TY  - JOUR
AU  - Rakić, Mia
AU  - Monje, Alberto
AU  - Radovanović, Sandro
AU  - Petković-Ćurčin, Aleksandra
AU  - Vojvodić, Danilo
AU  - Tatić, Zoran
PY  - 2020
UR  - https://pubmed.ncbi.nlm.nih.gov/31773730/
UR  - http://www.ncbi.nlm.nih.gov/pubmed/31773730
UR  - https://radar.ibiss.bg.ac.rs/handle/123456789/3828
AB  - BACKGROUND Study objectives were 1) to estimate diagnostic capacity of clinical parameters, receptor activator of nuclear factor kappa-B (RANKL) and osteoprotegerin (OPG) to diagnose healthy peri-implant condition (HI), peri-implant mucositis (PIM) and peri-implantitis (PIMP) by assessing respective diagnostic accuracy, sensitivity, specificity and diagnostic ranges 2) to develop personalized diagnostic model (PDM) for implant monitoring. METHODS Split-mouth study included 126 patients and 252 implants (HI = 126, PIM = 57, and PIMP = 69). RANKL and OPG concentrations were estimated in peri-implant crevicular fluid using enzyme-linked immunosorbent assay method and assessed with clinical parameters using routine statistics, while the diagnostic capacity of individual parameters and overall clinical diagnosis were estimated using classifying algorithms. PDM was developed using decision trees. RESULTS Bleeding on probing (BOP), plaque index, and probing depth (PD) were confirmed reliable discriminants between peri-implant health and disease, while increase in PD (PD > 4 mm) and suppuration were good discriminants amongst PIM/PIMP. Bone turnover markers (BTMs) demonstrated presence of bone resorption in PIM; between comparable diagnostic ranges PIM/PIMP, PIMP was clinically distinguished from PIM in about 60% of patients while 40% remained diagnosed as false negatives. PDM demonstrated highest diagnostic capacity (accuracy: 96.27%, sensitivity: 95.00%, specificity: 100%) and defined HI: BOP ≤0.25%; PIM: BOP >0.25%, PD ≤4.5 mm; PIMP: BOP >0.25%, PD >4.5 mm and RANKL ≤19.9 pg/site; PIM: BOP >0.25%, PD >4.5 mm, and RANKL >19.9 pg/site. CONCLUSIONS BTMs demonstrated capacity to substantially improve clinical diagnosis of peri-implant conditions. Considering lack of difference in BTMs between PIM/PIMP and cluster of PIM with exceeding BTMs, a more refined definition of peri-implant conditions according to biological characteristics is required for further BTMs validation and appropriate PIMP management.
PB  - Wiley-Blackwell
T2  - Journal of Periodontology
T1  - Is the personalized approach the key to improve clinical diagnosis of peri-implant conditions? The role of bone markers.
IS  - 7
VL  - 91
DO  - 10.1002/JPER.19-0283
SP  - 859
EP  - 869
ER  - 

