1
|
Emfietzoglou R, Dereka X. Survival Rates of Short Dental Implants (≤6 mm) Used as an Alternative to Longer (>6 mm) Implants for the Rehabilitation of Posterior Partial Edentulism: A Systematic Review of RCTs. Dent J (Basel) 2024; 12:185. [PMID: 38920886 PMCID: PMC11202938 DOI: 10.3390/dj12060185] [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: 03/25/2024] [Revised: 05/30/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
Short dental implants have been proposed as an alternative treatment option to bone regeneration procedures for the rehabilitation of resorbed alveolar ridges. The aim of this paper was to systematically review randomized controlled trials (RCTs) comparing short implants (≤6 mm) and longer implants (>6 mm) in atrophic alveolar ridges in terms of implant survival rates, peri-implant marginal bone loss (MBL), prevalence of peri-implantitis and technical complications. A thorough electronic search was performed until September 2023. RCTs with follow-up of at least 1-year post-loading comparing short implants with rough surfaces to longer implants in the posterior jaws of systemically and periodontally healthy, partially edentulous adults were considered. Studies with incomplete information on the number of patients, follow-up or definition of "short implants" were excluded. The revised Cochrane risk-of-bias tool for randomized trials was used for Risk of bias assessment. Fixed-effects meta-analysis of the selected studies was applied to compare the outcome variables. Random-effect meta-analysis was performed, on the basis of within-study comparisons. In total, 16 articles were selected for meta-analysis and incorporated 408 short implants and 475 longer implants inserted in 317 and 388 patients, respectively. The survival rates of longer implants in pristine or augmented bone were significantly increased compared to short implants (95%CI: 2-5%, p < 0.001). Standard-length implants displayed increased, although non-statistically significant MBL (95%CI: -0.17-0.04, p > 0.05), and prevalence of peri-implantitis (95%CI: 0-5%, p > 0.05). No statistically significant differences were observed between short and long implants in terms of technical complications (implant-level 95%CI: -4-6%, p > 0.05). Short implants represent a promising alternative treatment option for the rehabilitation of posterior jaws to avoid additional bone augmentation procedures. Nonetheless, they should be selected cautiously due to a potentially limited survival rate compared to longer implants. A major limitation of this study is the variability in the included studies regarding sample size, patient profile, type of bone, loading protocol, definition of peri-implantitis, among others. This study received no external funding. The study protocol was registered in PROSPERO (CRD42023485514).
Collapse
|
2
|
Hu Z, Yang F, Xiang P, Luo Z, Liang T, Xu H. Effect of polydimethylsiloxane surface morphology on osteogenic differentiation of mesenchymal stem cells through SIRT1 signalling pathway. Proc Inst Mech Eng H 2024; 238:537-549. [PMID: 38561625 DOI: 10.1177/09544119241242964] [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: 04/04/2024]
Abstract
Constructing surface topography with a certain roughness is a widely used, non-toxic, cost-effective and effective method for improving the microenvironment of cells, promoting the proliferation and osteogenic differentiation of mesenchymal stem cells (MSCs), and promoting the osseointegration of grafts and further improving their biocompatibility under clinical environmental conditions. SIRT1 plays an important regulatory role in the osteogenic differentiation of bone marrow-derived MSCs (BM-MSCs). However, it remains unknown whether SIRT1 plays an important regulatory role in the osteogenic differentiation of BM-MSCs with regard to surface morphology. Polydimethylsiloxane (PDMS) with different surface morphologies were prepared using different grits of sandpaper. The value for BMSCs added on different surfaces was detected by cell proliferation assays. RT-qPCR and Western blotting were performed to detect SIRT1 activation and osteogenic differentiation of MSCs. Osteogenesis of MSCs was detected by alkaline phosphatase (ALP) and alizarin red S staining. SIRT1 inhibition experiments were performed to investigate the role of SIRT1 in the osteogenic differentiation of MSCs induced by surface morphology. We found that BM-MSCs have better value and osteogenic differentiation ability on a surface with roughness of PDMS-1000M. SIRT1 showed higher gene and protein expression on a PDMS-1000M surface with a roughness of 13.741 ± 1.388 µm. The promotion of the osteogenic differentiation of MSCs on the PDMS-1000M surface was significantly decreased after inhibiting SIRT1 expression. Our study demonstrated that a surface morphology with certain roughness can activate the SIRT1 pathway of MSCs and promote the osteogenic differentiation of BMSCs via the SIRT1 pathway.
Collapse
Affiliation(s)
- Zezun Hu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, P.R. China
- Orthopedic Institute, Medical College, Soochow University, Suzhou, Jiangsu, P.R. China
| | - Fanlei Yang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, P.R. China
- Orthopedic Institute, Medical College, Soochow University, Suzhou, Jiangsu, P.R. China
| | - Pan Xiang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, P.R. China
- Orthopedic Institute, Medical College, Soochow University, Suzhou, Jiangsu, P.R. China
| | - Zongping Luo
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, P.R. China
| | - Ting Liang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, P.R. China
- Orthopedic Institute, Medical College, Soochow University, Suzhou, Jiangsu, P.R. China
| | - Hao Xu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, P.R. China
- Orthopedic Institute, Medical College, Soochow University, Suzhou, Jiangsu, P.R. China
| |
Collapse
|
3
|
Jia P, Tang Y, Niu L, Qiu L. Clinical and radiographic outcomes of a combined surgery approach to treat peri-implantitis. Int J Oral Maxillofac Surg 2024; 53:333-342. [PMID: 38154998 DOI: 10.1016/j.ijom.2023.11.013] [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: 01/12/2023] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 12/30/2023]
Abstract
Peri-implant infra-bony defects are difficult to treat, and data on the management of peri-implantitis are lacking. The aim of this study was to evaluate the effect of a combined surgical approach to manage peri-implantitis: implantoplasty with xenogeneic bone grafting and a concentrated growth factor membrane. Two independent examiners analysed the medical records and radiographs taken before surgery and at the last follow-up. Data were analysed at the implant level; some patient-level data (age, sex, smoking habit) were also considered. Linear regression analysis with generalized estimating equations (GEE) was used to explore the effect of variables of interest (including marginal bone level (MBL)) on implantitis treatment success and resolution rates. The effect of the prosthesis type on postoperative clinical and radiographic parameters was also explored by GEE, with adjustment for age, sex, tooth site, location, follow-up duration, and implant length (model IV including all). Thirty patients with 72 implants were investigated. The implant survival rate was 100% over a mean observation period of 3.3 years (range 2-11 years). The treatment success rate (bone loss <0.5 mm, no bleeding on probing (BOP), no suppuration, probing depth (PD) < 5 mm) was higher in females than males (50% vs 19.0%; P = 0.008). At the last postoperative follow-up, the MBL (1.51 ± 1.07 vs 4.01 ± 1.13 mm), PD (3.61 ± 0.84 vs 6.54 ± 1.01 mm), and BOP (23.38 ± 23.18% vs 79.17 ± 15.51%) were significantly reduced when compared to pre-surgery values (all P < 0.001). Furthermore, a significantly higher PD reduction (β = -1.10 mm, 95% confidence interval -1.97 to -0.23 mm, P = 0.014) was observed for implants with a single crown than a full-arch prosthesis (GEE model IV). Preliminary clinical and radiographic data indicate that implantoplasty in combination with surgery could be an effective treatment option for peri-implantitis.
Collapse
Affiliation(s)
- P Jia
- Fourth Division, Peking University School and Hospital of Stomatology, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China; Research Center of Engineering and Technology for Digital Dentistry of the Ministry of Health, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Y Tang
- Fourth Division, Peking University School and Hospital of Stomatology, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China; Research Center of Engineering and Technology for Digital Dentistry of the Ministry of Health, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - L Niu
- Fourth Division, Peking University School and Hospital of Stomatology, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China; Research Center of Engineering and Technology for Digital Dentistry of the Ministry of Health, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - L Qiu
- Fourth Division, Peking University School and Hospital of Stomatology, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China; Research Center of Engineering and Technology for Digital Dentistry of the Ministry of Health, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China.
| |
Collapse
|
4
|
Carvalhaes JM, Ponzoni D, Tonini KR, de Carvalho PSP. Clinical study on the association between keratinized mucosa and peri-implant health when external hexagon implants are installed in the posterior region of the maxilla and mandible: a cohort study. Int J Oral Maxillofac Surg 2024; 53:231-238. [PMID: 37468344 DOI: 10.1016/j.ijom.2023.06.007] [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: 09/13/2022] [Revised: 06/25/2023] [Accepted: 06/28/2023] [Indexed: 07/21/2023]
Abstract
This study evaluated the association between keratinized mucosa (KM) and peri-implant health of external hexagon implants in the posterior region in 84 patients with 242 implants. Modified plaque index (MPI), modified sulcular bleeding index (MSBI), probing depth (PD), keratinized mucosa (KM) width, and peri-implant bone loss were evaluated. The implants were divided according to the KM: (1) absence of KM, (2) KM width >0 and <2 mm, and (3) KM width ≥2 mm. Of the 242 implants evaluated, 63 (26.0%) had no KM band, 56 (23.1%) had KM width <2 mm, and 123 (50.8%) had KM width ≥2 mm. One hundred and sixty-seven (69.0%) were used in multiple unit restorations and 75 (31.0%) in single tooth restorations; 66.9% were placed in the mandible and 33.1% in the maxilla. For single tooth and multiple unit implant restorations, MPI (P=0.069 and P=0.387, respectively), MSBI (P=0.695 and P=0.947, respectively), PD (P=0.270 and P=0.258, respectively), and mesial bone loss (P=0.121 and P=0.239, respectively) were not affected by the KM width. On the distal surface, bone loss was influenced by the absence of KM when single tooth implant restorations were used (P=0.032). No association was found between KM width and the peri-implant tissue health.
Collapse
Affiliation(s)
- J M Carvalhaes
- Brazilian Association of Dentistry, Maceió, Alagoas, Brazil
| | - D Ponzoni
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil.
| | - K R Tonini
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - P S P de Carvalho
- Bauru School of Dentistry, University of São Paulo - USP, Bauru, São Paulo, Brazil
| |
Collapse
|
5
|
Mattila V, Wilkman T, Avellán NL, Mesimäki K, Furuholm J, Ruokonen H, Nylund K. Survival of dental implants and occurrence of mucosal overgrowth in patients with head and neck cancer treated with/without radiotherapy and mucosal graft-two-year follow-up. Clin Oral Investig 2024; 28:117. [PMID: 38273180 PMCID: PMC10811186 DOI: 10.1007/s00784-023-05479-0] [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: 06/13/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024]
Abstract
OBJECTIVES The primary aim of the present study was to compare head and neck cancer treatment modality surgery and surgery with radiotherapy or chemoradiotherapy alone for dental implant (DI) survival. The second aim was to evaluate the prevalence of mucosal overgrowth around DI after treatment with or without mucosal grafts. MATERIALS AND METHODS An observational retrospective study consisted of 59 patients with malignant head and neck tumors that received DI between 2015 and 2019. Treatment modalities together with information on oral rehabilitation with DI, prevalence of mucosal overgrowth, and precursor lesions were gathered from the hospital records. Radiation doses were determined using a sum of three-dimensional dose distributions. RESULTS Overall DI survival rate was 88%, in irritated jaw 89%, and in nonirradiated jaw 88% in this observational period (p = 0.415, mean follow-up was 2 years 10 months, range 9-82 months). Mucosal overgrowth was found in 42 of 196 implants (21%), of which 36 cases (86%) were associated in grafted areas (p < 0.001). Oral lichen planus/lichenoid reaction was diagnosed in 14 of all 59 (24%) oral cancer patients. CONCLUSION Implant survival was not significantly influenced by radiation therapy in this observational period. In grafted bone, implant survival was significantly inferior than in native bone. Mucosal overgrowth around implants was more common in mucosal grafted areas versus nongrafted. CLINICAL RELEVANCE This study demonstrates the impact of grafted bone to dental implant survival rate and mucosal overgrowth.
Collapse
Affiliation(s)
- Viivi Mattila
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Tommy Wilkman
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Nina-Li Avellán
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karri Mesimäki
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jussi Furuholm
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Hellevi Ruokonen
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karita Nylund
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| |
Collapse
|
6
|
Sanjuán M, Brizuela-Velasco A, Gil J, Cerrolaza M, Montalvillo E, Fernández-Hernández S, Robles D. Hybrid surface implants: Influence of residual stress on mechanical behavior, evaluated by finite element analysis and validation by fatigue tests. Dent Mater 2024; 40:9-18. [PMID: 37858421 DOI: 10.1016/j.dental.2023.10.002] [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: 06/22/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVES To determine the influence of different surface roughness and residual stress of hybrid surface implants on their behavior and mechanical failure. METHODS Three types of implants with different surface roughness were used as specimens: smooth, rough, and hybrid. A diffractometer was used to determine the residual stress of the implants according to their different surface treatment. These results were used as an independent variable in a finite element analysis that compared the three specimens to determine the von Mises stress transferred to the implants and supporting bone and the resulting microdeformations. Flexural strength and fatigue behavior tests were performed to compare the results of the three types of implants. RESULTS Higher residual stress values were found for rough surfaces (p < 0.05, Student's t-test) compared to smooth surfaces, and both types of stress were different for the two types of hybrid implant surfaces. Finite element analysis found different von Mises stress and microdeformation results, both at the level of the implant and the bone, for the three types of implants under study. These results were correlated with the different flexural strength behaviors (lower resistance for hybrids and higher for rough surfaces, p < 0.05) and fatigue behavior (the rough implant had the longest fatigue life, while the hybrid implant exhibited the worst fatigue behavior). SIGNIFICANCE The results show a trend toward a less favorable mechanical behavior of the hybrid implants related to the retention of different residual stresses caused by the surface treatment.
