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Bingul MB, Gul M, Dundar S, Bozoglan A, Kirtay M, Ozupek MF, Ozcan EC, Habek O, Tasdemir I. Effects of the Application Local Zoledronic Acid On Different Dental Implants in Rats On Osseointegration. Drug Des Devel Ther 2024; 18:2249-2256. [PMID: 38895174 PMCID: PMC11185166 DOI: 10.2147/dddt.s459125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 06/11/2024] [Indexed: 06/21/2024] Open
Abstract
Objective Recently, a lot of research has been done around the world to popularize the osseointegration of dental implants. In this study, it was investigated the effect of local zoledronic acid application on implants with machined (MAC), resorbable blast materials (RBM), sandblasted and acid-etched (SLA) surface implants integrated in rat tibias. Methodology A total of 60 female Wistar rats weighing between 270 and 300 g were used in the study. The rats were passing divided into six classes: controls; MAC (n = 10), RBM (n = 10), SLA (n = 10), and local zoledronic acid (LZA) applied groups; LZA-MAC (n = 10), LZA-RBM (n=10) and LZA-SLA (n = 10) and implants were surgically placement into rat tibias in general anesthesia. After a four-week experimental period, the biomechanical bone implant connection level was determined with reverse torque analysis. Results Osseointegration levels were detected highly in SLA and RBM surface compared with the machined surfaced implants in both control and treatment groups (p < 0.05). Additionally, local application of zoledronic acid in both three groups; implants increased the biomechanic osseointegration level compared with the controls (p < 0.05). Conclusion In this research, we observe that the local application of the zoledronic acid could increase the osseointegration, and RBM and SLA surface could be better than machined surfaced implants in terms of bone implant connection. In addition, local application of zoledronic acid may be a safer method than systemic application.
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Affiliation(s)
- Muhammet Bahattin Bingul
- Department of Oral and Maxillofacial Surgery, Harran University, Faculty of Dentistry, Sanliurfa, Turkiye
| | - Mehmet Gul
- Department of Periodontology, Harran University, Faculty of Dentistry, Sanliurfa, Turkiye
| | - Serkan Dundar
- Department of Periodontology, Firat University, Faculty of Dentistry, Elazig, Turkiye
| | - Alihan Bozoglan
- Department of Periodontology, Firat University, Faculty of Dentistry, Elazig, Turkiye
| | - Mustafa Kirtay
- Private Practice, Oral and Maxillofacial Surgery, London, Ontario, Canada
| | - Muhammet Fatih Ozupek
- Department of Oral and Maxillofacial Surgery, Firat University, Faculty of Dentistry, Elazig, Turkiye
| | - Erhan Cahit Ozcan
- Department of Plastic, Aesthetic and Reconstructive Surgery, Firat University, Faculty of Medicine, Elazig, Turkiye
| | - Osman Habek
- Department of Oral and Maxillofacial Surgery, Harran University, Faculty of Dentistry, Sanliurfa, Turkiye
| | - Ismail Tasdemir
- Department of Periodontology, Karamanoglu Mehmet Bey University, Faculty of Dentistry, Karaman, Turkiye
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Mokhtari RA, Olsson M, Östman PO, Dahlin C. A randomized, multicenter, double-blinded parallel study to evaluate the safety and performance of zoledronate-coated versus uncoated dental implants in partially edentulous patients. Clin Implant Dent Relat Res 2024; 26:78-87. [PMID: 37849436 DOI: 10.1111/cid.13288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 09/19/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE To evaluate patient safety, implants survival and implant stability of the bisphosphonate (zoledronate) as a coating on dental implants in patients requiring oral rehabilitation in the posterior maxilla. MATERIALS AND METHODS In this multicenter, double-blind, randomized controlled study, 62 patients were randomized to receive either zoledronate-coated or uncoated control implants in the premolar or molar area of the maxilla, using a one stage-protocol. Due to dropouts and exclusion 49 patients completed the study. The implants were examined by resonance frequency analysis (RFA) using an implant stability quotient (ISQ) scale at the time of insertion, and at 8 weeks, and after 12 weeks prior to prosthetic restoration. Radiographs were taken prior to surgery, directly after insertion, and during the follow-up at 12 weeks, 6 months, and 1 year to analyze changes in marginal bone levels (MBL). Finally, all complications and adverse effects (AE) were observed and recorded. RESULTS Out of 62 included patients, 49 patients completed the study. No AE were reported by patients receiving zoledronate-coated implants. There was no statistically significant difference between the zoledronate-coated or uncoated implant groups when comparing ISQ levels at insertion and after 12 weeks of healing, the mean of the ISQ values demonstrated a change of 4.64 (95% confidence interval: 15.46; 5.79, p = 0.43) between the two groups. At 8- and 12-weeks, ISQ values remained stable (range 62-70). Radiographic analysis showed no statistically significant difference in MBL between the two implant groups after 1 year of loading neither at the mesial side (p = 0.99) or the distal side (p = 0.97). MBL for coated implants were 0.57 mm at the mesial side and 0.46 mm at the distal side. For the uncoated implants, MBL was 0.48 mm at the mesial side and 0.47 mm at the distal side. CONCLUSION The zoledronate-coated dental implants are safe to use in a one-stage surgery protocol in patients requiring oral rehabilitation in the posterior maxilla, after 1 year of loading. There were no statically significant changes in implant stability and marginal bone levels measured by intraoral radiographs in comparison to uncoated control implants.
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Affiliation(s)
- Reza A Mokhtari
- Department of ENT & Oral and Maxillofacial Surgery, Nu-Sjukvården, Trollhättan, Sweden
- Department of Biomaterials, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Morgan Olsson
- Private Practice of Dental and Oral Surgery, Dingle, Sweden
| | | | - Christer Dahlin
- Department of ENT & Oral and Maxillofacial Surgery, Nu-Sjukvården, Trollhättan, Sweden
- Department of Biomaterials, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Zhang J, Liu Z, Qiu J, Yang J. Impact of locally delivered diphosphonates on dental implants: A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101521. [PMID: 37276968 DOI: 10.1016/j.jormas.2023.101521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 04/21/2023] [Accepted: 05/26/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Dental implants are a common solution for edentulous patients. This systematic review and meta-analysis aimed to determine whether locally delivered diphosphonates influence the osseointegration of dental implants in humans. MATERIAL & METHODS In March 2023, we conducted an electronic systematic literature search using three databases (MEDLINE/PubMed, Embase, Web of Science). We included randomized trials documenting locally delivered diphosphonates in partly edentulous patients. Two independent reviewers evaluated study eligibility, extracted data, and assessed study quality. RESULTS We have identified 752 studies, out of which 7 studies involving 154 patients met the inclusion criteria. The overall meta-analysis indicates that diphosphonates are associated with marginal bone loss during the pre-loading period (mean difference (MD) of -0.18 mm, 95% CI -0.24 to -0.12, p<0.00001; I²=83%), marginal bone loss after one year (MD -0.35 mm, 95% CI -0.56 to -0.14, p = 0.0009; I²=14%), and five years loading (MD -0.34 mm, 95% CI -0.56 to -0.13, p = 0.002; I²=0%). However, the drug did not seem to affect the implant survival rate (risk ratios (RR) of 1.02, 95% CI 0.98 to 1.08, P = 0.33; I²=9%). DISCUSSION This study suggests that local use of diphosphonates does not affect implant survival, but it does reduce marginal bone loss and improve the osseointegration of dental implants in humans. However, future research must be more standardized and address methodological biases to draw more conclusive findings.
