Kharkina, T. A., Solovyova A. A.

Bashkir state medical University, Russia

Factors of development and methods of treatment of inflammation in peri-implant tissues

Despite the fact that implantation has been widely used in dental practice, the most urgent problem is the occurrence of complications such as inflammation of the tissues surrounding the implant [1,2,].

In 2008, the workshop of the European Federation of Periodontology on the basis of current scientific evidence had produced a consensus about the infectious and inflammatory lesions in the field of dental implants. Proposed periimplantation mucositis and periimplant. [3, 4] Clinically mucositis manifests as inflammation of the mucous membrane in the region of the implant, accompanied by pain, swelling and profuse bleeding when probing. When periimplantitis inflammatory process is localized in the bone tissue which surrounds the implant. [5]

These two pathologies correlate to each other as gingivitis correlates with periodontitis, that is, have common etiological factors, a similar pathogenesis, and represent in fact different stages of the same inflammatory-atrophic process.[6] the Factors in the development of mucositis and peri-implantitis can be divided into General and local. The main common factors include: diabetes, hypothyroidism, systemic disease after radiation therapy [7, 8].

Major local factors include: 1) Smoking. Revealed that the annual rate of bone loss in smokers is increased, and the rate and degree of osseointegration is reduced [4]

2)inadequate oral hygiene, which leads to the appearance of the biofilm [9,10]

3)periodontal Disease. The relationship between peri-implantitis and chronic inflammatory periodontal disease is confirmed by numerous studies, the factors in the development of peri-implantitis is almost identical to periodontitis [6,11] Microbiological composition during periimplantitis represents a wide variety of aerobes and anaerobes, which are also characteristic of the inflammatory periodontal diseases (Prevotella Intermedia, Porphyromonas Gingivalis, Treponema Denticola, Veillonella spp, Branhamella Catarrhalis). The risk of developing peri-implantitis is associated mainly with a high content in inflammation Prevotella Intermedia, Porphyromonas Gingivalis. [3]

4) Occlusal overload due to improperly selected orthopedic design.

The diagnosis is made on the basis of visual inspection, x-ray diagnostics and sensing of pathological pockets. If you encounter periimplantation mucositis or peri-implantitis should be combined integrated treatment aimed at elimination of inflammation and preservation of the implant [5,10]. The first thing to carry out mechanical cleaning, antiseptic treatment and antibiotic therapy. For mechanical treatment of the implant surface can be used with curettes with a plastic or ceramic coating, ultrasonic instrument and method of Air-Flow powder glycine [1,9,10]. Antiseptic treatment of the implant surface and soft tissue is carried out with 3% hydrogen peroxide or 0.1% chlorhexidine solution. In complex therapy can be used an injectable form of autologous platelet plasma [1]. The loss of bone tissue is laid material based on hydroxyapatite and collagen membrane closes.[11]

To help prevent the occurrence of inflammation in the peri-implant tissues prior to the surgery, the doctor - periodontist needs a thorough sanitation of the oral cavity. The patient should be aware of home how to care for the oral cavity in the postoperative period. In the subsequent permanent control of the periodontist to maintain the hygiene of the oral cavity.

Literature:

1. Аверьянов С.В., Гуляева О.А. Повышение эффективности консервативного лечения воспалительных осложнений после дентальной имплантации //Стоматология. 2017. Т. 96. № 6-2. С. 20.

2. Буляков Р.Т., Гуляева О.А., Чемикосова Т.С., Тухватуллина Д.Н., Саляхова Г.А., Гумерова М.И., Сабитова Р.И. Опыт применения аквакинетического метода для лечения периимплантита //Проблемы стоматологии. 2012. № 4. С. 24-28.

3. А.М. Соловьева «Периимплантит: этапы достижения консенсуса в диагностике и лечении» / Клиническая стоматология, 2011.С 50-53

4. Д.В. Михальченко, А.Т. Яковлев, Е.Ю. Бадрак, А.В. Михальченко Проблема воспаления в периимплантных тканях, факторы, влияющие на его течение // Волгоградский научно-медицинский журнал 4/2015. С 17-18.

5. Сельский Н.Е., Буляков Р.Т., Галиева Э.И., Гуляева О.А., Викторов С.В., Трохалин А.В., Коротик И.О. Дентальная имплантация: учебное пособие. - Уфа: Изд-во ФГБОУ ВО БГМУ МЗ РФ, 2016. - 116 с.

6. В.С Булгаков, И.И. Шакеров, Т.В. Лукоянова «Современные представления о некоторых осложнениях дентальной имплантации»/ Здоровье и образование в XXI веке, №3, 2006 г., (Т.8). С 127-128

7. М.Нортон Лечение периимплантатного мукозита и периимплантита /Стоматолог-практик, №1, 2013г. С 98

8. О.Ф. Гусев, А.В. Шишканов Ошибки и осложнения в дентальной имплантации//Здоровье и образование в XXI веке, №5, 2006 г., (Т.8). С 217-218

9. Гуляева О.А., Аверьянов С.В.Профилактика воспалительных осложнений после дентальной имплантации/ / Пародонтология. 2017. Т. 22. № 2 (83). С. 84-88.

10. Гуляева О.А., Буляков Р.Т., Герасимова Л.П., Чемикосова Т.С. Современные методы в комплексном лечении воспалительных заболеваний пародонта Монография - Уфа:Изд-во «УралПолиграфСнаб», 2016. - 190 c.

11. И.С. Мащенко, А.А. Гударьян, С.В. Ширинкин Современные подходы к комплексной терапии дентального периимплантита / Clinical Medicine of Kazakhstan №4 (38) 2015. С 50-55