@article{
author = "Rakić, Mia and Monje, Alberto and Radovanović, Sandro and Petković-Ćurčin, Aleksandra and Vojvodić, Danilo and Tatić, Zoran",
year = "2020",
abstract = "BACKGROUND Study objectives were 1) to estimate diagnostic capacity of clinical parameters, receptor activator of nuclear factor kappa-B (RANKL) and osteoprotegerin (OPG) to diagnose healthy peri-implant condition (HI), peri-implant mucositis (PIM) and peri-implantitis (PIMP) by assessing respective diagnostic accuracy, sensitivity, specificity and diagnostic ranges 2) to develop personalized diagnostic model (PDM) for implant monitoring. METHODS Split-mouth study included 126 patients and 252 implants (HI = 126, PIM = 57, and PIMP = 69). RANKL and OPG concentrations were estimated in peri-implant crevicular fluid using enzyme-linked immunosorbent assay method and assessed with clinical parameters using routine statistics, while the diagnostic capacity of individual parameters and overall clinical diagnosis were estimated using classifying algorithms. PDM was developed using decision trees. RESULTS Bleeding on probing (BOP), plaque index, and probing depth (PD) were confirmed reliable discriminants between peri-implant health and disease, while increase in PD (PD > 4 mm) and suppuration were good discriminants amongst PIM/PIMP. Bone turnover markers (BTMs) demonstrated presence of bone resorption in PIM; between comparable diagnostic ranges PIM/PIMP, PIMP was clinically distinguished from PIM in about 60% of patients while 40% remained diagnosed as false negatives. PDM demonstrated highest diagnostic capacity (accuracy: 96.27%, sensitivity: 95.00%, specificity: 100%) and defined HI: BOP ≤0.25%; PIM: BOP >0.25%, PD ≤4.5 mm; PIMP: BOP >0.25%, PD >4.5 mm and RANKL ≤19.9 pg/site; PIM: BOP >0.25%, PD >4.5 mm, and RANKL >19.9 pg/site. CONCLUSIONS BTMs demonstrated capacity to substantially improve clinical diagnosis of peri-implant conditions. Considering lack of difference in BTMs between PIM/PIMP and cluster of PIM with exceeding BTMs, a more refined definition of peri-implant conditions according to biological characteristics is required for further BTMs validation and appropriate PIMP management.",
publisher = "Wiley-Blackwell",
journal = "Journal of Periodontology",
title = "Is the personalized approach the key to improve clinical diagnosis of peri-implant conditions? The role of bone markers.",
number = "7",
volume = "91",
doi = "10.1002/JPER.19-0283",
pages = "859-869"
}

Rakić, M., Monje, A., Radovanović, S., Petković-Ćurčin, A., Vojvodić, D.,& Tatić, Z.. (2020). Is the personalized approach the key to improve clinical diagnosis of peri-implant conditions? The role of bone markers.. in Journal of Periodontology
Wiley-Blackwell., 91(7), 859-869.
https://doi.org/10.1002/JPER.19-0283

Rakić M, Monje A, Radovanović S, Petković-Ćurčin A, Vojvodić D, Tatić Z. Is the personalized approach the key to improve clinical diagnosis of peri-implant conditions? The role of bone markers.. in Journal of Periodontology. 2020;91(7):859-869.
doi:10.1002/JPER.19-0283 .

Rakić, Mia, Monje, Alberto, Radovanović, Sandro, Petković-Ćurčin, Aleksandra, Vojvodić, Danilo, Tatić, Zoran, "Is the personalized approach the key to improve clinical diagnosis of peri-implant conditions? The role of bone markers." in Journal of Periodontology, 91, no. 7 (2020):859-869,
https://doi.org/10.1002/JPER.19-0283 . .