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Affiliation(s)
- Jiahao Zhang
- The Center of Stomatology, Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Zhenni Liu
- The Center of Stomatology, Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Jiezi Qiu
- The Center of Stomatology, Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Jianxin Yang
- The Center of Stomatology, Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
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The Effects of Local Alendronate With or Without Recombinant Human Bone Morphogenetic Protein 2 on Dental Implant Stability and Marginal Bone Level: A Randomized Controlled Study. J Craniofac Surg 2021; 33:1003-1007. [PMID: 34456283 DOI: 10.1097/scs.0000000000008102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT The aim of this study was to evaluate the effects of local application of bisphosphonate gel and recombinant human bone morphogenic protein 2 gel, on titanium dental implant stability and marginal bone level. Twenty-seven patients with upper and lower missing posterior tooth/teeth were included in the study with a total of 71 implants that were used for rehabilitation. The implants were randomly divided into 4 groups: 3 study groups and 1 control. Group1; local application of bisphosphonate gel, group 2; local application of recombinant human bone morphogenic protein 2 gel, group 3; local application of a mixed formula of both gels. The gel application was immediately preimplant insertion, group 4; implant insertion without application of any medication. Using resonance frequency analyzer, implant stability was measured 4 times; primary, 8 weeks (second stage surgery), 12 weeks, and at least 14 weeks post functional loading. The level of the marginal bone around each implant were assessed using cone beam computed tomography. Four implants failed. Generally, there was a similar pattern of changes in implant stability over the study period in all groups and the stability was dependent on the healing time with no significant difference between groups. There was no significant treatment effect regarding marginal bone level differences of study groups against control, although there were significant differences on palatal and mesiodistal surfaces among the study (test) groups.
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Abtahi J, Klintström B, Klintström E. Ibandronate Reduces the Surface Bone Resorption of Mandibular Bone Grafts: A Randomized Trial With Internal Controls. JBMR Plus 2021; 5:e10468. [PMID: 33778329 PMCID: PMC7990152 DOI: 10.1002/jbm4.10468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 11/19/2022] Open
Abstract
Autologous bone grafts are considered the gold standard for reconstruction of the edentulous alveolar ridges. However, this procedure is associated with unpredictable bone loss caused by physiological bone resorption. Bisphosphonates are antiresorptive drugs that act specifically on osteoclasts, thereby maintaining bone density, volume, and strength. It was hypothesized that the resorption of bone grafts treated with an ibandronate solution would be less advanced than bone grafts treated with saline. Ten patients who underwent bilateral sagittal split osteotomy were included in a randomized double‐blind trial with internal controls. Each patient received a bone graft treated with a solution of ibandronate on one side and a graft treated with saline (controls) contralaterally. Radiographs for the measurement of bone volume were obtained at 2 weeks and at 6 months after surgery. The primary endpoint was the difference in the change of bone volume between the control and the ibandronate bone grafts 6 months after surgery. All of the bone grafts healed without complications. One patient was excluded because of reoperation. In eight of the nine patients, the ibandronate bone grafts showed an increase in bone volume compared with baseline, with an average gain of 126 mm3 (40% more than baseline) with a range of +27 to +218 mm3. Only one ibandronate‐treated graft had a decrease in bone volume (8%). In the controls, an average bone volume loss of −146 mm3 (58% of baseline) with a range of −29 to −301 mm3 was seen. In the maxillofacial field, the reconstructions of atrophic alveolar ridges, especially in the esthetical zones, are challenging. These results show that bone grafts locally treated with ibandronate solution increases the remaining bone volume. This might lead to new possibilities for the maxillofacial surgeons in the preservation of bone graft volumes and for dental implant installations. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Jahan Abtahi
- Department of Oral & Maxillofacial Surgery and Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden.,Center for Medical Image Science and Visualization (CMIV) Linköping University Linköping Sweden
| | - Benjamin Klintström
- Department of Biomedical Engineering and Health Systems KTH Royal Institute of Technology Stockholm Sweden
| | - Eva Klintström
- Center for Medical Image Science and Visualization (CMIV) Linköping University Linköping Sweden.,Department of Radiology and Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden
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Albano CS, Moreira Gomes A, da Silva Feltran G, da Costa Fernandes CJ, Trino LD, Zambuzzi WF, Lisboa-Filho PN. Biofunctionalization of titanium surfaces with alendronate and albumin modulates osteoblast performance. Heliyon 2020; 6:e04455. [PMID: 32715131 PMCID: PMC7378701 DOI: 10.1016/j.heliyon.2020.e04455] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/08/2020] [Accepted: 07/10/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Biofunctionalization of titanium surfaces can improve host responses, especially considering the time for osteointegration and patient recovery. This prompted us to modify titanium surfaces with alendronate and albumin and to investigate the behavior of osteoblasts on these surfaces. METHODS The biofunctionalization of titanium surfaces was characterized using classical physicochemical approaches and later used to challenge pre-osteoblast cells up to 24 h. Then their viability and molecular behavior were investigated using mitochondrial dehydrogenase activity and RTq-PCR technologies, respectively. Potential stimulus of extracellular remodeling was also investigated by zymography. RESULTS Our data indicates a differential behavior of cells responding to the surfaces, considering the activity of mitochondrial dehydrogenases. Molecularly, the differential expression of genes related with cell adhesion highlighted the importance of Integrin-β1, Fak, and Src. These 3 genes were significantly decreased in response to titanium surfaces modified with alendronate, but this behavior was reverted when alendronate was associated with albumin. Alendronate-modified surfaces promoted a significant increase on ECM remodeling, as well as culminating with greater gene activity related to the osteogenic phenotype (Runx2, Alp, Bsp). CONCLUSION Altogether, our study found interesting osteogenic behavior of cells in response to alendronate and albumin surfaces, which indicates the need for in vivo analyses to better consider these surfaces before clinical trials within the biomedical field.