Collapse
Affiliation(s)
- Marta Sanjuán
- Bioengineering Institute of Technology, International University of Catalonia, Barcelona, Spain
| | - Aritza Brizuela-Velasco
- DENS-ia Research Group, Faculty of Health Sciences, Miguel de Cervantes European University, Valladolid, Spain.
| | - Javier Gil
- Bioengineering Institute of Technology, International University of Catalonia, Barcelona, Spain
| | - Miguel Cerrolaza
- Bioengineering Institute of Technology, International University of Catalonia, Barcelona, Spain
| | - Enrique Montalvillo
- Bioengineering Institute of Technology, International University of Catalonia, Barcelona, Spain; DENS-ia Research Group, Faculty of Health Sciences, Miguel de Cervantes European University, Valladolid, Spain
| | - Saray Fernández-Hernández
- DENS-ia Research Group, Faculty of Health Sciences, Miguel de Cervantes European University, Valladolid, Spain
| | - Daniel Robles
- DENS-ia Research Group, Faculty of Health Sciences, Miguel de Cervantes European University, Valladolid, Spain
| |
Collapse
|
7
|
Kesar N, Weigl P, Nentwig GH, Krebs M. Prevalence and risk of peri-implant diseases based on the type of prosthetic restoration: A retrospective study after 17 to 23 years. J Prosthet Dent 2023; 130:690-697. [PMID: 35016794 DOI: 10.1016/j.prosdent.2021.11.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM Information on the epidemiology and etiopathology of peri-implant diseases in reference to prostheses is sparse. PURPOSE The purpose of this retrospective clinical study was to analyze the prevalence and risk of peri-implant diseases based on the type of prosthesis. MATERIAL AND METHODS A total of 274 implants in 106 patients were evaluated by clinical and radiological examination. Peri-implant mucositis was defined by bleeding on probing, whereas peri-implantitis was defined by additional bone loss ≥1.5 mm since seating of the definitive prosthesis. Prosthetic design and anamnestic risk factors were assessed in a regression analysis, whereas clinical and radiological differences between the prosthesis groups were compared by the Pearson chi-squared test (α=.05 for all procedures). RESULTS The median observation period was 18 years. Seventy-two implants were restored with single crowns, 138 implants with fixed partial dentures, and 64 implants with removable prostheses. Peri-implant mucositis was diagnosed more often in implants supporting fixed partial dentures (42.8%), whereas peri-implantitis was found more frequently in implants supporting removable prostheses (31.3%) (overall distribution pattern: P<.001). The type of prosthetic restoration was confirmed to be an independent prognostic risk factor regarding peri-implant diseases (P=.005). Additionally, increased bone loss was found with implant-supported removable prostheses, regardless of peri-implantitis (P<.001). CONCLUSIONS The type of prosthetic restoration was identified as an independent risk factor for the development of peri-implant diseases. Particularly, implants supporting double crown-retained removable prostheses might be at risk.
Collapse
Affiliation(s)
- Nikolina Kesar
- Doctoral Graduate, Department of Oral Surgery and Implantology, Center for Dentistry and Oral Medicine (Carolinum), University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Paul Weigl
- Head, Department of Postgraduate Education, Center for Dentistry and Oral Medicine (Carolinum), University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Georg-Hubertus Nentwig
- Former Head and Professor Emeritus, Department of Oral Surgery and Implantology, Center for Dentistry and Oral Medicine (Carolinum), University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Mischa Krebs
- Consultant, Department of Oral Surgery and Implantology, Center for Dentistry and Oral Medicine (Carolinum), University Hospital Frankfurt, Frankfurt am Main, Germany; Private practice, Alzey, Germany.
| |
Collapse
|
8
|
Donos N, Akcali A, Padhye N, Sculean A, Calciolari E. Bone regeneration in implant dentistry: Which are the factors affecting the clinical outcome? Periodontol 2000 2023; 93:26-55. [PMID: 37615306 DOI: 10.1111/prd.12518] [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: 02/10/2023] [Revised: 07/08/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
The key factors that are needed for bone regeneration to take place include cells (osteoprogenitor and immune-inflammatory cells), a scaffold (blood clot) that facilitates the deposition of the bone matrix, signaling molecules, blood supply, and mechanical stability. However, even when these principles are met, the overall amount of regenerated bone, its stability over time and the incidence of complications may significantly vary. This manuscript provides a critical review on the main local and systemic factors that may have an impact on bone regeneration, trying to focus, whenever possible, on bone regeneration simultaneous to implant placement to treat bone dehiscence/fenestration defects or for bone contouring. In the future, it is likely that bone tissue engineering will change our approach to bone regeneration in implant dentistry by replacing the current biomaterials with osteoinductive scaffolds combined with cells and mechanical/soluble factors and by employing immunomodulatory materials that can both modulate the immune response and control other bone regeneration processes such as osteogenesis, osteoclastogenesis, or inflammation. However, there are currently important knowledge gaps on the biology of osseous formation and on the factors that can influence it that require further investigation. It is recommended that future studies should combine traditional clinical and radiographic assessments with non-invasive imaging and with patient-reported outcome measures. We also envisage that the integration of multi-omics approaches will help uncover the mechanisms responsible for the variability in regenerative outcomes observed in clinical practice.
Collapse
Affiliation(s)
- Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aliye Akcali
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Periodontology, Faculty of Dentistry, Dokuz Eylul University, Izmir, Turkey
| | - Ninad Padhye
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Medicine and Dentistry, Dental School, University of Parma, Parma, Italy
| |
Collapse
|
9
|
D’Addazio G, Manciocchi E, Tafuri G, Schiavone R, Murmura G, Mavriqi L, Sinjari B, Caputi S. Long-Term Efficacy of Chlorhexidine Gel in Single-Crown Implant Rehabilitation: A Five-Year Follow-Up Study. Dent J (Basel) 2023; 11:228. [PMID: 37886913 PMCID: PMC10605130 DOI: 10.3390/dj11100228] [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: 07/27/2023] [Revised: 09/07/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
Chlorhexidine digluconate (CHX) has shown the ability to significantly reduce inflammation and marginal bone loss (MBL) at the 1-year follow-up but limited data exist regarding its long-term efficacy in peri-implant stability. The objective was to compare the long-term effects (5 years of follow-up) of a placebo gel (16 patients in Group A) or a 0.20% CHX gel (15 patients in Group B) used at each previous surgical and prosthetic stage. Control visits were conducted in 2022, investigating the long-term effects by biological, radiological, and clinical evaluation. The data were statistically analyzed. The research achieved a 96.7% implant success rate over five years, but 41.9% of patients did not attend annual oral hygiene check-ups. The average MBL was 1.04 ± 0.39 mm, with no significant differences between the two groups. Notably, patients who attended regular periodontal check-ups experienced significantly less MBL than those who did not (p < 0.05). At five years, direct effects of CHX were absent, with both groups showing moderate bone loss. However, the results suggest that early disinfection could enhance both short- and long-term outcomes. In fact, patients with initial minor MBL due to use of CHX, preserve this advantage also after 5 years of follow-up. Additionally, the data underscore the importance of annual check-ups in early detection and management of biological complications.
Collapse
Affiliation(s)
- Gianmaria D’Addazio
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (E.M.); (G.T.); (R.S.); (G.M.); (S.C.)
- Electron Microscopy Laboratory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Eugenio Manciocchi
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (E.M.); (G.T.); (R.S.); (G.M.); (S.C.)
- Electron Microscopy Laboratory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Giuseppe Tafuri
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (E.M.); (G.T.); (R.S.); (G.M.); (S.C.)
- Electron Microscopy Laboratory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Ruggero Schiavone
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (E.M.); (G.T.); (R.S.); (G.M.); (S.C.)
| | - Giovanna Murmura
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (E.M.); (G.T.); (R.S.); (G.M.); (S.C.)
- Electron Microscopy Laboratory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Luan Mavriqi
- Department of Dentistry, Albanian University, 1001 Tirana, Albania;
| | - Bruna Sinjari
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (E.M.); (G.T.); (R.S.); (G.M.); (S.C.)
- Electron Microscopy Laboratory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Sergio Caputi
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (E.M.); (G.T.); (R.S.); (G.M.); (S.C.)
- Electron Microscopy Laboratory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| |
Collapse
|
10
|
Sadowsky SJ. Peri-implantitis after 40 years: Evidence, mechanisms, and implications: A mapping review. J Prosthet Dent 2023:S0022-3913(23)00114-2. [PMID: 36935269 DOI: 10.1016/j.prosdent.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 03/19/2023]
Abstract
STATEMENT OF PROBLEM The high prevalence of peri-implantitis (PI) continues to plague patients and the disease is resistant to present treatment regimens. An analysis of the available research is lacking. PURPOSE Given the abundance and diversity of research on the topic of PI, the purpose of this mapping review was to synthesize the literature on the prevention of PI, the histopathology of the disease, the state of present therapeutics, and any emerging treatments. MATERIAL AND METHODS An extensive literature search was undertaken by using the electronic databases of PubMed, Web of Science, and Science Direct. The keyword strings were peri-implantitis, dental implant, risk assessment, histopathology, prosthesis design, and treatment. The filters applied were time interval from 2000 to 2002; language, English. RESULTS A total of 3635 articles were taken from PubMed, 3686 articles from Web of Science, and 2450 articles from Science Direct. After applying the inclusion and exclusion criteria to the titles and abstracts of selected investigations, 214 studies were retrieved. CONCLUSIONS The evidence reflects a concerning incidence of PI, without a predictable treatment protocol. An in-depth patient risk assessment considering risk modification, emphasis on surgical and restorative expertise, and strict recall and maintenance is essential to minimize PI.
Collapse
Affiliation(s)
- Steven J Sadowsky
- Professor, Preventive and Restorative Department, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, Calif.
| |
Collapse
|
11
|
Ravidà A, Samal A, Qazi M, Webber LP, Wang HL, Galindo-Moreno P, Borgnakke WS, Saleh MHA. Interproximal implant thread exposure after initial bone remodeling as a risk indicator for peri-implantitis. J Periodontol 2022. [PMID: 36576085 DOI: 10.1002/jper.22-0499] [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: 08/22/2022] [Revised: 11/26/2022] [Accepted: 11/26/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Due to the clinical challenges involved in successfully treating peri-implantitis, it is imperative to identify patient- and implant-level risk factors for its prevention. The main goal of this retrospective longitudinal radiographic and clinical study was to investigate whether interproximal radiographic implant thread exposure after physiological bone remodeling may be a risk factor for peri-implantitis. The secondary goal was to evaluate several other potential risk indicators. METHODS Of 4325 active dental school patients having implants placed, 165 partially edentulous adults (77 men, 88 women) aged 30-91 with ≥2 years of follow-up upon implant restoration were included. Implants with ≥1 interproximal thread exposed (no bone-to-implant contact) (n = 98, 35%) constituted the test group and those without exposed threads (n = 182, 65%) the control group. Descriptive, binary, and multivariate regression analyses were evaluated for goodness of fit. Wald tests were used to evaluate for significance set at 0.05. RESULTS Of the 280 implants (98 test, 182 control), 8 (2.9%) failed over a mean follow-up period of 7.67 (±2.63) years, and 27 implants (19 test, 8 control) developed peri-implantitis, with the exposed group having eight-fold (7.82 times) adjusted greater odds than the non-exposed. The risk increased four-fold (3.77 times) with each thread exposed. No other patient- or implant-related potentially confounding risk factors were identified. CONCLUSIONS Exposed interproximal implant threads after physiologic bone remodeling may be an independent risk indicator for incident peri-implantitis. Hence, clinicians should closely monitor patients with implant threads that have no bone-to-implant contact for incident peri-implantitis.
Collapse
Affiliation(s)
- Andrea Ravidà
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Ankita Samal
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Musa Qazi
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Liana Preto Webber
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Hom-Lay Wang
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implantology, University of Granada, Granada, Spain
| | - Wenche S Borgnakke
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
12
|
Kniha K, Hermanns-Sachweh B, Al-Sibai F, Kneer R, Möhlhenrich SC, Heitzer M, Hölzle F, Modabber A. Effect of thermal osteonecrosis around implants in the rat tibia: numerical and histomorphometric results in context of implant removal. Sci Rep 2022; 12:22227. [PMID: 36564495 PMCID: PMC9789117 DOI: 10.1038/s41598-022-25581-9] [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] [Received: 09/16/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022] Open
Abstract
The purpose of this rat study was to explore the feasibility of in vivo temperature thresholds affecting bone contact at the implant surface. Based on these data, thermal necrosis should be used for implant removal in the subsequent in vivo study. Rat tibiae of 48 animals at one site were randomly treated with heat or cold before implant insertion. Temperatures of 4 °C, 3 °C, 2 °C, 48 °C, 49 °C and 50 °C for a tempering time of 1 min were evaluated. Numerical simulations of the heat source-implant-bone system were carried out. Effects were assessed by histomorphometrical measurements. The results showed that the selected method of direct tempering using a tempering pin was suitable for maintaining a uniform layer around the pin. Starting at warm temperatures of 48 °C and rising to 50 °C, the BIC ratio revealed declining values and a significant difference was observed when comparing 50 °C to the control group (p = 0.03). However, there were no significant variations within the cold temperatures. This study pinpointed temperature discovered that could lead to the thermo-explantation and so that the number of samples used in future studies on temperature-induced bone necrosis can be reduced to a minimum. Significant BIC value reduction was seen at a temperature of 50 °C for 1 min.
