51
|
Aspirin Thromboprophylaxis Confers No Increased Risk for Aseptic Loosening Following Cementless Primary Hip Arthroplasty. J Arthroplasty 2019; 34:2978-2982. [PMID: 31383492 DOI: 10.1016/j.arth.2019.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/06/2019] [Accepted: 07/10/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Aspirin has been shown to be a safe and cost-effective thromboprophylaxis agent with equivalent preventive efficacy to warfarin and fewer side-effects. However, animal studies have suggested delayed bone healing with aspirin and other inhibitors of prostaglandin synthesis. The impact of aspirin on aseptic loosening following cementless total hip arthroplasty (THA) has yet to be explored. Our aim was to determine if patients receiving aspirin for thromboprophylaxis had higher rates of aseptic loosening vs patients receiving warfarin after THA. METHODS We identified 11,262 consecutive primary uncemented THA performed between 2006 and 2017. Postoperatively, either warfarin (target international normalized ratio 1.5-2.0) or aspirin chemoprophylaxis were prescribed for 4 weeks. We recorded demographics, length of stay, body mass index, preoperative nonsteroidal antiinflammatory drug use, and Elixhauser comorbidity index. All revisions because of aseptic loosening within 1 year of the index procedure were identified radiographically, confirmed intraoperatively, and did not fulfill Musculoskeletal Infection Society criteria for periprosthetic infection. Multivariate logistic regression analysis was performed. RESULTS There was no difference (P = .14) in the rates of revision for aseptic loosening between patients in the aspirin cohort (14/4530; 0.31%; P = .14) and the warfarin cohort (36/6682; 0.54%). After accounting for confounding variables, no significant difference was noted in aseptic loosening rates between patients treated with aspirin vs those treated with warfarin (adjusted odds ratio 0.51; P = .11). Perioperative nonsteroidal antiinflammatory drug was not significantly associated with aseptic loosening (adjusted odds ratio 1.20; P = .67). CONCLUSION While multiple agents are available for venous thromboprophylaxis, there is increasing evidence in favor of the use of aspirin. This study allays the notion that aspirin increases the rates of aseptic loosening following uncemented hip arthroplasty.
Collapse
|
52
|
Apostu D, Lucaciu O, Mester A, Oltean-Dan D, Baciut M, Baciut G, Bran S, Onisor F, Piciu A, Pasca RD, Maxim A, Benea H. Systemic drugs with impact on osteoarthritis. Drug Metab Rev 2019; 51:498-523. [DOI: 10.1080/03602532.2019.1687511] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Dragos Apostu
- Department of Orthopaedics and Traumatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ondine Lucaciu
- Department of Oral Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandru Mester
- Department of Oral Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daniel Oltean-Dan
- Department of Orthopaedics and Traumatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Baciut
- Department of Maxillofacial Surgery and Oral Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Baciut
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simion Bran
- Department of Maxillofacial Surgery and Oral Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Florin Onisor
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andra Piciu
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Roxana D. Pasca
- Department of Biomolecular Physics, Faculty of Physics, Cluj-Napoca, Romania
- Department of Molecular and Biomolecular Physics, National Institute for Research and Development of Isotopic and Molecular Technologies, Cluj-Napoca, Romania
| | - Andrei Maxim
- Department of Orthopaedics and Traumatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Horea Benea
- Department of Orthopaedics and Traumatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| |
Collapse
|
53
|
Vacaras S, Baciut M, Lucaciu O, Dinu C, Baciut G, Crisan L, Hedesiu M, Crisan B, Onisor F, Armencea G, Mitre I, Barbur I, Kretschmer W, Bran S. Understanding the basis of medical use of poly-lactide-based resorbable polymers and composites – a review of the clinical and metabolic impact. Drug Metab Rev 2019; 51:570-588. [DOI: 10.1080/03602532.2019.1642911] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Sergiu Vacaras
- Department of Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Mihaela Baciut
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Ondine Lucaciu
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Grigore Baciut