TY  - JOUR
AU  - Monje, Alberto
AU  - Caballé-Serrano, Jordi
AU  - Nart, Jose
AU  - Peñarrocha, David
AU  - Wang, Hom-Lay
AU  - Rakić, Mia
PY  - 2018
UR  - http://doi.wiley.com/10.1002/JPER.17-0454
UR  - https://radar.ibiss.bg.ac.rs/handle/123456789/3148
AB  - BACKGROUND The aim of this case-control study was to estimate the diagnostic accuracy of the standard clinical parameters in diagnosing healthy peri-implant tissues, peri-implant mucositis, and peri-implantitis. METHODS A case-control study was designed to compare the clinical parameters used in the diagnosis of peri-implant diseases such as: probingdepth (PD), bleeding on probing (BOP), mucosal redness (MR), suppuration (SUP), and plaque index (PI). Furthermore, the influence of patient- (sex, age) and implant-related variables (implant neck configuration, time in function after loading) were evaluated to investigate the association with the clinical findings. The inferential analysis consisted of estimation by generalized estimating equations (GEE) of multilevel logistic regression models. RESULTS In total, 1,572 sites were evaluated around 262 implants from 141 patients. Sites with implant mucositis showed significant levels of BOP (OR = 3.56), MR (OR = 7.66) and PD (OR = 1.48) compared to healthy sites. The specificity was 90.3% while the sensitivity was only 43.6%. Likewise, sites exhibiting peri-implantitis showed significant levels of BOP (OR = 2.32), MR (OR = 7.21), PD (OR = 2.43) and SUP (OR = 6.81) compared to healthy sites. Again, the multiple logistic regressions showed high specificity (92.1%) but modest sensitivity (52.5%). PD was the only diagnostic marker displaying significance comparing peri-implant mucositis and peri-implantitis sites (OR = 1.76). Moreover, tissue-level compared to bone-level implants were less associated with SUP+ (OR = 0.20), and PI (OR = 0.36) and demonstrated statistical significance. In addition, age, sex, and function time significantly influenced the tested clinical parameters. CONCLUSIONS The diagnosis of peri-implant diseases cannot rely solely upon individual clinical parameters but rather require a combination of criteria. The clinical parameters, particularly probing depth, might accurately discern between diagnoses among peri-implant conditions. Nevertheless, the specificity of the clinical parameters surpasses the sensitivity in the detection of peri-implant diseases, validating its potential use as a diagnostic tool.
T2  - Journal of Periodontology
T1  - Diagnostic accuracy of clinical parameters to monitor peri-implant conditions: A matched case-control study.
IS  - 4
VL  - 89
DO  - 10.1002/JPER.17-0454
SP  - 407
EP  - 417
ER  - 

@article{
author = "Monje, Alberto and Caballé-Serrano, Jordi and Nart, Jose and Peñarrocha, David and Wang, Hom-Lay and Rakić, Mia",
year = "2018",
abstract = "BACKGROUND The aim of this case-control study was to estimate the diagnostic accuracy of the standard clinical parameters in diagnosing healthy peri-implant tissues, peri-implant mucositis, and peri-implantitis. METHODS A case-control study was designed to compare the clinical parameters used in the diagnosis of peri-implant diseases such as: probingdepth (PD), bleeding on probing (BOP), mucosal redness (MR), suppuration (SUP), and plaque index (PI). Furthermore, the influence of patient- (sex, age) and implant-related variables (implant neck configuration, time in function after loading) were evaluated to investigate the association with the clinical findings. The inferential analysis consisted of estimation by generalized estimating equations (GEE) of multilevel logistic regression models. RESULTS In total, 1,572 sites were evaluated around 262 implants from 141 patients. Sites with implant mucositis showed significant levels of BOP (OR = 3.56), MR (OR = 7.66) and PD (OR = 1.48) compared to healthy sites. The specificity was 90.3% while the sensitivity was only 43.6%. Likewise, sites exhibiting peri-implantitis showed significant levels of BOP (OR = 2.32), MR (OR = 7.21), PD (OR = 2.43) and SUP (OR = 6.81) compared to healthy sites. Again, the multiple logistic regressions showed high specificity (92.1%) but modest sensitivity (52.5%). PD was the only diagnostic marker displaying significance comparing peri-implant mucositis and peri-implantitis sites (OR = 1.76). Moreover, tissue-level compared to bone-level implants were less associated with SUP+ (OR = 0.20), and PI (OR = 0.36) and demonstrated statistical significance. In addition, age, sex, and function time significantly influenced the tested clinical parameters. CONCLUSIONS The diagnosis of peri-implant diseases cannot rely solely upon individual clinical parameters but rather require a combination of criteria. The clinical parameters, particularly probing depth, might accurately discern between diagnoses among peri-implant conditions. Nevertheless, the specificity of the clinical parameters surpasses the sensitivity in the detection of peri-implant diseases, validating its potential use as a diagnostic tool.",
journal = "Journal of Periodontology",
title = "Diagnostic accuracy of clinical parameters to monitor peri-implant conditions: A matched case-control study.",
number = "4",
volume = "89",
doi = "10.1002/JPER.17-0454",
pages = "407-417"
}