Collapse
Affiliation(s)
- Kristian Kniha
- grid.412301.50000 0000 8653 1507Department of Oral and Cranio-Maxillofacial Surgery, University Hospital, RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany ,Private Clinic for Oral Surgery Dres. Kniha, Rosental 6, 80331 Munich, Germany
| | - Benita Hermanns-Sachweh
- Private Institute for Implant Pathology, ZBMT, Campus Melaten, Pauwelsstaße 17, Aachen, Germany
| | - Faruk Al-Sibai
- grid.1957.a0000 0001 0728 696XInstitute of Heat and Mass Transfer, RWTH Aachen University, Augustinerbach 6, Aachen, Germany
| | - Reinhold Kneer
- grid.1957.a0000 0001 0728 696XInstitute of Heat and Mass Transfer, RWTH Aachen University, Augustinerbach 6, Aachen, Germany
| | - Stephan Christian Möhlhenrich
- grid.412581.b0000 0000 9024 6397Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455 Witten, Germany
| | - Marius Heitzer
- grid.412301.50000 0000 8653 1507Department of Oral and Cranio-Maxillofacial Surgery, University Hospital, RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany
| | - Frank Hölzle
- grid.412301.50000 0000 8653 1507Department of Oral and Cranio-Maxillofacial Surgery, University Hospital, RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany
| | - Ali Modabber
- grid.412301.50000 0000 8653 1507Department of Oral and Cranio-Maxillofacial Surgery, University Hospital, RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany
| |
Collapse
|
13
|
Monje A, Kan JY, Borgnakke W. Impact of local predisposing/precipitating factors and systemic drivers on peri‐implant diseases. Clin Implant Dent Relat Res 2022. [PMID: 36533411 DOI: 10.1111/cid.13155] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/01/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Strong evidence suggests the infectious nature of peri-implant diseases occurring in susceptible hosts. Epidemiological reports, though, indicate that peri-implantitis is a site-specific entity. Hence, the significance of local factors that may predispose/precipitate plaque accumulation and the impact of systemic drivers that alter the immune response are relevant in the prevention and management of peri-implant disorders. PURPOSE The purpose of the present review is to shed light on the significance of local and systemic factors on peri-implant diseases, making special emphasis on the associations with peri-implantitis. METHODS The biologic plausibility and supporting evidence aiming at providing a concluding remark were explored in the recent scientific literature for local predisposing/precipitating factors and systemic drivers related to peri-implant diseases. RESULTS Local predisposing factors such as soft tissue characteristics, implant position and prosthetic design proved being strongly associated with the occurrence of peri-implant diseases. Hard tissue characteristics, however, failed to demonstrate having a direct association with peri-implant diseases. Robust data points toward the strong link between residual sub-mucosal cement and peri-implant diseases, while limited data suggests the impact of residual sub-mucosal floss and peri-implantitis. Systemic drivers/habits such as hyperglycemia and smoking showed a strong negative impact on peri-implantitis. However, there is insufficient evidence to claim for any link between metabolic syndrome, atherosclerotic cardiovascular disease, and obesity and peri-implant diseases. CONCLUSION Local predisposing/precipitating factors and systemic drivers may increase the risk of peri-implant diseases. Therefore, comprehensive anamnesis of the patients, educational/motivational programs and exhaustive prosthetically-driven treatment planning must be fostered aiming at reducing the rate of biological complications in implant dentistry.
Collapse
Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine University of Michigan Ann Arbor Michigan USA
- Department of Periodontology Universitat Internacional de Catalunya Barcelona Spain
- Department of Periodontology, ZMK University of Bern Bern CH Switzerland
| | - Joseph Y. Kan
- Department of Implantology Loma Linda University Loma Linda California USA
| | - Wenche Borgnakke
- Department of Periodontology and Oral Medicine University of Michigan Ann Arbor Michigan USA
| |
Collapse
|
14
|
Shirazi S, Ravindran S, Cooper LF. Topography-mediated immunomodulation in osseointegration; Ally or Enemy. Biomaterials 2022; 291:121903. [PMID: 36410109 PMCID: PMC10148651 DOI: 10.1016/j.biomaterials.2022.121903] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
Osteoimmunology is at full display during endosseous implant osseointegration. Bone formation, maintenance and resorption at the implant surface is a result of bidirectional and dynamic reciprocal communication between the bone and immune cells that extends beyond the well-defined osteoblast-osteoclast signaling. Implant surface topography informs adherent progenitor and immune cell function and their cross-talk to modulate the process of bone accrual. Integrating titanium surface engineering with the principles of immunology is utilized to harness the power of immune system to improve osseointegration in healthy and diseased microenvironments. This review summarizes current information regarding immune cell-titanium implant surface interactions and places these events in the context of surface-mediated immunomodulation and bone regeneration. A mechanistic approach is directed in demonstrating the central role of osteoimmunology in the process of osseointegration and exploring how regulation of immune cell function at the implant-bone interface may be used in future control of clinical therapies. The process of peri-implant bone loss is also informed by immunomodulation at the implant surface. How surface topography is exploited to prevent osteoclastogenesis is considered herein with respect to peri-implant inflammation, osteoclastic precursor-surface interactions, and the upstream/downstream effects of surface topography on immune and progenitor cell function.
Collapse
Affiliation(s)
- Sajjad Shirazi
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA.
| | - Sriram Ravindran
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Lyndon F Cooper
- School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA.
| |
Collapse
|
15
|
Attik N, Phantarasmy M, Abouelleil H, Chevalier C, Barraco A, Grosgogeat B, Lafon A. Comparison of the Biological Behavior and Topographical Surface Assessment of a Minimally Invasive Dental Implant and a Standard Implant: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15217540. [PMID: 36363140 PMCID: PMC9655689 DOI: 10.3390/ma15217540] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/03/2022] [Accepted: 10/20/2022] [Indexed: 05/31/2023]
Abstract
The current study aimed to assess the topographical and physical properties of a minimally invasive implant (MagiCore®: MC®, InnosBioSurg, IBS) and to evaluate its biological behavior compared to a gold standard implant (NobelParallel™: NB™, Nobel Biocare™). After surface characterization, the biological behavior assessment was conducted regarding human gingival fibroblasts (hGF) and osteoblast-like cells (MG63). Roughness values for NBTM were Ra = 1.28 µm and for MC® they were Ra = 2.02 µm. Alamar BlueTM assay LIVE/DEADTM staining results indicated equivalent biological development regarding both cell types for the two implants. Significant enhancement was found for hGF ALP activity in the presence of the two tested implants in a time-dependent manner from day 7 to day 14 (** p < 0.01). Alizarin red staining demonstrated significant calcium deposition enhancement when cells were interfaced with the NB™ compared to the MC® implant (** p < 0.05). Moreover, SEM and confocal imaging revealed good cell adhesion with a denser cellular layer on the MC® than the NB™ surface. The MC® cytocompatibility was ranked as equivalent to the gold standard implant despite the surface properties differences. These findings provide new insights about the minimally invasive implant’s biological behavior and its potential clinical implication in different implantology situations.
Collapse
Affiliation(s)
- Nina Attik
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69622 Villeurbanne, France
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69372 Lyon, France
| | - Marina Phantarasmy
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69372 Lyon, France
| | - Hazem Abouelleil
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69622 Villeurbanne, France
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69372 Lyon, France
| | - Charlène Chevalier
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69622 Villeurbanne, France
| | - Aurore Barraco
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69622 Villeurbanne, France
- Hospices Civils de Lyon, Service d’Odontologie, 69003 Lyon, France
| | - Brigitte Grosgogeat
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69622 Villeurbanne, France
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69372 Lyon, France
- Hospices Civils de Lyon, Service d’Odontologie, 69003 Lyon, France
| | - Arnaud Lafon
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69622 Villeurbanne, France
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69372 Lyon, France
- Hospices Civils de Lyon, Service d’Odontologie, 69003 Lyon, France
| |
Collapse
|
16
|
He F, Li J, Wang Y, Li Z, Wang L, Li Y, Chen H, Wang C, Liu B, Ma P, Dong G, Zhou P. Design of Cefotaxime Sodium-Loaded Polydopamine Coatings with Controlled Surface Roughness for Titanium Implants. ACS Biomater Sci Eng 2022; 8:4751-4763. [PMID: 36191062 DOI: 10.1021/acsbiomaterials.2c00702] [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: 11/28/2022]
Abstract
The success rate of dental implants is limited by peri-implant infection and insufficient osseointegration. Therefore, reducing the occurrence of peri-implantitis and promoting osseointegration are in demand. A roughened surface has commonly been applied to improve the osseointegration of implants, but it will accelerate the attachment of bacteria. We have developed novel antibiotic-decorated titanium (Ti) surfaces by the immobilization of dopamine and cefotaxime sodium (CS) simultaneously. Moreover, the surface roughness of the polydopamine (PDA)/CS coating was controlled by the changes in polymerization times as determined by atomic force microscopy. Then, all antibiotic-grafted Ti surfaces could effectively prevent the adhesion and proliferation of both Escherichia coli and Streptococcus mutans in comparison to the pristine control. For the culture and osteogenic differentiation of human umbilical mesenchymal stem cells (hUMSCs) on the substrate surface, PDA/CS coating with polymerization times less than 30 min showed acceptable biocompatibility, but the upregulation of marker genes and proteins was detected when the polymerization time was more than 30 min. Moreover, the best calcium deposition results were found in the 30 min PDA/CS group with or without the addition of osteogenic factors. Therefore, our PDA/CS coating with a polymerization time of 30 min holds great potential to design dental implants with dual bacteriostatic and osteogenic properties.
Collapse
Affiliation(s)
- Fei He
- School and Hospital of Stomatology, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou 730000, Gansu, P. R. China.,Key Laboratory of Mechanics on Disaster and Environment in Western China, Ministry of Education, College of Civil Engineering and Mechanics, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou 730000, Gansu, P. R. China
| | - Jing Li
- School and Hospital of Stomatology, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou 730000, Gansu, P. R. China
| | - Yixi Wang
- School and Hospital of Stomatology, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou 730000, Gansu, P. R. China
| | - Zhipeng Li
- School and Hospital of Stomatology, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou 730000, Gansu, P. R. China
| | - Lu Wang
- School and Hospital of Stomatology, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou 730000, Gansu, P. R. China
| | - Yuchen Li
- School and Hospital of Stomatology, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou 730000, Gansu, P. R. China
| | - Huiling Chen
- School and Hospital of Stomatology, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou 730000, Gansu, P. R. China
| | - Chenggang Wang
- School and Hospital of Stomatology, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou 730000, Gansu, P. R. China
| | - Bin Liu
- School and Hospital of Stomatology, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou 730000, Gansu, P. R. China
| | - Peng Ma
- School and Hospital of Stomatology, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou 730000, Gansu, P. R. China
| | - Genxi Dong
- School and Hospital of Stomatology, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou 730000, Gansu, P. R. China
| | - Ping Zhou
- School and Hospital of Stomatology, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou 730000, Gansu, P. R. China.,Department of Orthopedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen Street, Lanzhou 730030, Gansu, P. R. China
| |
Collapse
|
17
|
Afshari Z, Yaghini J, Naseri R. LEVELS OF SMOKING AND PERI‑IMPLANT MARGINAL BONE LOSS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2022; 22:101721. [PMID: 36162899 DOI: 10.1016/j.jebdp.2022.101721] [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: 07/06/2021] [Revised: 02/09/2022] [Accepted: 03/13/2022] [Indexed: 10/18/2022]
Abstract
AIM This systematic review and meta-analysis sought to determine if there was a significantly enhanced risk of peri‑implant marginal bone loss (MBL) due to the increased number of cigarettes smoked per day. MATERIALS AND METHODS Six databases, including Medline, Embase, Cochrane Library, Web of Science, Scopus, and ProQuest, were searched until February, 2021. The search terms "dental implant, oral implant, smoking, smoker, non-smoker, marginal bone loss and crestal bone loss" were used in combination to seek the articles providing data for MBL related to the smoking habit. Articles were excluded if the quantity of cigarettes smoked per day was not reported. Random-effects meta-analyses were used to pool the estimates of mean difference (MD) with 95% confidence intervals (CI). RESULTS Eight studies were included for qualitative and 5 for quantitative synthesis. The meta-analyses revealed higher levels of MBL in patients who smoked <10 or >10 cigarettes/day than in non-smokers (<10: (MD -0.33, 95% CI -0.69-0.03 and >10: MD -0.58, 95% CI -0.96- -0.19). There was a significant risk of MBL between patients who smoked >10 and <10 cigarettes/day (MD -0.23, 95% CI -0.47-0.01). CONCLUSION It seems the risk of MBL is steadily increasing as daily smoking increases.
Collapse
Affiliation(s)
- Zohreh Afshari
- Dental Implants Research Center, Department of Periodontics, Dental research institute, School of dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jaber Yaghini
- Dental Implants Research Center, Department of Periodontics, Dental research institute, School of dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roohollah Naseri
- Dental Research Center, Department of Periodontics, Dental Research Institute, School of Dentistry, Isfahan University of Medical Science, Isfahan, Iran.
| |
Collapse
|
18
|
Coyac BR, Wolf BJ, Bahat DJ, Arioka M, Brunski JB, Helms JA. A WNT protein therapeutic accelerates consolidation of a bone graft substitute in a pre-clinical sinus augmentation model. J Clin Periodontol 2022; 49:782-798. [PMID: 35713219 DOI: 10.1111/jcpe.13674] [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: 10/20/2021] [Revised: 04/28/2022] [Accepted: 05/28/2022] [Indexed: 11/30/2022]
Abstract
AIM Autologous bone grafts consolidate faster than bone graft substitutes (BGSs) but resorb over time, which compromises implant support. We hypothesized that differences in consolidation rates affected the mechanical properties of grafts and implant stability, and tested whether a pro-osteogenic protein, liposomal WNT3A (L-WNT3A), could accelerate graft consolidation. MATERIALS AND METHODS A transgenic mouse model of sinus augmentation with immunohistochemistry, enzymatic assays, and histology were used to quantitatively evaluate the osteogenic properties of autografts and BGSs. Composite and finite element modelling compared changes in the mechanical properties of grafts during healing until consolidation, and secondary implant stability following remodelling activities. BGSs were combined with L-WNT3A and tested for its osteogenic potential. RESULTS Compared with autografts, BGSs were bioinert and lacked osteoprogenitor cells. While in autografted sinuses, new bone arose evenly from all living autograft particles, new bone around BGSs solely initiated at the sinus floor, from the internal maxillary periosteum. WNT treatment of BGSs resulted in significantly higher expression levels of pro-osteogenic proteins (Osterix, Collagen I, alkaline phosphatase) and lower levels of bone-resorbing activity (tartrate-resistant acid phosphatase activity); together, these features culminated in faster new bone formation, comparable to that of an autograft. CONCLUSIONS WNT-treated BGSs supported faster consolidation, and because BGSs typically resist resorption, their use may be superior to autografts for sinus augmentation.
