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Mosaddad SA, Talebi S, Keyhan SO, Fallahi HR, Darvishi M, Aghili SS, Tavahodi N, Namanloo RA, Heboyan A, Fathi A. Dental implant considerations in patients with systemic diseases: An updated comprehensive review. J Oral Rehabil 2024; 51:1250-1302. [PMID: 38570927 DOI: 10.1111/joor.13683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 10/27/2023] [Accepted: 03/02/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Various medical conditions and the drugs used to treat them have been shown to impede or complicate dental implant surgery. It is crucial to carefully monitor the medical status and potential post-operative complications of patients with systemic diseases, particularly elderly patients, to minimize the risk of health complications that may arise. AIM The purpose of this study was to review the existing evidence on the viability of dental implants in patients with systemic diseases and to provide practical recommendations to achieve the best possible results in the corresponding patient population. METHODS The information for our study was compiled using data from PubMed, Scopus, Web of Science and Google Scholar databases and searched separately for each systemic disease included in our work until October 2023. An additional manual search was also performed to increase the search sensitivity. Only English-language publications were included and assessed according to titles, abstracts and full texts. RESULTS In total, 6784 studies were found. After checking for duplicates and full-text availability, screening for the inclusion criteria and manually searching reference lists, 570 articles remained to be considered in this study. CONCLUSION In treating patients with systemic conditions, the cost-benefit analysis should consider the patient's quality of life and expected lifespan. The success of dental implants depends heavily on ensuring appropriate maintenance therapy, ideal oral hygiene standards, no smoking and avoiding other risk factors. Indications and contraindications for dental implants in cases of systemic diseases are yet to be more understood; broader and hardcore research needs to be done for a guideline foundation.
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Affiliation(s)
- Seyed Ali Mosaddad
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
| | - Sahar Talebi
- Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seied Omid Keyhan
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
- Department of Oral & Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung, South Korea
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA
- Iface Academy, Istanbul, Turkey
| | - Hamid Reza Fallahi
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
- Department of Oral & Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung, South Korea
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA
- Iface Academy, Istanbul, Turkey
| | - Mohammad Darvishi
- Faculty of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Narges Tavahodi
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Fathi
- Department of Prosthodontics, Dental Materials Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Song YW, Park JY, Kwon YH, Jang WE, Kim SJ, Seo JT, Moon SJ, Jung UW. Host modulation therapy for improving the osseointegration of dental implants under bone healing-suppressed conditions: a preclinical rodent-model experiment. J Periodontal Implant Sci 2024; 54:177-188. [PMID: 37857517 DOI: 10.5051/jpis.2301800090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/27/2023] [Accepted: 07/26/2023] [Indexed: 10/21/2023] Open
Abstract
PURPOSE Placing dental implants in areas with low bone density or in conditions where bone healing is suppressed is challenging for clinicians. An experiment using a rodent model was performed with the aim of determining the efficacy of host modulation by increasing the systemic level of cholesterol sulfate (CS) using Irosustat in the context of the bone healing process around dental implants. METHODS In 16 ovariectomised female Sprague-Dawley rats, 2 implant fixtures were placed in the tibial bones (1 fixture on each side). At 1 week after surgery, the high-CS group (n=8) received Irosustat-mixed feed, while the control group (n=8) was fed conventionally. Block specimens were obtained at 5 weeks post-surgery for histologic analysis and the data were evaluated statistically (P<0.05). RESULTS Unlike the high-CS group, half of the specimens in the control group demonstrated severe bone resorption along with a periosteal reaction in the cortex. The mean percentages of bone-to-implant contact (21.5%) and bone density (28.1%) near the implant surface were significantly higher in the high-CS group than in the control group (P<0.05), as was the number of Haversian canals (by 5.3). CONCLUSIONS Host modulation by increasing the CS level may enhance the osseointegration of dental implants placed under conditions of impaired bone healing.
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Affiliation(s)
- Young Woo Song
- Department of Periodontology, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
| | - Yoon-Hee Kwon
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
| | - Wooyoung Eric Jang
- Department of Oral Biology, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Sung-Jin Kim
- Department of Oral Histology and Developmental Biology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Jeong Taeg Seo
- Department of Oral Biology, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Seok Jun Moon
- Department of Oral Biology, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea.
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Liao Y, Xu J, Zheng Z, Fu R, Zhang X, Gan S, Yang S, Hou C, Xu HHK, Chen W. Novel Nonthermal Atmospheric Plasma Irradiation of Titanium Implants Promotes Osteogenic Effect in Osteoporotic Conditions. ACS Biomater Sci Eng 2024; 10:3255-3267. [PMID: 38684056 DOI: 10.1021/acsbiomaterials.4c00202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Osteoporosis is a metabolic disease characterized by bone density and trabecular bone loss. Bone loss may affect dental implant osseointegration in patients with osteoporosis. To promote implant osseointegration in osteoporotic patients, we further used a nonthermal atmospheric plasma (NTAP) treatment device previously developed by our research group. After the titanium implant (Ti) is placed into the device, the working gas flow and the electrode switches are turned on, and the treatment is completed in 30 s. Previous studies showed that this NTAP device can remove carbon contamination from the implant surface, increase the hydroxyl groups, and improve its wettability to promote osseointegration in normal conditions. In this study, we demonstrated the tremendous osteogenic enhancement effect of NTAP-Ti in osteoporotic conditions in rats for the first time. Compared to Ti, the proliferative potential of osteoporotic bone marrow mesenchymal stem cells on NTAP-Ti increased by 180% at 1 day (P = 0.004), while their osteogenic differentiation increased by 149% at 14 days (P < 0.001). In addition, the results indicated that NTAP-Ti significantly improved osseointegration in osteoporotic rats in vivo. Compared to the Ti, the bone volume fraction (BV/TV) and trabecular number (Tb.N) values of NTAP-Ti in osteoporotic rats, respectively, increased by 18% (P < 0.001) and 25% (P = 0.007) at 6 weeks and the trabecular separation (Tb.Sp) value decreased by 26% (P = 0.02) at 6 weeks. In conclusion, this study proved a novel NTAP irradiation titanium implant that can significantly promote osseointegration in osteoporotic conditions.
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Affiliation(s)
- Yihan Liao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jia Xu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zheng Zheng
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ruijie Fu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xinyuan Zhang
- Jinjiang Out-Patient Section, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Shuaiqi Gan
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Shuhan Yang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Chuping Hou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hockin H K Xu
- Biomaterials and Tissue Engineering Division, Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, Maryland 21201, United States
- Center for Stem Cell Biology and Regenerative Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, United States
- University of Maryland Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, United States
- Department of Biomaterials and Regenerative Dental Medicine, University of Maryland School of Dentistry, Baltimore, Maryland 21201, United States
| | - Wenchuan Chen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Jinjiang Out-Patient Section, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Tabrizi R, Shafiei S, Moslemi H, Dastgir R, Peacock ZS. Impact of Osteoporosis on Autogenous Bone Graft Resorption. J Oral Maxillofac Surg 2024:S0278-2391(24)00203-9. [PMID: 38615693 DOI: 10.1016/j.joms.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Osteoporosis is a common disorder that is characterized by decreased bone density and increased bone resorption. This bone resorption may affect the grafted bone during the maxillofacial reconstruction. PURPOSE This study aimed to measure the association between osteoporosis and resorption of anterior iliac crest bone grafts used to reconstruct the atrophic anterior maxillae. STUDY DESIGN, SETTING, SAMPLE This prospective cohort study included female patients requiring bone augmentation of the anterior maxilla. Patients with a ridge width of <4 mm and ridge height of >7 mm were enrolled in the study. Exclusion criteria were chronic use of corticosteroids or intravenous bisphosphonates, history of maxillofacial radiation therapy, current smoking, and underlying conditions contributing to bone metabolism (eg, hyperparathyroidism, chronic renal failure, and hypophosphatemia). PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE Osteoporosis status was a predictor variable. Patients were allocated to the osteoporosis or control group based on T-scores obtained by dual-energy x-ray absorptiometry. Mean T-scores ≤ -2.5 were assigned to the osteoporosis group. MAIN OUTCOME VARIABLE(S) The outcome variable was graft resorption, defined as the difference in ridge width between measurements made immediately (T1) and 6 months postoperatively (T2) using cone-beam computed tomography. COVARIATES Patient age, preoperative (T0) bone width, and the amount of bone augmentation, defined as the differences in ridge width between measurements made preoperatively (T0) and immediately after grafting (T1), were covariates of this study. ANALYSES Descriptive, analytic, and general linear models were computed. Statistical significance was set a P < .05. RESULTS Thirty-two patients were included in the study (15 in the osteoporosis group and 17 in the control group). The amount of graft resorption at 6 months after grafting was 2.57 ± 0.59 mm in the osteoporosis group and 0.97 ± 0.59 mm in the control group (P < .001). A significant correlation was found between the mean T-score and graft resorption 6 months after grafting (P < .001). CONCLUSION AND RELEVANCE A significant correlation was observed between osteoporosis and graft resorption in the anterior maxilla after 6 months.
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Affiliation(s)
- Reza Tabrizi
- Associate Professor of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shervin Shafiei
- Assistant Professor of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hamidreza Moslemi
- Assistant Professor of Oral and Maxillofacial Surgery, School of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Ramtin Dastgir
- Research Fellow, Department of Oral and Maxillofacial Surgery, Case Western Reserve University, Cleveland, OH
| | - Zachary S Peacock
- Chair, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA
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Costa MSC, Daltro Rosa CDDR, Bento VAA, da Silva Costa SM, Santiago JF, Pellizzer EP, Fraga de Almeida ALP. Efficacy of acellular xenogeneic dermal matrix graft in the treatment of multiple gingival recessions: systematic review and meta-analysis. Clin Oral Investig 2024; 28:177. [PMID: 38409621 DOI: 10.1007/s00784-024-05560-2] [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: 08/31/2023] [Accepted: 02/14/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVE This study aimed to compare the efficacy of acellular xenogeneic dermal matrix graft (AXDM) compared to connective tissue graft (CTG) in treating multiple gingival recessions. MATERIALS AND METHODS A systematic search of electronic databases was conducted to identify randomized clinical trials (RCTs) that compared AXDM and CTG. The selected studies were subjected to bias risk assessment, data extraction, and meta-analyses. Parameters such as gingival recession height, width, mean percentage of root coverage, and complete root coverage were analyzed. RESULTS Seven RCTs involving 146 patients were included. The meta-analyses indicated that CTG was statistically superior to AXDM in reducing gingival recession height at the final follow-up (mean difference: -0.104 mm, 95% confidence interval [CI]: -0.180-0.028, p = 0.008) and width at the final follow-up (mean difference: -0.285 mm, 95% CI: -0.541-0.030, p = 0.029). CTG also demonstrated a significantly higher mean percentage of root coverage at the 6-month follow-up (difference in means: -2.761 mm, 95% CI: -4.932-0.590, p = 0.013) and a higher percentage of complete root coverage at the 6-month follow-up (odds Ratio [OR]: 0.598, 95% CI: 0.4-0.892, p = 0.012) compared to AXDM. However, there was no significant difference in the number of teeth with complete root coverage between CTG and AXDM (OR: 1.610, 95% CI: 0.983-2.636, p = 0.058) and aesthetic outcomes (mean difference: 0.148, 95% CI: -0.277-0.573, p = 0.494). CONCLUSIONS CTG is more effective than AXDM in treating multiple gingival recessions. This is evidenced by significant reductions in gingival recession height and width, a higher mean percentage of root coverage, and a greater percentage of complete root coverage at the 6-month follow-up. CLINICAL RELEVANCE In some clinical situations an alternative to CTG is required for the treatment of multiple gingival recessions. AXDM, despite presenting clinical outcomes that are not as satisfactory as CTG, can be used for this purpose.
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Affiliation(s)
- Matheus Souza Campos Costa
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil.
| | - Cléber Davi Del Rei Daltro Rosa
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Victor Augusto Alves Bento
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Sandy Maria da Silva Costa
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil
| | - Joel Ferreira Santiago
- Departament of Health Sciences, School of Dentistry, Centro Universitário Sagrado Coração- UNISAGRADO, Bauru, SP, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Ana Lúcia Pompéia Fraga de Almeida
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP) and Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of São Paulo, Bauru, SP, Brazil
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Samara W, Moztarzadeh O, Hauer L, Babuska V. Dental Implant Placement in Medically Compromised Patients: A Literature Review. Cureus 2024; 16:e54199. [PMID: 38496195 PMCID: PMC10942790 DOI: 10.7759/cureus.54199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
As a discipline of dentistry, oral implantology deals with the diagnosis, design, insertion, restoration, and/or management of alloplastic or autogenous oral structures for the purpose of regaining contour, function, aesthetics, and speech in a partially or completely edentulous patient. The present review aims to provide the currently available knowledge about the impact of certain systemic disorders and the usage of some medications on the survival rate of dental implant therapy and to highlight the importance of patient management under these conditions. Diabetes, osteoporosis, cardiovascular diseases, and the intake of some medications can increase the risk of the failure of a dental implant. Even though there are relatively few medical contraindications to dental implant treatment, certain conditions may increase the risk of failure or complications.