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Affiliation(s)
- Carolina Simão Albano
- Bioassays and Cell Dynamics Laboratory – UNESP – São Paulo State University, Biosciences Institute, Department of Chemistry and Biochemistry, Botucatu, Brazil
- Advanced Materials and Nanotechnology Laboratory – UNESP – São Paulo State University School of Sciences, Department of Physics, Bauru, Brazil
| | - Anderson Moreira Gomes
- Bioassays and Cell Dynamics Laboratory – UNESP – São Paulo State University, Biosciences Institute, Department of Chemistry and Biochemistry, Botucatu, Brazil
| | - Geórgia da Silva Feltran
- Bioassays and Cell Dynamics Laboratory – UNESP – São Paulo State University, Biosciences Institute, Department of Chemistry and Biochemistry, Botucatu, Brazil
| | - Célio Junior da Costa Fernandes
- Bioassays and Cell Dynamics Laboratory – UNESP – São Paulo State University, Biosciences Institute, Department of Chemistry and Biochemistry, Botucatu, Brazil
| | - Luciana Daniele Trino
- Advanced Materials and Nanotechnology Laboratory – UNESP – São Paulo State University School of Sciences, Department of Physics, Bauru, Brazil
| | - Willian Fernando Zambuzzi
- Bioassays and Cell Dynamics Laboratory – UNESP – São Paulo State University, Biosciences Institute, Department of Chemistry and Biochemistry, Botucatu, Brazil
| | - Paulo Noronha Lisboa-Filho
- Advanced Materials and Nanotechnology Laboratory – UNESP – São Paulo State University School of Sciences, Department of Physics, Bauru, Brazil
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Abstract
Dental implants are frequently used to support fixed or removable dental prostheses to replace missing teeth. The clinical success of titanium dental implants is owed to the exceptional biocompatibility and osseointegration with the bone. Therefore, the enhanced therapeutic effectiveness of dental implants had always been preferred. Several concepts for implant coating and local drug delivery had been developed during the last decades. A drug is generally released by diffusion-controlled, solvent-controlled, and chemical controlled methods. Although a range of surface modifications and coatings (antimicrobial, bioactive, therapeutic drugs) have been explored for dental implants, it is still a long way from designing sophisticated therapeutic implant surfaces to achieve the specific needs of dental patients. The present article reviews various interdisciplinary aspects of surface coatings on dental implants from the perspectives of biomaterials, coatings, drug release, and related therapeutic effects. Additionally, the various types of implant coatings, localized drug release from coatings, and how released agents influence the bone–implant surface interface characteristics are discussed. This paper also highlights several strategies for local drug delivery and their limitations in dental implant coatings as some of these concepts are yet to be applied in clinical settings due to the specific requirements of individual patients.
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The influence of local delivery of bisphosphonate on osseointegration of dental implants. Evid Based Dent 2020; 19:82-83. [PMID: 30361658 DOI: 10.1038/sj.ebd.6401326] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Data sourcesThe databases searched were the Cochrane Library, PubMed/Medline, Embase, ISI Web of Knowledge, Scopus and SIGLE OpenGrey. Databases were searched with no restriction on year of publication or language.Study selectionRandomised controlled clinical trials (RCTs), prospective and retrospective studies, case-control studies and case series studies in humans were included. The test group received implants with the local delivery of bisphosphonates, controls received implants only. Studies involving patients with metabolic bone diseases or undergoing systemic medications for bone bio-modulation or immunosuppression or with relevant pathologies were excluded.Data extraction and synthesisThree authors independently selected studies with disagreements being resolved by discussion. Study quality was assessed by two reviewers using the Newcastle-Ottawa scale (NOS).ResultsThree articles published between 2010 and 2013 met the selection criteria. Sample size ranged from five to 39. Mean age was 52.6 to 66. Efficacy was assessed using radiographic analysis, implant stability quotient (ISQ) and histological assessment. Despite methodological differences, all articles reported positive results for osseointegration when a local bisphosphonate was used, either on the implant surface or direct application of a pharmacologically active compound at the surgical site or in the form of a gel directly at the surgical site. Greater implant stability, better implant survival rates and reduced peri-implant bone loss were recorded in the test groups compared with controls. As well as formation of lamellar bone trabeculae in intimate contact with the implants.ConclusionsThe local use of a bisphosphonate appears to favour the osseointegration of titanium implants in humans.
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Goonoo N, Bhaw-Luximon A. Mimicking growth factors: role of small molecule scaffold additives in promoting tissue regeneration and repair. RSC Adv 2019; 9:18124-18146. [PMID: 35702423 PMCID: PMC9115879 DOI: 10.1039/c9ra02765c] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 06/02/2019] [Indexed: 12/31/2022] Open
Abstract
The primary aim of tissue engineering scaffolds is to mimic the in vivo environment and promote tissue growth. In this quest, a number of strategies have been developed such as enhancing cell-material interactions through modulation of scaffold physico-chemical parameters. However, more is required for scaffolds to relate to the cell natural environment. Growth factors (GFs) secreted by cells and extracellular matrix (ECM) are involved in both normal repair and abnormal remodeling. The direct use of GFs on their own or when incorporated within scaffolds represent a number of challenges such as release rate, stability and shelf-life. Small molecules have been proposed as promising alternatives to GFs as they are able to minimize or overcome many shortcomings of GFs, in particular immune response and instability. Despite the promise of small molecules in various TE applications, their direct use is limited by nonspecific adverse effects on non-target tissues and organs. Hence, they have been incorporated within scaffolds to localize their actions and control their release to target sites. However, scanty rationale is available which links the chemical structure of these molecules with their mode of action. We herewith review various small molecules either when used on their own or when incorporated within polymeric carriers/scaffolds for bone, cartilage, neural, adipose and skin tissue regeneration.
