Focus on Peri-implantitis: Speakers

Tord Berglundh graduated (DDS) 1978 in Göteborg and received the specialist certificate in Periodontics 1992, the Odont. Dr. (PhD) degree 1993, the Docent (Associate professor) degree 1994 and the Professor degree 2002 from the Department of Periodontology, University of Gothenburg, where he has served since 1981.

Dr Berglundh is Professor and Head of the Periodontal Research Laboratory in Göteborg, Associate Editor of “Clinical Oral Implants Research” and serves as a referee in several other journals.

He has produced more than 160 scientific publications within the field of dental implants, periodontology, immunology, genetics, soft and hard tissue integration and regeneration.

Peri-implantitis - characteristics, prevalence and implant surface as a risk

Peri-implantitis is characterised by bleeding/suppuration on probing together with loss of supporting bone and recent cross-sectional studies demonstrated that the prevalence varies between 28% and 56% of subjects. The peri-implantitis lesion exhibits histopathological features that are similar, but not identical, to those in periodontitis. In the presentation, results from recent studies on peri-implantitis and periodontitis will be reported and important differences between the two conditions will be described.

Implant surface modifications are a risk for peri-implantitis. Experimental models using spontaneous progression of peri-implantitis demonstrated that certain types of implants exhibited larger amounts of bone loss. The presentation will provide new data in this series of experiments and effects on the outcome of treatment of peri-implantitis will be discussed.

Niklaus P. Lang is Professor of Implant Dentistry, Univ. of Hong Kong, 2008- Professor Emeritus, Univ. of Berne, Switzerland, Chairman 1980-2008; Odont. Dr. h.c., Univ. of Gothenburg, Sweden, 1997; Honorary Fellow RCPS Glasgow, 1995; Dr. odont. h.c., Univ. of Buenos Aires, Argentina, 1994; Dr. odont. h.c., Univ. of Athens, Greece, 1989; PhD, University of Berne, 1978; Master of Science in Periodontics, Univ. of Michigan, Ann Arbor, 1975; Dr. med. dent., Univ. of Berne, 1970; Published over 450 articles in peer-reviewed scientific journals & several textbooks. Over 2000 lecturs in 5 continents. Editor-inchief: Clinical Oral Implants Research, Editor: Oral Health and Preventive Dentistry. Honorary member of: the American Academy of Periodontology, the Danish, German, Helenic, Italian, Lithuanian, Slovenian, South African and Swiss Societies of Periodontology, Italian Society of Osseointegration, International Team of Implantology (ITI).

Peri-implantitis as an opportunistic infection - the challenge for the future in dental medicine

Peri-implant lesions represent opportunistic infections. Hence, their therapy must be based on infection control. Under these conditions progression of the disease may be arrested and subsequently, lost peri-implant tissues may be regenerated by surgical procedures. In this context a treatment approach for peri-implant mucositis and peri-implantitis termed Cumulative Interceptive Supportive Therapy (CIST) has been propagated and validated in clinical studies. Under the CIST concept mechanical debridement and antiseptic cleansing will be followed by the application of antibiotics, depending on the diagnosis of the peri-implant condition.

This presentation will focus on the differing clinical presentations and their respective therapies using the CIST concept.

Andrea Mombelli is Professor and Chair, Division of Periodontology and Oral Physiopathology (since 1999); Associate Vice Dean, Faculty of Medicine, University of Geneva, Switzerland (since 2005). Private Docent (Ph.D.), Faculty of Medicine, University of Bern, Switzerland, 1992, Board certified periodontist, Swiss Society of Periodontology, 1988, Doctorate in dentistry (Dr. med. dent.), Faculty of Medicine, University of Bern, 1980, Swiss Federal Diploma in Dentistry (D.D.S.), School of Dental Medicine, University of Bern, 1979. Bachelor of Science (Maturität Typ C), 1973. He is President of the Swiss Society of Periodontology, 1992 to 1996, and 2004 to 2008; President of the dental section of the Faculty of Medicine at the University of Geneva, 2001 to 2005; Prof. for periodontology and oral microbiology, and head of the laboratory for oral microbiology at the School of Dental Medicine of the University of Bern, 1992 to 1999.

He has extensive experience in the field of periodontology and has published numerous research papers on clinical and microbiological aspects of periodontal diseases and peri-implant infections.

Differential microbial diagnosis and appropriate antimicrobial therapies for peri-implant infections

The cardinal symptoms of peri-implantitis are the formation of a peri-implant pocket and circumferential loss of supporting bone. Suppuration on gentle probing is often the first sign of the presence of a peri-implant infection. Pain and mucosal redness or swellings, however, are not always noted. The differential diagnosis includes infection due to the persistence of submucosal luting cement ("cementitis"), the accumulation of bacteria in microgaps between imperfectly fitting implant components, or bone loss as a result of improper placement of the implant. Therapy will depend on aetiology and also an evaluation of the microflora since both anaerobes and staphylococci have been implicated in the disease process.

Stefan Renvert is Professor of Oral Health Sciences and Research Director at Kristianstad University, Sweden. Professor Renvert also holds a position as visiting professor at Dublin Dental Hospital and at the Blekinge Institute of Technology, Karlskrona, Sweden. Professor Renvert is past chairman the Swedish Society of Periodontology, and of the EFP. He was Scientific Chairman for Europerio 5 in Madrid 2005 and Chairman of the Europerio 6 meeting in Stockholm 2009.

Professor Renvert has published more than 100 papers in international and national journals. His present research focuses on peri-implantitis, risk assessments and the association of periodontitis to cardiovascular disease.

Epidemiology and therapy of peri-implant diseases

Recent data indicate that 28-56 % of patients with implants demonstrate peri-implantitis after 5-10 years and periodontitis patients seem to be at higher risk for developing peri-implantitis. In the every day clinic, it is important to monitor the patients after implant installation in order to observe early signs of infection. Non-surgical treatment of peri-implantitis seems to be inadequate

However, animal studies have documented that it is possible to obtain re-osseointegration after surgical cleansing of the infected implant surface, and in human studies bone apposition have been demonstrated after surgical treatment modalities. This presentation will focus on treatment modalities of peri-implantitis.