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Affiliation(s)
- Walla Samara
- Department of Stomatology, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
| | - Omid Moztarzadeh
- Department of Stomatology, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
- Department of Anatomy, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
| | - Lukas Hauer
- Department of Stomatology, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
| | - Vaclav Babuska
- Department of Medical Chemistry and Biochemistry, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
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Amiri MA, Farshidfar N, Miron RJ, Dziedzic A, Hamedani S, Daneshi S, Tayebi L. The Potential Therapeutic Effects of Platelet-Derived Biomaterials on Osteoporosis: A Comprehensive Review of Current Evidence. Int J Biomater 2023; 2023:9980349. [PMID: 38098766 PMCID: PMC10721351 DOI: 10.1155/2023/9980349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/09/2023] [Accepted: 11/24/2023] [Indexed: 12/17/2023] Open
Abstract
Osteoporosis is a chronic multifactorial condition that affects the skeletal system, leading to the deterioration of bone microstructure and an increased risk of bone fracture. Platelet-derived biomaterials (PDBs), so-called platelet concentrates, such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), have shown potential for improving bone healing by addressing microstructural impairment. While the administration of platelet concentrates has yielded positive results in bone regeneration, the optimal method for its administration in the clinical setting is still debatable. This comprehensive review aims to explore the systemic and local use of PRP/PRF for treating various bone defects and acute fractures in patients with osteoporosis. Furthermore, combining PRP/PRF with stem cells or osteoinductive and osteoconductive biomaterials has shown promise in restoring bone microstructural properties, treating bony defects, and improving implant osseointegration in osteoporotic animal models. Here, reviewing the results of in vitro and in vivo studies, this comprehensive evaluation provides a detailed mechanism for how platelet concentrates may support the healing process of osteoporotic bone fractures.
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Affiliation(s)
- Mohammad Amin Amiri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nima Farshidfar
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Richard J. Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Arkadiusz Dziedzic
- Department of Conservative Dentistry with Endodontics, Medical University of Silesia, Katowice, Poland
| | - Shahram Hamedani
- Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sajad Daneshi
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Lobat Tayebi
- Marquette University School of Dentistry, Milwaukee, WI 53233, USA
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8
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Faverani LP, Rios BR, Santos AMDS, Mendes BC, Santiago-Júnior JF, Sukotjo C, Callahan N, Miloro M. Predictability of single versus double-barrel vascularized fibula flaps and dental implants in mandibular reconstructions: A systematic review and meta-analysis of prospective studies. J Prosthet Dent 2023:S0022-3913(23)00686-8. [PMID: 37978003 DOI: 10.1016/j.prosdent.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023]
Abstract
STATEMENT OF PROBLEM Patients with vascularized bone flaps from the fibula have reduced bone height, in which case a higher prosthetic abutment is needed for their implant-supported prosthesis. Although the double-flap technique seems promising, systematic reviews and meta-analyses of prospective studies are lacking. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the grafted areas of single barrel fibular flaps (SBFF) and double-barrel fibular flaps (DBFF) by considering failure rates, dental implant complications, and bone union at the osteotomy sites. MATERIAL AND METHODS A systematic review and meta-analysis was performed in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, population, intervention, control, and outcomes (PICO) question, and the National Health and Medical Research Council scales. The event rate of complications and failures was calculated with a confidence interval (CI) of 95%. RESULTS A total of 13 prospective studies with 441 participants and 330 graft sites were identified. A total of 235 participants had SBFF with 445 implants, and 95 had DBFF with 164 implants. The overall combined graft failure rates were 4.2% for SBFF and 3.2% for DBFF. The complication rate was 10% for SBFF and 1.9% for DBFF. Implant failure was at 4.7% in the SBFF group and 3.4% in the DBFF group. CONCLUSIONS Complication rates and implant failures were similar for SBFF and DBFF. Therefore, for long-term oral rehabilitation, both SBFF and DBFF are suitable procedures for mandibular reconstruction.
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Affiliation(s)
- Leonardo P Faverani
- Associate Professor, Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, São Paulo State University (UNESP), Araçatuba, SP, Brazil.
| | - Barbara R Rios
- PhD student, Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Anderson Maikon de Souza Santos
- PhD student, Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Bruno C Mendes
- PhD student, Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Joel F Santiago-Júnior
- Assistant Professor, Department of Health Sciences, Sacred Heart University, Bauru, SP, Brazil
| | - Cortino Sukotjo
- Associate Professor, Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, Ill
| | - Nicholas Callahan
- Assistant Professor, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Illinois at Chicago, Chicago, Ill
| | - Michael Miloro
- Professor and Head of Department, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Illinois at Chicago, Chicago, Ill
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Bogner MS, Chambas V, Nicolas E, Faulks D, Hennequin M. Implant-supported prostheses in patients with special needs: A systematic literature review of protocols and outcomes. J Prosthet Dent 2023:S0022-3913(23)00628-5. [PMID: 37880026 DOI: 10.1016/j.prosdent.2023.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 10/27/2023]
Abstract
STATEMENT OF PROBLEM Implant-supported prostheses for individuals with special needs have been considered high-risk because of the prevalence of poor oral hygiene and parafunction in this population; however, systematic evidence on protocols and outcomes is scarce. PURPOSE The purpose of this systematic review was to summarize implant procedures and outcomes for the special needs population. MATERIAL AND METHODS A systematic literature review was conducted using PubMed, Embase, and Scopus databases in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodological framework. Data collected included patient information, location and number of implants, surgical and prosthetic procedures, behavior support techniques, postoperative follow-up, complications, and criteria for outcome assessment. Survival rates were pooled for quantitative analysis, and a separate analysis pooling data from groups of special needs patients that present similar risks was undertaken. RESULTS The qualitative analysis included 79 studies involving 759 patients and 2269 implants. The quantitative analysis included 65 studies concerning 666 patients with special needs and 1886 implants. The overall weighted implant survival rate was 95.4%, with a mean follow-up duration of 40.7 ±29.5 months. CONCLUSIONS In individuals with special needs considered suitable for implant-supported prostheses by their clinician, implant survival rates were similar to those reported in the general population. (J Prosthet Dent xxxx;xxx:xxx-xxx).
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Affiliation(s)
- Marie-Sophie Bogner
- Specialist, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, Clermont-Ferrand, France.
| | - Vivien Chambas
- Specialist, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, Clermont-Ferrand, France; and Private practice, Clermont-Ferrand, France
| | - Emmanuel Nicolas
- Professor, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, Clermont-Ferrand, France; and CHU Clermont-Ferrand, Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
| | - Denise Faulks
- Specialist Consultant, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, F-63000 Clermont-Ferrand, France; and CHU Clermont-Ferrand, Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
| | - Martine Hennequin
- Professor, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, Clermont-Ferrand, France; and CHU Clermont-Ferrand, Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
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Lee SH, Yun PY, Yi YJ, Kim YK, Lee HJ, Jo DW. Low Bone Density Predictability of CBCT and Its Relation to Primary Stability of Tapered Implant Design: A Pilot Study. J ORAL IMPLANTOL 2023; 49:556-563. [PMID: 35881816 DOI: 10.1563/aaid-joi-d-21-00159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 04/04/2022] [Accepted: 05/31/2022] [Indexed: 11/22/2022]
Abstract
Research regarding bone density assessment using cone beam computed tomography (CBCT) in low bone density regions is sparse. This in vitro study aimed to evaluate the predictability of CBCT for low bone density regions and its correlations with primary implant stability when placing tapered design implants with a stepped osteotomy. Eighteen porcine mandibular condyles were used as simulated low bone density regions. Hounsfield units (HU), obtained via multislice computed tomography, and gray values (GVs), obtained via CBCT, were measured 3 times at 1-month intervals. The maximum implant insertion torque (MIT) and implant stability quotient (ISQ) were recorded as the taper design implants were placed using a stepped osteotomy. Hounsfield units and GV were measured as 335.05-803.07 and 389.98-906.40, respectively. For repeated measurements of HU and GV, the intraclass correlation coefficients were 0.989 and 0.980; the corresponding value for mean HU and GV was 0.768. Bland-Altman plots showed a mean difference between HU and GV of -78.15. Pearson correlation coefficients revealed a strong correlation between HU and GV (r = 0.91, P < .01). The mean ± SD values for MIT and ISQ were 36.44 ± 6.64 Ncm and 80.85 ± 2.03, respectively, but no statistically significant correlations were found with GV and HU. Within the study's limitations, GV showed similar bone density estimation compared with HU in soft bones. Tapered implant placement with a stepped osteotomy achieved stable primary implant stability in soft bones. However, these in vitro results need to be approved in further clinical studies.
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Affiliation(s)
- Sang-Hoon Lee
- Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Yang-Jin Yi
- Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Deuk-Won Jo
- Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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Chappuis-Chocano AP, Venante HS, da Costa RMB, Pordeus MD, Marcillo-Toala OO, Santiago JF, Porto VC. A systematic review and meta-analysis of the clinical performance of implant-supported overdentures retained by CAD-CAM bars. J Appl Oral Sci 2023; 31:e20230054. [PMID: 37646715 PMCID: PMC10501751 DOI: 10.1590/1678-7757-2023-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/07/2023] [Accepted: 07/10/2023] [Indexed: 09/01/2023] Open
Abstract
Currently, there is no consensus on the indications and clinical performance of implant-supported overdentures (IODs) involving computer-aided design and manufacturing (CAD-CAM) bars. OBJECTIVE To evaluate the performance of IODs involving CAD-CAM bars. METHODOLOGY A comprehensive search of studies published until May 2023 was conducted in many databases, including PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The population, intervention, comparison, outcome (PICO) question was: "How do IODs retained by bars fabricated by CAD-CAM technology perform in daily clinical practice?" The meta-analysis included clinical studies based on effect size and a two-tailed null test with a 95% confidence interval (CI). RESULTS Ten studies were included in the meta-analysis. Among them, nine reported a 100% implant survival rate for all CAD-CAM milled bars. Complications were reported in two studies with CAD/CAM-milled titanium bars, and one study reported more fractures in soldered gold bars used in maxillary rehabilitation. However, no fractures were observed in IODs retained by PEEK and zirconia bars. According to six studies, biological complications, including peri-implantitis, were minimal in the BioHPP and PEEK bar groups, while no cases were reported in the titanium or zirconia bar groups. CAD-CAM-milled zirconia bars had higher plaque and bleeding indices compared with titanium bars, as evidenced by findings from five studies. All four studies that evaluated Oral Health Impact Profile (OHIP) scores showed a positive effect of IODs retained by CAD-CAM milled titanium bars on quality of life. Patient satisfaction and acceptance by prosthodontists were significantly high, according to the results of five studies. CONCLUSION Overdentures retained with CAD-CAM milled titanium bars show great potential for use in daily clinical practice. Moreover, patient and practitioner satisfaction was very high when this method was used.
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Affiliation(s)
- Ana Paula Chappuis-Chocano
- Universidade de São PauloFaculdade de Odontologia de BauruBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, São Paulo, Brasil.
| | - Helena Sandrini Venante
- Universidade de São PauloFaculdade de Odontologia de BauruBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, São Paulo, Brasil.
| | - Rodrigo Moreira Bringel da Costa
- Universidade de São PauloFaculdade de Odontologia de BauruBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, São Paulo, Brasil.
| | - Mariana Domingues Pordeus
- Universidade de São PauloFaculdade de Odontologia de BauruBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, São Paulo, Brasil.
| | - Oscar Oswaldo Marcillo-Toala
- Universidad de Especialidades Espíritu SantoSamborondónEcuadorUniversidad de Especialidades Espíritu Santo (UEES), Samborondón, Ecuador.
| | - Joel Ferreira Santiago
- Universidade de São PauloFaculdade de Odontologia de BauruBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, São Paulo, Brasil.
| | - Vinícius Carvalho Porto
- Universidade de São PauloFaculdade de Odontologia de BauruBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, São Paulo, Brasil.
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D'Ambrosio F, Amato A, Chiacchio A, Sisalli L, Giordano F. Do Systemic Diseases and Medications Influence Dental Implant Osseointegration and Dental Implant Health? An Umbrella Review. Dent J (Basel) 2023; 11:146. [PMID: 37366669 DOI: 10.3390/dj11060146] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023] Open
Abstract
The aim of this umbrella review is to evaluate what are the most common medications and systemic diseases that can affect bone-implant integration, the success rate and survival rate of dental implants, peri-implant tissue health, and implant loss. Systematic reviews, with meta-analysis or not, about how systemic diseases and medications influence dental implant osseointegration, survival rate, success rate, and peri-implant diseases, published only in the English language, are electronically searched across the most important scientific databases. The present umbrella review includes eight systematic reviews, and osteoporosis and diabetes are the most investigated pathologies. Systemic diseases, such as neurologic disorders, HIV, hypothyroidism, cardiovascular diseases, and drugs, such as beta blockers, anti-hypertensives, or diuretics do not show a decreased rate of implant osseointegration. It seems that drugs, such as proton-pump inhibitors (PPIs) or serotonin reuptake inhibitors (SSRIs), negatively affect implant osseointegration. Few studies compare the effects of drugs and systemic diseases on the parameters considered in this overview. It is important to underline how the results of this review need to be validated with subsequent and more reviews.
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Affiliation(s)
- Francesco D'Ambrosio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Alessandra Amato
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80138 Naples, Italy
| | - Andrea Chiacchio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Laura Sisalli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Francesco Giordano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
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Guabello G, Zuffetti F, Ravidà A, Deflorian M, Carta G, Saleh MHA, Serroni M, Pommer B, Watzek G, Francetti L, Testori T. Avoiding implant-related complications in medically compromised patients with or without unhealthy lifestyle/Elevated oxidative stress. Periodontol 2000 2023; 92:329-349. [PMID: 37350348 DOI: 10.1111/prd.12503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/11/2023] [Accepted: 04/26/2023] [Indexed: 06/24/2023]
Abstract
Increased human life expectancy broadens the alternatives for missing teeth and played a role in the widespread use of dental implants and related augmentation procedures for the aging population. Though, many of these patients may have one or more diseases. These systemic conditions may directly lead to surgical complications, compromise implant/bone healing, or influence long-term peri-implant health and its response to biologic nuisances. Offering patients credible expectations regarding intra- and postoperative complications and therapeutic prognosis is an ethical and legal obligation. Clear identification of potential types of adverse effects, complications, or errors is important for decision-making processes as they may be related to different local, systemic, and technical aspects. Therefore, the present review structures the underlying biological mechanisms, clinical evidence, and clinical recommendations for the most common systemic risk factors for implant-related complications.