- Department of Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Liana Crisan
- Department of Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Mihaela Hedesiu
- Department of Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Bogdan Crisan
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Florin Onisor
- Department of Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Gabriel Armencea
- Department of Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Ileana Mitre
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Ioan Barbur
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Winfried Kretschmer
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Simion Bran
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| |
Collapse
|
54
|
Altay MA, Sindel A, Özalp Ö, Yıldırımyan N, Kocabalkan B. Proton pump inhibitor intake negatively affects the osseointegration of dental implants: a retrospective study. J Korean Assoc Oral Maxillofac Surg 2019; 45:135-140. [PMID: 31334101 PMCID: PMC6620305 DOI: 10.5125/jkaoms.2019.45.3.135] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/05/2018] [Accepted: 08/08/2018] [Indexed: 12/14/2022] Open
Abstract
Objectives This study sought to investigate the association between the systemic intake of proton pump inhibitors (PPI) and the early failure of dental implants. Materials and Methods A retrospective cohort study involving 1,918 dental implants in 592 patients (69 implants in 24 PPI users and 1,849 implants in 568 nonusers, respectively) was conducted. The effect of PPI intake on the osseointegration of dental implants was evaluated using patient- and implant-level models. Results Among 24 PPI users, two patients experienced implant failure, one of whom had three and the other of whom had one failed implant, respectively. Thus, the rate of failure for this population was 8.3%. Separately, 11 nonusers each experienced one implant failure, and the failure rate for these patients was 1.9%. Fisher's exact test revealed statistically significant differences between PPI users and nonusers at the implant level (P=0.002) but failed to show any significance at the patient level (P=0.094). The odds of implant failure were 4.60 times greater among PPI users versus nonusers. Dental implants that were placed in patients using PPIs were found to be 4.30 times more likely to fail prior to loading. Conclusion The findings of this study suggest that PPI intake may be associated with an increased risk of early dental implant failure.
Collapse
Affiliation(s)
- Mehmet Ali Altay
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Akdeniz University, Antalya, Turkey
| | - Alper Sindel
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Akdeniz University, Antalya, Turkey
| | - Öznur Özalp
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Akdeniz University, Antalya, Turkey
| | - Nelli Yıldırımyan
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Akdeniz University, Antalya, Turkey
| | - Burak Kocabalkan
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Akdeniz University, Antalya, Turkey
| |
Collapse
|
55
|
Heo HA, Park S, Jeon YS, Pyo SW. Effect of Raloxifene Administration on Bone Response Around Implant in the Maxilla of Osteoporotic Rats. IMPLANT DENT 2019; 28:272-278. [DOI: 10.1097/id.0000000000000881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
56
|
Mester A, Apostu D, Ciobanu L, Piciu A, Lucaciu O, Campian RS, Taulescu M, Bran S. The impact of proton pump inhibitors on bone regeneration and implant osseointegration. Drug Metab Rev 2019; 51:330-339. [PMID: 31055956 DOI: 10.1080/03602532.2019.1610767] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Proton pump inhibitors (PPIs) have become known for the treatment of gastric-acid related disorders. Similar to any other drugs, PPIs have possible adverse reactions, being associated with bone fractures, infections, kidney disease, mineral deficiency, dementia, and pneumonia. Multiple analyses have stated that PPIs therapy may affect bone regeneration and osseointegration process, causing an increased risk of bone fracture, deterioration of bone metabolism and impaired bone healing. In this review, we emphasized the current literature regarding the influence of proton pump inhibitors in the bone regeneration process. Results from the studies suggest a link between PPIs intake and bone regeneration, but several concerns are raised regarding inadequate recipient bone, surgical trauma, limitations on the titanium surface, comorbidities or interference with other pharmacological agents. Further studies are needed to determine whether the impaired bone regeneration process is due to PPI or coexisting factors.