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Affiliation(s)
- Nowsheen Goonoo
- Biomaterials, Drug Delivery and Nanotechnology (BDDN) Unit, Centre for Biomedical and Biomaterials Research, University of Mauritius Réduit Mauritius
| | - Archana Bhaw-Luximon
- Biomaterials, Drug Delivery and Nanotechnology (BDDN) Unit, Centre for Biomedical and Biomaterials Research, University of Mauritius Réduit Mauritius
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Does local delivery of bisphosphonates influence the osseointegration of titanium implants? A systematic review. Int J Oral Maxillofac Surg 2017; 46:1429-1436. [DOI: 10.1016/j.ijom.2017.04.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/21/2017] [Accepted: 04/18/2017] [Indexed: 11/22/2022]
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Najeeb S, Zafar MS, Khurshid Z, Zohaib S, Hasan SM, Khan RS. Bisphosphonate releasing dental implant surface coatings and osseointegration: A systematic review. J Taibah Univ Med Sci 2017; 12:369-375. [PMID: 31435266 PMCID: PMC6694927 DOI: 10.1016/j.jtumed.2017.05.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/01/2017] [Accepted: 05/08/2017] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Bisphosphonates (BPs) are a class of drugs that are used to treat osteoporosis. It has been suggested that BP coatings on dental implants have a positive effect on new bone formation. The purpose of this review is to analyse the currently available data concerning the clinical and experimental efficacy of BP-releasing titanium implants such that their potential in clinical oral implant dentistry may be ascertained. METHODS Based on a literature review, a focused research question was constructed: what is the effect of a BP-releasing coating on the osseointegration of titanium dental implant? The databases of PubMED/MEDLINE; ISI Web of Knowledge; Embase and Google Scholar were searched electronically using the keywords 'dental implant'; 'bisphosphonate' and 'titanium.' The quality; general characteristics and outcomes of each study were summarized and analysed systematically. RESULTS A total of eleven articles fulfilled the criteria to be included in this review. Eight studies were experimental; two studies were clinical; and one study was experimental and clinical. In nine studies (82%), BP-coated implants resulted in higher osseointegration, as indicated by higher resonance frequency values, removal torque, bone-implant contact and new bone formation. In two studies (18%), there was no difference between the osseointegration of BP-coated implants and controls. CONCLUSIONS Bisphosphonates-loaded implants may have a positive effect on osseointegration. However, more well-designed clinical studies are required to demonstrate their osseoconductive effects.
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Affiliation(s)
- Shariq Najeeb
- Restorative Dental Sciences, Al-Farabi College, Al Khaleej, King Abdullah Road, Riyadh, KSA
| | - Muhammad S. Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Almadinah Almunawwarah, KSA
| | - Zohaib Khurshid
- Department of Prosthodontics and Implantology, College of Dentistry, King Faisal University, Al-Ahsa, KSA
| | - Sana Zohaib
- Department of Biomedical Engineering, King Faisal University, Al Hofuf, KSA
| | - Syed M. Hasan
- Department of Oral Medicine, Dow International Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | - Rabia S. Khan
- Department of Oral Pathology, College of Dentistry, Baqai Medical University, Karachi, Pakistan
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Effects of Local and Systemic Zoledronic Acid Application on Titanium Implant Osseointegration. J Craniofac Surg 2017; 28:935-938. [DOI: 10.1097/scs.0000000000003568] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Jian P, Qizhang W, Jiyuan L. [Research progress on bisphosphonate-related osteonecrosis of the jaws]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2017; 35:29-36. [PMID: 28326724 PMCID: PMC7030198 DOI: 10.7518/hxkq.2017.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 11/13/2016] [Indexed: 02/05/2023]
Abstract
Bisphosphonates (BPs), as potent drugs inhibiting bone resorption, have been widely used for treatment of several diseases. In recent years, dentists and oral and maxillofacial surgeons reported continuously increasing cases of bisphosphonate-related osteonecrosis of the jaws (BRONJ). This disease is clinically characterized by exposed bones, formation of sequestrum, pain, and halitosis. Provided that pathogenesis of BRONJ is unclear, effective treatments for this disease are currently unavailable. Thus, prevention plays an important role in the management of BRONJ. This review summarizes research progress on pathogenesis, risk factors, clinical characteristics, treatment, and prevention of this condition.
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Affiliation(s)
- Pan Jian
- State Key Laboratory of Oral Diseases, Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Wang Qizhang
- State Key Laboratory of Oral Diseases, Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Liu Jiyuan
- State Key Laboratory of Oral Diseases, Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Kellesarian SV, Abduljabbar T, Vohra F, Gholamiazizi E, Malmstrom H, Romanos GE, Javed F. Does Local Ibandronate and/or Pamidronate Delivery Enhance Osseointegration? A Systematic Review. J Prosthodont 2016; 27:240-249. [PMID: 27870311 DOI: 10.1111/jopr.12571] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2016] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To our knowledge from indexed literature, the present study is the first one to systematically review the influence of local delivery of pamidronate (PAM) and/or ibandronate (IBA) on osseointegration enhancement. The aim of the present systematic review was to assess the efficacy of IBA and/or PAM local delivery (topically or coating on implants surfaces) in promoting osseointegration. MATERIALS AND METHODS To address the focused question, "Does local IBA and/or PAM delivery enhances osseointegration?," indexed databases were searched without time or language restrictions up to and including May 2016 using various combinations of the following keywords: "pamidronate," "ibandronate," "bisphosphonates," "osseointegration," and "topical administration." Letters to the Editor, historic reviews, commentaries, case series, and case reports were excluded. RESULTS Fifteen studies were included. Fourteen studies were performed in animals and 2 were clinical trials. One study reported an experimental model and a clinical trial in the same publication. Results from 12 experimental studies and 2 clinical studies reported improved biomechanical properties and/or osseointegration around implants with PAM and/or IBA. Two experimental studies showed that PAM and/or IBA did not improve osseointegration. CONCLUSIONS On experimental grounds, local IBA and/or PAM delivery seems to enhance osseointegration; however, from a clinical perspective, further randomized control trials are needed to assess the effectiveness of IBA and PAM in promoting osseointegration around dental implants.
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Affiliation(s)
- Sergio Varela Kellesarian
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Elham Gholamiazizi
- Department of Engineering, Capital College, Penn State University Harrisburg, Middletown, PA
| | - Hans Malmstrom
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Georgios E Romanos
- Department of Oral Surgery and Implant Dentistry, Dental School, Johann Wolfgang Goethe, University of Frankfurt, Germany.,Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY
| | - Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
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15
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Abtahi J, Henefalk G, Aspenberg P. Randomised trial of bisphosphonate-coated dental implants: Radiographic follow-up after five years of loading. Int J Oral Maxillofac Surg 2016; 45:1564-1569. [PMID: 27688166 DOI: 10.1016/j.ijom.2016.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 07/09/2016] [Accepted: 09/07/2016] [Indexed: 11/27/2022]
Abstract
The results of a randomised trial with bisphosphonate-coated dental implants have been reported previously. Each patient received one coated and one uncoated implant in a double-blind split-mouth design study. After 6 months of osseointegration, resonance frequency analysis indicated better fixation of the coated implants. Reduced marginal bone resorption was also shown. However, it was not known whether the advantage of the bisphosphonate coating would persist over time. The radiographic results at 5 years after implant installation are reported herein. A blinded investigator measured marginal resorption on fresh radiographs obtained for 14 of the 16 patients (two had died) and compared these with the post-implantation images. Non-parametric statistics were used. All implants functioned well. The median marginal bone loss for control implants was found to be 0.70mm, which is less than usually reported in the literature. The bisphosphonate-coated implants showed even less resorption (median 0.20mm). The median difference within each pair of implants after 5 years of use was 0.34mm (95% confidence interval 0.00-0.75mm; P=0.04). The present data suggest that bisphosphonate-coated implants enable prolonged preservation of the marginal bone.