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Affiliation(s)
- Gregorio Guabello
- Endocrinology Unit, IRCCS Galeazzi Sant'Ambrogio Hospital, Milan, Italy
| | - Francesco Zuffetti
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
| | - Andrea Ravidà
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Matteo Deflorian
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
| | - Giorgio Carta
- Argo Academy International Research Bologna, Bologna, Italy
- Private Practice, Bologna, Italy
- Lake Como Institute, Como, Italy
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Matteo Serroni
- Department of Innovative Technologies in Medicine & Dentistry, University 'G. D'Annunzio', Chieti-Pescara, Italy
| | - Bernhard Pommer
- Academy for Oral Implantology, Vienna, Austria
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Luca Francetti
- IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Tiziano Testori
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Perez E, Salinas L, Mendoza R, Guerrero ME, Oliva J, Mayta-Tovalino F. Osseointegration of Dental Implants in Patients with Congenital and Degenerative Bone Disorders: A Literature Review. J Int Soc Prev Community Dent 2023; 13:167-172. [PMID: 37564172 PMCID: PMC10411298 DOI: 10.4103/jispcd.jispcd_51_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/19/2022] [Accepted: 05/03/2022] [Indexed: 08/12/2023] Open
Abstract
Aims and Objectives The aim of this study was to describe the mechanism of dental implants osseointegration in patients with congenital and degenerative genetic bone disorders. Materials and Methods A PubMed and Scopus documents search was carried out between November 2021 in the, using words such as "osseointegration," "degenerative disease," "congenital disease," and "dental implants." Results The thirteen articles selected dealt with dental implants osseointegration in patients with congenital and degenerative bone disorders. The influence and repercussion of these diseases on the bone system, as well as the osseointegration process were described from healing to bone remodeling. In addition, certain articles described some considerations to improve the osseointegration process in patients suffering from these types of conditions. Conclusions Within the limitations of this literature review we can conclude that osseointegration in patients with ectodermal dysplasia and osteoporosis could be achieved. However, the planning process for dental implant placement in these patients should be more meticulous and individualized considering the degree of tissue involvement as well as the patient's age and skeletal development compared to systemically healthy patients.
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Affiliation(s)
- Edith Perez
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Liliana Salinas
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Roman Mendoza
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Maria Eugenia Guerrero
- Academic Department of Medical and Surgical Stomatology, Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Jose Oliva
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
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Lemos CAA, de Oliveira AS, Faé DS, Oliveira HFFE, Del Rei Daltro Rosa CD, Bento VAA, Verri FR, Pellizzer EP. Do dental implants placed in patients with osteoporosis have higher risks of failure and marginal bone loss compared to those in healthy patients? A systematic review with meta-analysis. Clin Oral Investig 2023:10.1007/s00784-023-05005-2. [PMID: 37043030 DOI: 10.1007/s00784-023-05005-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE This systematic review and meta-analysis aimed to compare the dental implant survival rate and marginal bone loss between patients with and without osteoporosis. MATERIALS AND METHODS This systematic review was registered in PROSPERO (CRD42022356377). A systematic search was performed using five databases: MEDLINE/PubMed, Web of Science, Scopus, Embase, and ProQuest for articles published up to July 2022. Additional searches in ClinicalTrials.gov and the reference lists of included studies were performed. The eligibility criteria comprised observational studies with a direct comparison between patients with and without osteoporosis, with a minimum follow-up of 1 year and 10 implants placed in each group, which consider data analysis based on implant level, without restrictions on period or language of publication. The meta-analysis was performed using RevMan 5.4 program. Risk of bias analysis of the included studies was performed using the Newcastle-Ottawa scale (NOS). RESULTS Twelve studies met the eligibility criteria, totaling 1132 patients with a mean age range from 54 to 76.6 years. Most of the included patients were women (73.6%). A total of 3505 implants were evaluated-983 in patients with osteoporosis and 2522 in patients without osteoporosis. The meta-analysis indicated no difference in implant survival rates between patients with and without osteoporosis (OR, 1.78; 95% confidence interval [CI], 0.86-3.70; P = 0.12). However, significant bone loss was observed around dental implants placed in patients with osteoporosis (SMD, 0.71 mm; 95% CI, 0.06-0.87 mm). The NOS indicated a low risk of bias in the studies included. However, the certainty of the evidence was classified as very low and low for implant survival rates and bone loss, respectively. CONCLUSION According to the limitations of the present review, the data suggest that dental implants are a viable treatment option for the rehabilitation of patients with osteoporosis. However, clinical care by professionals is necessary to ensure the maintenance of peri-implant bone stability, as these patients may be susceptible to increased bone loss.
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Affiliation(s)
- Cleidiel Aparecido Araujo Lemos
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil.
| | - Andreza Soares de Oliveira
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Daniele Sorgatto Faé
- Postgraduate Program in Applied Health Sciences (PPGCAS), Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | | | - Cleber Davi Del Rei Daltro Rosa
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Victor Augusto Alves Bento
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Fellippo Ramos Verri
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, SP, Brazil
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Accuracy of marginal fit of an implant-supported framework fabricated by 3D printing versus subtractive manufacturing technique: A systematic review and meta-analysis. J Prosthet Dent 2023; 129:301-309. [PMID: 34147238 DOI: 10.1016/j.prosdent.2021.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 11/20/2022]
Abstract
STATEMENT OF PROBLEM Evidence comparing additive 3-dimensional printing (3DP) with subtractive milling for implant-supported frameworks is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to compare the marginal fit and accuracy of complete arch implant-supported frameworks (CA), implant-retained fixed partial dentures (IRFPDs), single implant crowns (SICs), and interim implant-retained restorations (IIRRs) by using additive manufacturing (AM) and subtractive manufacturing (SM) methods. MATERIAL AND METHODS An electronic search was performed in PubMed, ScienceDirect, Google Scholar, and the Cochrane Library for articles published up to August 2020. The authors acquired the data and evaluated the articles, and the final selection of articles was made according to the inclusion and exclusion criteria. The Methodological Index for Non-Randomized Studies (MINORS) scale was used to evaluate the quality of the included studies. Heterogeneity was evaluated, and meta-analyses with subgroup analyses were performed in the selected studies. RESULTS The database search resulted in 960 articles. After removing duplicate articles (410 studies), the titles and abstracts were screened in detail, and 10 in vitro studies were selected for qualitative analysis and 9 for quantitative analysis according to the eligibility criteria. Subgroup analyses were performed to compare the 3DP versus the SM technique for different types of implant-supported frameworks (IRFPDs, SICs, IIRRs, and CA). In the IRFPDs analysis, the marginal fit accuracy of the 3DP systems was higher than that with the subtractive manufacturing method (P<.001). In the subgroup analysis of SIC frameworks (P=.55) and CA (P=.67) frameworks, no significant difference was observed in the assessed techniques. CONCLUSIONS The marginal fit of implant-supported frameworks manufactured by AM or SM methods is in the clinically acceptable range.
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Kemuriyama S, Aita H, Maida T, Kawamura N, Nezu T, Iijima M, Endo K, Koshino H. Effect of photofunctionalization on titanium bone-implant integration in ovariectomized rats. Dent Mater J 2023; 42:11-18. [PMID: 36123044 DOI: 10.4012/dmj.2022-081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Osteoporosis is considered a risk factor for osseointegration during implant treatment. Photofunctionalization of titanium has been shown to improve bone-based cell adhesion, proliferation, and functional expression, increasing the bone-implant contact rate and bone-implant integration strength. This study aimed to test the hypothesis that photofunctionalization is effective for implant fixation using an osteoporosis rat model. In the biomechanical push-in test, the bone-implant integration strength of the photofunctionalization treatment group was 1.53 times that of the control group (p<0.05). These values implied that photofunctionalization restored the ovariectomy-induced low bone-implant integration strength to normal states. In the micro-CT analysis, the BV/TV of the photofunctionalization treatment group was 1.32 times that of the control group (p<0.05). These values implied that photofunctionalization restored the ovariectomy-induced low peri-implant bone formation to normal states. These results indicate that photofunctionalization treatment increased peri-implant bone formation and bone-implant integration strength in ovariectomized rats.
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Affiliation(s)
- Shuhei Kemuriyama
- Division of Geriatric Dentistry, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido
| | - Hideki Aita
- Division of Geriatric Dentistry, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido
| | - Takeo Maida
- Division of Advanced Prosthodontics, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido
| | | | - Takashi Nezu
- Division of Biomaterials and Bioengineering, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido
| | - Masahiro Iijima
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido
| | - Kazuhiko Endo
- Division of Biomaterials and Bioengineering, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido
| | - Hisashi Koshino
- Division of Occlusion and Removable Prosthodontics, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido
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Zamai RS, Corrêa MG, Ribeiro FV, Cirano FR, Casati MZ, Messora MR, Pimentel SP. Does resveratrol favor peri-implant bone repair in rats with ovariectomy-induced osteoporosis? Gene expression, counter-torque and micro-CT analysis. Braz Oral Res 2023; 37:e003. [PMID: 36700588 DOI: 10.1590/1807-3107bor-2023.vol37.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 11/11/2020] [Indexed: 01/27/2023] Open
Abstract
This study investigated the influence of resveratrol on peri-implant repair and its effects on bone-related markers in ovariectomy-induced osteoporosis in rats. Animals were divided into: OVX+PLAC (n = 10): ovariectomized animals treated with placebo; OVX+RESV (n = 10): OVX treated with resveratrol; OVX+PLAC+ZOL (n = 10): OVX treated with PLAC and zoledronate; OVX+RESV+ZOL (n = 10): OVX treated with RESV and ZOL; and SHOVX+PLAC (n = 10): sham ovariectomy treated with PLAC. RESV and PLAC were administrated after ovariectomy and ZOL after six weeks after OVX, until the end of experiment. One implant was inserted in each tibiae of animals 18 weeks after ovariectomy. After 4 weeks, one implant was removed for counter-torque, and peri-implant tissue was collected for mRNA quantification of several osteogenic markers by PCR. The other tibia was submitted to micro-computed tomography analysis. Reduced counter-torque values, bone-implant contact (BIC) and bone volume fraction (BV/TV), and higher bone porosity (BP) were detected in OVX+PLAC group when compared to SHOVX+PLAC (p < 0.05). OVX+RESV rats presented lower BIC, BV/TV, and trabecular number (Tb.N), and augmented BP and trabecular spacing (Tb.Sp) when compared to SHOVX+PLAC (p < 0.05). Higher Tb.N and connectivity density (Conn.Dn) and reduced Tb.Sp were observed in OVX rats treated with ZOL, independently of RESV, when compared to OVX+PLAC and OVX+RESV groups (p < 0.05), whereas the combination ZOL+RESV promoted lower BP when compared to OVT+PLAC and OVX+RESV (p < 0.05). Gene expression was not influenced by RESV (p > 0.05), whereas ZOL promoted up-regulation of BMP-2 (p<0.05). RESV did not improve peri-implant bone repair in rats with ovariectomy-induced osteoporosis.
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Affiliation(s)
- Rodrigo Soler Zamai
- Universidade Paulista - UNIP, School of Dentistry , Dental Research Division , São Paulo , SP , Brazil
| | - Monica Grazieli Corrêa
- Universidade Paulista - UNIP, School of Dentistry , Dental Research Division , São Paulo , SP , Brazil
| | - Fernanda Vieira Ribeiro
- Universidade Paulista - UNIP, School of Dentistry , Dental Research Division , São Paulo , SP , Brazil
| | - Fabiano Ribeiro Cirano
- Universidade Paulista - UNIP, School of Dentistry , Dental Research Division , São Paulo , SP , Brazil
| | - Marcio Zaffalon Casati
- Universidade Paulista - UNIP, School of Dentistry , Dental Research Division , São Paulo , SP , Brazil
| | - Michel Reis Messora
- Universidade de São Paulo - USP, Ribeirão Preto School of Dentistry , Department of Surgery and Bucco-Maxillofacial Traumatology and Periodontology , Ribeirão Preto , SP , Brazil
| | - Suzana Peres Pimentel
- Universidade de São Paulo - USP, Ribeirão Preto School of Dentistry , Department of Surgery and Bucco-Maxillofacial Traumatology and Periodontology , Ribeirão Preto , SP , Brazil
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19
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Kolarkodi SH, Alotaibi KZ. Artificial Intelligence in Diagnosis of Oral Diseases: A Systematic Review. J Contemp Dent Pract 2023; 24:61-68. [PMID: 37189014 DOI: 10.5005/jp-journals-10024-3465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
AIM To understand the role of Artificial intelligence (AI) in oral radiology and its applications. BACKGROUND Over the last two decades, the field of AI has undergone phenomenal progression and expansion. Artificial intelligence applications have taken up new roles in dentistry like digitized data acquisition and machine learning and diagnostic applications. MATERIALS AND METHODS All research papers outlining the population, intervention, control, and outcomes (PICO) questions were searched for in PubMed, ERIC, Embase, CINAHL, database from the last 10 years on first January 2023. Two authors independently reviewed the titles and abstracts of the selected studies, and any discrepancy between the two review authors was handled by a third reviewer. Two independent investigators evaluated all the included studies for the quality assessment using the modified tool for the quality assessment of diagnostic accuracy studies (QUADAS- 2). REVIEW RESULTS After the removal of duplicates and screening of titles and abstracts, 18 full texts were agreed upon for further evaluation, of which 14 that met the inclusion criteria were included in this review. The application of artificial intelligence models has primarily been reported on osteoporosis diagnosis, classification/segmentation of maxillofacial cysts and/or tumors, and alveolar bone resorption. Overall study quality was deemed to be high for two (14%) studies, moderate for six (43%) studies, and low for another six (43%) studies. CONCLUSION The use of AI for patient diagnosis and clinical decision-making can be accomplished with relative ease, and the technology should be regarded as a reliable modality for potential future applications in oral diagnosis.