Collapse
Affiliation(s)
- Alexandru Mester
- Department of Oral Rehabilitation, Oral Health and Dental Office Management, University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| | - Dragos Apostu
- Department of Orthopedics and Traumatology, University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| | - Lidia Ciobanu
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| | - Andra Piciu
- Department of Medical Oncology, University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| | - Ondine Lucaciu
- Department of Oral Rehabilitation, Oral Health and Dental Office Management, University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| | - Radu Septimiu Campian
- Department of Oral Rehabilitation, Oral Health and Dental Office Management, University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| | - Marian Taulescu
- Department of Pathology, University of Agricultural Sciences and Veterinary Medicine , Cluj-Napoca , Romania
| | - Simion Bran
- Department of Maxillofacial Surgery and Implantology, University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| |
Collapse
|
57
|
Apostu D, Lucaciu O, Mester A, Benea H, Oltean-Dan D, Onisor F, Baciut M, Bran S. Cannabinoids and bone regeneration. Drug Metab Rev 2019; 51:65-75. [PMID: 30702341 DOI: 10.1080/03602532.2019.1574303] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Bone is a complex tissue with unique properties such as high strength and regeneration capabilities while carrying out multiple functions. Bone regeneration occurs both in physiological situations (bone turnover) and in pathological situations (e.g. fractures), being performed by osteoblasts and osteoclasts. If this process is inadequate, fracture nonunion or aseptic loosening of implants occurs and requires a complex treatment. Exogenous factors are currently used to increase bone regeneration process when needed, such as bisphosphonates and vitamin D, but limitations do exist. Cannabinoid system has been shown to have positive effects on bone metabolism. Cannabinoids at bone level mainly act on two receptors called CB-1 and CB-2, but GPR55, GPR119, TPRV1, TPRV4 receptors may also be involved. The CB-2 receptors are found in bone cells at higher levels compared to other receptors. Endocannabinods represented by anandamide and 2-arachidonoylglycerol, can stimulate osteoblast formation, bone formation and osteoclast activity. CB-2 agonists including HU-308, HU-433, JWH133, and JWH015 can stimulate osteoblast proliferation and activity, while CB-2 antagonists such as AM630 and SR144528 can inhibit osteoclast differentiation and function. CB-1 antagonist AM251 has been shown to inhibit osteoclast differentiation and activity, while GPR55 antagonist cannabidiol increases osteoblast activity and decreases osteoclast function. An optimal correlation of dose, duration, moment of action, and affinity can lead to an increased bone regeneration capacity, with important benefits in many pathological situations which involve bone tissue. As adverse reactions of cannabinoids have not been described in patients under controlled medication, cannabinoids can represent future treatment for bone regeneration.
Collapse
Affiliation(s)
- Dragos Apostu
- a Department of Orthopedics and Traumatology , University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| | - Ondine Lucaciu
- b Department of Oral Rehabilitation, Oral Health and Dental Office Management , University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| | - Alexandru Mester
- b Department of Oral Rehabilitation, Oral Health and Dental Office Management , University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| | - Horea Benea
- a Department of Orthopedics and Traumatology , University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| | - Daniel Oltean-Dan
- a Department of Orthopedics and Traumatology , University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| | - Florin Onisor
- c Department of Maxillofacial Surgery and Implantology , University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| | - Mihaela Baciut
- c Department of Maxillofacial Surgery and Implantology , University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| | - Simion Bran
- c Department of Maxillofacial Surgery and Implantology , University of Medicine and Pharmacy "Iuliu Hatieganu" , Cluj-Napoca , Romania
| |
Collapse
|
58
|
Naringenin mitigates titanium dioxide (TiO 2)-induced chronic arthritis in mice: role of oxidative stress, cytokines, and NFκB. Inflamm Res 2018; 67:997-1012. [PMID: 30370484 DOI: 10.1007/s00011-018-1195-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 09/14/2018] [Accepted: 10/12/2018] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To evaluate the effect and mechanisms of naringenin in TiO2-induced chronic arthritis in mice, a model resembling prosthesis and implant inflammation. TREATMENT Flavonoids are antioxidant and anti-inflammatory molecules with important anti-inflammatory effect. Mice were daily treated with the flavonoid naringenin (16.7-150 mg/kg, orally) for 30 days starting 24 h after intra-articular knee injection of 3 mg of TiO2. METHODS TiO2-induced arthritis resembles cases of aseptic inflammation induced by prosthesis and/or implants. Mice were stimulated with 3 mg of TiO2 and after 24 h mice started to be treated with naringenin. The disease phenotype, treatment toxicity, histopathological damage, oxidative stress, cytokine expression and NFκB were evaluated after 30 days of treatment. RESULTS Naringenin inhibited TiO2-induced mechanical hyperalgesia (96%), edema (77%) and leukocyte recruitment (74%) without inducing toxicity. Naringenin inhibited histopathological index (HE, 49%), cartilage damage (Toluidine blue tibial staining 49%, and proteoglycan 98%), and bone resorption (TRAP-stained 73%). These effects were accompanied by inhibition of oxidative stress (gp91phox 93%, NBT 83%, and TBARS 41%) cytokine mRNA expression (IL-33 82%, TNFα 76%, pro-IL-1β 100%, and IL-6 61%), and NFκB activation (100%). CONCLUSION Naringenin ameliorates TiO2-induced chronic arthritis inducing analgesic and anti-inflammatory responses with improvement in the histopathological index, cartilage damage, and bone resorption.