Collapse
Affiliation(s)
- Benjamin R Coyac
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA.,Department of Periodontology and Implant Dentistry, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Benjamin J Wolf
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
| | - Daniel J Bahat
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
| | - Masaki Arioka
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
| | - John B Brunski
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
| | - Jill A Helms
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
| |
Collapse
|
19
|
Collins JR, Ogando BP, Hong H, Hou W, Romanos GE. Clinical and Radiographic Evaluation of a Novel Triangular Implant Neck Design: A Case Series. Dent J (Basel) 2022; 10:dj10060113. [PMID: 35735655 PMCID: PMC9221962 DOI: 10.3390/dj10060113] [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: 05/06/2022] [Revised: 06/06/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023] Open
Abstract
The objective of this study was to evaluate the clinical and radiographic behavior of a novel triangular neck implant configuration in partially edentulous patients. Sixteen patients with a mean age of 58.3 years, were rehabilitated with 25 implants inserted in the healed sites of the maxilla and mandible; implant diameter was Ø3.3 and 3.9 mm. Clinical and radiographic measurements were first performed at prosthesis delivery that served as baseline; they were further evaluated after a mean period of 15.6 months. The interproximal peri-implant bone levels were the primary outcome; the mesial and distal data were recorded and a mean value was calculated. Secondary outcomes included peri-implant probing depth (PPD) and bleeding on probing (BoP). The paired t-test was used to compare the radiographic and clinical outcomes between baseline and follow-up. The mean bone levels at the mesial and distal aspects at baseline were 0.45 (0.47) and 0.57 (0.69), respectively; at follow-up they were 0.59 (0.42) and 0.78 (0.59), respectively. The differences were not statistically significant. Similarly, no significant differences were found for the clinical parameters. Within the limitations of the present study, it could be concluded that this new triangular neck bone level implant macro-design was used successfully to treat partially edentulous patients. Larger controlled clinical studies are warranted to confirm the present radiographic and clinical findings.
Collapse
Affiliation(s)
- James Rudolph Collins
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM), Santo Domingo 10109, Dominican Republic; (J.R.C.); (B.P.O.)
| | - Brendha P. Ogando
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM), Santo Domingo 10109, Dominican Republic; (J.R.C.); (B.P.O.)
| | - Houlin Hong
- School of Public Health & Health Policy, City University of New York, New York, NY 10031, USA;
| | - Wei Hou
- Department of Family, Population and Preventive Medicine, School of Medicine, Stony Brook University, New York, NY 11794, USA;
| | - Georgios E. Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, New York, NY 11794, USA
- Correspondence:
| |
Collapse
|
20
|
Stavropoulos A, Bertl K, Winning L, Polyzois I. What is the influence of implant surface characteristics and/or implant material on the incidence and progression of peri-implantitis? A systematic literature review. Clin Oral Implants Res 2021; 32 Suppl 21:203-229. [PMID: 34642989 DOI: 10.1111/clr.13859] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/06/2021] [Accepted: 04/27/2021] [Indexed: 12/09/2022]
Abstract
OBJECTIVES To answer the focused question, 'In animals or patients with dental implants, does implant surface characteristics and/or implant material have an effect on incidence and progression of peri-implantitis?' MATERIAL AND METHODS Pre-clinical in vivo experiments on experimental peri-implantitis and clinical trials with any aim and design, and ≥5 years follow-up, where the effect of ≥2 different type of implant material and/or surface characteristics on peri-implantitis incidence or severity, and/or progression, implant survival or losses due to peri-implantitis, and/or marginal bone levels/loss was assessed. RESULTS Meta-analyses based on data of pre-clinical experiments, using the ligature induced peri-implantitis model in the dog, indicated that after the spontaneous progression phase implants with a modified surface showed significantly greater radiographic bone loss (effect size 0.44 mm; 95%CI 0.10-0.79; p = .012; 8 publications) and area of infiltrated connective tissue (effect size 0.75 mm2 ; 95%CI 0.15-1.34; p = .014; 5 publications) compared to non-modified surfaces. However, in 9 out of the 18 included experiments, reported in 25 publications, no significant differences were shown among the different implant surface types assessed. Clinical and/or radiographic data from 7605 patients with 26,188 implants, reported in 31 publications (20 RCTs, 3 CTs, 4 prospective cohort, and 4 retrospective studies; 12 with follow-up ≥10 years), overall did not show significant differences in the incidence of peri-implantitis, when this was reported or could be inferred, among the various implant surfaces. In general, high survival rates (90-100%) up to 30 years and no clinically relevant differences in marginal bone loss/levels, merely compatible with crestal remodelling, were presented for the various implant types. CONCLUSION Pre-clinical in vivo experiments indicate that surface characteristics of modified implants may have a significant negative impact on peri-implantitis progression, while clinical studies do not support the notion that there is a difference in peri-implantitis incidence among the various types of implant surfaces. No assumptions can be made regarding the possible impact of implant material on incidence and/or peri-implantitis progression due to limited information.
Collapse
Affiliation(s)
- Andreas Stavropoulos
- Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland.,Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Lewis Winning
- Department of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Ioannis Polyzois
- Department of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| |
Collapse
|
21
|
Kc K, Bhattarai BP, Shrestha S, Shrestha B, Shrestha M. EFFECT OF LOCALLY DELIVERED BISPHOSPHONATES ON ALVEOLAR BONE: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2021; 21:101580. [PMID: 34479678 DOI: 10.1016/j.jebdp.2021.101580] [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: 10/11/2020] [Revised: 02/23/2021] [Accepted: 04/10/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To assess the effect of locally applied bisphosphonate drugs on alveolar bone defects caused by periodontitis and marginal bone level after placement of dental implants. MATERIALS AND METHODS Three electronic databases (PubMed/MEDLINE, Web of Science, and Scopus) were searched from January 2010 until May 2020 for randomized controlled clinical trials reporting the effect of locally delivered bisphosphonates on alveolar bone. The risk of bias was assessed and quantitative synthesis was conducted with both fixed and random-effects meta-analyses by using RevMan version 5.3. Subgroup and sensitivity analyses were performed whenever required. RESULTS Among the included studies, the effect of locally delivered bisphosphonates on alveolar bone regeneration in periodontitis was measured by 15 studies and on marginal bone level after installation of dental implants by three studies. Bisphosphonates showed significantly higher intrabony defect depth reduction than placebo/control in vertical bone defects treated with non-surgical approach (MD = 1.69mm; 95% CI, 1.32-2.05; P < 0.00001; I²=93%) or surgical approach (MD = 0.70mm; 95% CI, 0.23-1.16; P = 0.003; I² = 78%) and in class II furcation defects treated with non-surgical approach (MD = 1.61mm; 95% CI, 1.15-2.07; P < 0.00001; I² = 99%) or surgical approach (MD = 0.24mm; 95% CI, 0.05-0.42; P = 0.01; I² = 62%). Clinical attachment loss increased by 1.39mm (95% CI, 0.92-1.85; P < 0.01; I²=93%) and 1mm (95% CI, 0.75-1.26; P < 0.001; I² = 0%) in vertical bone defects after non-surgical and surgical treatments, respectively, and by 1.95mm (95% CI, 1.37-2.53; P < 0.00001; I² = 96%) and 0.84mm (95% CI, 0.58-1.10; P < 0.01, I² = 47%) after non-surgical and surgical treatment in class II furcation defects, respectively. Lesser marginal bone loss during pre-loading (MD = -0.18 mm; 95% CI, -0.24- -0.12; P<0.00001; I²=0%) and 1-year post-loading (MD = -0.33 mm; 95% CI, -0.59-0.07; P = 0.01; I² = 0%) periods was observed when bisphosphonate coated dental implants were used. CONCLUSION Locally delivered bisphosphonates induce bone regeneration in periodontal defects and decrease the rate of marginal bone loss after dental implant therapy.
Collapse
Affiliation(s)
- Kumar Kc
- BDS, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Bishwa Prakash Bhattarai
- BDS, MScD, Department of Clinical Dentistry, Walailak University International College of Dentistry, Bangkok, Thailand
| | - Shilu Shrestha
- BDS, MDS, Department of Periodontology, People's Dental College and Hospital, Kathmandu, Nepal.
| | - Bijaya Shrestha
- BPT, MPH, Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Manash Shrestha
- BDS, MPH, Department of society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| |
Collapse
|
22
|
Windael S, Collaert B, De Buyser S, De Bruyn H, Vervaeke S. Early peri-implant bone loss as a predictor for peri-implantitis: A 10-year prospective cohort study. Clin Implant Dent Relat Res 2021; 23:298-308. [PMID: 34076941 DOI: 10.1111/cid.13000] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 03/06/2021] [Accepted: 04/01/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE To evaluate the effect of early bone loss (EBL), on long-term bone stability and future peri-implantitis development. MATERIALS AND METHODS Patients referred for implant placement between 2005 and 2009 were consecutively treated and followed for 10 years. After 10 years, patients were invited for a scientific diagnostic visit to evaluate implant survival and bone loss. Bone level changes were compared with baseline. Non-parametric testing was performed in cross-tabs (Pearson Chi-square and Fishers's exact test). Kaplan-Meier-estimated survival curves were plotted for different thresholds for EBL at different timepoints. Generalized linear mixed models with binomial distribution and logit link for peri-implantitis were fitted. An adjusted logistic mixed model was made to evaluate peri-implantitis, in relation with smoking status, history of periodontitis, and EBL > 0.5 mm. RESULTS Four hundred and seven patients (mean age of 64.86 years [range 28-92, SD 10.11]), with 1482 implants, responded to the 10-year recall invitation. After an average follow-up time of 10.66 years (range 10-14, SD 0.87), implant survival was 94.74%. Mean crestal bone loss after 10 years was 0.81 mm (SD 1.58, range 0.00-17.00). One hundred and seventy five implants in 76 patients had peri-implantitis (11.8% on implant level, 18.7% on patient level). EBL of 0.5, 1, and 2 mm were significant predictors for peri-implantitis and implant loss after 10 years. Implants with EBL ≥0.5 mm during the first year of function showed a 5.43 times higher odds for future peri-implantitis development. Probability in developing peri-implantitis was 52.06% when smoking, Periodontal history and EBL of >0.5 mm was combined. CONCLUSION The present study suggests that EBL is a predictor for long-term peri-implant pathology, with a significant higher risk for peri-implantitis when early bone loss exceeds the thresholds of 0.5 and 1 mm, especially when additional risk factors such as smoking or susceptibility for periodontal disease prior to implant treatment are present. Clinical trial registration number B670201524796.
Collapse
Affiliation(s)
- Simon Windael
- Faculty of Medicine and Health Sciences, School of Dental Medicine, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Bruno Collaert
- Center for Periodontology and Implantology Leuven, Heverlee, Belgium
| | - Stefanie De Buyser
- Biostatistics Unit, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Hugo De Bruyn
- Faculty of Medicine and Health Sciences, School of Dental Medicine, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.,Radbound University Medical Center, Implantology and Periodontology, Nijmegen, The Netherlands.,Department of Prosthodontics, University of Malmö, Malmö, Sweden
| | - Stijn Vervaeke
- Faculty of Medicine and Health Sciences, School of Dental Medicine, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.,Private Practice Periodontology and Oral Implantology, Geluwe, Belgium
| |
Collapse
|
23
|
Wessels R, Cosyn J, Eghbali A, De Bruyn H, Christiaens V. A 5 to 7-year case series on single angulated implants installed following papilla-sparing flap elevation. Clin Implant Dent Relat Res 2021; 23:400-407. [PMID: 33595178 DOI: 10.1111/cid.12988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/12/2021] [Accepted: 01/24/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Bony concavities at the buccal aspect may cause a distortion between the implant axis and ideal prosthetic axis. Angulated implants can overcome this problem, yet long-term data are lacking. In addition, papilla-sparing incisions have been proposed to reduce tissue loss, yet aesthetic outcomes have not been published. PURPOSE To evaluate the 5 to 7-year outcome of single angulated implants installed following papilla-sparing flap elevation. MATERIALS AND METHODS Patients who had been consecutively treated with a single angulated implant (Co-axis®, Southern Implants, Irene, South Africa) in the anterior maxilla were re-examined after 5 to 7 years. Available data at 1 year (T1) were compared to those obtained at 5 to 7 years (T2). RESULTS Twenty out of 22 treated patients (11 females, 9 males, mean age of 52) with 22 implants attended the 5 to 7-year reassessment. All implants survived and stable clinical conditions could be reached with mean marginal bone loss of 1.28 mm at T2. Papilla-sparing flap elevation resulted in Pink Esthetic Score of 9.83 at T1 and 8.23 at T2 (p = 0.072). Mucosal Scarring Index was 4.61 at T1 and 3.50 at T2 (p = 0.165). The overall appearance of scarring significantly improved over time (p = 0.032), yet 59% of the cases still demonstrated scarring at T2.c CONCLUSIONS: Within the limitations of the study, angulated implants (Co-axis®, Southern Implants) reached stable clinical conditions. Papilla-sparing incisions may not be recommended in aesthetically demanding patients due to high risk of scarring.
Collapse
Affiliation(s)
- Retief Wessels
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Jan Cosyn
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.,Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Aryan Eghbali
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.,Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Hugo De Bruyn
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Véronique Christiaens
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| |
Collapse
|
24
|
Abaricia JO, Shah AH, Ruzga MN, Olivares-Navarrete R. Surface characteristics on commercial dental implants differentially activate macrophages in vitro and in vivo. Clin Oral Implants Res 2021; 32:487-497. [PMID: 33502059 DOI: 10.1111/clr.13717] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/16/2020] [Accepted: 01/20/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Biomaterial implantation provokes an inflammatory response that controls integrative fate. M2 macrophages regulate the response to implants by resolving the inflammatory phase and recruiting progenitor cells to aid healing. We have previously shown that modified titanium (Ti) disks directly induce M2 macrophage polarization. The aim of this study was to examine macrophage response to commercially available Ti or Ti alloy implants with comparable roughness and varying hydrophilicity. MATERIAL AND METHODS Eleven commercially available Ti (A-F) or Ti alloy (G-K) dental implants were examined in this study. Surface topography, chemistry, and hydrophilicity were characterized for each implant. To compare the immune response in vitro, human monocyte-derived macrophages were seeded on implants and secreted pro- and anti-inflammatory proteins measured. To evaluate the inflammatory response in vivo, mice were subcutaneously instrumented with clinical implants, and implant adherent macrophage populations were characterized by flow cytometry. RESULTS Macrophages on hydrophobic Implant C produced the highest level of pro-inflammatory proteins in vitro. In contrast, hydrophilic Implant E produced the second-highest pro-inflammatory response. Implants F and K, both hydrophilics, produced the highest anti-inflammatory protein secretions. Likewise, pro-inflammatory CD80hi macrophages predominated in vivo on implants C and E, and M2 CD206 + macrophages predominated on implants F and K. CONCLUSIONS These findings show that hydrophilicity alone is insufficient to predict the anti-inflammatory effect on macrophage polarization and that other properties-surface composition or topography-determine immune modulation. This in vivo model may be a useful screening method to compare the immunomodulatory response to clinical implants of disparate geometry or size.