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Affiliation(s)
- Shaul Hameed Kolarkodi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Buraydah, Saudi Arabia, Phone: +96 6533653299, e-mail:
| | - Khalid Zabin Alotaibi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Buraydah, Saudi Arabia
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Wang Z, Zhang J, Hu J, Yang G. Gene-activated titanium implants for gene delivery to enhance osseointegration. BIOMATERIALS ADVANCES 2022; 143:213176. [PMID: 36327825 DOI: 10.1016/j.bioadv.2022.213176] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/22/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Osseointegration is the direct and intimate contact between mineralized tissue and titanium implant at the bone-implant interface. Early establishment and stable maintenance of osseointegration is the key to long-term implant success. However, in patients with compromised conditions such as osteoporosis and patients beginning early load-bearing activities such as walking, lower osseointegration around titanium implants is often observed, which might result in implant early failure. Gene-activated implants show an exciting prospect of combining gene delivery and biomedical implants to solve the problems of poor osseointegration formation, overcoming the shortcomings of protein therapy, including rapid degradation and overdose adverse effects. The conception of gene-activated titanium implants is based on "gene-activated matrix" (GAM), which means scaffolds using non-viral vectors for in situ gene delivery to achieve a long-term and efficient transfection of target cells. Current preclinical studies in animal models have shown that plasmid DNA (pDNA), microRNA (miRNA), and small interference RNA (siRNA) functionalized titanium implants can enhance osseointegration with safety and efficiency, leading to the expectation of applying this technique in dental and orthopedic clinical scenarios. This review aims to comprehensively summarize fabrication strategies, current applications, and futural outlooks of gene-activated implants, emphasizing nucleic acid targets, non-viral vectors, implant surface modification techniques, nucleic acid/vector complexes loading strategies.
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Affiliation(s)
- Zhikang Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Jing Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Jinxing Hu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Guoli Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China.
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21
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Al-Qahtani F, Alqhtani N, Divakar DD, Alkhtani F, Alqarawi FK. Levels of whole salivary advanced glycation end products and interleukin-17 and peri-implant clinical and radiographic status in patients with osteoporosis at 6-years' follow-up. BMC Oral Health 2022; 22:526. [PMID: 36424586 PMCID: PMC9685916 DOI: 10.1186/s12903-022-02591-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There are no studies that have assessed advanced glycation end products (AGEs) and interleukin 17A (IL-17A) levels in whole saliva (WS) of patients with dental implants. The aim was to compare levels of AGEs and IL-17A in WS and peri-implant clinical and radiographic status of patients with and without osteoporosis at 6-years' follow-up. METHODS Osteoporotic (Group-1) and systemically healthy controls (Group-2) having undergone dental implant therapy at least 5 years ago were included. A questionnaire was used to collect information about age, gender, duration and treatment of osteoporosis, number and duration of implants in function, and frequencies of toothbrushing, flossing and hygiene visits. Modified bleeding and plaque indies (mBI and mPI), peri-implant probing depth (PD) and crestal bone loss (CBL) were recorded. WS was collected and levels of AGEs and IL-17A were determined using enzyme linked immunosorbent assay. Sample-size estimation was done and statistical analyses were doing using the independent t- and Wilcoxon rank-sum tests. Statistical significance was marked for P-values that were below 0.01. RESULTS In patients with (n = 24) and without (n = 27) osteoporosis, implants were in function for 6.3 ± 0.27 and 6.6 ± 0.5 years, respectively. There was no significant difference in peri-implant mBI, PD, mPI and CBL in both groups. Levels of AGE in patients with (119.6 ± 26.5 μg/ml) and without (91.5 ± 14.6 μg/ml) osteoporosis were comparable. Levels of whole salivary IL-17A in patients without and with osteoporosis were 4.6 ± 0.3 and 5.1 ± 0.8 pg/ml, respectively. Flossing of full mouth interproximal spaces once and twice daily toothbrushing daily was reported by 100% patients with osteoporosis. Among patients with osteoporosis 75% and 25% individuals were receiving professional dental prophylaxis every 4 and 6 months, respectively. CONCLUSION Within the limitations of the present study osteoporotic patients are not at an increased risk of peri-implant diseases and can demonstrate salivary AGE and IL-17A levels comparable to non-osteoporotic individuals as long as oral hygiene is stringently maintained.
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Affiliation(s)
- Fawaz Al-Qahtani
- grid.449553.a0000 0004 0441 5588Department of Prosthodontics, School of Dentistry, Prince-Sattam Bin Abdulaziz University, Al-Kharj, 11942 Saudi Arabia
| | - Nasser Alqhtani
- grid.449553.a0000 0004 0441 5588Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942 Saudi Arabia
| | - Darshan Devang Divakar
- Department of Dental Medicine, Sharavathi Dental College and Hospital, Shivamogga, Karnataka 577204 India
| | - Fahad Alkhtani
- grid.449553.a0000 0004 0441 5588Department of Prosthodontics, College of Dentistry, Prince Sattam Bin Abdulaziz University, 11942, Al-Kharj, Saudi Arabia
| | - Firas K. Alqarawi
- grid.411975.f0000 0004 0607 035XDepartment of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, 31441 Saudi Arabia
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22
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Li Y, Li F. Mechanism and Prospect of Gastrodin in Osteoporosis, Bone Regeneration, and Osseointegration. Pharmaceuticals (Basel) 2022; 15:1432. [PMID: 36422561 PMCID: PMC9698149 DOI: 10.3390/ph15111432] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/08/2022] [Accepted: 11/16/2022] [Indexed: 11/14/2023] Open
Abstract
Gastrodin, a traditional Chinese medicine ingredient, is widely used to treat vascular and neurological diseases. However, recently, an increasing number of studies have shown that gastrodin has anti-osteoporosis effects, and its mechanisms of action include its antioxidant effect, anti-inflammatory effect, and anti-apoptotic effect. In addition, gastrodin has many unique advantages in promoting bone healing in tissue engineering, such as inducing high hydrophilicity in the material surface, its anti-inflammatory effect, and pro-vascular regeneration. Therefore, this paper summarized the effects and mechanisms of gastrodin on osteoporosis and bone regeneration in the current research. Here we propose an assumption that the use of gastrodin in the surface loading of oral implants may greatly promote the osseointegration of implants and increase the success rate of implants. In addition, we speculated on the potential mechanisms of gastrodin against osteoporosis, by affecting actin filament polymerization, renin-angiotensin system (RAS) and ferroptosis, and proposed that the potential combination of gastrodin with Mg2+, angiotensin type 2 receptor blockers or artemisinin may greatly inhibit osteoporosis. The purpose of this review is to provide a reference for more in-depth research and application of gastrodin in the treatment of osteoporosis and implant osseointegration in the future.
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Affiliation(s)
| | - Fenglan Li
- Department of Prosthodontics, Shanxi Provincial People’s Hospital, Shanxi Medical University, Taiyuan 030000, China
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23
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Prasad S, Faverani LP, Santiago Junior JF, Sukotjo C, Yuan JCC. Attachment systems for mandibular implant-supported overdentures: A systematic review and meta-analysis of randomized controlled trials. J Prosthet Dent 2022:S0022-3913(22)00485-1. [PMID: 36115712 DOI: 10.1016/j.prosdent.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 10/14/2022]
Abstract
STATEMENT OF PROBLEM Although mandibular implant-supported overdentures have been highly recommended as a treatment option, a consensus on the type of attachment systems that can be used to increase implant and prostheses survivability is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to compare different types of attachments for retention by investigating outcome measures such as implant and prosthesis survival rates and biological and prosthesis complications in participants with a mandibular implant-supported overdenture. MATERIAL AND METHODS The search was performed in the PubMed, Cochrane, Embase, and Scopus databases by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria and registered with the International Prospective Register of Systematic Reviews (CRD42021253566). An analysis of association was conducted between different attachment systems and implant and overdenture survival rates in randomized controlled clinical trials. RESULTS The initial search indicated 477 studies, of which 25 randomized controlled trials (RCTs) were included for analysis. A total of 2154 implants and 737 overdentures were analyzed in the meta-analysis. The main results indicated the failure rate for dental implants to be 2.0% (95% confidence interval [CI], 1.3 to 3.2) and overdentures 4.2% (95% CI, 1.6 to 10.5), respectively. With regard to different attachment systems, a similar failure rate was identified with bar-type retention (7.7% to 95% CI, 3.0 to 18.1), magnetic retention systems (7.6% to 95% CI, 2.2 to 22.7), and ball-type retention (6.8% to 95% CI, 3.0 to 14.3). No significant difference was found in biological complications for splinted and unsplinted implant overdentures (P=.902). Regarding prosthetic complications, the most favorable groups were LOCATOR attachments followed by telescopic and Conus, bar, and ball attachments. Magnet attachments had higher prosthetic complications (7.4 times) than the other attachments. CONCLUSIONS Implants and implant-supported mandibular overdentures showed a high survival rate irrespective of the attachment system used. Splinting implants did not significantly affect the rate of biological complications. Prosthetic complications were most common for magnet and least common for LOCATOR attachments.
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Affiliation(s)
- Soni Prasad
- Associate Professor and Director, Pre-Doctoral Implant Program, Department of General Dental Sciences, Marquette University School of Dentistry, Milwaukee, Wisc
| | - Leonardo P Faverani
- Assistant Professor, Division of Oral and Maxillofacial Surgery and Implantology, Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University - UNESP, Araçatuba, Sao Paulo, Brazil
| | - Joel Ferreira Santiago Junior
- Assistant Professor, Department of Health Sciences, Centro Universitário Sagrado Coração - UNISAGRADO, Bauru, Sao Paulo, Brazil; Assistant Professor, Department of Prosthesis and Periodontics, Bauru School of Dentistry - University of São Paulo (FOB-USP), Bauru, Sao Paulo, Brazil
| | - Cortino Sukotjo
- Professor and Director Pre-Doctoral Implant Program, Department of Restorative Dentistry, University of Illinois Chicago College of Dentistry, Chicago, Ill
| | - Judy Chia-Chun Yuan
- Associate Professor and Managing Partner, Department of Restorative Dentistry, University of Illinois Chicago College of Dentistry, Chicago, Ill.
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Cheng YC, Ewers R, Morgan K, Hirayama M, Murcko L, Morgan J, Bergamo ETP, Bonfante EA. Antiresorptive therapy and dental implant survival: an up to 20-year retrospective cohort study in women. Clin Oral Investig 2022; 26:6569-6582. [PMID: 36001145 DOI: 10.1007/s00784-022-04609-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 06/26/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the effects of antiresorptive treatment on the survival of plateau-root form dental implants. MATERIALS AND METHODS Patients undergoing antiresorptive therapy via oral or intravenous administration as well as patients not undergoing antiresorptive therapy and healthy control patients were included in this retrospective cohort study. In total, 1472 implants placed in 631 postmenopausal patients (M: 66.42 ± 9.10 years old), who were followed for a period of up to 20 years (8.78 ± 5.68 years). Kaplan-Meier survival analysis was performed, and univariate and multivariate Cox regression, clustered by each patient, was used to evaluate and study factors affecting the survival of their implants. RESULTS Implants placed in patients undergoing oral antiresorptive treatment presented significantly higher survival rates, than implants placed in the osteoporosis/osteopenia control cohort (p value < 0.001), and similar survival rates, when compared to healthy controls (p value = 0.03). Additionally, clustered univariate and multivariate Cox regression analysis also revealed higher implant survival when oral antiresorptive drugs (p value = 0.01 and 0.007, respectively) were used, and lower implant survival in the presence of untreated osteoporosis/osteopenia (p value = 0.002 and 0.005, respectively). Overall, the 20-year implant survival in osteoporotic patients undergoing antiresorptive therapy was 94%. For the failed implants, newly replaced implants in patients under antiresorptive treatment presented a 10-year survival of 89%. CONCLUSIONS Long-term plateau-root form implant survival in osteoporotic patients taking oral antiresorptives was similar to a healthy population and significantly higher than the untreated controls. CLINICAL RELEVANCE These results suggest that plateau-root form implants provide a robust solution for treating tooth loss in patients, who are undergoing antiresorptive therapy.
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Affiliation(s)
- Yu-Chi Cheng
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Rolf Ewers
- University Hospital for Cranio-Maxillofacial and Oral Surgery and CMF Institute Vienna, Vienna, Austria
| | | | | | | | | | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of Sao Paulo - Bauru School of Dentistry, 9-75 Octavio Pinheiro Brizola, Bauru, SP, 17012-901, Brazil.