Collapse
|
59
|
Manea A, Bran S, Baciut M, Armencea G, Pop D, Berce P, Vodnar DC, Hedesiu M, Dinu C, Petrutiu A, Tomina D, Baciut G. Sterilization protocol for porous dental implants made by Selective Laser Melting. CLUJUL MEDICAL (1957) 2018; 91:452-457. [PMID: 30564023 PMCID: PMC6296721 DOI: 10.15386/cjmed-987] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 06/29/2018] [Accepted: 07/10/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS Although dental implants are widely and successfully used, failure rates because of bacterial colonization are still high. Adequate fabrication and sterilization techniques as well as proper management of infectious complications represent a constant field of interest and research. In this study, we focused our attention on implants with controlled porosity produced by Selective Laser Melting (SLM). The difficulty to sterilize porous implantable devices is well known and finding an adequate sterilization protocol represents a challenge worldwide. Before testing the biological and mechanical properties of porous implants, a preliminary study in order to determine a correct sterilization protocol must be conducted.Our aim was to establish a valid sterilization protocol for porous titanium alloy dental implants, as such protocols are not officially available yet. METHODS Twenty dental implants were fabricated from a titanium alloy by SLM. Ten of them were made using a 150W laser beam (porosity of 1% - group A) and the rest using a 75W laser beam (porosity of 23% - Group B), all of them with a non-defined internal structure. The implants were initially sterilized (5 from group A and 5 from group B, using dry heat - 180°C for 2 hours; the rest using steam sterilization - 121 °C for15 min) and then spent 18 hours in culture media with developing bacteria (Bacillus cereus (ATCC 11778), Staphylococcus aureus (ATCC 49444), Enterococcus faecalis (ATCC 29212), Listeria monocytogenes (ATCC 19114), three Gram negative bacteria: Escherichia coli (ATCC 25922), Salmonella typhimurium (ATCC 14028) and Pseudomonas aeruginosa (ATCC 27853). The first ten implants (5 from group A and 5 from group B) were then sterilized with dry heat and the others with steam. After sterilization, they were all placed in sterile culture media in order to observe if any bacterial growth were present. RESULTS The culture media was observed 18 hours after the sterilized implants were placed inside. No bacterial growth was observed. CONCLUSIONS Our tests reached their aims of defining a protocol to sterilize porous implants. Future tests regarding biological and mechanical aspects of these implants may now follow.
Collapse
Affiliation(s)
- Avram Manea
- Department I - Maxillo-Facial Surgery and Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simion Bran
- Department III - Oral Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Baciut
- Department III - Oral Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriel Armencea
- Department I - Maxillo-Facial Surgery and Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dumitru Pop
- Department of Mechanical Systems Engineering, Technical University of Cluj-Napoca, Romania
| | - Petru Berce
- Department of Engineering Fabrication, Technical University of Cluj-Napoca, Romania
| | - Dan-Cristian Vodnar
- Faculty of Food Science and Technology, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Romania
| | - Mihaela Hedesiu
- Department I - Maxillo-Facial Surgery and Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristian Dinu
- Department I - Maxillo-Facial Surgery and Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Adrian Petrutiu
- Department III - Oral Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Darius Tomina
- Department III - Oral Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Baciut
- Department I - Maxillo-Facial Surgery and Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| |
Collapse
|
60
|
Guido Mangano F, Ghertasi Oskouei S, Paz A, Mangano N, Mangano C. Low serum vitamin D and early dental implant failure: Is there a connection? A retrospective clinical study on 1740 implants placed in 885 patients. J Dent Res Dent Clin Dent Prospects 2018; 12:174-182. [PMID: 30443302 PMCID: PMC6231147 DOI: 10.15171/joddd.2018.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 08/26/2018] [Indexed: 01/21/2023] Open
Abstract
Background. Since osseointegration depends on bone metabolism, low levels of vitamin D in the blood may negatively
affect bone formation around dental implants. To date, only a few studies have investigated the possible connection between
serum levels of vitamin D and early dental implant failure (EDIF), i.e. failure that occurs within 4 months after placement,
before the connection of the prosthetic abutment. The aim of this study was to investigate whether there is a relationship
between low serum levels of vitamin D and EDIF.