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Affiliation(s)
- J Abtahi
- Orthopaedics, Department of Clinical and Experimental Medicine, Faculty of Medicine, Linköping University, Linköping, Sweden; Department of Oral and Maxillofacial Surgery, Linköping University Hospital, Linköping, Sweden.
| | - G Henefalk
- Department of Oral and Maxillofacial Surgery, Linköping University Hospital, Linköping, Sweden
| | - P Aspenberg
- Orthopaedics, Department of Clinical and Experimental Medicine, Faculty of Medicine, Linköping University, Linköping, Sweden
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16
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Dundar S, Ozgur C, Yaman F, Cakmak O, Saybak A, Ozercan IH, Alan H, Artas G, Nacakgedigi O. Guided bone regeneration with local zoledronic acid and titanium barrier: An experimental study. Exp Ther Med 2016; 12:2015-2020. [PMID: 27698687 PMCID: PMC5038562 DOI: 10.3892/etm.2016.3598] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 05/27/2016] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to evaluate the effects on new bone formation of autogenous blood alone or in combination with zoledronic acid (ZA), a β-tricalcium phosphate (β-TCP) graft or ZA plus a β-TCP graft placed under titanium barriers. For this purpose, eight adult male New Zealand white rabbits were used in the study, each with four titanium barriers fixed around four sets of nine holes drilled in the calvarial bones. The study included four groups, each containing 2 rabbits. In the autogenous blood (AB group), only autogeneous blood was placed under the titanium barriers. The three experimental groups were the AB+ZA group, with autogenous blood plus ZA, the AB+β-TCP group, with autogeneous blood plus a β-TCP graft, and the AB+β-TCP+ZA group, with autogeneous blood plus a β-TCP graft and ZA mixture under the titanium barriers. The animals were sacrificed after 3 months. The amounts of new bone formation identified histomorphometrically were found to be higher after 3 months than at the time of surgery in all groups. The differences between the groups were examined with histomorphometric analysis, and statistically significant differences were identified at the end of the 3 months. The bone formation rate in the AB+β-TCP+ZA group was determined to be significantly higher than that in the other groups (P<0.05). In the AB+ZA and AB+β-TCP groups, the bone formation rate was determined to be significantly higher than that in the AB group (P<0.05). No statistically significant difference in bone formation rate was observed between the AB+β-TCP and AB+ZA groups. Local ZA used with autogeneous blood and/or graft material appears to be a more effective method than the use of autogeneous blood or graft alone in bone augmentation executed with a titanium barrier.
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Affiliation(s)
- Serkan Dundar
- Department of Periodontology, Faculty of Dentistry, Firat University, Elazığ, 23119 Elazığ, Turkey
| | - Cem Ozgur
- Department of Oral Maxillofacial Surgery, Corlu Dental and Oral Health Centre, Ministry of Health, Tekirdağ, 59850 Tekirdağ, Turkey
| | - Ferhan Yaman
- Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Dicle University, Diyarbakır, 21280 Diyarbakır, Turkey
| | - Omer Cakmak
- Department of Periodontology, Faculty of Dentistry, Afyon Kocatepe University, Afyonkarahisar, 03200 Afyon, Turkey
| | - Arif Saybak
- Private Practice, Adana, 01220 Adana, Turkey
| | - Ibrahim Hanifi Ozercan
- Department of Medical Pathology, Faculty of Medicine, Firat University, Elazığ, 23119 Elazığ, Turkey
| | - Hilal Alan
- Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Inonu University, Malatya, 44280 Malatya, Turkey
| | - Gokhan Artas
- Department of Medical Pathology, Faculty of Medicine, Firat University, Elazığ, 23119 Elazığ, Turkey
| | - Onur Nacakgedigi
- Department of Restorative Dentistry, Dicle University, Diyarbakır, 21280 Diyarbakır, Turkey
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17
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Kim HS, Lee JI, Yang SS, Kim BS, Kim BC, Lee J. The effect of alendronate soaking and ultraviolet treatment on bone-implant interface. Clin Oral Implants Res 2016; 28:1164-1172. [PMID: 27458172 DOI: 10.1111/clr.12933] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2016] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Rapid and stable fixation of dental implants is crucial for successful treatment. Herein, we examined whether the simultaneous treatment of titanium implants with ultraviolet (UV) and alendronate (ALN) synergistically improved the bone-to-implant contact. MATERIALS AND METHODS We assessed the in vitro effects of UV radiation-treated (UV+/ALN-), ALN-soaked (UV-/ALN+), and UV radiation/ALN-treated (UV+/ALN+) titanium implants on cell proliferation, cytotoxicity, cell adhesion, and osteoblast differentiation using MG-63 osteoblast-like cells by the assays of MTS, live/dead, scanning electron microscopy (SEM), alkaline phosphatase (ALP) activity, and alizarin red S (AR-S) staining, respectively. Furthermore, in vivo bone formation at the bone-implant interface efficiency determined using a rabbit tibia implantation. Implants were divided into 3 experimental groups (UV+/ALN-, UV-/ALN+, UV+/ALN+) and the non-treated control (UV-/ALN-) group and transplanted into the proximal tibia of rabbits. At 1, 2, 4, and 8 weeks post-operation, bone formation at the bone-implant interface was evaluated by micro-computed tomography and histological analysis. RESULTS MG-63 cells cultured on UV+/ALN+ implants showed significantly higher cell proliferation, ALP activity, and calcium mineralization than those cultured on other implants (P < 0.05). Furthermore, SEM observation showed the highest increase in cell attachment and growth on the UV+/ALN+ implants. In vivo, experimental groups at all time points showed greater peri-implant bone formation than the control group. At 8 weeks post-implantation, in the UV+/ALN+ group, significantly higher bone formation was observed than the UV+/ALN- or UV-/ALN+ group, respectively (P < 0.05). CONCLUSIONS Treatment of titanium surfaces with UV and ALN may synergistically enhance osteoblastic differentiation and mineralization in vitro and enhance bone formation at the bone-implant interface in vivo. These data suggest that UV and ALN treatment may improve the osseointegration of titanium implants.
