3. Postere - rmr.medica.ro

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Peri-implanti ti s versus periodonti ti s –
similariti es and diff erences
Cristi na Alexandra Berechet 1 , Ioan Sarbu 2
1 Emergency Hospital Bucharest
2 “Carol Davila” University of Medicine and Pharmacy,
Bucharest
Novelty and motivation
Hard and soft tissues around an osseointegrated
dental implant have some similarities with the periodontium
of natural teeth. The major difference occurs
when collagen fi bers, which are singles and
are parallel to the dental implant surface, compared
with insertion of the natural teeth, which is perpendicular
and functional, between bone and cement.
(6)
Like the gingival crevice around the natural
tooth, the peri-implant mucosa is adapted to the implant.
Microbial colonization and infl ammatory reactions
in the peri-implant tissues might be analogous
to key events in the pathogenesis of
periodontitis. (2)
As untreated periodontitis can ultimately lead to
loss of natural teeth, peri-implantitis can result in
loss dental implants. (3)
Progressive changes of traditional periodontal
parameters (depth appreciation of the space surrounding
the implant, clinical gingival insertion
levels, gingival bleeding on examination with the
probe, mobility) are important indicators for detecting
potential pathological conditions for implants.
Recent studies show that the main causative factor
both of tooth loss (periodontitis), as for the loss of
dental implants (peri-implantitis) is the microbial
dental plaque. (2,4,5)
Aims
In this paper I have studied similarities and differences
between periodontitis and peri-implantitis
and the correlations that can be established between
these disorders.
•
•
Methods
Review of literature:
specialized primary literature: scientifi c articles,
specialized undergraduate theses;
specialized secondary literature: reference
books, implantology papers;
REVISTA MEDICALÅ ROMÂNÅ – VOLUMUL LIX, NR. 2, An 2012
•
Specialized tertiary literature: journal literature,
summarized articles.
Description
Periodontitis or periodontal disease is a general
notion that indicates pathological changes of the
periodontium. They are: acute or chronic – infl ammatory
– dystrophic – involution – hyperplasic or
proliferative. (1)
The periodontal ligament consists of functionally
oriented collagen fi bers (main), fi ber orientation
vaguely anarchic (secondary) and elastic fi bers
arranged around vessels, oxytalan and reticuline fi -
bers. Main collagen fi bers consist of fi brils, grouped
in the form of bands that make the periodontal ligament
developed area whose section for a maxillary
central incisor is about 3 cm2 . Fiber orientation is
oblique, between alveolar bone and cementum, root
to tip and the tooth to the bone. The fi bers are wavy,
with one end caught in the second end bone cement
trapped by mineralization of the two ends. (1)
Periodontal illness presents several clinical
forms: mostly or predominantly infl ammatory or
dystrophic predominantly proliferative. These various
manifestations were called generic or periodontitis
– periodontal disease. Periodontal disease
is considered a disease of the periodontal structures
of infectious cause of chronic infl ammatory lesions,
with or without dystrophic or proliferative lesions
with progressive disease, leading to destruction of
supporting tissues and, ultimately, to tooth loss. (1, 3)
Criteria for successful dental implant treatment:
• favorable bone reaction without acute infl ammation;
• primary stability after implant placement;
• osseointegration;
• higher aesthetic restauration;
•
optimal morphological and functional integra-
tion of the implant (6).
The peri-implant ligament and periodontal ligament
do similar work, but structurally they are different.
Peri-implant fi brous tissue collagen has an
orientation and a specifi c interaction with the surrounding
bone implant design and how to load it.
These fi bers are oriented in three-dimensional
space-implant bone biomechanics following distribution
of forces, and remain constant throughout
the operation to implant. (6)
The fi broblast-rich barrier next to the titanium
surface has a high cell turnover, and fi broblasts may
play an important role in establishing and maintaining
the mucosal seal. (2)
Thickness and density of bone around the implant
is higher than with natural teeth, implants and