Methods. Data used for this retrospective study were derived from the records of a private dental clinic. Inclusion criteria
were patients who had been treated with dental implants, inserted with a submerged technique from January 2003 to December
2017. EDIF was the outcome of this study. Chi-squared test was used to investigate the effect of patient-related variables (age,
gender, smoking habit, history of periodontal disease and serum levels of vitamin D) on EDIF.
Results. Originally, 885 patients treated with 1,740 fixtures were enrolled in this study. Overall, 35 EDIFs (3.9%) were
reported. No correlation was found between EDIF and the patients' gender (P=0.998), age (P=0.832), smoking habit (P=0.473)
or history of periodontal disease (P=0.386). Three EDIFs (11.1%) were reported in 27 patients with serum levels of vitamin
D <10 ng/mL, 20 EDIFs (4.4%) in 448 patients with levels between 10 and 30 ng/mL, and 12 EDIFs (2.9%) in 410 patients
with levels >30 ng/mL. Although there was a clear trend toward an increased incidence of EDIF with lowering of serum
vitamin D levels, no statistically significant difference (P=0.105) was found among these three groups.
Conclusion. Within its limitations (retrospective design, low number of patients with severe blood levels of vitamin D
enrolled), this study failed to demonstrate a significant relationship between low serum levels of vitamin D and increased risk
of EDIF. However, since a dramatic increase in EDIFs with lowering of vitamin D levels in the blood has been reported,
further clinical studies with appropriate design (prospective or randomized controlled studies on a larger sample of severely
deficient patients) are needed to better investigate this topic
Collapse
Affiliation(s)
| | | | - Ana Paz
- Private Practice, Lisbon, Portugal
| | - Natale Mangano
- Division of Endocrinology and Metabolism, Moriggia Pelascini Hospital, Gravedona ed Uniti, Italy
| | - Carlo Mangano
- Department of Dental Sciences, University Vita Salute San Raffaele, Milan, Italy
| |
Collapse
|
61
|
Altay MA, Sindel A, Özalp Ö, Yildirimyan N, Kader D, Bilge U, Baur DA. Does the Intake of Selective Serotonin Reuptake Inhibitors Negatively Affect Dental Implant Osseointegration? A Retrospective Study. J ORAL IMPLANTOL 2018. [DOI: 10.1563/aaid-joi-d-17-00240] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The success of osseointegration is influenced by several factors that affect bone metabolism and by certain systemic medications. Selective serotonin reuptake inhibitors (SSRIs) have been previously suggested to be among these medications. This study aims to investigate the association between systemic intake of SSRIs and failure of osseointegration in patients rehabilitated with dental implants. A retrospective cohort study was conducted, including a total of 2055 osseointegrated dental implants in 631 patients (109 implants in 36 SSRI \users and 1946 in 595 nonusers). Predictor and outcome variables were SSRI intake and osseointegration failure, respectively. The data were analyzed with Mann–Whitney test or Fisher exact test accordingly. Both patient-level and implant-level models were implemented to evaluate the effect of SSRI exposure on the success of osseointegration of dental implants. Median duration of follow-up was 21.5 months (range = 4–56 months) for SSRI users and 23 months (range –60 months) for nonusers (P = .158). Two of 36 SSRI users had 1 failed implant each; thus, the failure rate was 5.6%. Eleven nonusers also had 1 failed implant each; thus, the failure rate was 1.85%. The difference between the 2 groups failed to reach statistical significance at patient and implant levels (P = .166, P = .149, respectively). The odds of implant failure were 3.123 times greater for SSRI users compared with nonusers. Patients using SSRIs were found to be 3.005 times more likely to experience early implant failure than nonusers. The results of this study suggest that SSRIs may lead to increase in the rate of osseointegration failure, although not reaching statistical significance.