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Affiliation(s)
- Hyung Soo Kim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University, Daejeon, Korea
| | - Jae In Lee
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Sun Sik Yang
- Wonkwnag Bone Regeneration Research Institute, Wonkwang University, Iksan, Korea
| | | | - Bong Chul Kim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University, Daejeon, Korea
| | - Jun Lee
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University, Daejeon, Korea
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18
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Influence of the local application of sodium alendronate gel on osseointegration of titanium implants. Int J Oral Maxillofac Surg 2015; 44:1423-9. [DOI: 10.1016/j.ijom.2015.05.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 04/01/2015] [Accepted: 05/20/2015] [Indexed: 11/19/2022]
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Vinzenz P, Schröckmair S, Gruber R, Agis H. Bone substitute materials supplemented with prolyl hydroxylase inhibitors decrease osteoclastogenesis in vitro. J Biomed Mater Res B Appl Biomater 2014; 103:1198-203. [PMID: 25312707 DOI: 10.1002/jbm.b.33295] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 08/14/2014] [Accepted: 09/12/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVE Inhibition of prolyl hydroxylases stimulates bone regeneration. Consequently, bone substitute materials were developed that release prolyl hydroxylase inhibitors. However, the impact of prolyl hydroxylase inhibitors released from these carriers on osteoclastogenesis is not clear. We therefore assessed the effect of bone substitute materials that release prolyl hydroxylase inhibitors on osteoclastogenesis. MATERIAL AND METHODS Dimethyloxalylglycine, desferrioxamine, and l-mimosine were lyophilized onto bovine bone mineral and hydroxyapatite, and supernatants were generated. Osteoclastogenesis was induced in murine bone marrow cultures in the presence of the supernatants from bone substitute materials. The formation of tartrate-resistant acid phosphatase (TRAP)-positive multinucleated cells and TRAP activity were determined. To test for possible effects on osteoclast progenitor cells, we measured the effect of the supernatants on proliferation and viability. In addition, experiments were performed where prolyl hydroxylase inhibitors were directly added to the bone marrow cultures. RESULTS We found that prolyl hydroxylase inhibitors released within the first hours from bone substitute materials reduce the number and activity of TRAP-positive multinucleated cells. In line with this, addition of prolyl hydroxylase inhibitors directly to the bone marrow cultures dose-dependently reduced the number of TRAP-positive multinucleated cells and the overall resorption activity. Moreover, the released prolyl hydroxylase inhibitors decreased proliferation but not viability of osteoclast progenitor cells. CONCLUSION Our results show that prolyl hydroxylase inhibitors released from bone substitute materials decrease osteoclastogenesis in murine bone marrow cultures.
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Affiliation(s)
- Philipp Vinzenz
- Department of Oral Surgery, Medical University of Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Stefan Schröckmair
- Department of Oral Surgery, Medical University of Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Reinhard Gruber
- Department of Oral Surgery, Medical University of Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria.,Laboratory of Oral Cell Biology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Hermann Agis
- Austrian Cluster for Tissue Regeneration, Vienna, Austria.,Department of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
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20
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Horasawa N, Yamashita T, Uehara S, Udagawa N. High-performance scaffolds on titanium surfaces: osteoblast differentiation and mineralization promoted by a globular fibrinogen layer through cell-autonomous BMP signaling. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 46:86-96. [PMID: 25491963 DOI: 10.1016/j.msec.2014.10.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 09/09/2014] [Accepted: 10/08/2014] [Indexed: 10/24/2022]
Abstract
Titanium has been widely used as a dental implant material. However, it takes several months for the implant body to bind with the jawbone. To develop new bioactive modification on titanium surfaces to achieve full osseointegration expeditiously, we used fibrinogen and fibronectin as bioactive scaffolds on the titanium plate, which are common extracellular matrix (ECM) proteins. We analyzed the features of the surface of ECM-modified titanium plates by atomic force microscopy and Fourier transform infrared spectrophotometry. We also evaluated the effect of ECM modification on promoting the differentiation and mineralization of osteoblasts on these surfaces. Fibrinogen had excellent adsorption on titanium surfaces even at low concentrations, due to the binding ability of fibrinogen via its RGD motif. The surface was composed of a fibrinogen monolayer, in which the ratio of β-sheets was decreased. Osteoblast proliferation on ECM-modified titanium surface was significantly promoted compared with titanium alone. Calcification on the modified surface was also accelerated. These ECM-promoting effects correlated with increased expression of bone morphogenetic proteins (BMPs) by the osteoblasts themselves and were inhibited by Noggin, a BMP inhibitor. These results suggest that the fibrinogen monolayer-modified titanium surface is recognized as bioactive scaffolds and promotes bone formation, resulting in the acceleration of osseointegration.
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Affiliation(s)
- Noriko Horasawa
- Department of Dental Materials, Matsumoto Dental University, 1780 Hiro-oka Gobara, Shiojiri, Nagano 399-0781, Japan.
