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Data sources Five electronic databases (PubMed, Embase, Central, Web of Science, and Epistemonikos) and grey literature were systematically searched up to November 22, 2021 to identify studies relevant to patient-reported outcome measures (PROMs) in peri-implant soft tissue augmentation. Study selection Two authors independently reviewed the title, abstrac (screening phase), and full text (eligibility phase) of the articles after removing the duplicates, based on the pre-established inclusion criteria. A total of 29 clinical studies (19 randomized clinical trials, 7 non-randomized studies, and 3 case series) fulfilled the eligibility criteria based on the PICO framework. Data extraction and synthesis Data were independently extracted from the included studies by two authors using data extraction tables. The mean values of PROMs were pooled and analyzed with the weighted mean difference (WMD) and 95% confidence intervals (CIs) to summarize and compare the studies. Eleven subgroup meta-analyses (including 2–6 studies in each) were conducted using random-effect models to determine the differences in mean values of PROMs (pain scores on the Visual Analog Scale [VAS], analgesic consumption, satisfaction on VAS, aesthetic perception, surgery duration, and quality of life) between soft tissue autografts and substitutes. Results For mucosal thickness gain, pain perception was significantly reduced with soft tissue substitutes compared to subepithelial connective tissue graft (SCTG) at both 0–100 ( n  = 4; WMD = 14.91 VAS units; 95% CI: 6.42–23.40; P  < 0.0006) and 0–10 VAS scale ( n  = 4; WMD = 1.62 VAS units; 95% CI: 0.01–3.23; P  = 0.05). Similar results of significantly reduced pain with soft tissue substitutes on a 0–100 ( n  = 2; WMD = 21.43 VAS units; 95% CI: 12.58–30.28; P  < 0.0001) and 0–10 VAS scale ( n  = 4; WMD = 1.65 VAS units; 95% CI: 0.66–2.64; P  = 0.001) were found for keratinized tissue gain. Furthermore, with soft tissue substitutes painkiller consumption ( n  = 6; WMD = 1.56 tablets; 95% CI: 1.22–1.91; P  < 0.00001) and surgery time ( n  = 5; WMD = 10.9 min; 95% CI: 4.60–17.19; P  < 0.00001) were significantly less in comparison to autogenous grafts. Patient satisfaction, aesthetic perception, and quality of life did not differ significantly between soft tissue substitutes and autogenous grafts for soft tissue augmentation around implants. Conclusion PROMs in terms of postoperative pain, analgesic intake, and surgery duration are significantly improved with the use of soft tissue substitutes for peri-implant soft tissue augmentation. Similar levels of patient satisfaction and aesthetic perception were achieved with soft tissue substitutes as with autogenous grafts, without impairing the clinical outcomes.

Peri-implantitis has a polymicrobial etiology and is a major cause of dental implant loss. Various clinical protocols for its prevention and treatment have been proposed; however, some cases show a rapid progression with non-resolving clinical symptoms. To clear a means of differentiating between such cases, the implants with peri-implantitis in this study were categorized as the active group and the remission group and that two kinds of samples were obtained from the same subjects (n = 20). The microbiome was analyzed through pyrosequencing of the 16S rRNA gene. From LEfSe results, Porphyomonas , Fusobacterium , Treponema , Tannerella, and other periodontal pathogens were abundant in the active group, while lactic acid bacteria ( Lactobacillales and Bifidobacterium ) were abundant in the remission group.

