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Objectives: The aim of this study was to assess the microbiological and clinical outcomes of immediate implants placed in chronically infected sockets for rehabilitation with fixed full-arch mandibular prostheses., Material and Methods: Fourteen individuals (mean age 60.14 ± 7.69 years) were enrolled in this investigation and followed up until 8 months of function. Microbiological (microbial count and profile) and clinical (probing depth, clinical attachment level, bleeding on probing, and bone resorption) parameters were conducted before teeth extraction (T 0 - baseline) and after 4 (T 1 ) and 8 (T 2 ) months of loading. Thirty-nine microbial species including periodontopathogenic species and Candida spp. were detected and quantified by DNA checkerboard analysis., Results: Moderate to high levels of pathogenic and non-pathogenic species were found colonizing teeth and implant-related sites. No significant differences in total or individual microbial counts and microbial profile were found over time (P = 0.4929). Probing depth values from teeth (T 0 : 3.05 ± 1.45) were significantly higher when compared with implants (T 1 : 1.81 ± 0.56; T 2 : 1.66 ± 0.53; P < 0.0001). High percentages of bleeding sites were found for both teeth and implants, with the highest values recorded for teeth (P < 0.05). No significant differences were detected comparing marginal bone resorption over time., Conclusions: Total and individual counts of target species did not differ between teeth and implants for 8 months of investigation. The mean proportions of pathogenic and non-pathogenic species remained unaltered, and no clinical complications were reported over time. Data obtained suggest that immediate loading of complete mandibular prostheses retained by implants placed immediately after extraction may be a viable treatment option for edentulous individuals with previous history of periodontal disease., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: To evaluate, by means of the polymerase chain reaction (PCR), the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia in the mandibular arch of completely edentulous subjects before implant placement and 4 and 6 months after the placement of mandibular implant-supported fixed prostheses., Materials and Methods: Fifteen patients had bacterial plaque collected with sterile paper points before implant placement (ie, when they were completely edentulous) and at 3 sites on the peri-implant sulci displaying the largest probing depths after placement of 5 implants., Results: For the edentulous arch, A actinomycetemcomitans was detected in 13.3% of subjects, P intermedia was detected in 46.7% of subjects, and there was no detection of P gingivalis. After 4 and 6 months of implant placement, A actinomycetemcomitans was detected in 60% and 73.3% respectively; P intermedia in 46.7% and 53.3% respectively; and P gingivalis in 46.7% and 53.3%, respectively., Discussion: Future diagnosis should not be restricted to distinguishing individuals at risk of peri-implant disease. Such individuals should be identified by the employment of microbiologic methods and knowledge of the multifactorial nature of the host response to the action of microorganisms., Conclusions: The longer the implants were in the oral cavity, the higher the occurrence of A. actinomycetemcomitans, P. gingivalis, and P. intermedia in the peri-implant sulci of completely edentulous patients rehabilitated with mandibular implant-supported fixed prostheses was, without any clinical or radiographic evidence indicating peri-implant disease in the studied period.

Background: Long-term data on microbiological and clinical outcome as well as on patient satisfaction after implant therapy in the edentulous mandible are limited. Especially comparisons between fixed full prostheses (FFPs) and overdentures (ODs), or between anchoring systems for the latter are scarce., Aim: This study aimed to evaluate both of these parameters at the 10-year follow-up in a group of fully edentulous patients rehabilitated via an OD or a FFP (the latter to allow inter-group comparison)., Material and Methods: A total of 37 fully edentulous patients (25 ODs, 12 FFPs, age at implant installation ranged from 36 to 85 years) participated in this study. All subjects received their implants (Branemark System, Nobel Biocare AB, Gothenburg, Sweden) 10 years previously. For the ODs different attachment systems (bar, magnets, ball) had been applied that allowed a further intra-group comparison. At the follow-up visit, 10 years after the abutment insertion, a series of periodontal parameters were recorded, long-cone radiographs were taken and subgingival plaque samples were collected for analysis using checkerboard DNA-DNA hybridization. The clinical and radiographic data were recorded at abutment connection and after 1 and 10 years., Results: After 10 years of loading, mean plaque and bleeding indices and changes in attachment or marginal bone level were not significantly different, neither between the OD and FFP group, nor within the OD group. The marginal bone loss between abutment connection and year 10 was 0.86 and 0.73 mm for OD and FFP groups, respectively. The subgingival microbiota at implant sites from all (sub)-groups was comparable, with low numbers of DNA counts (+/-10 x 10(5)) but high detection frequencies of Actinobacillus actinomycetemcomitans (>90%), Porphyromonas gingivalis (>85%) and Tannerella forsythensis (30%). The composition of the subgingival microbiota was influenced by probing depth and bleeding tendency. Patient satisfaction was very high for both types of prosthetic rehabilitation. The FFP group scored only slightly better for chewing comfort and general satisfaction., Conclusion: These data indicate that from the clinical and microbiological standpoint, as well as patient satisfaction, both an OD and a FFP offer a favourable long-term outcome.

The soft tissues adjacent to osseointegrated dental implants (OII) were investigated using clinical, biochemical and microbiological methods. Tooth and implant crevices were compared in 15 partially edentulous patients, examining 28 peri-implant and 19 periodontal sites, and in 6 edentulous patients, examining 13 implant sites. Sites were classified by standard periodontal indices; the crevicular fluid flow determined; crevicular fluid was collected for collagenase assays; and the subgingival bacterial flora was examined and cultured. Differences in clinical parameters were noted in that implants had significantly less keratinized gingiva and deeper probing depths. Crevicular fluid was present in the OII sulcus but the crevicular fluid flow did not differ from that observed from tooth sites either in the partially edentulous or edentulous patients. Tissue collagenase activity and collagenase inhibitor were detected in the implant crevicular fluid and, as in periodontal sites, a strong inverse relationship was found between the levels of active collagenase and collagenase inhibitor. Microbiology included darkfield microscopy, anaerobic culturing for total colony forming unit counts and identification of black pigmented Bacteroides (BPB). Few differences were observed between implants and teeth in partially edentulous patients, indicating that crevices around teeth may act as reservoirs of bacteria which can colonize implant sites. A higher percentage of BPBs and wet spreaders (Capnocytophaga) was noted at partially edentulous implant sites when compared with edentulous implant sites, perhaps reflecting the lower numbers of periodontal pathogens present in edentulous mouths. Overall, the characteristics of implant sulci appear to be similar to periodontal sulci with respect to crevicular fluid flow and microflora.

11 edentulous patients (mean age 71.2 years) with oral or oropharyngeal malignancies were examined clinical and microbiologically before, during, and after receiving tumoricidal radiation doses (26.4-74 Gy) towards the head and neck regions. The effect of a supervised oral hygiene program and a saliva substitute (Va-OraLube) was studied. The 9 patients who survived the observation period, showed increased xerostomia and mucositis related to increased radiation. Radionecrosis or oral infections were not observed. The patients wore their dentures throughout the observation period and preferred to use the saliva substitute. The initial number of acidophilic bacteria was high, Candida albicans were present in low numbers and enteric bacteria occurred more frequently than normally. There was a reduction of micro-organisms after introduction of the hygiene program. It is concluded that careful planning of the radiotherapy, pre-radiation oral examination, denture control and instruction and an effective oral hygiene program are essential for the reduction of oral complications in edentulous patients receiving tumoricidal radiotherapy to the head and neck regions.

Six middle-aged and elderly edentulous, systemically ill patients complaining of burning mouth sensation had a fusospirochetal infection of the oral mucosa. Metronidazole was successful in the treatment of three of these patients.