Collapse
Affiliation(s)
- Mehmet Ali Altay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Alper Sindel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Öznur Özalp
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Nelli Yildirimyan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Dinçer Kader
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Uğur Bilge
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Dale A. Baur
- Department of Oral and Maxillofacial Surgery, Case Western Reserve University, School of Dental Medicine, Cleveland, Ohio
| |
Collapse
|
62
|
Scardueli CR, Bizelli-Silveira C, Marcantonio RAC, Marcantonio E, Stavropoulos A, Spin-Neto R. Systemic administration of strontium ranelate to enhance the osseointegration of implants: systematic review of animal studies. Int J Implant Dent 2018; 4:21. [PMID: 30014305 PMCID: PMC6047953 DOI: 10.1186/s40729-018-0132-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 04/23/2018] [Indexed: 12/31/2022] Open
Abstract
The literature states that Strontium (Sr) is able to simultaneously stimulate bone formation and suppress bone resorption. Recent animal studies suggest that the systemic administration of Sr, in the form of strontium ranelate (SRAN), would enhance the osseointegration of implants. The purpose of the present study was to undertake a systematic review on animal studies evaluating the systemic administration of Sr to enhance the osseointegration of titanium implants and the remodeling of bone grafts. The MEDLINE (PubMed) and Scopus bibliographic databases were searched from 1950 to October 2017 for reports on the use of systemic and non-radioactive Sr to enhance the osseointegration of titanium implants and the remodeling of bone grafts in animals. The search strategy was restricted to English language publications using the combined terms: "strontium" and "implant or graft or biomaterial or bone substitute". Five studies were included, all related to the systemic administration of Sr in the form SRAN, and its effects on osseointegration of titanium implants. No studies on the use of SRAN-based therapy to enhance the remodeling of bone grafts were found. The studies differed notably with respect to the study population (healthy female rats, healthy male rats, and female rats with induced osteoporosis) and SRAN dose (ranging from 500 to 1000 mg/kg/day). Results were diverse, but a tendency suggesting positive influence of systemic SRAN administration on the osseointegration of titanium implants was observed. No major side-effects due to strontium administration were reported. Systemic Sr administration, in the form of SRAN, seems to enhance peri-implant bone quality and implant osseointegration in animals, however, at a moderate extent. Further studies, evaluating both the effects of this drug on implant osseointegration and the risk/benefit of its use, are needed to provide a rationale of this therapeutic approach.
Collapse
Affiliation(s)
- Cassio Rocha Scardueli
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Department of Periodontology, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo Brazil
| | | | | | - Elcio Marcantonio
- Department of Periodontology, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo Brazil
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
63
|
Vitamin K and Bone Metabolism: A Review of the Latest Evidence in Preclinical Studies. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4629383. [PMID: 30050932 PMCID: PMC6040265 DOI: 10.1155/2018/4629383] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/27/2018] [Indexed: 01/09/2023]
Abstract
Bone is a metabolically active tissue that renews itself throughout one's life. Cytokines along with several hormonal, nutritional, and growth factors are involved in tightly regulated bone remodeling. Accordingly, vitamin K as a multifunctional vitamin has been recently deemed appreciable as a topic of research as it plays a pivotal role in maintenance of the bone strength, and it has been proved to have a positive impact on the bone metabolism. Vitamin K exerts its anabolic effect on the bone turnover in different ways such as promoting osteoblast differentiation, upregulating transcription of specific genes in osteoblasts, and activating the bone-associated vitamin k dependent proteins which play critical roles in extracellular bone matrix mineralization. There is also credible evidence to support the effects of vitamin k2 on differentiation of other mesenchymal stem cells into osteoblast. The main objective of the present paper is to comprehensively outline the preclinical studies on the properties of vitamin K and its effects on the bone metabolism. The evidence could shed light on further clinical studies to improve osteogenesis in bone graft surgeries.
