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Erschienen in:
Biomaterial-Associated Infection: A Perspective from the Clinic Kapitel lesen Erstes Kapitel lesen

2013 | OriginalPaper | Buchkapitel

20. Topical Antimicrobial-Containing Biomaterials for Peri-Implant Infections in the Oral Cavity

verfasst von : Stefan Renvert, G. Rutger Persson

Erschienen in: Biomaterials Associated Infection

Verlag: Springer New York

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Abstract

Implant mucositis and peri-implantitis have an infectious etiology. If left untreated the inflammatory responses and the infection will result in loss of alveolar bone around dental implants. Clinically, this is combined with edema and redness of the soft tissues surrounding the implant. The ultimate consequences of implant mucositis and peri-implantitis may be loss of the implant.
Dental implant manufacturers have focused on implant design, ease of placement, esthetics, and new prosthetic components. Enhancement of osseo-integration has been attempted by changing titanium surface structures, titanium purity, and various coatings.
The biofilm structures at titanium dental implants comprise of bacteria that co-aggregate with each other and are difficult to eliminate mainly due to the rough threaded surfaces of oral implants making them difficult to debride. The microbiota initiates a host inflammatory response that in many aspects are similar to what can be seen in periodontitis. The prevalence of peri-implantitis ranges between 15 and 25%. Patients who have lost teeth due to periodontitis may be more prone to peri-implantitis. The susceptibility may be directly associated with a genetically complex predisposing risk.
Recent data suggest that professional mechanical debridement of pockets around implants and the patients’ own ability to keep implants free from bacteria is unpredictable. Professional debridement may be efficacious over shorter time periods and would most likely require intensive supportive therapy. In the event of limited response to nonsurgical mechanical supportive therapy, the adjunct use of local application of a slow-release antimicrobial agent could be considered. Surgical treatment to eliminate soft tissue pocket and attempts to establish hygienic conditions may not be acceptable to the patient in the esthetic areas. In these situations regenerative therapy may be considered.
Antibiotics are commonly used in medicine to treat infections. Restrictive use of antibiotics is a necessity to prevent the occurrence of wide-spread antibiotic resistance. Peri-implantitis is a local infection confined to the area around the affected implant. Therefore, local administration of an antibiotic drug in a high concentration is logical. Several local antibiotic products have been developed and studied extensively. Such local antibiotic drugs have been on the market for some years but due to a variety of factors some of these local antibiotics have been withdrawn from the market or may only be available in some countries. There is a need to develop new methods allowing effective delivery of local antibacterial and anti-inflammatory agents for the treatment of implant infections.

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Vorheriges Kapitel Antimicrobial-Modified Vascular Catheters
Nächstes Kapitel Preventive Strategies in VAP: Focus on Silver-Coated Endotracheal Tubes
Glossar
Autogenous bonegraft
Involves utilizing bone obtained from the same individual receiving the graft
Bactericidal
A substance that kills bacteria
Bacteriostatic
A substance that inhibit growth and reproduction of bacteria without killing them
Biofilm
A biofilm is an aggregate of microorganisms in which cells adhere to each other and/or to a surface
Gingivitis
A reversible inflammation of the soft tissue surrounding the teeth
Implant Mucositis
An inflammatory lesion that resides in the mucosa. This is clinically identified by redness, swelling, and bleeding on probing
Nanotechnology
Nanotechnology deals with structures sized between 1 and 100 nm in at least one dimension and involves developing materials or devices within that size
Osseo-integration
A direct structural and functional connection between living bone and the surface of a load-bearing artificial implant
Peri-implantitis
An inflammatory lesion in the mucosa also affecting the supporting bone. This is clinically identified by redness, swelling bleeding on probing and bone loss
Periodontitis
An irreversible inflammation of the soft and hard tissues surrounding the teeth leading to a loss of bone support
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Metadaten
Titel
Topical Antimicrobial-Containing Biomaterials for Peri-Implant Infections in the Oral Cavity
verfasst von
Stefan Renvert
G. Rutger Persson
Copyright-Jahr
2013
Verlag
Springer New York
Buch
Biomaterials Associated Infection

Print ISBN: 978-1-4614-1030-0

Electronic ISBN: 978-1-4614-1031-7

Copyright-Jahr: 2013

DOI
https://doi.org/10.1007/978-1-4614-1031-7_20

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