Even though metagenomics have revolutionized the characterization of the human microbiome, detailed mechanistic studies are impracticable, as there is a dearth of robust culture collections. We now describe the development and use of a laser-assisted culturomics platform, incorporating the elements of a bioprinter, the culture conditions, the methods to characterize the microorganisms and a biobank. With laser-assisted bioprinting, the microorganisms can be rapidly and precisely transferred from clinical biofilms to highly organized arrays of microbial colonies, which are suitable for co-culturing and molecular analyses. The presented technique has propagated 99 of 100 microbial species and recovered 79% of abundant species from dental plaque in accordance with full 16S rRNA gene profiling of 691,199 sequences. Microscopy, spectroscopy and enzyme assays have been used to guide isolations. Processing of oral biofilms from four individuals has yielded 249 representative isolates, from 14 classes and 124 species in total. Functional profiling with bioprinting has indicated commensals which could potentially contribute to disease development. Isolates from peri-implantitis cover 85.4% of the transcriptionally active clinical biofilms at genus level. Taken together, this work provides the basis for generating on-demand culture collections and biofilms for research and clinical use. Representative microbial isolates and patient-specific biobanks are crucial for microbiome investigation and management. Here, authors develop laser-assisted microbial culturomics, combining high-throughput, precise bioprinting on diverse media with rapid, non-invasive analyses.

Design This multi-center, randomized clinical trial compared the long-term outcomes of guided bone regeneration (GBR) with open flap debridement (OFD) in treating peri-implantitis-related bony defects with ≥3 osseous walls over 36 months. The study aimed to evaluate the healing potential of GBR using a deproteinized bovine bone mineral (DBBM) graft and native bilayer collagen membrane (NBCM) compared to OFD without the use of graft materials. Case selection Sixty-six individuals diagnosed with peri-implantitis were randomly assigned to either GBR (34 patients) or OFD (32 patients). The OFD group served as the control, where inflamed tissue was removed and the implant surface decontaminated using 3% hydrogen peroxide, but no bone graft was placed. The GBR group received DBBM and NBCM for defect reconstruction. Radiographic defect fill (RDF), probing pocket depth (PPD), bleeding on probing (BOP), suppuration (SUP), mucosal recession (MREC), and patient-reported outcomes (PROs) were assessed over the study duration. Post-surgical care included azithromycin, ibuprofen, and chlorhexidine rinses. Study timeline The study involved baseline assessments, surgical interventions, and follow-ups at 6, 12, and 36 months. Supportive peri-implant therapy was provided every 3 months during the additional 24-month follow-up. Data analysis Primary outcome was RDF at 36 months. Secondary outcomes included PPD, BOP, SUP, MREC, and PROs. Descriptive statistics and ANCOVA models were used for analysis. Results At 36 months, GBR resulted in a mean RDF of 2.13  ±  1.26 mm, compared to 1.64  ±  1.54 mm with OFD (p  =  .18). No significant differences were found in PPD, BOP, SUP, REC, or PROs between the groups. Treatment success (defined as no additional bone loss, PPD ≤ 5 mm, no BOP, and no SUP) was achieved in 46.2% of GBR cases and 20% of OFD cases (p = 0.053). Conclusions GBR provided improved short-term defect fill and higher treatment success compared to OFD, although the differences were not statistically significant. Both procedures maintained clinical parameters over 36 months, with similar patient satisfaction (PROs) observed for GBR and OFD. The adjunct use of DBBM and NBCM may offer clinical benefits for peri-implantitis cases with specific bony defect morphology.

The oral microbiota change dramatically with each part of the oral cavity, even within the same mouth. Nevertheless, the microbiota associated with peri-implantitis and periodontitis have been considered the same. To improve our knowledge of the different communities of complex oral microbiota, we compared the microbial features between peri-implantitis and periodontitis in 20 patients with both diseases. Although the clinical symptoms of peri-implantitis were similar to those of periodontitis, the core microbiota of the diseases differed. Correlation analysis revealed the specific microbial co-occurrence patterns and found some of the species were associated with the clinical parameters in a disease-specific manner. The proportion of Prevotella nigrescens was significantly higher in peri-implantitis than in periodontitis, while the proportions of Peptostreptococcaceae sp. and Desulfomicrobium orale were significantly higher in periodontitis than in peri-implantitis. The severity of the peri-implantitis was also species-associated, including with an uncultured Treponema sp. that correlated to 4 clinical parameters. These results indicate that peri-implantitis and periodontitis are both polymicrobial infections with different causative pathogens. Our study provides a framework for the ecologically different bacterial communities between peri-implantitis and periodontitis and it will be useful for further studies to understand the complex microbiota and pathogenic mechanisms of oral polymicrobial diseases.