Monje, A., Caballé-Serrano, J., Nart, J., Peñarrocha, D., Wang, H.,& Rakić, M.. (2018). Diagnostic accuracy of clinical parameters to monitor peri-implant conditions: A matched case-control study.. in Journal of Periodontology, 89(4), 407-417.
https://doi.org/10.1002/JPER.17-0454

Monje A, Caballé-Serrano J, Nart J, Peñarrocha D, Wang H, Rakić M. Diagnostic accuracy of clinical parameters to monitor peri-implant conditions: A matched case-control study.. in Journal of Periodontology. 2018;89(4):407-417.
doi:10.1002/JPER.17-0454 .

Monje, Alberto, Caballé-Serrano, Jordi, Nart, Jose, Peñarrocha, David, Wang, Hom-Lay, Rakić, Mia, "Diagnostic accuracy of clinical parameters to monitor peri-implant conditions: A matched case-control study." in Journal of Periodontology, 89, no. 4 (2018):407-417,
https://doi.org/10.1002/JPER.17-0454 . .

TY  - JOUR
AU  - Monje, Alberto
AU  - Insua, Angel
AU  - Rakić, Mia
AU  - Nart, Jose
AU  - Moyano-Cuevas, Jose Luis
AU  - Wang, Hom-Lay
PY  - 2018
UR  - http://doi.wiley.com/10.1002/JPER.18-0081
UR  - https://radar.ibiss.bg.ac.rs/handle/123456789/3210
AB  - BACKGROUND Lack of consensus on the clinical parameters of peri-implantitis may complicate accurate diagnosis of the disorder. Furthermore, the lack of reliable estimates of the diagnostic capacity of the clinical endpoints precludes the definition of an effective treatment protocol for peri-implantitis. The present canine study assesses the diagnostic accuracy of the clinical parameters for monitoring the peri-implant tissues in a controlled ligature-induced peri-implantitis model followed by a spontaneous progression phase. METHODS Six beagle dogs were followed-up on during three episodes of ligature-induced peri-implantitis and a further episode of spontaneous progression. Probing depth (PD), bleeding on probing (BOP), mucosal recession (MR), and suppuration (SUP) were recorded at four sites per implant and at four study timepoints. Moreover, the implant mucosal index (IMI) was calculated at implant level. Marginal bone loss (MBL) was determined using computed tomography at four sites per implant. A linear regression model was used to estimate clinical and radiological parameters during peri-implantitis progression. RESULTS Progressive peri-implant bone loss is characterized by an increase in PD, more profuse BOP, MR, and SUP in advanced cases (p < 0.001). However, even in the presence of severe bone loss, SUP was not a common finding, with an incidence of approximately 10% at the last timepoint. These clinical parameters were significantly correlated to MBL at most of the timepoints. The IMI, in turn, showed a positive correlation to MBL and the peri-implant inflammatory signs (r = 0.39; p < 0.001), with a tendency to exhibit higher scores during ligature-induced peri-implantitis, followed by a slight decrease during the spontaneous progression period. CONCLUSION The clinical features of peri-implantitis and spontaneous progression of the disorder may facilitate an accurate monitoring of peri-implant pathologic bone loss.
T2  - Journal of Periodontology
T1  - Estimation of the diagnostic accuracy of clinical parameters for monitoring peri-implantitis progression: An experimental canine study.
IS  - 12
VL  - 89
DO  - 10.1002/JPER.18-0081
SP  - 1442
EP  - 1451
ER  - 

