Media Releases
Diagnosis and treatment of periimplant infections
Europerio5 Scientific Press Conference
Madrid, June 30, 2006 – The ever-increasing number of
implants being placed means that the number of bacterial
infections, up to and including implant loss, is also increasing.
The increased number of implants also places greater
emphasis on the importance of correct oral hygiene for the
increasing number of patients with implants. Early treatment
can prevent loss of the implant even if periimplantitis is
already present. The state of the art in microbiological
diagnostics and specification of the treatment strategy is the
Real-Time PCR. GABA International sponsored two
workshops on the significance of oral hygiene, correct
diagnosis and close dental supervision in the scientific
program at Europerio 5 in Madrid.
In his workshop in the scientific sessions Professor Andrea
Mombelli of the University of Geneva discussed the
prevention and treatment of complications of dental implants
caused by bacteria using an evidence-based clinical
treatment and retention plan. Modern dental implants do have
a high success rate, but even so problems requiring
treatment occur in four of ten cases. The deposition of
bacteria on the implant causes a periimplant mucositis in the
early stages, which like periodontitis can frequently extend
internally unnoticed. Periimplantitis is defined as an
inflammation process of the tissue surrounding the implant
and it is associated with bone atrophy. Clinical trials indicate
that successfully integrated implants are surrounded by a
microflora consisting primarily of Gram-positive bacteria,
while infected implants are colonised by much higher
numbers of Gram-negative bacteria.
If periimplantitis is already present, loss of the implant can be
prevented by correct treatment involving thorough cleaning of
the implant and suppression of bacterial growth, if the
treatment is started at a sufficiently early stage. As the first
diagnostic step, Mombelli proposes measurement of the
pocket depth in addition to assessment of the oral hygiene
status and checking the tendency to bleed. If the gum pocket
is greater than three millimetres, an x-ray examination is
recommended for additional diagnosis to check for possible
bone loss. In the case of bone loss, pocket depth of 4-5 mm,
tendency to bleed and possible appearance of pus the use of
antiseptics (chlorhexidine 0.2%) is indicated as well as
thorough cleaning of the implants and instruction in oral
hygiene. If pockets are deeper than 5 mm surgical treatment
may be required, because thorough cleaning of the rough
implant surface is frequently difficult. Treatment with
antiseptics and antibiotics is recommended to support
mechanical implant cleaning. For identifying the right way of
therapy microbiological tests can be helpful. The procedure
with the highest specificity and sensitivity for early and secure
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diagnosis is the Real-Time PCR for quantitative detection of
the six most important marker organisms for periimplantitis
and the total bacterial count.
Professor Søren Jepsen and Dr Pia-Merete Jervœ-Storm of
the University of Bonn tested the sensitivity of various
microbiological test procedures and presented their results at
the Forum for Innovation at Europerio 5. They referred to
meridol® Perio Diagnostics, whose technology is based on the
Real-Time Polymerase Chain Reaction (Real-Time PCR), as
the state of the art. Compared to methods using conventional
culturing of bacteria, the Real-Time PCR does not require
vital specimen material. This offers significant advantages in
cases of periodontal pathogenic Gram-negative microbes,
which require anaerobic conditions for growth. In the RealTime PCR method the specimens are tested for specific DNA
sequences. The automated analysis can identify and quantify
six periodontal pathogenic marker organisms (A.
actinomycetemcomitans, P. gingivalis, T. forsythensis, F.
nucleatum, P. intermedia, T. denticola). Quantification of the
bacterial population in the subgingival plaque alone offers
great advantages when it comes to making a decision on the
treatment required.
The Bonn scientists also presented the results of a
comparative study on the clinical effects of full-mouth root
planing (FMRP) compared to root planing of single quadrants
(QRP). In the case of FMRP the test subjects received
subgingival scaling and root planing in all quadrants in two
sessions within 24 hours. In the case of QRP the scaling was
conducted by quadrant at weekly intervals. No significant
differences in the individual parameters and the entire mouth
could be found for the parameters of pocket depth (PPD),
bleeding index (BOP) and attachment loss (RAL).
The two workshops presented by Prof. Mombelli (University of
Geneva) and Prof. Jepsen and Dr. Jervœ-Storm (University
of Bonn) were sponsored by GABA International at Europerio
5 in Madrid.
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Media Contact:
GABA International AG
Dr. Stefan Hartwig
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Emil Frey-Strasse 100
4142 Münchenstein
Switzerland
Phone: +41 61 415 60 74
Fax: +41 61 415 60 00
E-Mail: info@gaba.com
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