Dental implant-associated infections increase the risk of implant failure, presenting significant challenges in modern dentistry. The host-microbe interaction plays a crucial role in the development of implant-associated infections. To gain a deeper understanding of the underlying mechanisms, numerous studies have been conducted using in vitro co-culture models of bacteria and human cells or in situ samples. Due to the complexity of the images generated throughout these studies, however, the analysis by means of classical image processing techniques is challenging. This study proposes a workflow—based on two custom Cellpose models—that, for the first time, allows the analysis of microbial surface coverage in microscopy images of fluorescent-stained and co-localized microorganisms and human cells with substantial background signals. The first Cellpose model demonstrated its efficacy in the analysis of individual bacteria within images derived from an 3D implant-tissue-oral biofilm in vitro co-culture model. In combination with the second custom model, which was trained to recognize microcolonies, images obtained from an in situ study could also be automatically segmented. The model’s segmentation accuracy could be further enhanced by acquiring additional training images and improving image quality, making the proposed workflow now valuable for a range of dental implant-related and other co-culture images.

Platelet-rich fibrin (PRF) and Enamel Matrix Derivatives (EMD) can support the local regenerative events in periodontal defects. There is reason to suggest that PRF and EMD exert part of their activity by targeting the blood-derived cells accumulating in the early wound healing blastema. However, the impact of PRF and EMD on blood cell response remains to be discovered. To this aim, we have exposed human peripheral blood mononucleated cells (PBMCs) to PRF lysates prepared by a swing-out rotor and EMD, followed by bulk RNA sequencing. A total of 111 and 8 genes are up- and down-regulated by PRF under the premise of an at least log2 two-fold change and a minus log10 significance level of two, respectively. Representative is a characteristic IFN response indicated by various human leukocyte antigens (HLA-DPA1, HLA-DPB1, HLA-DQA1, HLA-DQA2, HLA-DRA, HLA-DRB1, HLA-DRB5), gamma Fc receptors (FCGR1A, FCGR1B, FCGR3B), chemokines (CXCL9-11), and calprotectin (S100A8/9 and S100A12), complement (C1QA/B, C2) and interferon-induced guanylate-binding proteins (GBP1, GBP5). With EMD, 67 and 29 genes are up- and down-regulated, respectively. Characteristic of the upregulated genes are tensins (TNS1 and TNS3). Among the genes downregulated by EMD were epsilon Fc receptors (FCER1A; FCER2), Fc receptor-like proteins (FCRL1, FCRL3) and CX3CR1. Genes commonly upregulated by PRF and EMD were most noticeably NXPH4 and MN1, as well as FN1, MMP14, MERTK, and AXL. Our findings suggest that PRF provokes an inflammatory response, while EMD dampens IgE signaling in peripheral mononucleated blood cells.