@article{
author = "Monje, Alberto and Insua, Angel and Rakić, Mia and Nart, Jose and Moyano-Cuevas, Jose Luis and Wang, Hom-Lay",
year = "2018",
abstract = "BACKGROUND Lack of consensus on the clinical parameters of peri-implantitis may complicate accurate diagnosis of the disorder. Furthermore, the lack of reliable estimates of the diagnostic capacity of the clinical endpoints precludes the definition of an effective treatment protocol for peri-implantitis. The present canine study assesses the diagnostic accuracy of the clinical parameters for monitoring the peri-implant tissues in a controlled ligature-induced peri-implantitis model followed by a spontaneous progression phase. METHODS Six beagle dogs were followed-up on during three episodes of ligature-induced peri-implantitis and a further episode of spontaneous progression. Probing depth (PD), bleeding on probing (BOP), mucosal recession (MR), and suppuration (SUP) were recorded at four sites per implant and at four study timepoints. Moreover, the implant mucosal index (IMI) was calculated at implant level. Marginal bone loss (MBL) was determined using computed tomography at four sites per implant. A linear regression model was used to estimate clinical and radiological parameters during peri-implantitis progression. RESULTS Progressive peri-implant bone loss is characterized by an increase in PD, more profuse BOP, MR, and SUP in advanced cases (p < 0.001). However, even in the presence of severe bone loss, SUP was not a common finding, with an incidence of approximately 10% at the last timepoint. These clinical parameters were significantly correlated to MBL at most of the timepoints. The IMI, in turn, showed a positive correlation to MBL and the peri-implant inflammatory signs (r = 0.39; p < 0.001), with a tendency to exhibit higher scores during ligature-induced peri-implantitis, followed by a slight decrease during the spontaneous progression period. CONCLUSION The clinical features of peri-implantitis and spontaneous progression of the disorder may facilitate an accurate monitoring of peri-implant pathologic bone loss.",
journal = "Journal of Periodontology",
title = "Estimation of the diagnostic accuracy of clinical parameters for monitoring peri-implantitis progression: An experimental canine study.",
number = "12",
volume = "89",
doi = "10.1002/JPER.18-0081",
pages = "1442-1451"
}

Monje, A., Insua, A., Rakić, M., Nart, J., Moyano-Cuevas, J. L.,& Wang, H.. (2018). Estimation of the diagnostic accuracy of clinical parameters for monitoring peri-implantitis progression: An experimental canine study.. in Journal of Periodontology, 89(12), 1442-1451.
https://doi.org/10.1002/JPER.18-0081

Monje A, Insua A, Rakić M, Nart J, Moyano-Cuevas JL, Wang H. Estimation of the diagnostic accuracy of clinical parameters for monitoring peri-implantitis progression: An experimental canine study.. in Journal of Periodontology. 2018;89(12):1442-1451.
doi:10.1002/JPER.18-0081 .

Monje, Alberto, Insua, Angel, Rakić, Mia, Nart, Jose, Moyano-Cuevas, Jose Luis, Wang, Hom-Lay, "Estimation of the diagnostic accuracy of clinical parameters for monitoring peri-implantitis progression: An experimental canine study." in Journal of Periodontology, 89, no. 12 (2018):1442-1451,
https://doi.org/10.1002/JPER.18-0081 . .

