tetracycline and Peri-Implantitis

Re-osseointegration of an infected/contaminated dental implant poses major clinical challenges. We tested the hypothesis that the application of an antibiotic-releasing construct, combined with hard/soft tissue replacement, increases the efficacy of reconstructive therapy. We initially fabricated semi-flexible hybrid constructs of β-TCP/PHBHHx, with tetracycline (TC) (TC amounts: 5%, 10%, and 15%). Thereafter, using in vitro assays, TC release profile, attachment to rat bone marrow-derived stem cells (rBMSCs) and their viability as well as anti-bacterial activity were determined. Thereafter, regenerative efficacies of the three hybrid constructs were assessed in a rat model of peri-implantitis induced by Aggregatibacter actinomycetemcomitans biofilm; control animals received β-TCP/Bio-Gide and TC injection. Eight weeks later, maxillae were obtained for radiological, histological, and histomorphometric analyses of peri-implant tissues. Sulcus bleeding index was chronologically recorded. Serum cytokines levels of IL-6 and IL-1β were also evaluated by enzyme-linked immunosorbent assay. Substantial amounts of tetracycline, from hybrid constructs, were released for 2 weeks. The medium containing the released tetracycline did not affect the adhesion or viability of rBMSCs; however, it inhibited the proliferation of A. actinomycetemcomitans. Osteogenesis and osseointegration were more marked for the 15% hybrid construct group than the other two groups. The height of attachment and infiltration of inflammatory cells within fibrous tissue was significantly reduced in the experimental groups than the control group. Our protocol resulted in re-osseointegration on a biofilm-contaminated implant. Thus, an antibiotic releasing inorganic/organic construct may offer a therapeutic option to suppress infection and promote guided tissue regeneration thereby serving as an integrated multi-layer substitute for both hard/soft tissues.

Topics: Animals; Anti-Bacterial Agents; Biofilms; Calcium Phosphates; Cytokines; Dental Implants; Interleukin-6; Osseointegration; Peri-Implantitis; Rats; Tetracycline

The purpose of this investigation was to determine the ability of tetracycline-containing fibers to inhibit biofilm formation of peri-implantitis-associated pathogens [i.e., Porphyromonas gingivalis (Pg), Fusobacterium nucleatum (Fn), Prevotella intermedia (Pi), and Aggregatibacter actinomycetemcomitans (Aa)]. Tetracycline hydrochloride (TCH) was added to a poly(DL-lactide) [PLA], poly(ε-caprolactone) [PCL], and gelatin [GEL] polymer blend solution at distinct concentrations to obtain the following fibers: PLA:PCL/GEL (TCH-free, control), PLA:PCL/GEL + 5 % TCH, PLA:PCL/GEL + 10 % TCH, and PLA:PCL/GEL + 25 % TCH. The inhibitory effect of TCH-containing fibers on biofilm formation was assessed by colony-forming units (CFU/mL). Qualitative analysis of biofilm inhibition was done via scanning electron microscopy (SEM). Statistical significance was reported at p < 0.05. Complete inhibition of biofilm formation on the fibers was observed in groups containing TCH at 10 and 25 wt%. Fibers containing TCH at 5 wt% demonstrated complete inhibition of Aa biofilm. Even though a marked reduction in CFU/mL was observed with an increase in TCH concentration, Pi proved to be the most resilient microorganism. SEM images revealed the absence of or a notable decrease in bacterial biofilm on the TCH-containing nanofibers. Collectively, our data suggest that tetracycline-containing fibers hold great potential as an antibacterial dental implant coating.

Topics: Aggregatibacter actinomycetemcomitans; Anti-Bacterial Agents; Biofilms; Coated Materials, Biocompatible; Dental Implants; Fusobacterium nucleatum; Microscopy, Electron, Scanning; Peri-Implantitis; Polyesters; Polymers; Porphyromonas gingivalis; Prevotella intermedia; Stem Cells; Tetracycline

This study used a dog model to evaluate two antimicrobial protocols with or without guided bone regeneration (GBR) in the surgical reconstruction of peri-implantitis defects.. Eight beagle dogs subject to ligature-induced peri-implantitis were used. The animals either received antimicrobial photodynamic therapy or topical tetracycline hydrochloride combined with GBR or as stand-alone surgical interventions. Block biopsies of the defect sites for histological analysis were obtained at euthanasia, 12 weeks postsurgery. The primary outcome of the study was re-osseointegration; secondary outcomes included alveolar bone gain and remaining defect characteristics. The effects of the implant site, early exposure, and type of antimicrobial protocol on bone regeneration were also evaluated.. No significant differences were observed between the two antimicrobial protocols, and the adjunctive use of GBR failed to significantly improve re-osseointegration or bone gain using either protocol. Buccal sites and implant early exposure negatively affected bone regeneration.. Both antimicrobial therapies stand-alone or combined with GBR allowed similar and limited bone gain.

Topics: Administration, Buccal; Animals; Anti-Infective Agents; Clinical Protocols; Dental Implantation, Endosseous; Dogs; Guided Tissue Regeneration, Periodontal; Male; Peri-Implantitis; Photochemotherapy; Tetracycline

The aim of this case report is to describe the surgical treatment of 2 implants affected by periimplantitis after 15 years of loading.. The treatment included mechanical and chemical decontamination with topical application of tetracycline associated with a regenerative approach. Both defects were filled with particulate autogenous bone from tuber and covered with resorbable collagen membrane.. The follow-up of 30 and 13 months of the implants 24 and 14, respectively, showed an absence of clinical signs of periimplant inflammation and near-complete bone regeneration.. The therapy approach was effective in eliminating periimplant inflammation and promoting bone gain around the implants.

Topics: Administration, Buccal; Anti-Bacterial Agents; Decontamination; Dental Implantation, Endosseous; Humans; Male; Middle Aged; Peri-Implantitis; Tetracycline; Time Factors

The objective of this study is to evaluate the use of tetracycline in a patient with peri-implantitis.. Tetracycline is widely used in regeneration procedures owing to its positive effect with bone graft material, regeneration of extraction socket bone and its traditional antibacterial effect. However, there have been limited reports on bone graft procedures combined with tetracycline application in peri-implantitis.. The detoxification procedure was performed with chlorhexidine and tetracycline, and the defect area was grafted with a 4:1 volume ratio combination of deproteinised bovine bone mixed with tetracycline.. Soft tissue healing was uneventful, and the treatment yielded improved clinical results with a reduced probing depth.. Tetracycline was used in the treatment of peri-implantitis by burnishing the implant surface and applying tetracycline in conjunction with an osseous graft to the defect area. The treatment of peri-implantitis with tetracycline seemed to show improved clinical results up to the follow-up period.

Topics: Animals; Anti-Bacterial Agents; Anti-Infective Agents, Local; Bone Matrix; Bone Regeneration; Bone Substitutes; Cattle; Chlorhexidine; Curettage; Debridement; Dental Implant-Abutment Design; Dental Implants; Follow-Up Studies; Humans; Male; Middle Aged; Minerals; Peri-Implantitis; Tetracycline; Treatment Outcome