Collapse
Affiliation(s)
- Jefferson O Abaricia
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Arth H Shah
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Marissa N Ruzga
- Department of Biomedical Engineering, College of Engineering, Ohio State University, Columbus, OH, USA
| | - Rene Olivares-Navarrete
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
25
|
Xiao W, Chen Y, Chu C, Dard MM, Man Y. Influence of implant location on titanium-zirconium alloy narrow-diameter implants: A 1-year prospective study in smoking and nonsmoking populations. J Prosthet Dent 2021; 128:159-166. [PMID: 33551139 DOI: 10.1016/j.prosdent.2020.09.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 02/05/2023]
Abstract
STATEMENT OF PROBLEM Titanium-zirconium (Ti-Zr) alloy (Roxolid) narrow-diameter implants (NDIs) have been widely used for implant-supported prostheses in anterior and posterior regions in the jaws. However, the relationship between implant location and clinical outcome remains unclear. PURPOSE The purpose of this clinical study was to evaluate and compare the clinical and radiographic outcomes of NDIs placed in different regions of the jaws in both smokers and nonsmokers. MATERIAL AND METHODS Eighty-four participants scheduled to receive NDIs for tooth rehabilitation were included, and the inserted NDIs were divided into 3 groups depending on their locations: implants used to restore anterior teeth, implants used to restore premolars, and implants used to restore molars. Crestal bone loss (CBL), implant survival and success rates, bleeding on probing (BOP), and pocket probing depth (PPD) were evaluated 6 and 12 months after implant loading (α=.017 for implant survival and success rates after Bonferroni correction, α=.05 for other parameters). RESULTS Statistical analysis of 6- and 12-month CBL of all participants presented no statistically significant difference among the 3 groups. For smokers, the molar group presented significantly more CBL than the premolar group (0.90 ±0.94 versus 0.16 ±0.27 mm, P=.027) at the 6-month examination. The implant survival rates were 95.65%, 100%, and 100% for anterior, premolar, and molar regions, respectively (P=.283). No statistically significant difference was observed regarding periodontal parameters (P>.05). CONCLUSIONS Implant location has no influence on the clinical and radiographic parameters of Ti-Zr NDIs placed in a nonsmoking population. However, the combination of posterior location and smoking may induce higher risk of crestal bone loss. Caution should be taken when restoring molars for smokers with NDIs.
Collapse
Affiliation(s)
- Wenlan Xiao
- Graduate student, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases &Department of Oral Implantology, West China School of Stomatology, Sichuan University, Chengdu, PR China
| | - Yaqian Chen
- Graduate student, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Chenyu Chu
- Graduate student, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Michel M Dard
- Global Medical Director, Medical Affairs, Straumann Group, Basel, Switzerland; Associate Professor of Dental Medicine, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University, College of Dental Medicine, New York, NY
| | - Yi Man
- Professor, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
| |
Collapse
|
26
|
Sicilia A, Gallego L, Sicilia P, Mallo C, Cuesta S, Sanz M. Crestal bone loss associated with different implant surfaces in the posterior mandible in patients with a history of periodontitis. A retrospective study. Clin Oral Implants Res 2021; 32:88-99. [PMID: 33210774 DOI: 10.1111/clr.13682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/26/2020] [Accepted: 10/25/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To retrospectively assess the interproximal bone loss (CBL) in external hexagon implants (EHI), with different surface micro-topography, placed in the posterior mandible in patients with a history of periodontitis undergoing supportive periodontal care. MATERIAL AND METHODS 268 consecutive patients received 755 EHI implants in the mandibular molar region between 2007 and 2015 with the following surface characteristics: 72 turned, 145 hybrids (double acid-etched/turned), and 538 anodized. CBL was yearly evaluated by analysing calibrated digital periapical radiographs, with a follow-up of 1-6 years. Data on implant survival were also calculated. RESULTS At 6 years (53 patients), the mean CBL was 1.34/1.42 mm at patient/implant level, respectively (range: 0-5.2 mm). Significantly higher CBL was detected in anodized implants than in turned and hybrid implants (1.92/1.46/1.02 mm) (p < .01). The maximum CBL values were found in 2 anodized implants at 4 years (6.3 and 8.1 mm). CBL ≥2 mm was detected in 18% of implants at 3 years and 35% at 6 (p < 2.2 × 10-16 ), this prevalence being 2.6 times higher in the anodized than in the hybrid and turned group (40%/15.6%, p < .0094). At 6 years, 25 anodized implants presented CBL ≥3 mm (18%). 6 anodized implants (5 patients) were removed between 4 and 5 years. CONCLUSION A significant higher CBL was observed in anodized, compared to hybrid and turned implants, when placed in the mandibular molar region of periodontal patients, with a follow-up of 1 to 6 years.
Collapse
Affiliation(s)
- Alberto Sicilia
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Luis Gallego
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Pelayo Sicilia
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Carmen Mallo
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Susana Cuesta
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Mariano Sanz
- Faculty of Odontology, ETEP Research Group, University Complutense of Madrid, Madrid, Spain
| |
Collapse
|
27
|
Freitas F, Pinheiro de Melo T, Delgado AHS, Monteiro P, Rua J, Proença L, Caldeira J, Mano Azul A, Mendes JJ. Varying the Polishing Protocol Influences the Color Stability and Surface Roughness of Bulk-Fill Resin-Based Composites. J Funct Biomater 2020; 12:jfb12010001. [PMID: 33375049 PMCID: PMC7838793 DOI: 10.3390/jfb12010001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 12/29/2022] Open
Abstract
Surface properties of composites such as roughness and color impact periodontal health and aesthetic outcomes. Novel bulk-fill composites with improved functionality are being introduced and, in light of the existing variety of finishing/polishing procedures, research of their surface properties is warranted. Sixty discs were prepared from bulk-fill composites (Filtek™ Bulk Fill Posterior Restorative and Fill-Up™) and incremental-fill Filtek™ Z250. They were further divided according to different polishing procedures (n = 5): three multi-step polishing procedures or finishing with a bur (control). Surface roughness (Ra) was measured using an atomic force microscope (The AFM Workshop TT-AFM). A spectrophotometer (Spectroshade Micro Optic) was used to determine color stability, after exposure to a coffee solution. Data were analyzed using two-way MANOVA (significance level of 5%). Resin composite type, polishing procedure, and their interaction had a statistically significant effect on surface roughness (p < 0.001) and color change (p < 0.001). Fill-Up™ exhibited the highest surface roughness and greatest color change. Differences in color change were statistically significant (p < 0.001). Filtek™ Bulk Fill registered the lowest surface roughness and color change, after the three-step polishing procedure. Both parameters were significantly correlated (ρ = 0.754, p < 0.001) and found to be material dependent and polishing-procedure dependent. Higher surface roughness relates to greater color changes.
Collapse
Affiliation(s)
- Filipa Freitas
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (F.F.); (T.P.d.M.); (P.M.); (J.R.); (L.P.); (J.C.); (A.M.A.); (J.J.M.)
| | - Teresa Pinheiro de Melo
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (F.F.); (T.P.d.M.); (P.M.); (J.R.); (L.P.); (J.C.); (A.M.A.); (J.J.M.)
| | - António HS Delgado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (F.F.); (T.P.d.M.); (P.M.); (J.R.); (L.P.); (J.C.); (A.M.A.); (J.J.M.)
- Department of Biomaterials and Tissue Engineering, Royal Free Hospital, UCL Eastman Dental Institute, London NW3 NPF, UK
- Correspondence:
| | - Paulo Monteiro
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (F.F.); (T.P.d.M.); (P.M.); (J.R.); (L.P.); (J.C.); (A.M.A.); (J.J.M.)
| | - João Rua
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (F.F.); (T.P.d.M.); (P.M.); (J.R.); (L.P.); (J.C.); (A.M.A.); (J.J.M.)
| | - Luís Proença
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (F.F.); (T.P.d.M.); (P.M.); (J.R.); (L.P.); (J.C.); (A.M.A.); (J.J.M.)
- Quantitative Methods for Health Research (MQIS), CiiEM, Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal
| | - Jorge Caldeira
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (F.F.); (T.P.d.M.); (P.M.); (J.R.); (L.P.); (J.C.); (A.M.A.); (J.J.M.)
- UCIBIO and LAQV Requimte, Faculdade de Ciências e Tecnologias, Universidade Nova de Lisboa, 2829-516 Almada, Portugal
| | - Ana Mano Azul
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (F.F.); (T.P.d.M.); (P.M.); (J.R.); (L.P.); (J.C.); (A.M.A.); (J.J.M.)
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (F.F.); (T.P.d.M.); (P.M.); (J.R.); (L.P.); (J.C.); (A.M.A.); (J.J.M.)
| |
Collapse
|
28
|
Lambrechts T, Doornewaard R, De Bruyckere T, Matthijs L, Deschepper E, Cosyn J. A multicenter cohort study on the association of the one-abutment one-time concept with marginal bone loss around bone level implants. Clin Oral Implants Res 2020; 32:192-202. [PMID: 33226676 DOI: 10.1111/clr.13689] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To investigate the association of the one-abutment one-time concept with marginal bone loss (MBL) around bone-level implants in relation to other factors. MATERIALS AND METHODS Records from patients treated by four experienced implant surgeons between January 2016 and July 2019 were scrutinized. Subjects treated with two bone-level implant types with varying machined collar (subgroups: 0.5 and 0.8 mm) were considered, receiving a healing abutment (HA cohort) or a permanent abutment at the time of surgery (OT cohort). The primary outcome was MBL registered at 3 months and the longest follow-up. A clustered two-part regression model for semicontinuous data was used. RESULTS Data pertaining to 160 patients (92 females, mean age 54) and 344 implants (125 in HA cohort, 219 in OT cohort) were available for evaluation. Mean MBL amounted to 0.52 mm (SD 0.68) after a mean follow-up of 20 (SD 9.2) months, with 33.8% of the implants showing complete bone preservation and 5.0% demonstrating >2mm MBL. OT was not related to the presence of MBL using MBL as dependent binary variable (0: no MBL; 1: MBL irrespective of its magnitude). However, OT significantly reduced the magnitude of MBL with 0.300mm when compared to HA (p = .023) in the cases where MBL was detected. Subgroup (p = .212), smoking (p = .789), history of periodontitis (p = .839), type of edentulism (p = .054), implant surgeon (p = .079), patient compliance (p = .617), and follow-up (p = .443) failed to show a significant association with MBL in the regression model. Ninety-eight % of the implants survived. CONCLUSION Within the limitations of a cohort study, the one-abutment one-time concept was associated with a decrease in MBL at implant sites with bone loss. Therefore, the placement of a permanent abutment at the time of surgery seems relevant to limit marginal bone-level alterations.
Collapse
Affiliation(s)
- Tijs Lambrechts
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Ron Doornewaard
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Thomas De Bruyckere
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| | | | - Ellen Deschepper
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jan Cosyn
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
29
|
Sordi MB, Perrotti V, Iaculli F, Pereira KCR, Magini RS, Renvert S, Gattone SA, Piattelli A, Bianchini MA. Multivariate analysis of the influence of peri-implant clinical parameters and local factors on radiographic bone loss in the posterior maxilla: a retrospective study on 277 dental implants. Clin Oral Investig 2020; 25:3441-3451. [PMID: 33155065 PMCID: PMC8137597 DOI: 10.1007/s00784-020-03666-x] [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: 09/03/2020] [Accepted: 10/28/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The aim of the present study was to investigate whether peri-implant clinical parameters (modified plaque index (mPI), bleeding and/or suppuration on probing (B/SOP)) and local factors (type of prostheses, screw emergence, platform diameter, and abutment angulation) might contribute to the development of additional bone loss and peri-implantitis around dental implants. MATERIALS AND METHODS Two hundred seventy-seven external hex connection implants placed in the posterior maxilla of 124 patients were retrospectively evaluated. They were divided into two groups: physiologic bone loss < 2 mm (PBL) or additional bone loss ≥ 2 mm (ABL). GEE logistic regression was applied to evaluate the influence of type of prostheses (implant-supported single crown (ISSC), fixed partial denture (ISFPD), and full denture (ISFD)) and clinical parameters (mPI and S/BOP) on bone loss. RESULTS Among the 277 implants, 159 (57.4%) presented PBL and 118 (42.6%) presented ABL. Within the ABL group, 20.6% implants were diagnosed with peri-implantitis. mPI significantly correlated with the type of prosthesis and the highest value of mPI (index = 3) was observed in ISFD (23.8%). Moreover, peri-implantitis was more frequently associated with ISFD (32.79%) than ISSC and ISFDP (13.79% and 13.48, respectively) CONCLUSIONS: ISFD in the posterior maxilla presented high rates of ABL and showed a higher prevalence of peri-implantitis. None of the local factors seemed to contribute to the development of these conditions. Further investigations are needed to prospectively support the results of the present study. CLINICAL RELEVANCE Patients rehabilitated with ISFD should be carefully monitored and have more frequent maintenance visits to prevent or control peri-implant bone loss.