BackgroundDental implantation has been practiced since ancient times and has gone through several stages. Dentists use dental implants to support dental prostheses such as crowns, bridges, dentures, face prostheses, or as an orthodontic anchor. Thus, the purpose of this study is to detect the role of the immune-genetic variation of IL-17A and related inflammatory cytokine (IL-23) in the initiation and progress of peri implantitis.Material and methodsThis cross-sectional study included 80 subjects (15 peri-implantitis patients, 35 successful implants, and 30 healthy controls); their mean age was (43.91 ± 11.33) years. Blood samples and Peri-implant sulcus fluid (PISF) were collected from all subjects (patients with peri-implantitis, successful implants, and healthy controls) attending the Department of Oral and Maxillofacial Surgery in the Dental College Teaching Hospital, Baghdad University, Baghdad, Iraq. The blood sample detects gene polymorphisms in interleukin-17A by a polymerase chain reaction (PCR). An enzyme-linked immunosorbent assay (ELISA) was carried out to estimate the Peri-implant sulcus fluid (PISF) levels of interleukin-23.ResultThe current study revealed an obvious significant elevation in the mean level of interleukin-23 in the peri-implantitis patient’s group more than its level in the successful implant and control groups (P < 0.05). In addition, the result showed that A/A genotype is associated significantly with peri-implantitis OR (95%confidence interval) =6.9 (1.7121 to 27.4638) folds increase risk of peri-implantitis) (p = 0.0065), while G/A genotype had OR 4.9 (0.9539–24.9394) folds increased risk of peri-implantitis, (p = 0.0572). But it was not statistically significant and G/G genotype had a one-fold increase risk of peri-implantitis.ConclusionThe increased level of inflammatory cytokine (interleukin-23) might add to the systemic inflammatory burden a predisposing factor, which may lead to impaired osseointegration and subsequent bone loss or implant failure. In addition, IL-17A gene polymorphism may play a role in peri-implant disease susceptibility, especially in persons carrying the rs2275913 A allele at a higher risk of developing peri-implantitits as compared with those carrying the G allele.

This in vivo animal study aimed to evaluate the diagnostic reliability of a damping capacity assessment by correlating dental implant stability with peri-implant bone loss in a beagle dog model. Thirty-two bone-level implants were immediately placed in four beagle dogs without bone grafting. Implants were divided into platform switching and platform matching groups. Each implant was loaded with a superstructure after a 4-week healing period, followed by 8 weeks of functional loading. Damping capacity assessment and resonance frequency analysis were performed every 4 weeks. Peri-implant bone loss, supporting bone volume, and bone-to-implant contact were assessed using micro-CT and histological analysis. Two implants in the platform switching group failed during the study. Among the remaining 30 implants, final implant stability indices by damping capacity assessment ranged from 44 to 80. Peri-implant bone loss varied from 0.25 mm to 6.96 mm. A strong negative correlation was found between final stability indices and bone loss ( r = − 0.745; p  ≤ 0.0001). Supporting bone volume and bone-to-implant contact ratio showed significant positive correlations with implant stability. Damping capacity assessment demonstrated diagnostic relevance by reflecting peri-implant bone loss and the degree of osseointegration. However, its ability to detect early bone resorption is uncertain.

The aim of this study was to investigate the bactericidal effect and recovery of biocompatibility of contaminated titanium surfaces using a combination treatment involving silver, copper, or iron ion application along with 400 nm purple-LED light irradiation. Additionally, the study sought to develop a functional calcium phosphate (CaP) coating treatment on titanium surfaces following disinfection, to promote re-osseointegration. A purple-LED emitting light at 400 nm was utilized to irradiate Staphylococcus aureus suspensions and biofilms in the presence of various concentrations of silver, copper, and iron solutions for 1 min. The bactericidal effect and electron spin resonance (ESR) spectrum were subsequently evaluated. Additionally, the hydrophilicity of the titanium surface and cell viability of MC3T3-E1 cells after combination treatment with silver ion was evaluated. Furthermore, a titanium surface coating with CaP gene transfection carrier containing plasmid DNA was developed using an electric current. The activity of hard tissue formation was then evaluated both in vitro and in vivo post-treatment. The bactericidal effect of the combination treatment with silver ions was attributed to the generation of hydroxyl radicals, whereas the effects from iron and copper treatments were not radical-mediated. The silver treatment significantly restored the hydrophilicity and cell affinity of the titanium surface. Moreover, CaP coating applied via an electric current (30 µA for 5 min) enhanced hard tissue formation activity on the titanium surface in both in vitro and in vivo settings. The combination treatment utilizing silver ions and purple-LED irradiation significantly enhanced bactericidal effects by generating high levels of hydroxyl radicals. Additionally, coating the titanium surface with functionalized CaP promoted early osseointegration, suggesting a promising strategy for improving implant outcomes.