Publication: Periodontal olarak sağlıklı ve periodontitis geçmişi olan bireylerde yüzeyi flor ile modifiye edilmiş kemik içi dental implantların klinik ve mikrobiyolojik açıdan değerlendirilmesi
Abstract
1. ÖZET Bu çalışmada, periodontal olarak sağlıklı (P.S.) (n=13) ve kronik periodontitis (K.P.) tedavisi görmüş (n=12) bireylere yerleştirilen OsseospeedTM implantlardan ve doğal dişlerden elde edilen klinik ve mikrobiyolojik bulguların karşılaştırmalı değerlendirilmesi amaçlanmıştır. Subgingival örnekler başlangıçta (-1. gün) öncelikle implanta komşu olacak doğal dişlerden ve implantların yerleştirildiği 0. günden sonra 10., 40., 90. ve 180. günlerde hem implantlar hem de doğal dişlerden elde edildi. Subgingival örnekler, zorunlu anaerob (Z.A.) mikroorganizma yüzdelerini saptayabilmek için kültür yöntemiyle, Porphyromonas gingivalis varlığı için polimeraz zincir reaksiyonu yöntemiyle incelendi. Çalışma süresince her iki grupta tüm klinik parametrelerin ortalama değerleri implant ve doğal dişlerde sağlıklı sınırlar içindeydi. İstatistiksel olarak anlamlı bir fark olmamasına rağmen Z.A. yüzdeleri implantlar ve komşu doğal dişler çevresinde K.P. grubunda P.S. grubuna kıyasla daha yüksek oranlarda bulundu ve bu oran K.P. grubunda zaman içinde artış gösterdi. Komşu doğal dişlerden elde edilen örneklerde, sadece K.P. grubuna ait 3 hastada, başlangıçta ve/ veya takip eden örnekleme günlerinin en az ikisinde P. gingivalis varlığı tespit edildi. Benzer şekilde bu hastalarda örnekleme günlerinin en az birinde implantlar çevresinde de P. gingivalis görüldü. K.P. grubunda 180. günde implant çevresinde tespit edilen Z.A. yüzdesinin dişlerden daha yüksek olduğu görüldü (p=0.008), ancak Z.A. mikrobiyal yükünün ve P. gingivalis varlığının 180 günlük takip döneminde implantların klinik durumuna yansımadığı görüldü. Bununla birlikte P. gingivalis’in periodontal ve peri-implant hastalıklar için bir risk faktörü olduğu gerçeği ve doğal diş çevresinde mevcut olduğunda implant çevresinde de kolonize olduğuna dair bulgularımız bu tip hastalarda destekleyici periodontal tedavinin ve periodontal hastalıkların kontrol altında tutulmasının önemini vurgulamaktadır. Anahtar Sözcükler: Dental implant, kronik periodontitis, kültür, polimeraz zincir reaksiyonu, P. gingivalis. 2.
Clinical and Microbiological Evaluation of Fluroide-Modified Titanium Endoosseous Dental Implants in Patients with a History of Chronic Periodontitis in Comparison with Healthy Patients The present study aimed to evaluate the clinical and microbiological findings of dental implants (OsseospeedTM) and neighbouring teeth in patients treated for chronic periodontitis (C.P.) (n=12) compared to periodontally healthy (P.H.) subjects (n=13). Subgingival sampling were carried out at baseline for the neighbouring teeth and at days 10, 40, 90, 180 after implant surgery for both the implants and the neighbouring teeth. Subgingival samples were cultured to investigate the proportions of obligate anaerobic (O.A.) microorganisms whereas polimerase chain reaction was performed for the detection of Porphyromonas gingivalis. The mean values for all clinical parameters were within healthy limits throughout the study in both groups. Although the differences were not significant, O.A. microorganisms were found to be present higher proportions around implants and neighbouring teeth in the C.P. group compared to the P.H. group and the proportions increased over time in the C.P. group. Regarding subgingival samples of the neighbouring teeth, only three C.P. patients harboured P. gingivalis at baseline and/ or at least in two of the follow-up periods. Similarly in these patients, P. gingivalis was also detected around the implants at least one of the follow-up periods. O.A. microorganisms in the C.P group were detected in higher proportions around implants compared to neighbouring teeth at the day 180, but as long as the patients were treated for C.P., the microbial load and the persistent colonization of P. gingivalis did not affect the clinical status of the implants during the experimental period of 180 days. However, owing to the fact that P. gingivalis is a risk factor for future development of periodontal and peri-implant diseases, the patients should be kept under strict-supportive maintenance care. Key words: Dental implant, chronic periodontitis, culture, polymerase chain reaction, P. gingivalis.
Clinical and Microbiological Evaluation of Fluroide-Modified Titanium Endoosseous Dental Implants in Patients with a History of Chronic Periodontitis in Comparison with Healthy Patients The present study aimed to evaluate the clinical and microbiological findings of dental implants (OsseospeedTM) and neighbouring teeth in patients treated for chronic periodontitis (C.P.) (n=12) compared to periodontally healthy (P.H.) subjects (n=13). Subgingival sampling were carried out at baseline for the neighbouring teeth and at days 10, 40, 90, 180 after implant surgery for both the implants and the neighbouring teeth. Subgingival samples were cultured to investigate the proportions of obligate anaerobic (O.A.) microorganisms whereas polimerase chain reaction was performed for the detection of Porphyromonas gingivalis. The mean values for all clinical parameters were within healthy limits throughout the study in both groups. Although the differences were not significant, O.A. microorganisms were found to be present higher proportions around implants and neighbouring teeth in the C.P. group compared to the P.H. group and the proportions increased over time in the C.P. group. Regarding subgingival samples of the neighbouring teeth, only three C.P. patients harboured P. gingivalis at baseline and/ or at least in two of the follow-up periods. Similarly in these patients, P. gingivalis was also detected around the implants at least one of the follow-up periods. O.A. microorganisms in the C.P group were detected in higher proportions around implants compared to neighbouring teeth at the day 180, but as long as the patients were treated for C.P., the microbial load and the persistent colonization of P. gingivalis did not affect the clinical status of the implants during the experimental period of 180 days. However, owing to the fact that P. gingivalis is a risk factor for future development of periodontal and peri-implant diseases, the patients should be kept under strict-supportive maintenance care. Key words: Dental implant, chronic periodontitis, culture, polymerase chain reaction, P. gingivalis.