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of Sao Paulo - Bauru School of Dentistry, 9-75 Octavio Pinheiro Brizola, Bauru, SP, 17012-901, Brazil
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25
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Chatzopoulos GS, Wolff LF. Survival Rates and Factors Affecting the Outcome Following Immediate and Delayed Implant Placement: A Retrospective Study. J Clin Med 2022; 11:jcm11154598. [PMID: 35956213 PMCID: PMC9369675 DOI: 10.3390/jcm11154598] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/20/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Immediate implant placement into extraction sockets has become a widely acceptable treatment option to decrease treatment time and enhance esthetics. The objectives of this study were to assess and compare the survival rates of immediate and delayed implant treatment as well as to investigate the effect of patient- and site-related variables on the treatment outcome in a large-scale population-based study. Methods: Dental records of patients who received implant therapy were retrieved from the electronic records of the University of Minnesota School of Dentistry. Demographic characteristics, dental insurance status, socioeconomic status as well as medical history and tobacco use were recorded. The treatment outcome was included as a binary variable (survival/failure). Time to failure (date of procedure to date of visit with failure) was compared between immediate and delayed implant treatment in Cox regression models. Kaplan−Meier plots for the survival of both treatment modalities were created. Patient-sites without failure were censored at the last follow-up visit. Results: A total of 4519 records of implants were included. The sample mean age was 60.27 years and included 50.7% males and 12.9% tobacco users. High socioeconomic status was characterized for 82.3% of the included population and 63.0% of them were self-payers. Immediate implants were significantly more frequently placed in the maxillary arch (p < 0.001) than in the mandible. Tobacco users received more often a delayed rather than an immediate implant placement (p = 0.001). The survival rate analysis revealed there were no significant differences between immediate and delayed implant placements (p = 0.48). The mean follow-up time was 32.27 months during which 1.5% immediate and 1.1% delayed implants were removed. The estimated mean survival time for immediate implants was 68.90 months, while delayed implants placed in healed sockets showed a mean survival time of 75.11 months. A statistically significant association was found between gender (p = 0.03) and osteoporosis (p = 0.001) with treatment outcome. Conclusions: The placement of immediate implants achieved similarly high survival rates when compared to delayed implants placed in healed sites. Males and osteoporotic individuals showed significantly higher implant failure than females and non-osteoporotic patients. This study demonstrated that both immediate and delayed implant placements are sound options with predictable treatment outcome.
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Affiliation(s)
- Georgios S. Chatzopoulos
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, 515 Delaware St. SE, Minneapolis, MN 55455, USA
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence:
| | - Larry F. Wolff
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, 515 Delaware St. SE, Minneapolis, MN 55455, USA
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Huang T, Yu Z, Yu Q, Chen Y, Jiang Z, Wang Y, Yang G. Electrochemical deposition of lithium coating on titanium implant with enhanced early stage osseointegration. J Biomed Mater Res B Appl Biomater 2022; 110:2399-2410. [PMID: 35604032 DOI: 10.1002/jbm.b.35085] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 04/19/2022] [Accepted: 04/30/2022] [Indexed: 11/10/2022]
Abstract
Recently, a large number of studies have reported that lithium (Li) displayed a positive effect on osteogenesis. However, only a few studies have investigated the Li-incorporated surfaces through electrochemical deposition. In this study, electrochemical deposition was conducted on a CHI600E electrochemical workstation. The characterization of electrochemical deposition (ECD) and ECD-Li surfaces were detected by field-emission scanning electron microscopy with energy-dispersive spectrometer. rBMSCs were cultured on two surfaces for subsequent adhesion, proliferation and live/dead assay. To evaluate the effects of Li-incorporated implants by electrochemical deposition on osseointegration in vivo, teeth extraction of two premolars and one first molar in bilateral mandible were performed on six male beagle dogs. After 3 months, ZDI and ZDI-Li implants were inserted into the bilateral mandible of each beagle dog. Micro Computed Tomography (Micro-CT) and hard tissue sectioning analysis were carried out to evaluate the osseointegration at 4- and 8-weeks post-implantation. Results showed that ECD-Li surface promoted adhesion and proliferation of BMSCs in the early stage. More importantly, through micro-CT analysis, the values of bone volume/total volume (BV/TV) (0.374 ± 0.015), bone-implant contact (BIC) (0.831 ± 0.025), and Tb.Th (0.412 ± 0.007) in ZDI-Li group was significantly higher than those of ZDI group (0.302 ± 0.009, 0.700 ± 0.023, 0.353 ± 0.001, p < .01) at 4 weeks. Similarly, ZDI-Li group manifested more bone contact with the implant surfaces at 4 weeks based on hard tissue sectioning analysis, whereas no significant difference was detected between two groups at 8 weeks. Therefore, incorporating Li into implant surface through ECD could enhance early osseointegration in vivo.
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Affiliation(s)
- Tingben Huang
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhou Yu
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Qiong Yu
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Yitong Chen
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhiwei Jiang
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Ying Wang
- Department of Oral Medicine, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Guoli Yang
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
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Effects of Magnetic Stimulation on Dental Implant Osseointegration: A Scoping Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This PRISMA-ScR driven scoping review aims to evaluate the influence of magnetic field stimulation on dental implant osseointegration. Seven databases were screened adopting ad-hoc strings. All clinical and preclinical studies analyzing the effects of magnetic fields on dental implant osseointegration were included. From 3124 initial items, on the basis of the eligibility criteria, 33 articles, regarding both Pulsed ElectroMagnetic Fields (PEMF) and Static magnetic Fields from permanent Magnets (SFM) were finally included and critically analyzed. In vitro studies showed a positive effect of PEMF, but contrasting effects of SFM on bone cell proliferation, whereas cell adhesion and osteogenic differentiation were induced by both types of stimulation. In vivo studies showed an increased bone-to-implant contact rate in different animal models and clinical studies revealed positive effects on implant stability, under magnetic stimulation. In conclusion, although positive effects of magnetic exposure on osteogenesis activity and osseointegration emerged, this scoping review highlighted the need for further preclinical and clinical studies. More standardized designs, accurate choice of stimulation parameters, adequate methods of evaluation of the outcomes, greater sample size and longer follow-ups are needed to clearly assess the effect of magnetic fields on dental implant osseointegration.
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Silva RCS, Agrelli A, Andrade AN, Mendes-Marques CL, Arruda IRS, Santos LRL, Vasconcelos NF, Machado G. Titanium Dental Implants: An Overview of Applied Nanobiotechnology to Improve Biocompatibility and Prevent Infections. MATERIALS (BASEL, SWITZERLAND) 2022; 15:3150. [PMID: 35591484 PMCID: PMC9104688 DOI: 10.3390/ma15093150] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023]
Abstract
This review addresses the different aspects of the use of titanium and its alloys in the production of dental implants, the most common causes of implant failures and the development of improved surfaces capable of stimulating osseointegration and guaranteeing the long-term success of dental implants. Titanium is the main material for the development of dental implants; despite this, different surface modifications are studied aiming to improve the osseointegration process. Nanoscale modifications and the bioactivation of surfaces with biological molecules can promote faster healing when compared to smooth surfaces. Recent studies have also pointed out that gradual changes in the implant, based on the microenvironment of insertion, are factors that may improve the integration of the implant with soft and bone tissues, preventing infections and osseointegration failures. In this context, the understanding that nanobiotechnological surface modifications in titanium dental implants improve the osseointegration process arouses interest in the development of new strategies, which is a highly relevant factor in the production of improved dental materials.
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Affiliation(s)
| | | | | | | | | | | | | | - Giovanna Machado
- Centro de Tecnologias Estratégicas do Nordeste-Cetene, Av. Prof. Luiz Freire, 01, Cidade Universitária, Recife CEP 50740-545, PE, Brazil; (R.C.S.S.); (A.A.); (A.N.A.); (C.L.M.-M.); (I.R.S.A.); (L.R.L.S.); (N.F.V.)
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29
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Retrospective Study of Biohorizons® Implants Placed by Postgraduate Students at the University of Barcelona. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12062958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The study aimed to evaluate the survival and failure rate, in the short- and medium-term, in addition to its relationship with risk factors, in implants placed by postgraduate students of the Master of Medicine, Surgery, and Oral Implantology course from the University of Barcelona. The study was designed including 192 patients with 422 implants placed between 2015 and 2018. Variables of implant failure were evaluated and related. Failure was split into early failure and late failure. Qualitative data were compared using the chi-squared test, taking p ≤ 0.05 as a significant value. The comparison of quantitative variables was carried out using the Student’s t-test for independent samples. The survival rate in a period of 6 months to 3 years was 97.87%. The mean age of the patients was (54.5 ± 13), and the largest number of implants were placed in the 51–60 age range. The failure rate was 2.13% (N = 9), 6 failed early and 3 failed after definitive prosthetic loading, with a p value < 0.0001. When comparing the failures according to their location in the anterior/posterior sector of the arch, the anterior sector showed statistically significant results (p = 0.027). Failed implants had a statistically significant relationship when they were placed in the anterior sector and were performed in the early stage.
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Schliephake H. The role of systemic diseases and local conditions as risk factors. Periodontol 2000 2022; 88:36-51. [PMID: 35103330 DOI: 10.1111/prd.12409] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Henning Schliephake
- Department of Oral Maxillofacial Surgery, University Medicine George-Augusta-University, Göttingen, Germany
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31
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Putra RH, Doi C, Yoda N, Astuti ER, Sasaki K. Current applications and development of artificial intelligence for digital dental radiography. Dentomaxillofac Radiol 2022; 51:20210197. [PMID: 34233515 PMCID: PMC8693331 DOI: 10.1259/dmfr.20210197] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
In the last few years, artificial intelligence (AI) research has been rapidly developing and emerging in the field of dental and maxillofacial radiology. Dental radiography, which is commonly used in daily practices, provides an incredibly rich resource for AI development and attracted many researchers to develop its application for various purposes. This study reviewed the applicability of AI for dental radiography from the current studies. Online searches on PubMed and IEEE Xplore databases, up to December 2020, and subsequent manual searches were performed. Then, we categorized the application of AI according to similarity of the following purposes: diagnosis of dental caries, periapical pathologies, and periodontal bone loss; cyst and tumor classification; cephalometric analysis; screening of osteoporosis; tooth recognition and forensic odontology; dental implant system recognition; and image quality enhancement. Current development of AI methodology in each aforementioned application were subsequently discussed. Although most of the reviewed studies demonstrated a great potential of AI application for dental radiography, further development is still needed before implementation in clinical routine due to several challenges and limitations, such as lack of datasets size justification and unstandardized reporting format. Considering the current limitations and challenges, future AI research in dental radiography should follow standardized reporting formats in order to align the research designs and enhance the impact of AI development globally.
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Affiliation(s)
| | - Chiaki Doi
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Sendai, Japan
| | - Nobuhiro Yoda
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Sendai, Japan
| | - Eha Renwi Astuti
- Department of Dentomaxillofacial Radiology, Faculty of Dental Medicine, Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo no 47, Surabaya, Indonesia
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Sendai, Japan
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Tabrizi R, Mohajerani H, Jafari S, Tümer MK. Does the serum level of vitamin D affect marginal bone loss around dental implants? Int J Oral Maxillofac Surg 2021; 51:832-836. [PMID: 34872836 DOI: 10.1016/j.ijom.2021.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 07/21/2021] [Accepted: 11/11/2021] [Indexed: 11/18/2022]
Abstract
Vitamin D is effective in bone healing. The aim of this study was to assess marginal bone loss (MBL) around dental implants in patients with sufficient and insufficient serum levels of vitamin D. This was a prospective cohort study with a pre-protocol population. Patients who underwent dental implantation in the first or second molar region and had a long-cone peri-apical digital radiograph taken at the time of loading and 12 months later were studied. Patients were assigned to one of three groups based on their serum vitamin D level: group 1, the serum level of vitamin D was deficient, group 2 insufficient, and group 3 sufficient. The marginal bone level change from immediately after loading to 12 months later was considered as MBL. Analysis of variance (ANOVA) was applied to compare MBL between the three groups. Ninety patients were included (30 in each group). The mean MBL was 1.38 ± 0.33 mm in group 1, 0.89 ± 0.16 mm in group 2, and 0.78 ± 0.12 mm in group 3. Analysis of the data demonstrated a significant difference in the mean MBL among the three groups (P < 0.001). There was a correlation between MBL and vitamin D serum levels (P < 0.001). It appears that a low serum level of vitamin D may be associated with increased MBL.
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Affiliation(s)
- R Tabrizi
- Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - H Mohajerani
- Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Jafari
- Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M K Tümer
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alanya Alaaddin Keykubat University, Alanya, Turkey
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da Costa RMB, Venante HS, Pordeus MD, Chappuis-Chocano AP, Neppelenbroek KH, Santiago Júnior JF, Porto VC. Does microwave disinfection affect the dimensional stability of denture base acrylic resins? A systematic review. Gerodontology 2021; 39:339-347. [PMID: 34661315 DOI: 10.1111/ger.12597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/17/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To systematically evaluate the effect of microwave disinfection on the dimensional stability of denture base acrylic resins. BACKGROUND Microwave disinfection has been considered as an alternative method for disinfecting complete dentures to help prevent and treat denture stomatitis. However, data on the impact of microwave disinfection on the dimensional stability of acrylic resins are still scarce. METHODS The PubMed/Medline, SCOPUS and EMBASE databases were searched in order to assess articles published in English up to January 2021 (CRD42021212267). We included studies that have assessed the effect of microwave disinfection, on the dimensional stability of acrylic resins, comparing them with negative or positive controls. RESULTS A total of seven in vitro studies were included. The qualitative synthesis demonstrated that, in general, microwave disinfection produced more distortion on the materials than do immersion in sodium hypochlorite, chloride solution, chlorhexidine, and water immersion. However, considering the dimensional stability of the specimens, microwave disinfection at 500 W for 3 minutes, and at 450 W for 5 minutes, produced similar or better outcomes than did control groups. CONCLUSION In general, microwave disinfection promotes changes in the dimensional stability of denture base acrylic resins, and should thus be used with caution. However, microwave disinfection protocols at lower power settings (500 and 450 W) and exposure times (3 and 5 minutes) produces similar or less distortion than chemical disinfection. More studies are still required in order to evaluate the clinical and long-term implications of microwave disinfection.