Collapse
|
64
|
Jiang L, Zhang W, Wei L, Zhou Q, Yang G, Qian N, Tang Y, Gao Y, Jiang X. Early effects of parathyroid hormone on vascularized bone regeneration and implant osseointegration in aged rats. Biomaterials 2018; 179:15-28. [PMID: 29960821 DOI: 10.1016/j.biomaterials.2018.06.035] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 06/19/2018] [Accepted: 06/22/2018] [Indexed: 01/02/2023]
Abstract
The decreased bone mass and impaired osteogenesis capacities that occur with aging may influence the outcome of dental implants. Parathyroid hormone (PTH) (1-34) is an anabolic agent for the treatment of osteoporosis. However, little is known about its effects and mechanisms on vascularized bone regeneration and implant osseointegration in aging. In current study, we adopted both in vivo and in vitro approaches to explore the mechanisms of early actions of PTH (1-34) on the angiogenic and osteogenic microenvironment to enhance implant osseointegration in aged rats. Daily subcutaneous injections of 30 μg/kg PTH (1-34) were given to female rats aged 20 months beginning on next day of implantation and lasting for 5 weeks. Radiological and histological analysis confirmed that PTH (1-34) improved new bone formation, angiogenesis and implant osseointegration in aged rats in the early stage. The osteogenic potential of aged bone mesenchymal stem cells (BMSCs) was enhanced, while their adipogenesis capacity was attenuated. Furthermore, PTH (1-34) was shown to promote angiogenesis directly via endothelial cell migration and blood vessel formation in vitro. Meanwhile, PTH (1-34) stimulated more osteoclasts participation in bone remodeling by secreting angiogenic and osteogenic growth factors to induce early vascularization and stimulate the migration or differentiation of BMSCs indirectly. Together, these results demonstrate mechanistic insight into how PTH (1-34) regulates the angiogenic and osteogenic microenvironment to result in more active bone remodeling and new bone formation, making it an excellent potential therapeutic agent for rapid vascularized bone regeneration and implant osseointegration in the aged population.
Collapse
Affiliation(s)
- Liting Jiang
- Department of Prosthodontics, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, 200011 Shanghai, China; Department of Stomatology, Ruijin Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, 200025 Shanghai, China
| | - Wenjie Zhang
- Department of Prosthodontics, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, 200011 Shanghai, China
| | - Li Wei
- Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, 200025 Shanghai, China
| | - Qi Zhou
- Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, 200025 Shanghai, China
| | - Guangzheng Yang
- Department of Prosthodontics, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, 200011 Shanghai, China
| | - Niandong Qian
- Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, 200025 Shanghai, China
| | - Yun Tang
- Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, 200025 Shanghai, China
| | - Yiming Gao
- Department of Stomatology, Ruijin Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, 200025 Shanghai, China.
| | - Xinquan Jiang
- Department of Prosthodontics, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, 200011 Shanghai, China.
| |
Collapse
|
65
|
Xu R, Shi G, Xu L, Gu Q, Fu Y, Zhang P, Cheng J, Jiang H. Simvastatin improves oral implant osseointegration via enhanced autophagy and osteogenesis of BMSCs and inhibited osteoclast activity. J Tissue Eng Regen Med 2018; 12:1209-1219. [PMID: 29498229 DOI: 10.1002/term.2652] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 02/07/2018] [Accepted: 02/17/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Rongyao Xu
- Jiangsu Key Laboratory of Oral Diseases; Nanjing Medical University; Nanjing Jiangsu Province China
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology; Nanjing Medical University; Nanjing Jiangsu Province China
| | - Guanghui Shi
- Jiangsu Key Laboratory of Oral Diseases; Nanjing Medical University; Nanjing Jiangsu Province China
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology; Nanjing Medical University; Nanjing Jiangsu Province China
| | - Ling Xu
- Jiangsu Key Laboratory of Oral Diseases; Nanjing Medical University; Nanjing Jiangsu Province China
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology; Nanjing Medical University; Nanjing Jiangsu Province China
| | - Qinyi Gu
- Jiangsu Key Laboratory of Oral Diseases; Nanjing Medical University; Nanjing Jiangsu Province China
| | - Yu Fu
- Jiangsu Key Laboratory of Oral Diseases; Nanjing Medical University; Nanjing Jiangsu Province China
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology; Nanjing Medical University; Nanjing Jiangsu Province China
| | - Ping Zhang
- Jiangsu Key Laboratory of Oral Diseases; Nanjing Medical University; Nanjing Jiangsu Province China
