Primjena lokalnog antibiotika kod liječenja periimplantnog mukozitisa i periimplantitisa

professional thesis

• Title (english): Application of local antibiotics in the tretment of Peri-implant mucositis and peri-implantitis
• Author: Nina Kujundžić
• Mentor: Domagoj Vražić (mentor)
• Committee member: Ivan Puhar (predsjednik povjerenstva)
• Committee member: Domagoj Vražić (član povjerenstva)
• Committee member: Marko Granić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Periodontology); Zagreb
• Defense date and country: 2023-07-18, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Periodontology

Abstract

Dentalni implantati pomažu u zbrinjavanju bezubih područja i omogućavaju pacijentu bolje žvačne sile u odnosu na tradicionalne restauracije. Ključna prijetnja uspjehu liječenja nastanak je za implantate specifičnih bolesti ­ periimplantnog mukozitisa i periimplantitisa. Zbog navedenog, od iznimne su važnosti rana dijagnoza i liječenje kako bi se spriječio gubitak dentalnog implantata. Istraživanja u dostupnoj literaturi pokazuju da bi kod liječenja periimplantne bolesti eliminacija bakterijskog biofilma s površine implantata, bilo kroz kirurški ili nekirurški pristup, trebala biti dopunjena dodatnim terapijskim pristupom u vidu
propisivanja antibiotika. Antibiotici u terapiji periimplantnih bolesti koriste se kod pozitivnog krvarenja pri sondiranju, uz moguće prisustvo supuracije, dubine parodontnih džepova u vrijednosti 5 mm ili više te prisutan gubitak alveolarne kosti. Lokalna primjena antibiotika na području zubnog implantata najčešće je usmjerena na regeneraciju mekog tkiva ili alveolarne kosti ili pak borbu protiv upale. Da bi se postigla učinkovitost i trajni terapeutski učinak u liječenju navedenih patoloških stanja, potrebno je postići strogo definiranu koncentraciju terapeutskih farmakoloških sredstava. Jedan od sustava koji sad rži
lokalni antibiotik dostupan na tržištu je Implacure® koji sadrži antibiotike piperacilin i tazobaktam. Usprkos pozitivnom kliničkom i radiološkom ishodu liječenja periimplantitisa spomenutim sustavom, u ovom prikazu slučaja potrebna su daljnja istraživanja koja će jasno definirati antibiotski terapijski režim i protokole, metodički zabilježiti ishode liječenja s najmanje tri godine praćenja, a kako bi se potom utvrdile indikacije za primjenu antibiotika uz procjenu rizika i koristi, uz istodobno ograničavanje rizika neprimjerenog korištenja antibiotika kako se dodatno ne bi pogodovalo razvoju jednog od najvećih globalnih problema ­ antimikrobnoj rezistenciji.

Abstract (english)

Dental implants help maintain bone levels and enable the patient to chew better than conventional restorations. A key threat to the success of treatment is the emergence of implants for specific diseases: peri­implant mucositis and peri­implantitis. Therefore, early diagnosis and treatment are essential to prevent the loss of a dental implant. Research of available literature suggests that in the treatment of peri­implant disease, elimination of bacterial biofilm from the implant surface, whether through surgical or non­surgical approach, should be complemented by an additional therapeutic approach in the form of antibiotic prescribing. Antibiotics in the treatment of peri­implant diseases are used in positive bleeding during probing, with the possible presence of suppuration, the depth of periodontal pockets of 6 mm or more and the presence of loss of alveolar bone. The local application of antibiotics in the area of dental implants is most often aimed at regenerating soft tissue or alveolar bone or fighting inflammation. In order to achieve efficacy and lasting therapeutic effect in the treatment of these pathological conditions, it is necessary to achieve a well­defined
concentration of therapeutic pharmacological agents. One of the systems that contain the local antibiotic available on the market is Implacure®, which contains the antibiotics piperacillin and tazobactam. Despite the positive clinical and radiological outcome of the treatment of peri­implantitis with the system mentioned in this case report, further research is needed to clearly define the antibiotic therapeutic regimen and protocols, methodically record the treatment outcomes with at least 3 years of follow­up, and then determine the indications for the use of antibiotics with an assessment of risks and benefits, while at the same time limiting the risk of inappropriate use of antibiotics in order not to further contribute to the development of one of the biggest global problems—antimicrobial resistance.

• Keywords: parodontitis; periimplantitis; zubni implantati; oseointegracija; antibiotici
• Keywords (english): periodontitis; peri-implantitis; dental implants; osseointegration; antibiotics
• Language: croatian
• URN:NBN: urn:nbn:hr:127:229338
• Study programme: Title: dental medicine; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/magistra dentalne medicine (sveučilišni/a magistar/magistra dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-08-24 08:37:11