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Affiliation(s)
| | - Helena Sandrini Venante
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Mariana Domingues Pordeus
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Ana Paula Chappuis-Chocano
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Karin Hermana Neppelenbroek
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | - Vinicius Carvalho Porto
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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Cheng YT, Liao J, Zhou Q, Huo H, Zellmer L, Tang ZL, Ma H, Hong W, Liao DJ. Zoledronic acid modulates osteoclast apoptosis through activation of the NF-κB signaling pathway in ovariectomized rats. Exp Biol Med (Maywood) 2021; 246:1727-1739. [PMID: 33926259 PMCID: PMC8719043 DOI: 10.1177/15353702211011052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 03/24/2021] [Indexed: 01/22/2023] Open
Abstract
Bone mass loss (osteoporosis) seen in postmenopausal women is an adverse factor for implant denture. Using an ovariectomized rat model, we studied the mechanism of estrogen-deficiency-caused bone loss and the therapeutic effect of Zoledronic acid. We observed that ovariectomized-caused resorption of bone tissue in the mandible was evident at four weeks and had not fully recovered by 12 weeks post-ovariectomized compared with the sham-operated controls. Further evaluation with a TUNEL assay showed ovariectomized enhanced apoptosis of osteoblasts but inhibited apoptosis of osteoclasts in the mandible. Zoledronic acid given subcutaneously as a single low dose was shown to counteract both of these ovariectomized effects. Immunohistochemical staining showed that ovariectomized induced the protein levels of RANKL and the 65-kD subunit of the NF-κB complex mainly in osteoclasts, as confirmed by staining for TRAP, a marker for osteoclasts, whereas zoledronic acid inhibited these inductions. Western blotting showed that the levels of RANKL, p65, as well as the phosphorylated form of p65, and IκB-α were all higher in the ovariectomized group than in the sham and ovariectomized + zoledronic acid groups at both the 4th- and 12th-week time points in the mandible. These data collectively suggest that ovariectomized causes bone mass loss by enhancing apoptosis of osteoblasts and inhibiting apoptosis of osteoclasts. In osteoclasts, these cellular effects may be achieved by activating RANKL-NF-κB signalling. Moreover, zoledronic acid elicits its therapeutic effects in the mandible by counteracting these cellular and molecular consequences of ovariectomized.
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Affiliation(s)
- Yu-Ting Cheng
- School/Hospital of Stomatology, Guizhou Medical University, Guizhou 550004, P.R. China
| | - Jian Liao
- School/Hospital of Stomatology, Guizhou Medical University, Guizhou 550004, P.R. China
| | - Qian Zhou
- School/Hospital of Stomatology, Guizhou Medical University, Guizhou 550004, P.R. China
| | - Hua Huo
- School/Hospital of Stomatology, Guizhou Medical University, Guizhou 550004, P.R. China
| | - Lucas Zellmer
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Zheng-Long Tang
- School/Hospital of Stomatology, Guizhou Medical University, Guizhou 550004, P.R. China
| | - Hong Ma
- School/Hospital of Stomatology, Guizhou Medical University, Guizhou 550004, P.R. China
| | - Wei Hong
- Key Laboratory of Endemic and Ethnic Diseases, Guizhou Medical University, Ministry of Education, Guizhou 550004, P.R. China
| | - Dezhong Joshua Liao
- Department of Pathology, Guizhou Medical University School of Medicine, Guizhou 550004, P.R. China
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Chappuis Chocano AP, Venante HS, Bringel da Costa RM, Pordeus MD, Santiago Junior JF, Porto VC. Evaluation of the clinical performance of dentures manufactured by computer-aided technology and conventional techniques: A systematic review. J Prosthet Dent 2021; 129:547-553. [PMID: 34332774 DOI: 10.1016/j.prosdent.2021.06.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 11/19/2022]
Abstract
STATEMENT OF PROBLEM The introduction of computer-aided design and computer-aided manufacturing (CAD-CAM) technology for complete denture fabrication may have improved clinical outcomes compared with conventional techniques. However, systematic reviews comparing these techniques are lacking. PURPOSE The purpose of this systematic review was to identify, compare, and synthesize the outcomes of published clinical studies related to complete denture fabrication, with respect to the differences between CAD-CAM technology and conventional techniques. MATERIAL AND METHODS A comprehensive search of studies published up to March 16, 2020, was conducted by using the PubMed/MEDLINE, Web of Science, Cochrane Library, SciELO, and Embase databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement criteria and was registered in the International Prospective Register of Systematic Reviews (PROSPERO ID 42020202614). The population, intervention, comparison, and outcome (PICO) question was: Do CAD-CAM complete dentures have a similar functional performance to those fabricated by conventional techniques? The quality of publications was appraised by using the Critical Appraisal Skills Program (CASP) checklists. RESULTS Of the 1232 titles, 6 articles were selected. The studies reported better retention of digitally manufactured complete dentures without denture adhesives than that of conventional complete dentures with or without denture adhesives. Other studies reported that dentures manufactured with digital systems were better adapted to tissue surfaces, required less clinical time, were lower in cost, and provided better experience and satisfaction to patients. CONCLUSIONS The assessment of CAD-CAM planning and manufacturing through clinical studies is ongoing. However, preliminary results indicate better clinical performance and lower overall costs of digital complete dentures than conventional dentures.
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Affiliation(s)
- Ana Paula Chappuis Chocano
- PhD student, Department of Periodontics and Prosthodontics, Dental School of Bauru, FOB-USP, University of São Paulo, Bauru, São Paulo, Brazil
| | - Helena Sandrini Venante
- PhD student, Department of Periodontics and Prosthodontics, Dental School of Bauru, FOB-USP, University of São Paulo, Bauru, São Paulo, Brazil.
| | - Rodrigo Moreira Bringel da Costa
- PhD student, Department of Periodontics and Prosthodontics, Dental School of Bauru, FOB-USP, University of São Paulo, Bauru, São Paulo, Brazil
| | - Mariana Domingues Pordeus
- PhD student, Department of Periodontics and Prosthodontics, Dental School of Bauru, FOB-USP, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Vinicius Carvalho Porto
- Professor, Department of Periodontics and Prosthodontics, Dental School of Bauru, FOB-USP, University of São Paulo, Bauru, São Paulo, Brazil
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Bayram YE, Eskan MA. A fixed reconstruction of partially edentulous patient with systemic scleroderma: A 4.8-year follow-up case report. Clin Adv Periodontics 2021; 12:159-162. [PMID: 34212516 DOI: 10.1002/cap.10174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 06/19/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Systemic scleroderma (SSc) is a progressive autoimmune multisystem disease affecting several organs. In the oral cavity, its manifestations include enlarged periodontal ligament, xerostomia, microsomia, alveolar bone loss, and premature teeth loss. A removable prosthesis would not be a treatment option due to loss of hand dexterity, reduced chewing capacity, microsomia, and xerostomia in these patients. Alternatively, implant-supported fixed restorations are a plausible treatment for these patients. However, there is very limited literature showing implant survival rate in patients with SSc for a long follow-up. CASE PRESENTATION A 57-year-old female patient with SSc presented to our clinic. She was diagnosed with SSc 25 years ago. Initial clinical and radiological examination revealed that she showed slight to moderate chronic periodontitis, tooth cavities, remaining tooth tips, and a partial edentulism in the posterior areas. A total of seven implants were placed at different time points. The remaining upper teeth were crowned. At 4.8 years follow-up, the placed implants showed no sign of peri-implant disease. CONCLUSION This case report indicated that 4.8 years of follow-up revealed good oral hygiene and clinically or radiologically no sign of peri-implant disease around the implants in a patient with SSc. Implant-supported fixed restoration could be a viable treatment approach in these patients.
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Affiliation(s)
- Yeter Eylul Bayram
- Hamidiye Sisli Etfal Education and Research Hospital, Department of Internal Medicine, Istanbul, Turkey
| | - Mehmet Akif Eskan
- Clinic Eska, Istanbul, Turkey.,NOVA Southeastern University College of Dental Medicine, Department of Periodontics, Fort Lauderdale, Florida, USA
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Wada M, Mameno T, Otsuki M, Kani M, Tsujioka Y, Ikebe K. Prevalence and risk indicators for peri-implant diseases: A literature review. JAPANESE DENTAL SCIENCE REVIEW 2021; 57:78-84. [PMID: 34158874 PMCID: PMC8203834 DOI: 10.1016/j.jdsr.2021.05.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 03/18/2021] [Accepted: 05/23/2021] [Indexed: 02/08/2023] Open
Abstract
Peri-implant diseases are known as undesirable conditions that can occur after implant therapy. Although several risk indicators are becoming clear, the causes of peri-implant diseases have not been completely investigated. The purpose of this review was to summarize the prevalence and risk indicators for peri-implant diseases by referring to current papers from various angles. Many studies have reported the varied prevalence of peri-implant mucositis (23.9%-88.0% at the patient level and 9.7%-81.0% at the implant level) and peri-implantitis (8.9%-45% at the patient level and 4.8%-23.0% at the implant level). Additionally, several studies concluded that poor oral hygiene and lack of regular maintenance were strongly correlated with the development of both peri-implant mucositis and peri-implantitis. Diabetes and a history of periodontitis were revealed as risk indicators for peri-implantitis. However, there was no definitive conclusion about the correlations between peri-implant diseases and other factors such as smoking, the shape of the implant superstructure, and the condition of the keratinized mucosa. Further studies useful for evidence-based decision-making are needed for predictable implant therapy in the long term.
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Affiliation(s)
- Masahiro Wada
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Tomoaki Mameno
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Motohiro Otsuki
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan.,Private Dental Office, Japan
| | - Misako Kani
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Yoshitaka Tsujioka
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Kazunori Ikebe
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
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Mozzati M, Gallesio G, Menicucci G, Manzella C, Tumedei M, Del Fabbro M. Dental Implants with a Calcium Ions-Modified Surface and Platelet Concentrates for the Rehabilitation of Medically Compromised Patients: A Retrospective Study with 5-Year Follow-Up. MATERIALS 2021; 14:ma14112718. [PMID: 34064086 PMCID: PMC8196782 DOI: 10.3390/ma14112718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 01/07/2023]
Abstract
Background: Platelet concentrates are biological, autologous products obtained from the patient’s whole blood, consisting of a supraphysiological concentration of platelets and growth factors, that have proved beneficial in different applications in the medical and dental fields. They are used in several medical and dental applications to enhance tissue healing. Previous evidence shows that platelet concentrates may be beneficial in patients with compromised systemic conditions, in which the healing process is impaired. Aim: To evaluate the 5-year clinical outcome of implant treatment using acid-etched implants with calcium ions-modified surface in association with plasma rich in growth factors, in patients with systemic diseases of a different nature. Methods: Charts of 99 medically compromised patients, who had received a total of 224 dental implants from January 2013 to June 2013, were retrospectively evaluated. Patients were divided into four groups, according to their condition: diabetes (n = 39 patients), osteoporosis (n = 36), lupus erythematosus systemic (n = 5), rheumatoid arthritis (n = 19). The main outcomes were implant survival, marginal bone level (MBL) change and complications throughout follow-up. Results: Mean follow-up was 63.06 ± 1.90 months (range 60.1 to 66.4 months). In total, eight implants failed in 6 diabetic patients and 4 in 3 patients with rheumatoid arthritis. Overall 5-year implant survival was 94.6%. In total, 30 complications occurred in 24 patients, mostly transient, and no severe adverse event occurred. Overall MBL change was 0.45 ± 0.12 mm, with no significant differences among groups. Conclusions: In the present sample of medically compromised patients, rehabilitation with calcium ions-modified surface implants associated with plasma rich in growth factors proved to be a safe and effective treatment. The satisfactory results achieved after 5-year follow-up are comparable to those historically reported for healthy patients.
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Affiliation(s)
- Marco Mozzati
- Private Practitioner, SIOM Oral Surgery and Implantology Center, 10126 Turin, Italy; (M.M.); (G.G.)
| | - Giorgia Gallesio
- Private Practitioner, SIOM Oral Surgery and Implantology Center, 10126 Turin, Italy; (M.M.); (G.G.)
| | - Giulio Menicucci
- Prosthodontic Department, School of Dentistry, University of Turin, 10124 Turin, Italy; (G.M.); (C.M.)
| | - Carlo Manzella
- Prosthodontic Department, School of Dentistry, University of Turin, 10124 Turin, Italy; (G.M.); (C.M.)
| | - Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti, 66100 Chieti, Italy;
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, 20122 Milan, Italy
- IRCCS Orthopedic Institute Galeazzi, Dental Clinic, 20161 Milan, Italy
- Correspondence: ; Tel.: +39-02-50319950
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Mohammed AO, Kaklamanos EG. Effect of ovariectomy-induced osteoporosis on the amount of orthodontic tooth movement: a systematic review of animal studies. Eur J Orthod 2021; 43:672-681. [PMID: 33866368 DOI: 10.1093/ejo/cjab013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Understanding the impact of osteopenia and osteoporosis on orthodontic tooth movement could be of benefit to the orthodontist, but research in humans presents practical and ethical problems. The ovariectomized animal model could provide useful information on osteoporosis. OBJECTIVE To compare the amount of tooth movement during or after the application of orthodontic forces between ovariectomized animals and control or sham-operated subjects. SEARCH METHODS Unrestricted searches in seven databases and manual searching of the reference lists in relevant studies were performed up to February 2021 (PubMed, Central, Cochrane Database of Systematic Reviews, Scopus, Web of Science, Arab World Research Source, ProQuest Dissertations, and Theses Global). SELECTION CRITERIA We searched for studies quantitatively comparing the amount of tooth movement during or after the application of orthodontic forces between ovariectomized animals and control or sham-operated subjects. DATA COLLECTION AND ANALYSIS Following study retrieval and selection, relevant data were extracted, and the risk of bias was assessed using the SYRCLE's Risk of Bias Tool. Exploratory synthesis and meta-regression were carried out using the random effects model. RESULTS Thirteen studies were finally selected and no specific concerns regarding bias were identified. During the active period, ovariectomy was associated with a statistically significant acceleratory effect on the rate of orthodontic tooth movement compared to non-treated rats (3 weeks; 4 studies, 0.15 mm more movement in the ovariectomized rats; 95 per cent confidence interval: 0.10-0.19; P = 0.000). Exploratory meta-regression showed that this difference could increase over time. Following force discontinuation, no statistically significant differences were observed [3 weeks; 1 study (median ± SE), Ovariectomy group: 0.30 ± 0.04 mm; Sham operation group: 0.18 ± 0.03; P = 0.1558]. CONCLUSIONS Ovariectomy-induced osteoporosis may affect the rate of orthodontic tooth movement. Although animal studies should be approached with caution regarding their translational potential, the safe practice would suggest that one should consider potential implications. REGISTRATION PROSPERO (CRD42018118003).
