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ePaper created 2017-01-11, 10:22:38 | version 1.38.0
Journal of Oral Science & Rehabilitation 60 Volume 2 | Issue 4/2016 S u r g i c a l t r e a t m e n t o f p e r i i m p l a n t i t i s Figs . 4a–c Table 2 Figs. 4a–c Clinical (occlusal and lateral) and radiographic view at the 12-month follow-up. Table 2 Bacteria counts at different sites (values expressed in millions of colony-forming units). Sites preop Total count Aa Pg Tf Td Pi Pm Fn Cr Ec Ca Periimplant sulcus 137.000 0 ± 0 36.3000 ± 31.6000 0.3230 ± 0.1670 0.0524 ± 0.0232 4.1200 ± 1.9200 0.041500 ± 0.009800 3.4100000± 1.0800000 0.4404 ± 0.209 0.2630 ± 0.0870 0.00 ± 0.38 Neighbor- ing teeth 885.000 0 ± 0 0.0212 ± 0.0121 0.0340 ± 0.0167 0.0000 ± 0.6200 2.1500 ± 0.9500 0.704000 ± 0.056900 0.4610000± 0.2160000 2.000 ± 0.780 2.4200 ± 1.0100 0.00 ± 0.04 Connection 9600.000 0 ± 0 0.0139 ± 0.0098 175.0000 ± 67.0000 18.3000 ± 7.0900 1.4200 ± 3.2000 9.900000 ± 4.320000 114.0000000 ± 56.2000000 40.300 ± 11.900 188.0000 ± 67.7000 0.00 ± 0.79 Sites postop Periimplant sulcus 2.565 0 ± 0 0.0000 ± 0.2600 0.2730 ± 0.0840 0.0000 ± 0.9000 0.0096 ± 0.000 0.001778 ± 0.000000 0.0034430 ± 0.0000000 0.000 ± 0.003 0.0000 ± 0.0023 0.00 ± 0.00 Neighbor- ing teeth 20.200 0 ± 0 0.0000 ± 0.0900 0.0000 ± 0.2300 0.0000 ± 0.2100 0.0250 ± 0.0300 0.079500 ± 0.020000 0.0043900 ± 0.0000000 0.000 ± 0.021 0.2160 ± 0.0540 0.00 ± 0.00 Connection 2.872 0 ± 0 0.0000 ± 0.1100 0.0000 ± 0.1200 0.0000 ± 0.9800 0.0000 ± 0.2800 0.001095 ± 0.000000 0.0018225 ± 0.0000000 0.000 ± 0.000 0.000 ± 0.0030 0.00 ± 0.00 P-value Periimplant sulcus 0.0000 1 0.0000 0.0021 0.0011 0.000 0.0001 0.0000 0.0001 0.0024 0.897 Neighbor- ing teeth 0.0000 1 0.0000 0.0000 0.8970 0.000 0.0000 0.0002 0.0000 0.0000 0.912 Connection 0.0001 1 0.0001 0.0000 0.0000 0.000 0.0000 0.0000 0.0000 0.0000 0.563 a b c Regarding the microbiological environment at the periimplant sulcus and neighboring teeth, a significantdecreaseofthebacterialloadinterms of total count and single pathogens was ob- served.Atthe sametime,these data corroborat- ed a significant decrease of the clinical parame- tersindicativeofareductionoftheperiimplantitis. The data suggest that a preoperative full-mouth prophylaxis, a tailored program of maintenance, recallandreinforcementofhomecare,represents a prerequisite for successful soft- and hard- tissue healing. In fact, while preoperative oral districtdisinfectionmightbeinvolvedinthemost considerable improvement of microbiological contamination(essentialforagoodsurgicalplan), a tailored program of oral hygiene might repre- sent an essential criterion for the longitudinal maintenance of the periimplant soft- and hard-tissue during healing. As documented by RenvertandPolyzoisandSerinoetal.,decreasing of home maintenance might compromise the clinically achieved outcomes in the mid-term.19, 4 Inthe analysis ofthe bacterialcontamination at the implant connection level, a statistically significant decrease ofthetotalaccountwas de- tected during the study. However, all of the connectionsstilldemonstratedabacteriological- ly polluted environment until the end of the fol- low-up period. It could be speculated that more effective bacterialcontrolatthe implant connec- tion level and in the periimplant sulcus would allowforlongerprotectionofthedefectsitefrom the disruptive effects of bacterial presence. For this reason, a different technique providing de- contamination and, therefore, maintenance of the condition might be suggested. In fact, as 137.0000 ± 0 885.0000 ± 0 Connection 9600.0000 ± 0 2.5650 ± 0 20.2000 ± 0 Connection 2.8720 ± 0 0.000010.00000.00210.00110.0000.00010.00000.00010.00240.897 0.000010.00000.00000.89700.0000.00000.00020.00000.00000.912 Connection 0.000110.00010.00000.00000.0000.00000.00000.00000.00000.563