TY  - JOUR
AU  - Rakić, Mia
AU  - Galindo-Moreno, Pablo
AU  - Monje, Alberto
AU  - Radovanović, Sandro
AU  - Wang, Hom-Lay
AU  - Cochran, David
AU  - Sculean, Anton
AU  - Canullo, Luigi
PY  - 2017
UR  - http://link.springer.com/10.1007/s00784-017-2276-y
UR  - http://www.ncbi.nlm.nih.gov/pubmed/29218422
UR  - https://radar.ibiss.bg.ac.rs/handle/123456789/2941
AB  - OBJECTIVES The objective of this study is to estimate the overall prevalence of peri-implantitis (PI) and the effect of different study designs, function times, and implant surfaces on prevalence rate reported by the studies adhering to the case definition of Sanz & Chapple 2012. MATERIAL AND METHODS Following electronic and manual searches of the literature published up to February 2016, data were extracted from the studies fitting the study criteria. Meta-analysis was performed for estimation of overall prevalence of PI while the effects of the study design, function time, and implant surface type on prevalence rate were investigated using meta-regression method. RESULTS Twenty-nine articles were included in this study. The prevalence rate in all subset meta-analyses was always higher at patient level when compared to the prevalence rate at the implant level. Prevalence of PI was 18.5% at the patient level and 12.8% at the implant level. Meta-regression analysis did not identify any association for different study designs and function times while it was demonstrated the significant association between moderately rough surfaces with lower prevalence rate of PI (p = 0.011). CONCLUSIONS The prevalence rate of PI remains highly variable even following restriction to the clinical case definition and it seems to be affected by local factors such as implant surface characteristics. The identification of adjuvant diagnostic markers seems necessary for more accurate disease classification. CLINICAL RELEVANCE The occurrence of PI is affected by local factors such as implant surface characteristics hence the careful assessment of the local factors should be performed within treatment planning.
T2  - Clinical Oral Investigations
T2  - Clinical Oral Investigations
T1  - How frequent does peri-implantitis occur? A systematic review and meta-analysis.
DO  - 10.1007/s00784-017-2276-y
ER  - 

@article{
author = "Rakić, Mia and Galindo-Moreno, Pablo and Monje, Alberto and Radovanović, Sandro and Wang, Hom-Lay and Cochran, David and Sculean, Anton and Canullo, Luigi",
year = "2017",
abstract = "OBJECTIVES The objective of this study is to estimate the overall prevalence of peri-implantitis (PI) and the effect of different study designs, function times, and implant surfaces on prevalence rate reported by the studies adhering to the case definition of Sanz & Chapple 2012. MATERIAL AND METHODS Following electronic and manual searches of the literature published up to February 2016, data were extracted from the studies fitting the study criteria. Meta-analysis was performed for estimation of overall prevalence of PI while the effects of the study design, function time, and implant surface type on prevalence rate were investigated using meta-regression method. RESULTS Twenty-nine articles were included in this study. The prevalence rate in all subset meta-analyses was always higher at patient level when compared to the prevalence rate at the implant level. Prevalence of PI was 18.5% at the patient level and 12.8% at the implant level. Meta-regression analysis did not identify any association for different study designs and function times while it was demonstrated the significant association between moderately rough surfaces with lower prevalence rate of PI (p = 0.011). CONCLUSIONS The prevalence rate of PI remains highly variable even following restriction to the clinical case definition and it seems to be affected by local factors such as implant surface characteristics. The identification of adjuvant diagnostic markers seems necessary for more accurate disease classification. CLINICAL RELEVANCE The occurrence of PI is affected by local factors such as implant surface characteristics hence the careful assessment of the local factors should be performed within treatment planning.",
journal = "Clinical Oral Investigations, Clinical Oral Investigations",
title = "How frequent does peri-implantitis occur? A systematic review and meta-analysis.",
doi = "10.1007/s00784-017-2276-y"
}

Rakić, M., Galindo-Moreno, P., Monje, A., Radovanović, S., Wang, H., Cochran, D., Sculean, A.,& Canullo, L.. (2017). How frequent does peri-implantitis occur? A systematic review and meta-analysis.. in Clinical Oral Investigations.
https://doi.org/10.1007/s00784-017-2276-y

Rakić M, Galindo-Moreno P, Monje A, Radovanović S, Wang H, Cochran D, Sculean A, Canullo L. How frequent does peri-implantitis occur? A systematic review and meta-analysis.. in Clinical Oral Investigations. 2017;.
doi:10.1007/s00784-017-2276-y .

Rakić, Mia, Galindo-Moreno, Pablo, Monje, Alberto, Radovanović, Sandro, Wang, Hom-Lay, Cochran, David, Sculean, Anton, Canullo, Luigi, "How frequent does peri-implantitis occur? A systematic review and meta-analysis." in Clinical Oral Investigations (2017),
https://doi.org/10.1007/s00784-017-2276-y . .