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Affiliation(s)
- Ayesha O Mohammed
- Dubai Health Authority, Dubai, United Arab Emirates.,Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Eleftherios G Kaklamanos
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Biguetti CC, Junior JFS, Fiedler MW, Marrelli MT, Brotto M. The toxic effects of chloroquine and hydroxychloroquine on skeletal muscle: a systematic review and meta-analysis. Sci Rep 2021; 11:6589. [PMID: 33758324 PMCID: PMC7988151 DOI: 10.1038/s41598-021-86079-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 02/23/2021] [Indexed: 12/30/2022] Open
Abstract
The aim of this systematic review was to perform qualitative and quantitative analysis on the toxic effects of chloroquine (CQ) and hydroxychloroquine (HCQ) on skeletal muscles. We designed the study according to PRISMA guidelines. Studies for qualitative and quantitative analyses were selected according to the following inclusion criteria: English language; size of sample (> 5 patients), adult (> age of 18) patients, treated with CQ/HCQ for inflammatory diseases, and presenting and not presenting with toxic effects on skeletal muscles. We collected data published from 1990 to April 2020 using PubMed, Cochrane Library, EMBASE, and SciELO. Risk of bias for observational studies was assessed regarding the ROBIN-I scale. Studies with less than five patients (case reports) were selected for an additional qualitative analysis. We used the software Comprehensive Meta-Analysis at the confidence level of 0.05. We identified 23 studies for qualitative analysis (17 case-reports), and five studies were eligible for quantitative analysis. From case reports, 21 patients presented muscle weakness and confirmatory biopsy for CQ/HCQ induced myopathy. From observational studies, 37 patients out of 1,367 patients from five studies presented muscle weakness related to the use of CQ/HCQ, and 252 patients presented elevated levels of muscle enzymes (aldolase, creatine phosphokinase, and lactate dehydrogenase). Four studies presented data on 34 patients with confirmatory biopsy for drug-induced myopathy. No study presented randomized samples. The chronic use of CQ/HCQ may be a risk for drug-induced myopathy. There is substantiated need for proper randomized trials and controlled prospective studies needed to assess the clinical and subclinical stages of CQ/HCQ -induced muscle myopathy.
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Affiliation(s)
- Claudia Cristina Biguetti
- Bone-Muscle Research Center, College of Nursing & Health Innovation, University of Texas-Arlington, 655 W. Mitchell Street, Arlington, TX, 76010, USA
- Department of Bioengineering, University of Texas-Dallas, 800 W. Campbell Road, Richardson, TX, 75080, USA
| | | | - Matthew William Fiedler
- Bone-Muscle Research Center, College of Nursing & Health Innovation, University of Texas-Arlington, 655 W. Mitchell Street, Arlington, TX, 76010, USA
| | - Mauro Toledo Marrelli
- Bone-Muscle Research Center, College of Nursing & Health Innovation, University of Texas-Arlington, 655 W. Mitchell Street, Arlington, TX, 76010, USA
- Department of Epidemiology, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, São Paulo, SP, 01246‑904, Brazil
| | - Marco Brotto
- Bone-Muscle Research Center, College of Nursing & Health Innovation, University of Texas-Arlington, 655 W. Mitchell Street, Arlington, TX, 76010, USA.
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Korsch M, Marten SM, Stoll D, Prechtl C, Dötsch A. Microbiological findings in early and late implant loss: an observational clinical case-controlled study. BMC Oral Health 2021; 21:112. [PMID: 33706748 PMCID: PMC7948356 DOI: 10.1186/s12903-021-01439-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 02/14/2021] [Indexed: 12/30/2022] Open
Abstract
Background Implants are a predictable and well-established treatment method in dentistry. Nevertheless, looking at possible failures of dental implants, early and late loss have to be distinguished. The intent of the study was to report microbiological findings on the surface of implants with severe peri-implantitis, which had to be explanted. Methods 53 specimens of implants from 48 patients without severe general illnesses have been examined. The groups investigated were implants that had to be removed in the period of osseointegration (early loss, 13 patients with 14 implants) or after the healing period (late loss, 14 patients with 17 implants). The implant losses were compared with two control groups (implants with no bone loss directly after completed osseointegration, two to four months after implant placement (17 patients with 17 implants) and implants with no bone loss and prosthetic restoration for more than three years (5 patients with 5 implants)). Data about the bacteria located in the peri-implant sulcus was collected using amplification and high throughput sequencing of the 16S rRNA gene. Results The biofilm composition differed substantially between individuals. Both in early and late implant loss, Fusobacterium nucleatum and Porphyromonas gingivalis were found to be abundant. Late lost implants showed higher bacterial diversity and in addition higher abundances of Treponema, Fretibacterium, Pseudoramibacter and Desulfobulbus, while microbial communities of early loss implants were very heterogeneous and showed no significantly more abundant bacterial taxa. Conclusions Specific peri-implant pathogens were found around implants that were lost after a primarily uneventful osseointegration. P. gingivalis and F. nucleatum frequently colonized the implant in early and late losses and could therefore be characteristic for implant loss in general. In general, early lost implants showed also lower microbial diversity than late losses. However, the microbial results were not indicative of the causes of early and late losses.
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Affiliation(s)
- Michael Korsch
- Dental Academy for Continuing Professional Development, Karlsruhe, Lorenzstrasse 7, 76135, Karlsruhe, Germany. .,Center for Implantology and Oral Surgery, Berliner Straße 41, 69120, Heidelberg, Germany. .,Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421, Homburg, Germany.
| | - Silke-Mareike Marten
- Institute of Functional Interfaces, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Dominic Stoll
- Department of Safety and Quality of Fruit and Vegetables, Max Rubner-Institut, Karlsruhe, Germany
| | - Christopher Prechtl
- Dental Academy for Continuing Professional Development, Karlsruhe, Lorenzstrasse 7, 76135, Karlsruhe, Germany.,Center for Implantology and Oral Surgery, Berliner Straße 41, 69120, Heidelberg, Germany
| | - Andreas Dötsch
- Institute of Functional Interfaces, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany.,Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Karlsruhe, Germany
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42
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Koth VS, Salum FG, de Figueiredo MAZ, Cherubini K. Repercussions of osteoporosis on the maxillofacial complex: a critical overview. J Bone Miner Metab 2021; 39:117-125. [PMID: 33048242 DOI: 10.1007/s00774-020-01156-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/07/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION We present here a literature review focusing on the repercussions of osteoporosis on the oral and maxillofacial complex. Osteoporosis is a silent metabolic disorder characterized by reduced bone mineral density (BMD), which can lead to bone fractures, particularly affecting elderly women. The prevalence of this disease has increased significantly worldwide, and since it accelerates bone resorption also in the jaw bones, some attention has been paid to possible oral and maxillofacial manifestations. MATERIALS AND METHODS The databases PubMed and Google Scholar were searched for reports of oral and maxillofacial changes related to osteoporosis. RESULTS Several parameters evaluating bone changes in panoramic radiography have been proposed to estimate osteoporosis-related BMD loss, but they tend to warn about the possibility of osteoporosis, rather than being diagnostic criteria. Meanwhile, it seems that osteoporosis-related BMD loss could delay alveolar bone healing and potentiate bone loss in periodontal disease. CONCLUSION Even though orofacial bones are not compromised by osteoporosis as much as the axial/appendicular skeleton, a regular dental follow-up of osteoporotic patients is advised, especially in the case of periodontal disease and maxillofacial surgery. Further controlled longitudinal studies considering the site-specificity of osteogenesis would be helpful regarding this issue.
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Affiliation(s)
- Valesca Sander Koth
- School of Health and Life Sciences, Serviço de Estomatologia - Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-001, Brazil.
| | - Fernanda Gonçalves Salum
- School of Health and Life Sciences, Serviço de Estomatologia - Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-001, Brazil
| | - Maria Antonia Zancanaro de Figueiredo
- School of Health and Life Sciences, Serviço de Estomatologia - Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-001, Brazil
| | - Karen Cherubini
- School of Health and Life Sciences, Serviço de Estomatologia - Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-001, Brazil
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43
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Amengual-Peñafiel L, Córdova LA, Constanza Jara-Sepúlveda M, Brañes-Aroca M, Marchesani-Carrasco F, Cartes-Velásquez R. Osteoimmunology drives dental implant osseointegration: A new paradigm for implant dentistry. JAPANESE DENTAL SCIENCE REVIEW 2021; 57:12-19. [PMID: 33737990 PMCID: PMC7946347 DOI: 10.1016/j.jdsr.2021.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/30/2020] [Accepted: 01/14/2021] [Indexed: 01/08/2023] Open
Abstract
There is a complex interaction between titanium dental implants, bone, and the immune system. Among them, specific immune cells, macrophages play a crucial role in the osseointegration dynamics. Infiltrating macrophages and resident macrophages (osteomacs) contribute to achieving an early pro-regenerative peri-implant environment. Also, multinucleated giant cells (MNGCs) in the bone-implant interface and their polarization ability, maintain a peri-implant immunological balance to preserve osseointegration integrity. However, dental implants can display cumulative levels of antigens (ions, nano and microparticles and bacterial antigens) at the implant–tissue interface activating an immune-inflammatory response. If the inflammation is not resolved or reactivated due to the stress signals and the immunogenicity of elements present, this could lead implants to aseptic loosening, infections, and subsequent bone loss. Therefore, to maintain osseointegration and prevent bone loss of implants, a better understanding of the osteoimmunology of the peri-implant environment would lead to the development of new therapeutic approaches. In this line, depicting osteoimmunological mechanisms, we discuss immunomodulatory strategies to improve and preserve a long-term functional integration between dental implants and the human body. Scientific field of dental science: implant dentistry.
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Affiliation(s)
| | - Luis A Córdova
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Chile, Chile.,Department of Oral and Maxillofacial Surgery, Clínica Las Condes, Santiago, Chile.,Department of Oral and Maxillofacial Surgery, Complejo Hospitalario San José. Craneofacial Translational Research Laboratory, Faculty of Dentistry, University of Chile, Santiago, Chile
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44
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Pordeus MD, Santiago Junior JF, Venante HS, Bringel da Costa RM, Chappuis Chocano AP, Porto VC. Computer-aided technology for fabricating removable partial denture frameworks: A systematic review and meta-analysis. J Prosthet Dent 2021; 128:331-340. [PMID: 33581866 DOI: 10.1016/j.prosdent.2020.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 11/18/2022]
Abstract
STATEMENT OF PROBLEM A consensus that establishes the indications and clinical performance of removable partial denture (RPD) frameworks designed and manufactured with computer-aided design and computer-aided manufacturing (CAD-CAM) systems is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the currently published literature investigating different CAD-CAM methods and techniques for RPD manufacturing and their clinical performance. MATERIAL AND METHODS A comprehensive search of studies published up to September 2019 was performed in PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA Statement) criteria and was registered and approved in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020152197). The population, intervention, comparison, outcome (PICO) question was "Do the CAD-CAM frameworks have similar performances to those fabricated by conventional techniques?" The meta-analysis included clinical and in vitro studies based on the effect size and test of Null (2-Tail) with 95% confidence interval (CI). Clinical and in vitro studies were selected and analyzed separately. RESULTS A total of 15 articles out of 358 were selected. For clinical studies, quantitative analysis with a sample of 25 participants showed a mean discrepancy between occlusal rests and rest seats of 184.91 μm (95% CI: 152.6 μm-217.15 μm) and heterogeneity (I2) of 0%. Clinical data considered that frameworks were acceptable for continuity of treatment. The predominant materials were cobalt-chromium (Co-Cr) and polyetheretherketone (PEEK), and studies using Co-Cr reported that the structure required adjustments. In addition, it has been reported that the indirect technique was time-consuming and selective laser melting (SLM) can be costly. PEEK structures have been more widely accepted because of improved esthetics. Quantitative data from the in vitro studies revealed that the additive manufacturing technique (2.006 mm: 95% CI: -2.021 mm to 6.032 mm) was not significantly different from the indirect technique (0.026 mm; P=.455; random: I2: 98.402%). CONCLUSIONS Clinical studies and in vitro research on CAD-CAM planning and manufacturing of removable prosthesis frameworks are still sparse. However, preliminary data indicate a similar fit and esthetic improvement when compared with the conventional technique.