| | - Teruhito Yamashita
- Institute for Oral Science, Matsumoto Dental University, 1780 Hiro-oka Gobara, Shiojiri, Nagano 399-0781, Japan
| | - Shunsuke Uehara
- Department of Biochemistry, Matsumoto Dental University, 1780 Hiro-oka Gobara, Shiojiri, Nagano 399-0781, Japan
| | - Nobuyuki Udagawa
- Department of Biochemistry, Matsumoto Dental University, 1780 Hiro-oka Gobara, Shiojiri, Nagano 399-0781, Japan
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22
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Local application of zoledronate enhances miniscrew implant stability in dogs. Am J Orthod Dentofacial Orthop 2014; 145:737-49. [DOI: 10.1016/j.ajodo.2014.01.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 01/01/2014] [Accepted: 01/01/2014] [Indexed: 11/23/2022]
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23
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Arnoldi J, Alves A, Procter P. Early tissue responses to zoledronate, locally delivered by bone screw, into a compromised cancellous bone site: a pilot study. BMC Musculoskelet Disord 2014; 15:97. [PMID: 24656151 PMCID: PMC3994401 DOI: 10.1186/1471-2474-15-97] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 03/12/2014] [Indexed: 11/30/2022] Open
Abstract
Background In fracture treatment, adequate fixation of implants is crucial to long-term clinical performance. Bisphosphonates (BP), potent inhibitors of osteoclastic bone resorption, are known to increase peri-implant bone mass and accelerate primary fixation. However, adverse effects are associated with systemic use of BPs. Thus, Zoledronic acid (ZOL) a potent BP was loaded on bone screws and evaluated in a local delivery model. Whilst mid- to long-term effects are already reported, early cellular events occurring at the implant/bone interface are not well described. The present study investigated early tissue responses to ZOL locally delivered, by bone screw, into a compromised cancellous bone site. Methods ZOL was immobilized on fibrinogen coated titanium screws. Using a bilateral approach, ZOL loaded test and non-loaded control screws were implanted into femoral condyle bone defects, created by an overdrilling technique. Histological analyses of the local tissue effects such as new bone formation and osteointegration were performed at days 1, 5 and 10. Results Histological evaluation of the five day ZOL group, demonstrated a higher osseous differentiation trend. At ten days an early influx of mesenchymal and osteoprogenitor cells was seen and a higher level of cellular proliferation and differentiation (p < 5%). In the ZOL group bone-to-screw contact and bone volume values within the defect tended to increase. Local drug release did not induce any adverse cellular effects. Conclusion This study indicates that local ZOL delivery into a compromised cancellous bone site actively supports peri-implant osteogenesis, positively affecting mesenchymal cells, at earlier time points than previously reported in the literature.
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24
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Zuffetti F, Testori T, Capelli M, Rossi MC, Del Fabbro M. The topical administration of bisphosphonates in implant surgery: a randomized split-mouth prospective study with a follow-up up to 5 years. Clin Implant Dent Relat Res 2013; 17 Suppl 1:e168-76. [PMID: 24107257 DOI: 10.1111/cid.12151] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the efficacy of the topical administration of bisphosphonates in implant therapy. MATERIALS AND METHODS Thirty-nine consecutive patients were selected for a split-mouth study. Inclusion criteria were: presence of a bilateral or total edentulism, ability to tolerate conventional implant procedures, older than 18 years. Ten patients were smokers. Ten patients were fully edentulous in both maxilla and mandible, 12 patients had fully edentulous maxilla or mandible, and 17 were bilaterally partially edentulous (9 in the mandible and 8 in the maxilla). A one-stage procedure was adopted in all cases. The prosthetic phase started 10 weeks after implant insertion. Each patient received implants on the control side and the test side, with insertion performed in the conventional way on the control side; on the test side, a 3% clodronate solution mixed with a surfactant (Tween-20) at a 1:3 ratio was topically administered both at the implant surface and at the implant site. RESULTS One hundred fifty-five implants were inserted. The test and control groups included 75 and 80 implants, respectively. The implant insertion torque was no less than 30 Ncm. A total of 7 implants failed in the control group (6 before loading and one after 12 months of loading). No failure occurred on the test side. By the 5-year follow-up, no further implant failure had been recorded. Overall, implant survival rates at 5 years for the test and control groups were, respectively, 100% and 91.3%, the difference being significant (p < .01). Mean marginal bone loss was 0.85 ± 0.71 mm in the test group and 1.12 ± 0.85 mm in the control group after 1 year of loading and stable thereafter. The difference was not significant. CONCLUSIONS The topical administration of bisphosphonates may positively affect implant survival in the preloading and postloading phases in partially and fully edentulous patients. However, a larger study population is needed to verify these promising clinical results.
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Affiliation(s)
- Francesco Zuffetti
- Section of Implant Dentistry and Oral Rehabilitation, Dental Clinic, Department of Biomedical, Surgical and Dental Sciences, IRCCS Galeazzi Orthopedic Institute, University of Milan, Italy
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25
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Huang J, Qu S, Wang J, Yang D, Duan K, Weng J. Reciprocating sliding wear behavior of alendronate sodium-loaded UHMWPE under different tribological conditions. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2013; 33:3001-9. [DOI: 10.1016/j.msec.2013.03.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 03/03/2013] [Accepted: 03/16/2013] [Indexed: 11/25/2022]
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26
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Alghamdi HS, Jansen JA. Bone Regeneration Associated with Nontherapeutic and Therapeutic Surface Coatings for Dental Implants in Osteoporosis. TISSUE ENGINEERING PART B-REVIEWS 2013; 19:233-53. [DOI: 10.1089/ten.teb.2012.0400] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Hamdan S. Alghamdi
- Department of Biomaterials, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - John A. Jansen
- Department of Biomaterials, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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27
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Hsu JT, Huang HL, Tsai MT, Wu AJ, Tu MG, Fuh LJ. Effects of the 3D bone-to-implant contact and bone stiffness on the initial stability of a dental implant: micro-CT and resonance frequency analyses. Int J Oral Maxillofac Surg 2013; 42:276-80. [DOI: 10.1016/j.ijom.2012.07.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Revised: 05/16/2012] [Accepted: 07/10/2012] [Indexed: 10/28/2022]
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Abtahi J, Agholme F, Sandberg O, Aspenberg P. Effect of local vs. systemic bisphosphonate delivery on dental implant fixation in a model of osteonecrosis of the jaw. J Dent Res 2012; 92:279-83. [PMID: 23264610 DOI: 10.1177/0022034512472335] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Locally applied bisphosphonates may improve the fixation of metal implants in bone. However, systemic bisphosphonate treatment is associated with a risk of osteonecrosis of the jaw (ONJ). We hypothesized that local delivery of bisphosphonate from the implant surface improves the fixation of dental implants without complications in a setting where systemic treatment induces ONJ. Forty rats were randomly allocated to 4 groups of 10. All groups received a titanium implant inserted in an extraction socket. Group I received the implants only. Group II received dexamethasone (0.5 mg/kg). Group III received dexamethasone as above plus alendronate (200 µg/kg). Group IV received zoledronate-coated implants and dexamethasone as above. The animals were sacrificed 2 weeks after tooth extraction. All 10 animals with systemic alendronate treatment developed large ONJ-like changes, while all with local treatment were completely healed. Implant removal torque was higher for the bisphosphonate-coated implants compared with the other groups (p < 0.03 for each comparison). Micro-computed tomography of the maxilla showed more bone loss in the systemic alendronate group compared with groups receiving local treatment (p = 0.001). Local bisphosphonate treatment appears to improve implant fixation in a setting where systemic treatment caused ONJ.
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Affiliation(s)
- J Abtahi
- Department of Clinical and Experimental Medicine, Faculty of Medicine, Linköping University, Linköping, Sweden.
