Browsing by Author "Alcoforado, Gil"
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- Peri-implantitis : summary and consensus statements of group 3 : the 6th EAO Consensus conference 2021Publication . Schwarz, Frank; Alcoforado, Gil; Guerrero, Adrian; Jönsson, Daniel; Klinge, Björn; Lang, Niklaus; Mattheos, Nikos; Mertens, Brenda; Pitta, João; Ramanauskaite, Ausra; Sayardoust, Shariel; Sanz-Martin, Ignacio; Stavropoulos, Andreas; Heitz-Mayfield, LisaObjective: To evaluate the influence of implant and prosthetic components on peri-implant tissue health. A further aim was to evaluate peri-implant soft-tissue changes following surgical peri-implantitis treatment. Materials and methods: Group discussions based on two systematic reviews (SR) and one critical review (CR) addressed (i) the influence of implant material and surface characteristics on the incidence and progression of peri-implantitis, (ii) implant and restorative design elements and the associated risk for peri-implant diseases, and (iii) peri-implant soft-tissue level changes and patient-reported outcomes following peri-implantitis treatment. Consensus statements, clinical recommendations, and implications for future research were discussed within the group and approved during plenary sessions. Results: Data from preclinical in vivo studies demonstrated significantly greater radiographic bone loss and increased area of inflammatory infiltrate at modified compared to non-modified surface implants. Limited clinical data did not show differences between modified and non-modified implant surfaces in incidence or progression of peri-implantitis (SR). There is some evidence that restricted accessibility for oral hygiene and an emergence angle of >30 combined with a convex emergence profile of the abutment/prosthesis are associated with an increased risk for peri-implantitis (CR). Reconstructive therapy for peri-implantitis resulted in significantly less soft-tissue recession, when compared with access flap. Implantoplasty or the adjunctive use of a barrier membrane had no influence on the extent of peri-implant mucosal recession following peri-implantitis treatment (SR). Conclusions: Prosthesis overcontouring and impaired access to oral hygiene procedures increases risk for peri-implantitis. When indicated, reconstructive peri-implantitis treatment may facilitate the maintenance of post-operative peri-implant soft-tissue levels.
- Periodontitis impact in interleukin-6 serum levels in solid organ transplanted patients: a systematic review and meta-analysisPublication . Machado, Vanessa; Botelho, João; Lopes, Joana; Patrão, Mariana; Alves, Ricardo; Chambrone, Leandro; Alcoforado, Gil; Mendes, José JoãoThis systematic review aimed to investigate the influence of periodontitis on post-transplant IL-6 serum levels of solid organ transplanted patients as compared to healthy subjects. Four databases (PubMed, Scholar, EMBASE, and CENTRAL) were searched up to February 2020 (PROSPERO CRD42018107817). Case-control and cohort studies on the association of IL-6 serum levels with a periodontal status of patients after solid organ transplantation were included. The risk of bias of observational studies was assessed through the Newcastle-Ottawa Scale (NOS). Random effects meta-analyses were thoroughly conducted. GRADE assessment provided quality evidence. Four case-control studies fulfilled the inclusion criteria (274 transplant recipients and 146 healthy controls), all of low risk of bias. Meta-analyses revealed significantly higher IL-6 levels in transplanted patients than healthy individuals with low-quality evidence (Mean Difference (MD): 2.55 (95% confidence interval (CI): 2.07, 3.03)). Transplanted patients with periodontitis have higher serum IL-6 levels than transplanted patients without periodontitis with moderate quality evidence (MD: 2.20 (95% CI: 1.00, 3.39)). We found low-quality evidence of higher IL-6 levels than healthy patients in patients with heart and kidney transplant. In these transplanted patients, there was moderate quality evidence that periodontitis is associated with higher IL-6 serum levels. Future research should consider the impact of such a difference in organ failure and systemic complications.
- A prospective observational study on perioperative use of antibacterial agents in implant surgeryPublication . Dominiak, Marzena; Shuleva, Stanislava; Silvestros, Spiridon; Alcoforado, GilBackground: Dental implant surgery has become routine practice for replacing missing teeth. Little is known about the use of local antisepsis to control the development of bacterial plaque and to facilitate healing, as current practice guidelines do not address this issue. Objectives: The objectives of this study were to describe antiseptic practices for implant surgery and to assess plaque control at the operative site as well as the investigator’s satisfaction. Material and Methods: This prospective, observational study conducted in 4 European countries enrolled 911 adult patients receiving a single or multiple implant on the day of inclusion. Any medication prescribed during the preor postoperative periods was documented, particularly antibiotics, antiseptic mouthwashes and topical antiseptic gels. At a follow-up visit, the presence of plaque was documented on teeth adjacent to the implant and its extent determined using the Silness–Löe index. Results: Oral antibiotics were prescribed prior to surgery in 53.8% of the patients. Antiseptic mouthwashes were prescribed to patients (49.6–65.7%) according to country. Following dental implant placement, 84.1–94.7% of patients were prescribed oral antibiotics, 45.6–86.5% of patients were prescribed antiseptic mouthwash and 72.8–100% of patients were prescribed an antiseptic gel. At the follow-up visit, plaque was observed in 45.4% of the patients. The mean Silness–Löe plaque index was 0.7 or 0.8, indicating a low level of plaque accumulation. The Löe and Silness gingival index was 0.6 or 0.7, which is consistent with a low level of gingival inflammation. Conclusion: Use of antibiotics preand post-surgery is frequent in implant surgery, despite it being discouraged in practice guidelines. Use of antiseptic mouthwashes and topical antiseptic gels is widespread, although treatment paradigms vary widely. Practice guidelines covering antisepsis provision would be useful, since those products could be used as an alternative to antibiotics to facilitate wound healing.