Periodontitis Clinical Trial
Official title:
Evaluation of the Health of Peri-implant Tissues Around Immediately Placed Dental Implants in Aggressive Periodontitis Patients Versus Periodontally Healthy Individuals in Maxillary Esthetic Zone
The aim of the present study is to evaluate the health of immediately placed dental implants in aggressive periodontitis patients versus those placed in periodontally healthy individuals in the maxillary esthetic zone.
Aggressive periodontitis is an enigmatic periodontal disease that characterized by massive
and undeterminable periods of tissue destruction. It gets along well to young individuals
with successive periods of disease activity. Aggressive bone destruction with limited plaque
and calculus deposits usually detected. According to microbial theory, Aggregatibacter
actinomycetemcomitans (A.a) and P. gingivalis (P. G) were claimed for such a disease.
Patients of aggressive periodontitis have disturbed esthetic and masticatory function
problems.
After wards, microbial theory was modified to enroll the genetic background that can be the
cause behind the developed body resistance. Although the importance of the genetic treatment
to improve the body response, it was totally dismissed during the routine periodontal work
attributable to high cost effectiveness of the needed genetic analysis especially in
developing countries.
Further researches tried to explain the cause behind the impaired body response. Impaired
functions of the immune cells and the massive amounts of catabolic cytokines such as IL-1,
IL-6, Il-17, TNF- α and prostaglan¬din E2 (PGE2) are usually released during the active
periods of the disease. On the other hand, matrix-metalloproteinases are destructive enzymes
that released in an uncontrollable manner. Host modulators were suggested to control the
released of the destructive agents.
Immediate implant placement provides an efficient modality that shortens the dental
management period. The aim behind immediate implant placement is the proper implant
positioning to counteract the advanced bone resorption following extraction.
Periodontitis is considered an important risk factor for peri-implantitis. The pre-existing
periodontitis must be treated prior to implant placement in order to avoid the bacterial
accumulation in the periodontal lesions regardless the type of periodontitis. Local and
systemic supportive therapy is strongly recommended in order to reduce the microbial colonies
and post-operative bone loss.
Higher rate of implant failure (peri-implantitis) has been reported in immediately placed
implants when compared with the delayed conventional technique. The failure rate markedly
increased with the immediate placement of implants in patients with history of periodontitis
especially the aggressive form.
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