Assessment of the effectiveness of differential management of patients in the early postoperative period following the dental implant surgery
DOI:
https://doi.org/10.14739/2310-1210.2018.6.146756Keywords:
dental implants, oral hygiene, differential treatmentAbstract
Development of the modern dental implantology as a science is rapidly advancing, making impressive gains. Despite the undoubted achievements, an important issue of the dental implantation is the risk of inflammatory post-surgical complications.
Aim of the study. To assess the effectiveness of the proposed differential medicamentous therapy after dental implant surgery based on the results of clinical picture dynamic monitoring in the early postoperative period (up to 3 months).
Materials and methods. 124 somatically healthy people (54 men and 70 women) aged from 18 to 34 years were examined, among them: 25 patients with intact periodontium, 35 patients with chronic catarrhal gingivitis (CCG), 30 patients with generalized periodontitis (GP) of the initial, initial-І degrees of severity, 34 patients with GP of the І and ІІІ degree of severity.
Patients were divided into 2 equal study groups: the proposed differential therapy was used for the experimental group (62 patients) in the early post-surgical period depending on the determined initial oral hygienic status; the traditional medicamentous treatment was applied for the control group (62 patients). Since the special medicamentous therapy was not advisable for the patients with healthy periodontium (25 patients) after the implant surgery, they made up the comparison group.
Immunomodulating monotherapy (6 “Imudon” lozenges per day for 2 weeks) was prescribed to patients with CCG in the postoperative period. Immunomodulating therapy (“Imudon” by the same scheme) combined with a universal broad-spectrum antimicrobial drug “Miramistin” was prescribed to patients with GP of the initial, initial-I, І and І–ІІ degrees of severity for 2 weeks. Control examinations were performed one week after removing the stitches, then weekly for 3 months before the second stage of surgery.
Results. One week after removing the stitches a significantly better oral hygienic status was observed in the main group of patients with CCG compared to the control (P < 0.05). When assessing the mucosa state above the intraosseous element in CCG patients, cases of peri-implantitis were detected neither in the main nor in the control group in the postoperative period. In the main group of patients with GP of the initial, initial-I degrees of severity the oral cavity hygienic status was significantly better in all periods of observation, starting from the first week after removing the stitches and after 3 months compared with the control (P < 0.05). When assessing the mucosa state above the intraosseous element in patients with GP of the initial, initial-I degree of severity in the postoperative period, one case of peri-implantitis was revealed in the control group. It manifested as hyperemia and edema of the mucosa above the intraosseous element during the 1st week after removing the stitches and granulation tissue growth during the 2nd week. The main group of patients with GP of the I, I–II degrees of severity were characterized by significantly better oral hygienic status – 1.90 times on average (P < 0.05), compared with the control, from the 1st week after removing the stitches and over the follow-up period up to 3 months. When assessing the mucosa state above the intraosseous element in patients with GP of the I, I–II degrees of severity in the postoperative period, one case of peri-implantitis was revealed in the control, similarly to patients with GP of the initial, initial-I degrees of severity.
Conclusions. Analysis of the clinical parameters dynamics in the patients after dental implant surgery suggests the effectiveness of the proposed methods in addition to the traditional maintenance therapy in the early period of 1 week after removing the stitches to 3 months.
The obtained results allow to recommend the proposed methods of differential medicamentous therapy in the early postoperative period following the dental implant surgery for a wide application in dental practice.
References
Blok, M. S. (2015) Dental'naya implantologiya. Hirurgicheskie aspekty [Dental implantology. Surgical aspects]. Moscow: MEDpress-inform. [in Russian].
Smektala, T., Tutak, M., Endzheievski, M., & Sporniak-Tutak, L. (2014) Biolohichni osnovy osteointehratsii [Biological bases of osteointegration]. Magazyn Stomatologiczy, 3, 68–72 [in Ukrainian].
Andriasyan, L. G., & Daburyan, P. A. (2015). E'pidemiologiya periimplantitov (obzor literaturnykh dannykh poslednikh let) [Epidemiology of peri-implantitis (review of literary data of recent years)]. Vestnik stomatologii i chelyustno-licevoj khirurgii, 3–4, 4–7 [in Russian].
Leus, P. A., & Fridberg, A. (2014) Teoretychne obhruntuvannia i praktychni mozhlyvosti profilaktyky periimplantytu [Theoretical substantiation and practical possibilities of preventive maintenance of a periimplant]. Implantolohiia Parodontolohiia Osteolohiia, 2, 77–83. [in Ukrainian].
Franke, M., Titman, K., & Brozelier, F. (2013) Periimplantyt – novyi vyklyk. Diahnostyka, preventyvni stratehii ta kontrolni ohliady [Periimplant is a new challenge. Diagnostics, Preventive Strategies and Controls]. Parodontologie, 24(1), 69–75. [in Ukrainian].
Korsch, M., Obst, U., & Walther, W. (2014) Cement-associated peri-implantitis: a retrospective clinical observational study of fixed implant-supported restorations using a methacrylate cement. Clin Oral Implants Res., 25(7), 797–802. doi: 10.1111/clr.12173.
Koutouzis, T., Wallet, S., Calderon, N., & Lundgren, T. (2011) Bacterial colonization of the implant–abutment interface using an in vitro dynamic loading model. J Periodontol, 82(4), 613–8. doi: 10.1902/jop.2010.100415.
Majkl, S. B. (2015) Dental'naya implantologiya. Khirurgicheskie aspekty [Dental implantology. Surgical aspects]. Moscow: Medpress-inform.
Nayak, A. G., Fernandes, A., Kulkarni, R., Ajantha, G. S., Lekha, K., & Nadiger, R. (2014) Efficacy of antibacterial sealing gel and O-ring to prevent microleakage at the implant abutment interface: an in vitro study. J Oral Implantol., 40(1), 11–4. doi: 10.1563/AAID-JOI-D-10-00167.
Mehta, A., Shukla, R., & Sodhi, S. P. S. (2014) Healing after gingivectomy by electrosurgery & periodontal knives. Мoscow: Lap lambert academic publishing.
Kalmin, O. V., & Fedorova, M.G. (2013) Morfologicheskie izmeneniya tkanej v zone implantacii. Мoscow: Lap lambert academic publishing.
D’Ercole, S., Scarano, A., Perrotti, V., Mulatinho, J., Piattelli, A., Iezzi, G., & Tripodi, D. J. (2011) Implants with external hexagon and conical implant–abutment connections: An in vitro study of the bacterial contamination. Oral Implantol, 40(1), 30–6. doi: 10.1563/AAID-JOI-D-11-00121.
Samoilenko, I. A. (2016) Reabilitatsiini zakhody, taktyka antyoksydantnoi ta imunokorehuiuchoi terapii pry dentalnii implantatsii u khvorykh na heneralizovanyi parodontyt (Avtoref. dis…kand. med. nauk). [Rehabilitation measures, tactics of antioxidant and immunocorrective therapy for dental implantation in patients with generalized periodontitis]. (Extended abstract of candidate’s thesis). Poltava. [in Ukrainian].
Nechaeva, N. K. (2016) Konusno-luchevaya tomografiya v dental'noj implantologii [Cone-ray tomography in dental implantology]. Moscow: GEOTAR-Media. [in Russian].
Kaushal, S. & Pal, A. S. (2014) Dental Implants and its design. Мoscow: LAP Lambert Academic Publishing.
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)