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Affiliation(s)
- Mariana Domingues Pordeus
- MSc student, Dental School of Bauru, FOB-USP - University of São Paulo, Octávio Pinheiro Brisolla, Jardim Brasil, Bauru, São Paulo, Brazil
| | | | - Helena Sandrini Venante
- PhD student, Dental School of Bauru, FOB-USP - University of São Paulo, Bauru, São Paulo, Brazil.
| | | | | | - Vinicius Carvalho Porto
- Associate Professor, Dental School of BauruFOB-USP - University of São Paulo, Bauru, São Paulo, Brazil
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45
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Ashrafi M, Ghalichi F, Mirzakouchaki B, Doblare M. On the effect of antiresorptive drugs on the bone remodeling of the mandible after dental implantation: a mathematical model. Sci Rep 2021; 11:2792. [PMID: 33531628 PMCID: PMC7854758 DOI: 10.1038/s41598-021-82502-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 01/12/2021] [Indexed: 01/30/2023] Open
Abstract
Bone remodeling identifies the process of permanent bone change with new bone formation and old bone resorption. Understanding this process is essential in many applications, such as optimizing the treatment of diseases like osteoporosis, maintaining bone density in long-term periods of disuse, or assessing the long-term evolution of the bone surrounding prostheses after implantation. A particular case of study is the bone remodeling process after dental implantation. Despite the overall success of this type of implants, the increasing life expectancy in developed countries has boosted the demand for dental implants in patients with osteoporosis. Although several studies demonstrate a high success rate of dental implants in osteoporotic patients, it is also known that the healing time and the failure rate increase, necessitating the adoption of pharmacological measures to improve bone quality in those patients. However, the general efficacy of these antiresorptive drugs for osteoporotic patients is still controversial, requiring more experimental and clinical studies. In this work, we investigate the effect of different doses of several drugs, used nowadays in osteoporotic patients, on the evolution of bone density after dental implantation. With this aim, we use a pharmacokinetic-pharmacodynamic (PK/PD) mathematical model that includes the effect of antiresorptive drugs on the RANK/RANK-L/OPG pathway, as well as the mechano-chemical coupling with external mechanical loads. This mechano-PK/PD model is then used to analyze the evolution of bone in normal and osteoporotic mandibles after dental implantation with different drug dosages. We show that using antiresorptive agents such as bisphosphonates or denosumab increases bone density and the associated mechanical properties, but at the same time, it also increases bone brittleness. We conclude that, despite the many limitations of these very complex models, the one presented here is capable of predicting qualitatively the evolution of some of the main biological and chemical variables associated with the process of bone remodeling in patients receiving drugs for osteoporosis, so it could be used to optimize dental implant design and coating for osteoporotic patients, as well as the drug dosage protocol for patient-specific treatments.
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Affiliation(s)
- Mehran Ashrafi
- grid.412345.50000 0000 9012 9027Faculty of Biomedical Engineering, Sahand University of Technology, Sahand New Town, Tabriz, Iran
| | - Farzan Ghalichi
- grid.412345.50000 0000 9012 9027Faculty of Biomedical Engineering, Sahand University of Technology, Sahand New Town, Tabriz, Iran
| | - Behnam Mirzakouchaki
- grid.412888.f0000 0001 2174 8913Tabriz Dental School, Orthodontic Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Manuel Doblare
- grid.11205.370000 0001 2152 8769Aragón Institute of Engineering Research (I3A), University of Zaragoza; Aragón Institute of Health Research (IIS-Aragón); Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), R&D Building, Block 5, 1st floor, Campus Rio Ebro, Mariano Esquillor s/n, 50018 Zaragoza, Spain
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46
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Yuan Q. [Oral implant treatment for elderly patients]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:616-621. [PMID: 33377336 DOI: 10.7518/hxkq.2020.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
With the advance of materials and technologies, modern oral implantology developed rapidly. Dental implant has become the first choice to restore the missing teeth. Although it achieves a high success rate among healthy adults, for elderly patients, with the decline of physical function and other systemic diseases, the risks of implant treatment increase accordingly. Doctors should pay more attention to the factors that may affect the implant treatment of the elderly and ways of preventing possible risks and complications. Here we discuss the specificity, success rate, effect of systemic diseases and drug considerations of implant treatments in elderly patients.
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Affiliation(s)
- Quan Yuan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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47
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Siqueira R, Ferreira JA, Rizzante FAP, Moura GF, Mendonça DBS, de Magalhães D, Cimões R, Mendonça G. Hydrophilic titanium surface modulates early stages of osseointegration in osteoporosis. J Periodontal Res 2020; 56:351-362. [PMID: 33368275 DOI: 10.1111/jre.12827] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/16/2020] [Accepted: 11/24/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Using a mouse osteoporotic model, this study aimed to determine the influence of hydrophilic titanium surfaces on gene expression and bone formation during the osseointegration process. BACKGROUND Based on the previous evidence, it is plausible to assume that osteoporotic bone has a different potential of bone healing. Therefore, implant surface modification study that aims at enhancing bone formation to further improve short- and long-term clinical outcomes in osteoporosis is necessary. MATERIAL AND METHODS Fifty female, 3-month-old mice were included in this study. Osteoporosis was induced by ovariectomy (OVX, test group) in 25 mice. The further 25 mice had ovaries exposed but not removed (SHAM, control group). Seven weeks following the ovariectomy procedures, one customized implant (0.7 × 8 mm) of each surface was placed in each femur for both groups. Implants had either a hydrophobic surface (SAE) or a hydrophilic treatment surface (SAE-HD). Calcium (Ca) and phosphorus (P) content was measured by energy-dispersive X-ray spectroscopy (EDS) after 7 days. The femurs were analyzed for bone-to-implant contact (BIC) and bone volume fraction (BV) by nano-computed tomography (nano-CT) after 14 and 28 days. Same specimens were further submitted to histological analysis. Additionally, after 3 and 7 days, implants were removed and cells were collected around the implant to access gene expression profile of key osteogenic (Runx2, Alp, Sp7, Bsp, Sost, Ocn) and inflammatory genes (IL-1β, IL-10, Tnf-α, and Nos2) by qRT-PCR assay. Statistical analysis was performed by ANOVA and paired t test with significance at P < .05. RESULTS The amount of Ca and P deposited on the surface due to the mineralization process was higher for SAE-HD compared to SAE on the intra-group analysis. Nano-CT and histology revealed more BV and BIC for SAE-HD in SHAM and OVX groups compared to SAE. Analysis in OVX group showed that most genes (ie, ALP, Runx2) involved in the bone morphogenetic protein (BMP) signaling were significantly activated in the hydrophilic treatment. CONCLUSION Both surfaces were able to modulate bone responses toward osteoblast differentiation. SAE-HD presented a faster response in terms of bone formation and osteogenic gene expression compared to SAE. Hydrophilic surface in situations of osteoporosis seems to provide additional benefits in the early stages of osseointegration.
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Affiliation(s)
- Rafael Siqueira
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Jessica Afonso Ferreira
- Department of Periodontology and Implant Dentistry, School of Dentistry, Federal University of Uberlandia, Uberlândia, Brazil.,Department of Biological and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Fábio Antônio Piola Rizzante
- Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Guilherme Faria Moura
- Department of Periodontology and Implant Dentistry, School of Dentistry, Federal University of Uberlandia, Uberlândia, Brazil.,Department of Biological and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | | | - Denildo de Magalhães
- Department of Periodontology and Implant Dentistry, School of Dentistry, Federal University of Uberlandia, Uberlândia, Brazil
| | - Renata Cimões
- Department of Prosthesis and Maxillofacial Surgery, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Gustavo Mendonça
- Department of Biological and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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48
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Tabrizi R, Mousavi F, Ghasemi S, Ozkan BT. Does osteoporosis increase marginal bone loss around dental implants in the posterior of the maxilla? Int J Oral Maxillofac Surg 2020; 50:964-968. [PMID: 33376042 DOI: 10.1016/j.ijom.2020.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/25/2020] [Accepted: 12/03/2020] [Indexed: 01/09/2023]
Abstract
Osteoporosis is caused by an imbalance in bone remodelling. The aim of this study was to compare the marginal bone loss (MBL) around dental implants placed in the posterior maxilla between osteoporotic and non-osteoporotic female patients. This was a prospective cohort study. Female patients needing a dental implant restoration in the posterior maxilla were included. Dual-energy X-ray absorptiometry was performed and the T-score recorded. MBL was measured at 12 months after loading. The patients were assigned to one of two groups: group 1, osteoporotic (T-score ≥2.5); group 2, non-osteoporotic (T-score <2.5). In this study, osteoporosis was the primary predictor variable and MBL was the outcome variable. The mean MBL was compared between the two groups using an independent t-test. Pearson's correlation test was applied to identify any correlation between the T-score and MBL. Ninety female patients were studied, 44 in group 1 and 46 in group 2. The mean MBL was 1.20±0.29mm in group 1 and 0.87±0.15 in group 2; this difference in mean MBL was statistically significant (P=0.001). There was a correlation between T-score and MBL (P=0.001). Despite the correlation between T-score and MBL, this study did not provide enough evidence to prove any causal relationship between MBL and osteoporosis.
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Affiliation(s)
- R Tabrizi
- Oral and Maxillofacial Surgery Department, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - F Mousavi
- Oral and Maxillofacial Surgery Department, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Ghasemi
- Universitat Internacional de Catalunya, Barcelona, Spain
| | - B T Ozkan
- Institute of Health Science, Toros University, Mersin, Turkey
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49
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Diachkova E, Abramova EV, Blagushina NA, Tarasenko S. Surgical treatment with dental implants in a patient with secondary loss of teeth and osteoporosis caused by an imbalance of vitamin D. BMJ Case Rep 2020; 13:13/11/e235585. [PMID: 33257353 DOI: 10.1136/bcr-2020-235585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
In recent years, the success of long-term dental implants has remained problematic, especially because of the increasing rate of mineral balance changes in patients with partial loss of teeth, regardless of their age, race and sex. This article describes the experience of 6 years of treatment with dental implants in a patient with secondary loss of tooth and mineral imbalance (osteopenia) due to vitamin D deficiency, in collaboration with endocrinologist. Along with basic dental care, special medicine was prescribed for this pathology. The bone system was monitored through regular blood tests, skeletal bone densitometry and X-ray of the maxillofacial region. This management plan allowed dental implants to be maintained in good condition for 7 years.
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Affiliation(s)
- Ekaterina Diachkova
- Dental Surgery, I M Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Elizaveta V Abramova
- Dental Surgery, I M Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Natalia A Blagushina
- Dental Surgery, I M Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Svetlana Tarasenko
- Dental Surgery, I M Sechenov First Moscow State Medical University, Moscow, Russian Federation
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50
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Basudan AM, Shaheen MY, Niazy AA, van den Beucken JJJP, Jansen JA, Alghamdi HS. Histomorphometric Evaluation of Peri-Implant Bone Response to Intravenous Administration of Zoledronate (Zometa ®) in an Osteoporotic Rat Model. MATERIALS (BASEL, SWITZERLAND) 2020; 13:ma13225248. [PMID: 33233722 PMCID: PMC7699926 DOI: 10.3390/ma13225248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/10/2020] [Accepted: 11/18/2020] [Indexed: 06/11/2023]
Abstract
We evaluated the response to peri-implant bone placed in the femoral condyle of osteoporotic rats, following intravenous zoledronate (ZOL) treatment in three settings: pre-implantation (ZOL-Pre), post-implantation (ZOL-Post), and pre- + post-implantation (ZOL-Pre+Post). Twenty-four female Wistar rats were ovariectomized (OVX). After 12 weeks, the rats received titanium implants in the right femoral condyle. ZOL (0.04 mg/kg, weekly) was administered to six rats 4 weeks pre-implantation and was stopped at implant placement. To another six rats, ZOL was given post-implantation and continued for 6 weeks. Additional six rats received ZOL treatment pre- and post-implantation. Control animals received weekly saline intravenous injections. At 6 weeks post-implantation, samples were retrieved for histological evaluation of the percentage of bone area (%BA) and of the percentage of bone-to-implant contact (%BIC). BA% for ZOL-Pre (29.6% ± 9.0%) and ZOL-Post (27.9% ± 5.6%) rats were significantly increased compared to that of the controls (17.3% ± 3.9%, p < 0.05). In contrast, ZOL-Pre+Post rats (20.4% ± 5.0%) showed similar BA% compared to Saline controls (p = 0.731). BIC% revealed a significant increase for ZOL-Post (65.8% ± 16.9%) and ZOL-Pre+Post (68.3% ± 10.0%) rats compared with that of Saline controls (43.3% ± 9.6%, p < 0.05), while ZOL-Pre rats (55.6% ± 19%) showed a BIC% comparable to that of Saline controls (p = 0.408). Our results suggest that receiving intravenous ZOL treatment before or after implant placement enhances peri-implant bone responses in terms of bone area. However, the effect of different ZOL treatment regimens on BIC% was found to be inconclusive.
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Affiliation(s)
- Amani M. Basudan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11451, Saudi Arabia; (A.M.B.); (M.Y.S.)
| | - Marwa Y. Shaheen
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11451, Saudi Arabia; (A.M.B.); (M.Y.S.)
| | - Abdurahman A. Niazy
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh 11451, Saudi Arabia;
| | | | - John A. Jansen
- Department of Dentistry-Biomaterials, Radboudumc, 6500HB Nijmegen, The Netherlands; (J.J.J.P.v.d.B.); (J.A.J.)
| | - Hamdan S. Alghamdi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11451, Saudi Arabia; (A.M.B.); (M.Y.S.)
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