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29
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Moon SH, Lee SJ, Park IS, Lee MH, Soh YJ, Bae TS, Kim HS. Bioactivity of Ti-6Al-4V alloy implants treated with ibandronate after the formation of the nanotube TiO2layer. J Biomed Mater Res B Appl Biomater 2012; 100:2053-9. [DOI: 10.1002/jbm.b.32769] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 04/10/2012] [Accepted: 06/13/2012] [Indexed: 11/08/2022]
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30
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Niu S, Cao X, Zhang Y, Zhu Q, Zhu J, Zhen P. Peri-implant and systemic effects of high-/low-affinity bisphosphonate-hydroxyapatite composite coatings in a rabbit model with peri-implant high bone turnover. BMC Musculoskelet Disord 2012; 13:97. [PMID: 22686414 PMCID: PMC3414815 DOI: 10.1186/1471-2474-13-97] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 06/11/2012] [Indexed: 11/11/2022] Open
Abstract
Background Hydroxyapatite (HA) coatings composed with bisphosphonates (BPs) which have high mineral-binding affinities have been confirmed to successfully enhance implant stability. However, few previous studies focused on HA coatings composed with low-affinity BPs or on systemic effects of locally released BPs. Methods In this long-term study, we developed two kinds of BP-HA composite coatings using either high-affinity BP (alendronate, ALN) or low-affinity BP (risedronate, RIS). Thirty-six rabbits were divided into three groups according to different coating applications (group I: HA, group II: ALN-HA, and group III: RIS-HA). Implants were inserted into the proximal region of the medullary cavity of the left tibiay. At insertion, 2 × 108 wear particles were injected around implants to induce a peri-implant high bone turnover environment. Both local (left tibias) and systemic (right tibias and lumbar vertebrae) inhibitory effect on bone resorption were compared, including bone-implant integration, bone architecture, bone mineral density (BMD), implant stability, and serum levels of bone turnover markers. Results The results indicated that ALN-HA composite coating, which could induce higher bone-implant contact (BIC) ratio, bone mass augmentation, BMD, and implant stability in the peri-implant region, was more potent on peri-implant bone, while RIS-HA composite coating, which had significant systemic effect, was more potent on non-peri-implant bone, especially lumbar vertebrae. Conclusions It is instructive and meaningful to further clinical studies that we could choose different BP-HA composite coatings according to the patient’s condition.
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Affiliation(s)
- Shun Niu
- Department of Orthopaedics, Xi Jing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China
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31
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Osteopathology induced by bisphosphonates and dental implants: clinical observations. Clin Oral Investig 2012; 17:167-75. [PMID: 22415216 DOI: 10.1007/s00784-012-0708-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Accepted: 02/27/2012] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Although there are many reports about risk factors for the development of BP-associated osteonecrosis of the jaws, the role of dental implants as a local risk factor is still discussed, especially in patients with oral BP treatment. Until now, a few case reports and surveys display a possible minor risk in patients with oral BP therapy, whereas the avoidance of implant placement is generally accepted in patients with intravenous BP therapy. PATIENT AND METHODS In this study, the cases of 14 patients with osteonecrosis of the jaws in association with BP therapy and dental implant placement were analyzed carefully with a detailed literature review. RESULTS Of 14 patients, nine had underlying malignant disease and five patients had osteoporosis. In ten patients, implants were placed either in the posterior mandible or maxilla; the mean interval between implant insertion and disease onset was 20.9 months. Pain (n12) and signs of infection (n10) were the most common symptoms. Histologically, signs of infection were found in nine of 11 analyzed patients with presence of Actinomyces in six patients. Two patients turned out to have infiltration of underlying malignant disease. CONCLUSIONS Posteriorly placed implants seem to be of higher risk of development of osteonecrosis of the jaws. Not only the implant placement but also the inserted implant itself seems to be a continuous risk factor. CLINICAL RELEVANCE The herein elaborated risk factors help dentists plan dental rehabilitation with implants in this high-risk group of patients and indicate careful and regular dental recall.
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Roshan-Ghias A, Arnoldi J, Procter P, Pioletti DP. In vivo assessment of local effects after application of bone screws delivering bisphosphonates into a compromised cancellous bone site. Clin Biomech (Bristol, Avon) 2011; 26:1039-43. [PMID: 21696870 DOI: 10.1016/j.clinbiomech.2011.06.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 05/17/2011] [Accepted: 06/01/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND The primary stability of cancellous screw is difficult to obtain in bone of compromised quality and failure of screw fixation is common. To overcome this problem, it is proposed to locally deliver bisphosphonate from the screw. An in vivo validation of the increase in fixation of the cancellous screw is then needed in compromised bone. METHODS In this study, we used an overdrilling procedure, which enables consistent modeling of reduced screw stability comparable to compromised cancellous bone. Forty eight adult NZW rabbits were used in this study and all animals underwent bilateral femur implantation. One leg was implanted with the screw containing the bisphosphonate (biocoated group) while the other was used as control (control group) with the screw only. Mechanical testing and micro-CT imaging were used to assess the effect of local drug delivery of Zoledronate on screws fixation at 5 time points. FINDINGS At the early time points (1, 5, and 10 days), no significant difference could be seen between the biocoated and control groups. At 6 weeks, the bone volume fraction was significantly higher in the trabecular region of the biocoated group. However, this increase did not have a significant effect on the pull-out force. At the last time point, 11 weeks, both the bone volume fraction and the pull-out force were significantly higher in the biocoated group. INTERPRETATION The results of this study suggest that, in compromised bone, local delivery of bisphosphonate enhances the stability of bone screws.
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Affiliation(s)
- Alireza Roshan-Ghias
- Laboratory of Biomechanical Orthopedics, Institute of Bioengineering, Ecole Polytechnique Federale de Lausanne (EPFL), Switzerland
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Lee SJ, Oh TJ, Bae TS, Lee MH, Soh Y, Kim BI, Kim HS. Effect of Bisphosphonates on Anodized and Heat-Treated Titanium Surfaces: An Animal Experimental Study. J Periodontol 2011; 82:1035-42. [DOI: 10.1902/jop.2010.100608] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Leonida A, Vescovi P, Baldoni M, Rossi G, Lauritano D. Immediate loading in mandible full-arch: pilot study in patients with osteoporosis in bisphosphonate therapy. J ORAL IMPLANTOL 2010; 38:85-94. [PMID: 20553153 DOI: 10.1563/aaid-joi-d-09-00132.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Alessandro Leonida
- Department of Periodontology, University of Milano-Bicocca, Milan, Italy.
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