Dr Olivier Carcuac
Dr Olivier Carcuac is a certified specialist in Periodontics since 2008. He is currently a part-time private practioner at My Dental Clinic, at Confident Dubai Palm and at Dr Joy Dental Clinic, in Dubai, UAE.
Dr Carcuac is also an active senior researcher at the Department of Periodontology at the Institue of Odontology, University of Gothenburg, Sweden. His research is focused on the pathogenesis and treatment of periodontal and peri-implant diseases.
Ukrainian Academy of
27 June 2020
MY LATEST RESEARCH
Re-osseointegration following reconstructive surgical therapy of experimental peri-implantitis. A pre-clinical in vivo study.
Clinical Oral Implants Research 2019
Almohandes A. et al.
Surgical treatment of peri-implantitis. 3-year results from a randomized controlled clinical trial
Journal of Clinical Periodontology 2017
Carcuac O. et al.
The aim of the current pre-clinical in vivo study was to evaluate the effect of bone substitute materials on hard and soft tissue healing in reconstructive surgical therapy of experimental peri-implantitis at implants with different surface characteristics.
Six female, Labrador dogs were used. Three months after tooth extraction, 4 implants with 2 different surface characteristics (A and B) were installed on each side of the mandible. Experimental peri-implantitis was induced 3 months later. During surgical treatment of peri-implantitis the implants were cleaned with curettes and cotton pellets soaked in saline. The implant sites were allocated to one of 4 treatment categories; (i) Group C; no augmentation, (ii) Group T1; bone defect filled with deproteinized bovine bone mineral (iii) Group T2; bone defect filled with a biphasic bone graft material, (iv) Group T3; bone defect filled as T1 and covered with a collagen membrane. Clinical and radiological examinations were performed and biopsies were obtained and prepared for histological analysis 6 months after peri-implantitis surgery.
Implant B (smooth surface) sites showed significantly (i) larger radiographic bone level gain, (ii) enhanced resolution of peri-implantitis lesions and (iii) larger frequency of re-osseointegration than implant A (moderately rough surface) sites. Implant B sites also showed superior preservation of the mucosal margin. Differences between bone substitute materials and control procedures were overall small with limited advantages for T1 and T2 sites.
It is suggested that healing following reconstructive surgical treatment of experimental peri-implantitis was superior around implants with a smooth surface than implants with a moderately rough surface. Benefits of using bone substitute materials during surgical therapy were overall small.
This study reports on the 3-year follow-up of patients enrolled in a randomized controlled clinical trial on surgical treatment of advanced peri-implantitis.
100 patients with advanced peri-implantitis were randomly assigned to one of four treatment groups. Surgical therapy aiming at pocket elimination was performed and, in three test groups, supplemented by either systemic antibiotics, use of an antiseptic agent for implant surface decontamination or both. Outcomes were evaluated after 1 and 3 years by means of clinical
and radiological examinations. Differences between groups were explored by regression analysis.
Clinical examinations at 3 years after treatment revealed (i) improved peri-implant soft tissue health with a mean reduction in probing depth of 2.7 mm and a reduction in bleeding/suppuration on probing of 40% and (ii) stable peri-implant marginal bone levels (mean bone loss during follow-up: 0.04 mm). Implant surface characteristics had a significant impact on 3-year outcomes, in favor of implants with non-modified surfaces. Benefits of systemic antibiotics were limited to implants with modified surfaces and to the first year of follow-up.
It is suggested that surgical treatment of peri-implantitis is effective and that outcomes of therapy are affected by implant surface characteristics. Potential benefits of systemic antibiotics are not sustained over 3 years.
Adjunctive systemic and local antimicrobial therapy in surgical treatment of peri-implantitis. A randomized controlled clinical trial.
Journal of Dental Research 2016
Carcuac O. et al.
The aim of the present randomized controlled clinical trial was to investigate the adjunctive effect of systemic antibiotics and the local use of chlorhexidine for implant surface decontamination in the surgical treatment of peri-implantitis.
One hundred patients with severe peri-implantitis were recruited. Surgical therapy was performed with or without adjunctive systemic antibiotics or the local use of chlorhexidine for implant surface decontamination. Treatment outcomes were evaluated at 1 y. A binary logistic regression analysis was used to identify factors influencing the probability of treatment success, that is, probing pocket depth ≤5 mm, absence of bleeding/suppuration on probing, and no additional bone loss.
Treatment success was obtained in 45% of all implants but was higher in implants with a nonmodified surface (79%) than those with a modified surface (34%).
The local use of chlorhexidine had no overall effect on treatment outcomes. While adjunctive systemic antibiotics had no impact on treatment success at implants with a nonmodified surface, a positive effect on treatment success was observed at implants with a modified surface. The likelihood for treatment success using adjunctive systemic antibiotics in patients with implants with a modified surface, however, was low. As the effect of adjunctive systemic antibiotics depended on implant surface characteristics, recommendations for their use in the surgical treatment of peri-implantitis should be based on careful assessments of the targeted implant.
Composition of human peri-implantitis and periodontitis lesions.
Journal of Dental Research 2014
Carcuac O. et Berglundh T.
The aim of the present study was to examine differences in cellular characteristics of human peri-implantitis and periodontitis lesions.
Two groups of patients were included: 40 patients with generalized severe chronic periodontitis and 40 patients presenting with severe peri-implantitis. Soft tissue biopsies were obtained from diseased sites (probing pocket depth ≥ 7 mm with bleeding on probing) and prepared for histologic and immunohistochemical analysis.
In contrast to periodontitis samples, peri-implantitis lesions were more than twice as large and contained significantly larger area proportions, numbers, and densities of CD138-, CD68-, and MPO-positive cells than periodontitis lesions. Peri-implantitis lesions also extended to a position that was apical of the pocket epithelium and not surrounded by noninfiltrated connective tissue. They further presented with significantly larger densities of vascular structures in the connective tissue area lateral to the infiltrated connective tissue than within the infiltrate.
This study suggests that peri-implantitis and periodontitis lesions exhibit critical histopathologic differences, which contribute to the understanding of dissimilarities in onset and progression between the 2 diseases.