Collapse
Affiliation(s)
- Mariane B Sordi
- Center for Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Vittoria Perrotti
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), University of Chieti-Pescara, Via dei vestini, 31, 66100, Chieti, Italy.
| | - Flavia Iaculli
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Keila C R Pereira
- Public Health Sciences, University of South of Santa Catarina, Tubarao, Brazil
| | - Ricardo S Magini
- Perio/Implantology, Department of Dentistry, Center for Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Stefan Renvert
- Oral Health Sciences, Kristianstad University School of Dentistry, Kristianstad, Sweden.,Dublin Dental Hospital, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - Stefano Antonio Gattone
- Department of Philosophical, Pedagogical and Economic-Quantitative Sciences (DiSFPEQ), University of Chieti-Pescara, Chieti, Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), University of Chieti-Pescara, Via dei vestini, 31, 66100, Chieti, Italy.,Biomaterials Engineering, Catholic University of Murcia (UCAM), Murcia, Spain.,Villaserena Foundation for Research, Città Sant'Angelo (Pescara), Italy
| | - Marco A Bianchini
- Perio/Implantology, Department of Dentistry, Center for Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil
| |
Collapse
|
30
|
Gaikwad AM, Joshi AA, Nadgere JB. Biomechanical and histomorphometric analysis of endosteal implants placed by using the osseodensification technique in animal models: A systematic review and meta-analysis. J Prosthet Dent 2020; 127:61-70. [PMID: 33139057 DOI: 10.1016/j.prosdent.2020.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM Osseodensification, a counterclockwise drilling technique for the placement of endosseous implants is a popular clinical technique. However, the effect of the osseodensification technique on primary implant stability, bone-implant contact, and bone area frequency occupancy is unclear. PURPOSE The purpose of this systematic review and meta-analysis was to investigate the biomechanical and histomorphometric outcomes of endosteal implants placed by using the osseodensification technique in animal models. MATERIAL AND METHODS An electronic search through Medline/PubMed, Lilacs, and Science Direct databases, and an additional manual search of the reference list of included articles was conducted by using specific keywords and Medical Subject Headings (MeSH) terms for articles in the English language and published up to April 31, 2020. Only animal studies comparing the biomechanical and histomorphometric outcomes of endosteal implants placed by using the osseodensification and conventional drilling protocol were included. The SYstematic Review Center for Laboratory animal Experimentation (SYRCLE) tool was used to determine the risk of bias assessment, and the quality of included studies was assessed by using Animal Research: Reporting in Vivo Experiments (ARRIVE) guidelines. RESULTS Nine studies were included. The results of the meta-analysis showed that the pooled weighted mean difference of the insertion torque value for the primary implant stability of endosseous dental implants placed by using the osseodensification technique was 2.270 (95% confidence interval [CI]=1.147 to 3.393; P<.001), the weighted mean difference of the percentage of bone-implant contact at 3 weeks was 0.487 (95% CI=0.220 to 0.754; P=.114), the weighted mean difference of the percentage of bone-implant contact at 6 weeks was 0.565 (95% CI=0.219 to 0.911; P=.448), the weighted mean difference of the percentage of bone area frequency occupancy at 3 weeks was 0.679 (95% CI=0.265 to 1.093; P=.073), and the weighted mean difference of the percentage of bone area frequency occupancy at 6 weeks was 0.391 (95% CI=-0.204 to 0.986; P=.027). CONCLUSIONS Limited data from animal studies suggest that the primary implant stability, bone-implant contact, and bone area frequency occupancy significantly improved for the endosteal implants placed by using the osseodensification technique compared with conventional drilling protocol. However, additional laboratory and clinical studies are recommended to provide stronger evidence.
Collapse
Affiliation(s)
- Amit M Gaikwad
- Assistant Professor, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India.
| | - Amruta A Joshi
- Tutor, Department of Periodontics, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Jyoti B Nadgere
- Professor and HOD, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| |
Collapse
|
31
|
Abstract
Peri-implant diseases are prevalent with a weighted mean prevalence rate of 43% across Europe and 22% across South and North America. Although the main etiologic agent is bacterial biofilm, a myriad of factors influence the initiation and progression of the disease. Unfortunately, the treatment of peri-implant diseases is at best favorable in the short term with a high rate of persistent inflammation and recurrence. Therefore, it is sensible to consider and control all potential factors that may predispose an implant to peri-implant tissue inflammation in an attempt to avoid the disease. This paper reviews recent evidence on factors that may predispose implants to peri-implantitis and measures that can be taken to prevent it.
Collapse
Affiliation(s)
- Jia-Hui Fu
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, USA
| |
Collapse
|
32
|
Liu T, Chen Y, Apicella A, Mu Z, Yu T, Huang Y, Wang C. Effect of Porous Microstructures on the Biomechanical Characteristics of a Root Analogue Implant: An Animal Study and a Finite Element Analysis. ACS Biomater Sci Eng 2020; 6:6356-6367. [PMID: 33449664 DOI: 10.1021/acsbiomaterials.0c01096] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Full ceramic or metal custom-made root analogue implants (RAIs) are made by replicating the natural tooth geometry. However, it may lead to the stress shielding of the surrounding bone, and an RAI is unable to easily achieve primary stability. Therefore, to improve primary stability and reduce stress shielding, RAI porous structures are proposed. The purpose of this study was to evaluate the effect of porous microstructures on the biomechanical characteristics of the custom-made RAI. METHODS Porous and bulk titanium cylinders and porous RAI and conventional implants for in vivo tests were fabricated using a selective laser melting (SLM) technology. The elastic modulus and the compressive strength of porous titanium cylinders were evaluated. These samples were then implanted into rabbit femurs (cylinders) and beagle dog mandibles (RAI and conventional implants). A simplified three-dimensional geometry of the anterior maxilla of a patient was constructed. Then, based on the extracted standard template library (STL) data, five different RAI models were constructed: (A) smooth surface, (B) pit surface, (C) bulb surface, (D) threaded surface, and (E) porous surface. A conventional implant model was also constructed. A static load of 100 N was applied to the crown in the multivectoral direction. RESULTS The results of the in vivo experiment confirmed that the porous structure decreased the elastic modulus of Ti6Al4V. Additionally, the implantation of the porous custom-made RAIs resulted in increased new bone ingrowth and decreased bone resorption compared to conventional implants. Moreover, the 3D finite element analysis suggested that the bone surrounding porous custom-made RAIs was subjected to a more uniform stress distribution, and the strain values of the surrounding bone were more conducive to bone formation. CONCLUSION Based on these findings, a custom-made RAI with a porous surface accelerates bone formation and might reduce the stress-shielding effect.
Collapse
Affiliation(s)
- Ting Liu
- College of Stomatology, Chongqing Medical University, Chongqing 401147, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 400010, China
| | - Yu Chen
- College of Stomatology, Chongqing Medical University, Chongqing 401147, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400010, China
| | - Antonio Apicella
- Advanced Materials Lab, University of Campania, Naples, Aversa (CE) 81100, Italy
| | - Zhixiang Mu
- College of Stomatology, Chongqing Medical University, Chongqing 401147, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 400010, China
| | - Ti Yu
- College of Stomatology, Chongqing Medical University, Chongqing 401147, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 400010, China
| | - Yuanding Huang
- College of Stomatology, Chongqing Medical University, Chongqing 401147, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400010, China
| | - Chao Wang
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 400010, China.,Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China
| |
Collapse
|
33
|
Mongardini C, Zeza B, Pelagalli P, Blasone R, Scilla M, Berardini M. Radiographic bone level around particular laser-treated dental implants: 1 to 6 years multicenter retrospective study. Int J Implant Dent 2020; 6:29. [PMID: 32719900 PMCID: PMC7385050 DOI: 10.1186/s40729-020-00230-w] [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: 03/25/2020] [Accepted: 05/25/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of the present retrospective study was to evaluate clinical and radiological outcomes, in terms of implant survival rate, marginal bone loss, and peri-implantitis incidence, of a titanium implants with an innovative laser-treated surface. Materials and methods A total of 502 dental implants were inserted in four dental practices (Udine, Arezzo, Frascati, Roma) between 2008 and 2013. All inserted implants had laser-modified surface characterized by a series of 20-μm-diameter holes (7–10 μm deep) every 10 μm (Synthegra®, Geass srl, Italy). The minimum follow-up period was set at 1 year after the final restoration. Radiographs were taken after implant insertion (T0), at time of loading (T1), and during the follow-up period (last recall, T2). Marginal bone loss and peri-implant disease incidence were recorded. Results A total of 502 implants with a maximum follow-up period of 6 years were monitored. The mean differential between T0 and T2 was 0.05 ± 1.08 mm at the mesial aspect and 0.08 ± 1.11 mm at the distal with a mean follow-up period of 35.76 ± 18.05 months. After being in function for 1 to 6 years, implants reported varying behavior: 8.8% of sites did not show any radiographic changes and 38.5% of sites showed bone resorption. The bone appeared to have been growing coronally in 50.7% of the sites measured. Conclusion Implants showed a maintenance of marginal bone levels over time, and in many cases, it seems that laser-modified implant surface could promote a bone growth. The low peri-implant disease incidence recorded could be attributed to the laser titanium surface features that seem to prevent bacterial colonization. Future randomized and controlled studies are needed to confirm the results of the present multi-centrical retrospective analysis.
Collapse
Affiliation(s)
- C Mongardini
- Department of Maxillo-Facial and Odontostomatologic Sciences, University "La Sapienza" of Rome, Rome, Italy
| | - B Zeza
- Department of Dentistry, Section of Periodontology, Albanian University, Tirana, Albania
| | | | | | | | | |
Collapse
|
34
|
Favero G, Apaza Alccayhuaman KA, Silva ER, Bengazi F, Urbizo J, Kotsu M, Botticelli D. Effect of lack of plaque control after the surgical treatment of peri-implantitis at surfaces with different characteristics: an experimental study in dogs. Oral Maxillofac Surg 2020; 24:431-439. [PMID: 32594345 DOI: 10.1007/s10006-020-00870-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 06/18/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The aim of the present study was to evaluate the effect of the induction of peri-implantitis and of plaque accumulation on implants with different surface characteristics after the surgical treatment. MATERIAL AND METHODS All mandibular premolars and first molars were extracted bilaterally in six dogs. After 3 months, two non-submerged implants were installed, each with either a hydrophilic sandblasted and acid-etched surface stored in saline solution (SLActive) or an acid-etched and modified with calcium ions surface (UnicCa). After 3 months, ligatures were placed in the sulcus around the implants to induce an experimental peri-implantitis and plaque accumulation was allowed. After 3 months, ligatures were removed and, after one more month of plaque accumulation, a surgical treatment was performed using gauzes soaked in saline and irrigations. X-rays were taken at this stage. Plaque control maintenance was established at the control sites, while plaque accumulation was allowed at the test sites (plaque sites). After 5 months, biopsies were obtained. Marginal bone levels were compared between x-rays and histological assessments. RESULTS At the time of peri-implantitis treatment, two SLActive implants were lost. At the euthanasia, seven more implants were lost only in the plaque group, one control and six test implants. The calculated mean values of the marginal bone level of the two surfaces at the treatment were 3.65 ± 1.71 mm in the control group, and 3.65 ± 1.76 mm in the plaque group (p = 0.463). The additional marginal bone loss after 5 months from surgical treatment was 0.67 ± 0.67 mm (UnicCa, 0.48 ± 1.06 mm and SLActive, 0.79 ± 2.10 mm) and 3.11 ± 1.38 mm (UnicCa, 2.67 ± 1.87 mm and SLActive, 3.94 ± 2.11 mm) for the control and plaque groups, respectively (p = 0.028). CONCLUSIONS The lack of plaque control after the surgical treatment of the peri-implantitis strongly influenced the marginal bone loss.
Collapse
Affiliation(s)
- Giovanni Favero
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923, Rimini, Italy
| | | | - Erick Ricardo Silva
- Depto CTBMF e Periodontia, FORP-USP-Faculty of Ribeirão Preto (SP), Ribeirão Preto, Brazil
| | - Franco Bengazi
- Faculty of Dentistry, University of Medical Science, La Habana, Cuba
| | - Joaquin Urbizo
- Faculty of Dentistry, University of Medical Science, La Habana, Cuba
| | - Mitsuo Kotsu
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923, Rimini, Italy
| | | |
Collapse
|
35
|
Carnovale F, Patini R, Peñarrocha-Oltra D, Muzzi M, Pistilli R, Canullo L. Measurement of gap between abutment and fixture in dental conical connection implants. A focused ion beam SEM observation. MEDICINA ORAL, PATOLOGIA ORAL Y CIRUGIA BUCAL 2020; 25:e449-e454. [PMID: 32520924 PMCID: PMC7338071 DOI: 10.4317/medoral.23281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 05/19/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND The aim of the authors was to examine the abutment-fixture interface in Morse-type conical implants in order to verify gaps at this level using a new microscopical approach. MATERIAL AND METHODS In this in vitro study, 20 abutment-fixture complexes were prepared by sectioning (longitudinal and cross-sectional to the long axis) with a microtome and then with a focused ion beam (FIB). This is a micrometric machine tool that uses gallium ions to abrade circumscribed areas to dig deeper into the cuts obtained with the microtome in order to eliminate cut-induced artifacts. This is because the FIB abrasion is practically free from artifacts, which are normally generated by the action of the microtome blades or other techniques. Samples were then observed by scanning electron microscopy (SEM). RESULTS The observation of the abraded parts with the FIB permitted measurement of the real gap between the implant-abutment components. A variable amount of gap was retrieved (from 0 to 3 μm) by the observations, confirming the non-hermetic nature of the connection. It has to be pointed out that in approximately 65% of cases, the gap accounted for less than 1 μm. CONCLUSIONS The reported data confirmed that the analyzed connection system allowed for minimal gap. However, from the evidence of the present analysis, it cannot be assumed that the 2 parts of a Morse-type conical implant are fused in 1 piece, which would create a perfectly matched hermetic connection.
Collapse
|
36
|
Yang J, Yu X, Zhang Z, Xu R, Wu F, Wang T, Liu Y, Ouyang J, Deng F. Surface modification of titanium manufactured through selective laser melting inhibited osteoclast differentiation through mitogen-activated protein kinase signaling pathway. J Biomater Appl 2020; 35:169-181. [PMID: 32340522 DOI: 10.1177/0885328220920457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Selective laser melting used in manufacturing custom-made titanium implants becomes more popular. In view of the important role played by osteoclasts in peri-implant bone resorption and osseointegration, we modified selective laser melting-manufactured titanium surfaces using sandblasting/alkali-heating and sandblasting/acid-etching, and investigated their effect on osteoclast differentiation as well as their underlying mechanisms. The properties of the surfaces, including elements, roughness, wettability and topography, were analyzed. We evaluated the proliferation and morphology of primary mouse bone marrow-derived monocytes, as well as induced osteoclasts derived from bone marrow-derived monocytes, on samples. Then, osteoclast differentiation was determined by the tartrate-resistant acid phosphatase activity assay, calcitonin receptors immunofluorescence staining and the expression of osteoclast-related genes. The results showed that sandblasting/alkali-heating established nanonet structure with the lowest water contact angle, and both sandblasting/alkali-heating and sandblasting/acid-etching significantly decreased surface roughness and heterogeneity compared with selective laser melting. Surface modifications of selective laser melting-produced titanium altered bone marrow-derived monocyte morphology and suppressed bone marrow-derived monocyte proliferation and osteoclastogenesis in vitro (sandblasting/alkali-heating>sandblasting/acid-etching>selective laser melting). These surface modifications reduced the activation of extracellular signal-regulated kinase and c-Jun N-terminal kinases compared to native-selective laser melting. Sandblasting/alkali-heating additionally blocked tumor necrosis factor receptor-associated factor 6 recruitment. The results suggested that sandblasting/alkali-heating and sandblasting/acid-etching modifications on selective laser melting titanium could inhibit osteoclast differentiation through suppressing extracellular signal-regulated kinase and c-Jun N-terminal kinase phosphorylation in mitogen-activated protein kinase signaling pathway and provide a promising technique which might reduce peri-implant bone resorption for optimizing native-selective laser melting implants.
Collapse
Affiliation(s)
- Jiamin Yang
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Xiaolin Yu
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Zhengchuan Zhang
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Ruogu Xu
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Fan Wu
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Tianlu Wang
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Yun Liu
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Jianglin Ouyang
- Guangzhou Institute of Advanced Technology, Chinese Academy of Science, Guangzhou, PR China.,Guangzhou Janus Biotechnology Co., Ltd, Chinese Academy of Sciences, Guangzhou, PR China
| | - Feilong Deng
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| |
Collapse
|
37
|
Windael S, Vervaeke S, De Buyser S, De Bruyn H, Collaert B. The Long-Term Effect of Smoking on 10 Years' Survival and Success of Dental Implants: A Prospective Analysis of 453 Implants in a Non-University Setting. J Clin Med 2020; 9:jcm9041056. [PMID: 32276371 PMCID: PMC7230390 DOI: 10.3390/jcm9041056] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 11/16/2022] Open
Abstract
Background: The purpose of this study was to compare the survival and peri-implant bone loss of implants with a fluoride-modified surface in smokers and non-smokers. Material and Methods: All patients referred for implant treatment between November 2004 and 2007 were scrutinized. All implants were placed by the same surgeon (B.C.). The single inclusion criterion was a follow-up time of at least 10 years. Implant survival, health, and bone loss were evaluated by an external calibrated examiner (S.W.) during recall visits. Radiographs taken at recall visits were compared with the post-surgical ones. Implant success was based on two arbitrarily chosen success criteria for bone loss (≤1 mm and ≤2 mm bone loss after 10 years). Implant survival in smokers and non-smokers was compared using the log-rank test. Both non-parametric tests and fixed model analysis were used to assess bone loss in both groups. Results: A total of 453 implants in 121 patients were included for survival analysis, and 397 implants in 121 patients were included for peri-implant bone-loss analysis. After a mean follow-up time of 11.38 years (SD 0.78; range 10.00–13.65), 33 implants out of 453 initially placed had failed in 21 patients, giving an overall survival rate of 92.7% and 82.6% on the implant and patient level, respectively. Cumulative 10 years’ survival rate was 81% on the patient level and 91% on the implant level. The hazard of implant loss in the maxilla was 5.64 times higher in smokers compared to non-smokers (p = 0.003). The hazard of implant loss for implants of non-smokers was 2.92 times higher in the mandible compared to the maxilla (p = 0.01). The overall mean bone loss was 0.97 mm (SD 1.79, range 0–17) at the implant level and 0.90 mm (SD 1.39, range 0–7.85) at the patient level. Smokers lost significantly more bone compared to non-smokers in the maxilla (p = 0.024) but not in the mandible. Only the maxilla showed a significant difference in the probability of implant success between smokers and non-smokers (≤1 mm criterion p = 0.003, ≤2 mm criterion p = 0.007). Taking jaw into account, implants in smokers experienced a 2.6 higher risk of developing peri-implantitis compared to non-smokers (p = 0.053). Conclusion: Dental implants with a fluoride-modified surface provided a high 10 years’ survival with limited bone loss. Smokers were, however, more prone to peri-implant bone loss and experienced a higher rate of implant failure, especially in the upper jaw. The overall bone loss over time was significantly higher in smoking patients, which might be suggestive for a higher peri-implantitis risk. Hence, smoking cessation should be advised and maintained after implant placement from the perspective of peri-implant disease prevention.
Collapse
Affiliation(s)
- Simon Windael
- School of Dental Medicine, Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (S.V.); (H.D.B.)
- Correspondence:
| | - Stijn Vervaeke
- School of Dental Medicine, Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (S.V.); (H.D.B.)
- Private Practice Periodontology and Oral Implantology, 8940 Geluwe, Belgium
| | - Stefanie De Buyser
- Biostatistics Unit, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Hugo De Bruyn
- School of Dental Medicine, Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (S.V.); (H.D.B.)
- Radboud Institute for Health Sciences, Department of Dentistry—Implantology & Periodontology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Bruno Collaert
- Center for Periodontology and Implantology Leuven, 3001 Heverlee, Belgium;
| |
Collapse
|
38
|
Oliveira Silva TS, Freitas AR, Albuquerque RF, Pedrazzi V, Ribeiro RF, Nascimento C. A 3‐year longitudinal prospective study assessing microbial profile and clinical outcomes of single‐unit cement‐retained implant restorations: Zirconia versus titanium abutments. Clin Implant Dent Relat Res 2020; 22:301-310. [DOI: 10.1111/cid.12888] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/16/2020] [Accepted: 01/22/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Thalisson S. Oliveira Silva
- Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, Molecular Diagnosis Laboratory University of São Paulo Ribeirão Preto São Paulo Brazil
| | - Alice R. Freitas
- Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, Molecular Diagnosis Laboratory University of São Paulo Ribeirão Preto São Paulo Brazil
| | - Rubens F. Albuquerque
- Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, Molecular Diagnosis Laboratory University of São Paulo Ribeirão Preto São Paulo Brazil
| | - Vinícius Pedrazzi
- Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, Molecular Diagnosis Laboratory University of São Paulo Ribeirão Preto São Paulo Brazil
| | - Ricardo F. Ribeiro
- Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, Molecular Diagnosis Laboratory University of São Paulo Ribeirão Preto São Paulo Brazil
| | - Cássio Nascimento
- Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, Molecular Diagnosis Laboratory University of São Paulo Ribeirão Preto São Paulo Brazil
| |
Collapse
|
39
|
Asensio G, Vázquez-Lasa B, Rojo L. Achievements in the Topographic Design of Commercial Titanium Dental Implants: Towards Anti-Peri-Implantitis Surfaces. J Clin Med 2019; 8:E1982. [PMID: 31739615 PMCID: PMC6912779 DOI: 10.3390/jcm8111982] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 12/12/2022] Open
Abstract
Titanium and its alloys constitute the gold standard materials for oral implantology in which their performance is mainly conditioned by their osseointegration capacity in the host's bone. We aim to provide an overview of the advances in surface modification of commercial dental implants analyzing and comparing the osseointegration capacity and the clinical outcome exhibited by different surfaces. Besides, the development of peri-implantitis constitutes one of the most common causes of implant loss due to bacteria colonization. Thus, a synergic response from industry and materials scientists is needed to provide reliable technical and commercial solutions to this issue. The second part of the review focuses on an update of the recent findings toward the development of new materials with osteogenic and antibacterial capacity that are most likely to be marketed, and their correlation with implant geometry, biomechanical behavior, biomaterials features, and clinical outcomes.
Collapse
Affiliation(s)
- Gerardo Asensio
- Instituto de Ciencia y Tecnología de Polímeros, Consejo Superior de Investigaciones Científicas, CSIC, 28006 Madrid, Spain; (G.A.); (B.V.-L.)
| | - Blanca Vázquez-Lasa
- Instituto de Ciencia y Tecnología de Polímeros, Consejo Superior de Investigaciones Científicas, CSIC, 28006 Madrid, Spain; (G.A.); (B.V.-L.)
- Consorcio Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, 28029 Madrid, Spain
| | - Luis Rojo
- Instituto de Ciencia y Tecnología de Polímeros, Consejo Superior de Investigaciones Científicas, CSIC, 28006 Madrid, Spain; (G.A.); (B.V.-L.)
- Consorcio Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, 28029 Madrid, Spain
| |
Collapse
|
40
|
Krebs M, Kesar N, Begić A, von Krockow N, Nentwig GH, Weigl P. Incidence and prevalence of peri-implantitis and peri-implant mucositis 17 to 23 (18.9) years postimplant placement. Clin Implant Dent Relat Res 2019; 21:1116-1123. [PMID: 31692243 DOI: 10.1111/cid.12848] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 07/07/2019] [Accepted: 09/07/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the prevalence of peri-implantitis (PI) and peri-implant mucositis (PM) in a long-term follow-up with comparison among different PI and PM definitions, and to report on the incidence of PI. MATERIALS AND METHODS In a retrospective clinical study five different PI and PM definitions were applied onto a population with 274 implants 17 to 23 years postimplant placement. Recommendations by the Eighth European Workshop on Periodontology (EWOP) were used as base reference. Clinical and radiological measurements were considered. Risk factors were evaluated in a regression analysis. RESULTS After an average observation period of 18.9 years, 40.1% of the implants were diagnosed with PM and 15.0% with PI (Eighth EWOP). PI incidence reached 7.9% on implant level and 13.2% on patient level. Implants diagnosed with PI and progressive bone loss displayed exceptionally vertical bone defect configuration (BDC). Diabetes mellitus, smoking, regular maintenance, or a former periodontal infection did not show significant influence on the prevalence of peri-implant diseases. Patients with bruxism displayed significantly less PM and PI. CONCLUSIONS Vertical BDC seems to correspond with active PI, wherefore we estimate such a defining factor of importance. Diagnosis of PM and evaluation of probing pocket depths might be only of descriptive interest as they could lead to false-positive results.
Collapse
Affiliation(s)
- Mischa Krebs
- Department of Oral Surgery and Implantology, Centre for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany.,Department of Postgraduate Education, Centre for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany.,Private Practice Dr. Krebs & Colleagues, Alzey, Germany
| | - Nikolina Kesar
- Department of Oral Surgery and Implantology, Centre for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Amira Begić
- Department of Oral Surgery and Implantology, Centre for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Nadine von Krockow
- Department of Oral Surgery and Implantology, Centre for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany.,Department of Postgraduate Education, Centre for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Georg-Hubertus Nentwig
- Department of Oral Surgery and Implantology, Centre for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Paul Weigl
- Department of Postgraduate Education, Centre for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany
| |
Collapse
|
41
|
Zhang Q, Liu J, Ma L, Bai N, Xu H. LOX-1 is involved in TLR2 induced RANKL regulation in peri-implantitis. Int Immunopharmacol 2019; 77:105956. [PMID: 31655342 DOI: 10.1016/j.intimp.2019.105956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/13/2019] [Accepted: 09/30/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To explore whether receptor activator of nuclear factor kappa-B ligand (RANKL) is involved in the nosogenesis of peri-implantitis and to reveal the regulatory mechanism in Porphyromonas gingivalis induced RANKL production. METHODS Therefore, we collected peri-implant crevicular fluid (PICF) and gingival tissues from healthy implants and peri-implantitis patients. The expression of RANKL in samples was tested by ELISA, Western blot and immunofluorescence staining. The production of RANKL in THP-1 macrophages stimulated with P. gingivalis was detected by qRT-PCR and Western blot. Then macrophages were pre-treated with neutralizing antibodies of Toll-like receptor 2 (TLR2) or lectin-type oxidized LDL receptor 1 (LOX-1) and inhibitors of TLR2, LOX-1 or Erk1/2 before P. gingivalis stimulation to evaluate the roles of TLR2, LOX-1 and Erk1/2 in RANKL production by qRT-PCR and Western blot. RESULTS The protein level of RANKL was higher in PICF of peri-implantitis patients than healthy implants. We observed increased RANKL expression in P. gingivalis infected macrophages compared to controls. RANKL induced by P. gingivalis stimulation was mediated by TLR2 and Erk1/2 signaling pathway in THP-1 macrophages. LOX-1 is involved in TLR2 induced RANKL expression. CONCLUSION RANKL was involved in peri-implantitis, and regulated by TLR2, LOX-1 and Erk1/2 signaling against P. gingivalis infection. As the novel inflammation pathway triggers, TLR2 and LOX-1 which mediate RANKL production seems to be potential drug targets of peri-implantitis.
Collapse
Affiliation(s)
- Qian Zhang
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.
| | - Jie Liu
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Lei Ma
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Na Bai
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Huirong Xu
- Department of Pathology, ZiBo Central Hospital, ZiBo, Shandong Province, China
| |
Collapse
|
42
|
Ganbold B, Heo SJ, Koak JY, Kim SK, Cho J. Human Stem Cell Responses and Surface Characteristics of 3D Printing Co-Cr Dental Material. MATERIALS 2019; 12:ma12203419. [PMID: 31635376 PMCID: PMC6829507 DOI: 10.3390/ma12203419] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/14/2019] [Accepted: 10/17/2019] [Indexed: 02/01/2023]
Abstract
Recently, the selective laser melting (SLM) method of manufacturing three dimensional (3D) dental prosthetics by applying a laser to metal powder has been widely used in the field of dentistry. This study investigated human adipose derived stem cell (hADSC) behavior on a 3D printed cobalt-chrome (Co-Cr) alloy and its surface characteristics and compared them those of a nickel-chrome (Ni-Cr) alloy. Alloys were divided into four groups according to the material and manufacturing methods. Co-Cr disks were manufactured with three different methods: a conventional casting method, a metal milling method, and an SLM method. Ni-Cr disks were manufactured with a conventional casting method. The surface roughness and compositions of the disks were assessed. hADSCs were then cultured on the disks. Cell morphologies on the disks were analyzed by a field emission scanning electron microscope (FE-SEM). Cell proliferation was assessed with a bromodeoxyuridine (BrdU) assay kit. Cell viability was evaluated with a water-soluble tetrazolium salt (WST) assay kit. There were no differences in surface roughness between all groups. The cells were well attached to the disks, and morphologies of the cells were similar. The cell proliferation and viability of the Ni-Cr disks were significantly lower than the other groups. However, the Co-Cr disks showed no differences in their different fabricating methods. In conclusion, the biocompatibility of 3D printed Co-Cr alloys showed comparable results compared to that of the conventional casting method, and these alloys were more biocompatible than Ni-Cr alloys.
Collapse
Affiliation(s)
- Boldbayar Ganbold
- Department of Prosthodontics, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea.
| | - Seong-Joo Heo
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea.
| | - Jai-Young Koak
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea.
| | - Seong-Kyun Kim
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea.
| | - Jaejin Cho
- Department of Dental Regenerative Biotechnology, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea.
| |
Collapse
|
43
|
Zandim-Barcelos DL, Carvalho GGD, Sapata VM, Villar CC, Hämmerle C, Romito GA. Implant-based factor as possible risk for peri-implantitis. Braz Oral Res 2019; 33:e067. [PMID: 31576951 DOI: 10.1590/1807-3107bor-2019.vol33.0067] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 06/11/2019] [Indexed: 11/21/2022] Open
Abstract
Peri-implantitis is currently a topic of major interest in implantology. Considered one of the main reasons of late implant failure, there is an emerged concern whether implant characteristics could trigger inflammatory lesion and loss of supporting bone. The purpose of this narrative review is to provide an evidence based overview on the influence of implant-based factors in the occurrence of peri-implantitis. A literature review was conducted addressing the following topics: implant surface topography; implant location; occlusal overload; time in function; prosthesis-associated factors (rehabilitation extension, excess of cement and implant-abutment connection); and metal particle release. Although existing data suggests that some implant-based factors may increase the risk of peri-implantitis, the evidence is still limited to consider them a true risk factor for peri-implantitis. In conclusion, further evidences are required to a better understanding of the influence of implant-based factors in the occurrence of peri-implantitis. Large population-based studies including concomitant analyses of implant- and patient-based factors are required to provide strong evidence of a possible association with peri-implantitis in a higher probability. The identification of these factors is essential for the establishment of strategies to prevent peri-implantitis.
Collapse
Affiliation(s)
- Daniela Leal Zandim-Barcelos
- Universidade Estadual Paulista - Unesp, Araraquara School of Dentistry, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | - Gabriel Garcia de Carvalho
- Universidade Estadual Paulista - Unesp, Araraquara School of Dentistry, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | - Vitor Marques Sapata
- Universidade de São Paulo - USP, Dental School, Department of Stomatology, São Paulo, Brazil
| | - Cristina Cunha Villar
- Universidade de São Paulo - USP, Dental School, Department of Stomatology, São Paulo, Brazil
| | - Christoph Hämmerle
- University of Zurich, Clinic for Fixed and Removable Prosthodontics and Dental Material Science, Zurich, Switzerland
| | | |
Collapse
|
44
|
Papi P, Di Carlo S, Rosella D, De Angelis F, Capogreco M, Pompa G. Peri-implantitis and extracellular matrix antibodies: A case-control study. Eur J Dent 2019; 11:340-344. [PMID: 28932144 PMCID: PMC5594963 DOI: 10.4103/ejd.ejd_28_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The aim of this case-control study was to compare patients with a healthy peri-implant environment and patients affected by peri-implantitis, evaluating the occurrence of antibodies to extracellular matrix (ECM) molecules. The authors hypothesized the presence of ECM autoantibodies in serum of peri-implantitis patients. MATERIALS AND METHODS Patients were divided into two groups: one with dental implants with a diagnosis of peri-implantitis and one control group with implants classified as being "healthy." Enzyme-linked immunosorbent assay was performed on patients' sera to detect human antibodies to type I, III, IV, and V collagens, laminin, and fibronectin. Fisher exact test was performed to evaluate statistical association, with a significant P < 0.05. RESULTS Forty-two patients were enrolled in this study, 27 females (64.28%) and 15 males (35.72%) with a mean age of 53 ± 29.69 years (age range 32-74). The presence of antibodies to CIII was recorded in 6/21 (28.57%) patients of test group, compared to just 2/21 (9.52%) for the control group, showing a statistically significant difference (P < 0.05). Other antibodies tested were found to be not statistically significant or absent. CONCLUSIONS Within the limitations of this study, it can be concluded that further studies, with larger sample and different design, are necessary to address the research purpose, evaluating possible associations between anti-ECM antibodies and peri-implantitis.
Collapse
Affiliation(s)
- Piero Papi
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Stefano Di Carlo
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Daniele Rosella
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Francesca De Angelis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - Mario Capogreco
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - Giorgio Pompa
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Rome, Italy
| |
Collapse
|
45
|
Zumstein T, Schütz S, Sahlin H, Sennerby L. Factors influencing marginal bone loss at a hydrophilic implant design placed with or without GBR procedures: A 5-year retrospective study. Clin Implant Dent Relat Res 2019; 21:817-826. [PMID: 31432605 DOI: 10.1111/cid.12826] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 06/24/2019] [Accepted: 07/08/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Ongoing marginal bone loss is a threat to the longevity of implant-supported prostheses. AIM The aim of the present study was to retrospectively evaluate the survival rate and factors affecting marginal bone levels at a hydrophilic implant design after 5 years in function. MATERIALS AND METHODS The study group consisted of 51 consecutive patients previously treated with 159 hydrophilic implants (Neoss Straight Proactive implants) and scheduled for annual check-ups with clinical and radiographic examinations during 5 years. Data were compiled for the entire study population as well as for two subgroups: one where guided bone regeneration (GBR) was performed (91 implants) and the other where no GBR procedures (68 implants) were performed. Marginal bone levels were measured from peri-apical radiographs taken at placement and annual follow-ups. Statistical analyses were applied to evaluate the effect of different factors on marginal bone remodeling. RESULTS Two implant failures, one from each subgroup, occurred during the first year of function resulting in an overall cumulative survival rate (CSR) of 98.7% after 5 years of loading. The mean marginal bone loss amounted to 0.7 ± 0.7 mm after 1 year and 0.8 ± 0.6 mm after 5 years. No implants showed more than 3 mm bone loss after 5 years. Age, gender, implant position, biotype, implant diameter, implant length, indication, surgical/loading protocol, and ISQ at prosthesis delivery were found to affect bone remodeling. No significant differences or correlations were seen for smoking, jaw, bone quantity, bone quality, GBR, sinus lift, and ISQ at implant placement. CONCLUSIONS The present implant design performed well with few failures and minimal marginal bone loss after 5 years of loading. Marginal bone remodeling at implants is a complex phenomenon, which is affected by many patient-, procedure-, and implant-related factors that need to be further investigated.
Collapse
Affiliation(s)
| | | | | | - Lars Sennerby
- Department of Oral & Maxillofacial Surgery, University of Gothenburg, Sweden
| |
Collapse
|
46
|
Aseptic Ligatures Induce Marginal Peri-Implant Bone Loss-An 8-Week Trial in Rabbits. J Clin Med 2019; 8:jcm8081248. [PMID: 31426572 PMCID: PMC6723089 DOI: 10.3390/jcm8081248] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 12/23/2022] Open
Abstract
The clinical value of ligature-induced experimental peri-implantitis studies has been questioned due to the artificial nature of the model. Despite repeated claims that ligatures of silk, cotton and other materials may not induce bone resorption by themselves; a recent review showed that the tissue reaction toward them has not been investigated. Hence, the current study aimed to explore the hard and soft tissue reactions toward commonly used ligature materials. A total of 60 dental implants were inserted into the femur (n = 20) and tibia (n = 40) of 10 rabbits. The femoral implants were ligated with sterile 3-0 braided silk in one leg and sterile cotton retraction chord in the other leg. The tibial implants were ligated with silk or left as non-ligated controls. All wounds were closed in layers. After a healing time of 8 weeks, femoral (silk versus cotton) and proximal tibial (silk versus non-ligated control) implants were investigated histologically. Distal tibial (silk versus non-ligated control) implants were investigated with real time polymerase chain reaction (qPCR). The distance from the implant-top to first bone contact point was longer for silk ligated implants compared to non-ligated controls (p = 0.007), but did not vary between cotton and silk. The ligatures triggered an immunological reaction with cell infiltrates in close contact with the ligature materials, adjacent soft tissue encapsulation and bone resorption. qPCR further demonstrated an upregulated immune response toward the silk ligatures compared to non-ligated controls. Silk and cotton ligatures provoke foreign body reactions of soft tissue encapsulation type and bone resorption around implants in the absence of plaque.
Collapse
|
47
|
Dixon DR, London RM. Restorative design and associated risks for peri‐implant diseases. Periodontol 2000 2019; 81:167-178. [DOI: 10.1111/prd.12290] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
48
|
Gehrke P, Bleuel K, Fischer C, Sader R. Influence of margin location and luting material on the amount of undetected cement excess on CAD/CAM implant abutments and cement-retained zirconia crowns: an in-vitro study. BMC Oral Health 2019; 19:111. [PMID: 31200680 PMCID: PMC6567410 DOI: 10.1186/s12903-019-0809-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 05/31/2019] [Indexed: 11/10/2022] Open
Abstract
Background The flexibility in designing the submucosal part of CAD/CAM customized implant abutments and the individual positioning of its shoulder line has been suggested to reduce the risk of leaving undetected cement residues, thus preventing adverse effects on peri-implant tissues. A high correlation between excess cement left in the soft tissues and the occurrence of increased biofilm accumulation with sulcular bleeding and/ or suppuration has been reported. This in turn may cause peri-implant inflammation and peri-implant marginal bone loss. The aim of this study was to assess the frequency of cement remnants after the luting of zirconia crowns on CAD/CAM custom molar abutments with different margin levels and to evaluate the impact of the luting material. Material and methods A total of 20 titanium molar CAD/CAM implant abutments (BEGO Medical GmbH) with internal taper connection/ internal hex anti-rotation protection, and a convex emergence profile with different margin positions (0, 1, 2 and 3 mm below the mucosa), were virtually designed (Implant Studio, 3Shape) and manufactured. A master cast was scanned, duplicated by a 3D printer and individual gingival masks were produced to simulate peri-implant soft tissues. 20 corresponding zirconia crowns were designed (Cerec 3D, Dentsply Sirona), produced and cemented to the abutments with two different luting materials; a zinc oxide non-eugenol cement (Temp Bond NE) or a methacrylate cement (Panavia V5). To ensure retrievability of the crown/abutment connection, occlusal openings providing access to the abutment screws were designed. Excess cement was thoroughly removed and the crown/abutment units were unscrewed to evaluate the occurrence of cement residues. All the quadrants of each specimen were evaluated for calculation of the ratio between the cement remnant area and the total specimen area using Adobe Photoshop. Spearman analysis was performed to detect correlations between different variables. A two-sided t-test, ANOVA, Mann–Whitney, and Kruskal–Wallis tests were applied to detect differences between the groups. Results Cement remnants were found in every depth of the crown abutment complex and in almost every area investigated. The amount of cement residues increased as the crown-abutment margin was located more submucosally. Lingual areas were more prone to cement remnants than other surface areas (p = 0.0291). Excess cement was not only found at the margins of the crown-abutment complex, but also underneath (basal) the abutment itself, where cleaning was impossible. No statistical difference in the effect of zinc oxide non-eugenol- and methacrylate cement on the frequency of excess material at the lateral abutment surfaces could be demonstrated in vitro. The proportion of basal abutment aspects covered with cement residues was, however, significantly smaller in Panavia V5 samples with an average of 4.9 ± 3.7% compared to Temp Bond samples with an average of 8.6 ± 5.5%. Conclusions Given the results obtained in the present investigation the margin of CAD/CAM molar abutments should be located as coronally as possible to minimize the amount of cement remnants. If an epigingival or supragingival margin location is not feasible due to esthetic concerns, it cannot be recommended to place the margin of molar CAD/CAM abutments deeper than 1.5 mm in the proximal and oral regions.
Collapse
Affiliation(s)
- Peter Gehrke
- Private Practice for Oral surgery and Implant Dentsitry, Bismarckstraße 27, 67059, Ludwigshafen, Germany. .,Department of Postgraduate Education, Oral and Dental Medicine, Johann Wolfgang Goethe-University, Frankfurt, Germany.
| | | | | | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt, Germany
| |
Collapse
|
49
|
Doornewaard R, Glibert M, Matthys C, Vervaeke S, Bronkhorst E, de Bruyn H. Improvement of Quality of Life with Implant-Supported Mandibular Overdentures and the Effect of Implant Type and Surgical Procedure on Bone and Soft Tissue Stability: A Three-Year Prospective Split-Mouth Trial. J Clin Med 2019; 8:jcm8060773. [PMID: 31159202 PMCID: PMC6617188 DOI: 10.3390/jcm8060773] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 05/27/2019] [Accepted: 05/28/2019] [Indexed: 12/01/2022] Open
Abstract
In fully edentulous patients, the support of a lower dental prosthesis by two implants could improve the chewing ability, retention, and stability of the prosthesis. Despite high success rates of dental implants, complications, such as peri-implantitis, do occur. The latter is a consequence of crestal bone loss and might be related to the implant surface and peri-implant soft tissue thickness. The aim of this paper is to describe the effect of implant surface roughness and soft tissue thickness on crestal bone remodeling, peri-implant health, and patient-centered outcomes. The mandibular overdenture supported by two implants is used as a split-mouth model to scrutinize these aims. The first study compared implants placed equicrestal to implants placed biologically (i.e., dependent on site-specific soft tissue thickness). The second clinical trial compared implants with a minimally to a moderately rough implant neck. Both studies reported an improvement in oral health-related quality of life and a stable peri-implant health after three years follow-up. Only equicrestal implant placement yielded significantly higher implant surface exposure, due to the establishment of the biologic width. Within the limitations of this study, it can be concluded that an implant supported mandibular overdenture significantly improves the quality of life, with limited biologic complications and high survival rates of the implants.
Collapse
Affiliation(s)
- Ron Doornewaard
- Department Periodontology & Oral Implantology, Dental School, Faculty Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Maarten Glibert
- Department Periodontology & Oral Implantology, Dental School, Faculty Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Carine Matthys
- Department Periodontology & Oral Implantology, Dental School, Faculty Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Stijn Vervaeke
- Department Periodontology & Oral Implantology, Dental School, Faculty Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Ewald Bronkhorst
- