interleukin-1β levels in one- and two-stage surgical procedures: a randomized prospective trial

Objective: Dental implants have been widely and successfully used in recent years as an alternative treatment for removable and fixed dental prostheses. The aim of this randomized prospective study was to determine the alveolar bone loss rate (ABLR) and IL-1β levels in one- and two-stage surgical procedures.

Materials and methods: This study included 40 patients with a single missing tooth in the posterior mandible; dental implants were inserted using a one-stage surgical procedure (Group I) or a two-stage surgical procedure (Group II). All clinical periodontal parameters were recorded; peri-implant crevicular fluid (PICF) samples were collected before loading (T0) and during the third (T1) and sixth (T2) months after loading. ABLR values were evaluated at T0 and T2 by using dental tomography. PICF was analysed after T2 samples were collected. The study was registered through clinicaltrials.gov; identifier NCT03045458.

Results: This study found that, the probing pocket depth was found to be significantly higher in Group I than Group II at both T1 and T2 (p?p?>?.05). There was a significant difference between Group I ABLR values at T0 and T2 (p?p?>?.05).

Conclusions: Within the limitations of the short observational period and small sample size of this study, two-stage implant placement shows comparable clinical outcomes to implants placed using a one-stage placement protocol.     

Early soft tissue healing around one-stage dental implants: clinical and microbiologic parameters

BACKGROUND: Despite the potential significance of early soft tissue healing to long-term outcomes, this aspect of one-stage dental implants has not been investigated. The purpose of this prospective study was to characterize clinical and microbiologic parameters of early soft tissue healing around dental implants placed following a one-stage protocol. METHODS: Twenty-one patients (11 females and 10 males, aged 18 to 78 years; two smokers) needing a single implant were included. Clinical parameters included probing depth, buccal flap thickness, papilla height, and bleeding on probing. Subgingival plaque samples were obtained pre- and postoperatively and analyzed using molecular techniques. RESULTS: The newly formed peri-implant sulcus probing depth remained fairly stable from 4 to 12 weeks (P > 0.05). There was no statistically significant association between flap thickness or papillary height and number of implant bleeding sites at 12 weeks (P > 0.05). Detection of known periodontal pathogens was rare. Fusobacterium nucleatum was present in 17 patients prior to surgery, and 71% of them became carriers of this bacterium at the implant site by the second postoperative week. The number of F. nucleatum-positive subjects around the implant was significantly lower than the number of F. nucleatum-positive subjects around teeth (P < 0.05). CONCLUSIONS: Peri-implant soft tissue clinical maturity may be established as early as 4 weeks following implant placement by a one-stage surgical protocol; neither preexisting flap thickness nor papillary height seemed to influence newly forming peri-implant sulcus depth or bleeding on probing prevalence. For the most part, the newly created peri-implant crevices were colonized by specific bacteria within 2 weeks.     

Ligature‐induced peri-implant infection in cynomolgus monkeys.Clinical and radiographic findings.

The purpose of this study was to compare the effect of plaque accumulation in conjunction with or without placement of plaque-retaining ligatures on peri-implant and periodontal tissues. Four cynomolgus monkeys received 2 ITI (Type F) dental implants in edentulous areas of each side of the mandible. Following a healing period of 2 months with regular prophylaxis procedures twice per week, plaque was allowed to accumulate. After 1 month (day 0), silk ligatures were placed around 1 of the 2 implants. The third molars served as controls and were ligated as well. Clinical examinations comprising Plaque Index (PlI), Gingival Index (GI), probing depth (PD) and loss of attachment (LA) were performed at the test and control sites before and 1, 2, 3, 4, 5, 6, 7 and 8 months after ligature placement. Sixty and 30 days prior to ligation and at 2, 5, 6 and 8 months following ligation, standardized radiographs were obtained and subtracted from a baseline radiograph obtained at the time of ligation. PI1 and GI scores increased significantly following the elimination of prophylaxis procedures. After ligation, these indices continued to increase and reached values significantly higher in ligated implant (LI) and ligated teeth (LT) sites than in non-ligated teeth (NLI) sites. PD also increased after plaque accumulation and ligature placement. Significantly greater PD values were noted in LI and LT sites than in NLI sites. Also, loss of attachment was observed already after 1 month following ligation in LI and LT sites and reached a value of 3.8 mm after 8 months, whereas only 1.0 mm of attachment was lost after 7 months of plaque accumulation in NLI. Similar results were noted in the analysis of the subtraction images. LI and LT sites lost significantly more bone density and more alveolar bone height, but the NLI sites yielded relatively stable conditions throughout the study. It is concluded that the development of a peri-implant infection progressed at a similar rate as the development of a periodontitis lesion and that ligature placement significantly promoted the development of these lesions when compared with the development of an inflammatory response in the peri-implant tissues as a result of bacterial plaque accumulation.     

IL-6 and IL-8 levels in GCF of the teeth supporting fixed partial denture

Objectives:  To evaluate the gingival crevicular fluid (GCF) contents of interleukin-6 (IL-6) and interleukin-8 (IL-8) and the clinical parameters of the teeth supporting fixed partial denture (FPD) and the contralateral teeth and to assess the effect of scaling and root planning (SRP) on clinical parameters and the GCF levels of cytokines.
Materials and methods:  The study population included 23 patients. Probing depth (PD), clinical attachment level (CAL), plaque index (PI), and gingival index (GI) were recorded, and GCF samples were collected for analysis of cytokine levels from the teeth with FPD (Test Group), the contralateral teeth (Control Group) of each participant at baseline. After initial measurements, all participants received primary phase of non-surgical treatment including oral hygiene instruction and scaling and root planning (SRP). At the 1st month and the 3rd month after SRP, these procedures were repeated.
Results:  In both groups, all clinical parameters and the total amount of IL-8 showed decreases from initial to the 3rd month ( P  < 0.05), but from the 1st month to the 3rd month; PD, PI, and GI values significantly increased in the test group ( P  < 0.05).
Conclusion:  The non-surgical periodontal treatment reduced the total amount of IL-8, not IL-6, and the clinical parameters of the teeth with FPD and contralateral teeth. But, there was a trend to the higher levels of PD, PI, and GI in the teeth with FPD. Therefore, a regular program for dental prophylaxis is also important for the maintenance of periodontal health in patients with FPD.     

Clinical and radiographic evaluation of soft and hard tissue changes around implants: a pilot study

BACKGROUND: The aim of this study was to evaluate the clinical and radiographic changes in the peri-implant tissues around one-stage implants with different smooth neck portion lengths before and after functional prosthetic loading. METHODS: Twelve one-stage implants were placed in adult patients with bilateral edentulous posterior mandibular ridges. The sites were randomly assigned into two groups of six each: group 1: 2.8 mm neck implants and group 2: neck implants. The parameters plaque index (PI), gingival index (GI), probing depth (PD), gingival margin level (GML), relative clinical attachment level (r-CAL), and optical density (OD) were measured at loading (4 months) and 12 months after implant placement. The radiographic parameter osseous level (OL) was measured at implant placement, loading, and at 12 months. Analysis of variance and the paired Student t test were used to detect difference over time and between groups. RESULTS: The results showed significant differences (P<0.05) for both groups for PD, r-CAL, and OL for intragroup comparisons over time. However, no significant differences were found for PI, GI, PD, GML, OD, and OL for between-group comparisons. CONCLUSION: Bony loss occurred before loading, supporting the soft tissues and maintaining the biologic width irrespective of the smooth portion length.     

The application of a collagen stabilizer to the gingiva of the beagle dog. Effect on ligature-induced periodontal disease

The objective of this study was to determine the effect of crevicular application of a collagen stabilizer on ligature-induced periodontal disease in beagle dogs. Fourteen male and female dogs, 15 months of age, were studied. The mandibular first molars and third and fourth premolars were ligated for 6 months and moderate periodontitis resulted. Ligatures were removed for 2 months and then replaced for an additional 3 months to experimentally mimic the episodic changes seen in human periodontal disease. Following this phase, ligatures were removed and the animals were assigned to a placebo or treatment group. Medications were then applied intracrevicularly, three times a week over 5 months using an IMAX irrigator. Clinical indices measured were plaque index (PI), gingival index (GI), gingival crevicular fluid flow (GCF), attachment level (AL), pocket depth (PD) and standardized radiographic analysis of alveolar bone height. While overall changes in PI, GI and GCF were not significant, the results showed that alveolar bone regeneration was increased approximately twice as much in the treatment group as compared to the placebo group, PD improved by 20% vs. 12.5% (P less than 0.001) and AL improved by 8.8% vs. 4.5% (P less than 0.001). The data were also evaluated in terms of the response in more severe sites as compared to those less severe. The results of these evaluations showed the more severe sites to be significantly more responsive to treatment than the less severe sites.(ABSTRACT TRUNCATED AT 250 WORDS)