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology; Nanjing Medical University; Nanjing Jiangsu Province China
| | - Jie Cheng
- Jiangsu Key Laboratory of Oral Diseases; Nanjing Medical University; Nanjing Jiangsu Province China
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology; Nanjing Medical University; Nanjing Jiangsu Province China
| | - Hongbing Jiang
- Jiangsu Key Laboratory of Oral Diseases; Nanjing Medical University; Nanjing Jiangsu Province China
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology; Nanjing Medical University; Nanjing Jiangsu Province China
| |
Collapse
|
66
|
Apostu D, Lucaciu O, Berce C, Lucaciu D, Cosma D. Current methods of preventing aseptic loosening and improving osseointegration of titanium implants in cementless total hip arthroplasty: a review. J Int Med Res 2017; 46:2104-2119. [PMID: 29098919 PMCID: PMC6023061 DOI: 10.1177/0300060517732697] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Hip osteoarthritis is the most common joint disorder, and is represented by a degenerative process, resulting in pain and functional impairment. If conservative treatment for hip osteoarthritis fails, the only remaining option is hip arthroplasty. Despite good survival of implants, loosening of components is the most common complication. This leads to revision surgeries, which are technically demanding, expensive, and result in a low satisfaction rate. Uncemented hip replacements require proper osseointegration for increased survival. Physical characteristics of implants include biocompatibility, Young’s modulus of elasticity, strength, and corrosion resistance, and each influence fixation of implants. Moreover, implant surface treatments, pore size, pore density, and femoral stem design should be appropriately selected. Patients’ optimization of obesity, osteoporosis, cardiovascular disease, psychotic disorders, and smoking cessation are associated with a higher survival of implants. Surgical factors, such as approach, drilling and rasping, acetabular bone coverage, acetabular cup positioning, and implant size, also affect survival of implants. Avoiding drugs, which may impair osseointegration of implants, and having an appropriate rehabilitation protocol are important. Future directions include anabolic and anti-catabolic bone-acting drugs to enhance osseointegration of implants. Comprehensive knowledge of the factors mentioned above is important for preventing aseptic loosening, with important socioeconomic consequences.
Collapse
Affiliation(s)
- Dragos Apostu
- 1 Department of Orthopaedics and Traumatology, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ondine Lucaciu
- 2 Department of Oral Rehabilitation, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristian Berce
- 3 Department of Animal Facility, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dan Lucaciu
- 4 Department of Orthopaedics and Traumatology, Rehabilitation Clinic, Cluj, Romania
| | - Dan Cosma
- 5 Department of Paediatric Orthopaedics, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| |
Collapse
|
67
|
Masalskas BF, Martins Júnior W, Leoni GB, Faloni APDS, Marcaccini AM, Silva Sousa YTC, Castro-Raucci LMSD. Local delivery of strontium ranelate promotes regeneration of critical size bone defects filled with collagen sponge. J Biomed Mater Res A 2017; 106:333-341. [PMID: 28913909 DOI: 10.1002/jbm.a.36237] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 08/31/2017] [Accepted: 09/12/2017] [Indexed: 01/12/2023]
Abstract
The effect of local delivery of strontium ranelate (SR) on bone regeneration of critical size bone defects filled with collagen sponge was evaluated. Bone defects of 5 mm diameter created in rat calvaria were filled with collagen sponge (C); collagen sponge with 5 mM Sr2+ SR (C5SR) or collagen sponge with 50 mM Sr2+ SR (C50SR). After 2, 4, and 6 weeks, bone volume (BV), bone surface (BS), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular separation (Tb.Sp) were evaluated by computed microtomography. At 6 weeks, histological analysis was performed. Intragroup comparisons were made by the Friedman test, while comparisons between groups were made by Kruskal-Wallis test (α = 5%). All groups showed increased BV, BS, Tb.Th, and Tb.N over time, but only C50SR promoted the reduction of Tb.Sp (p < 0.05). No significant differences between groups were detected at weeks 2 and 4. However, C50SR showed the highest values of BV, BS, and Tb.Th at 6 weeks (p < 0.05). Histological analysis revealed connective tissue in C and C5SR and immature bone tissue in C50SR. Local delivery of SR 50 mM Sr2+ associated with collagen sponge increased and accelerated bone regeneration in critical bone defects. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 333-341, 2018.
Collapse
Affiliation(s)
| | - Walter Martins Júnior
- School of Dentistry, University of Ribeirao Preto, Ribeirao Preto, Sao Paulo, Brazil
| | | | | | | | | | | |
Collapse
|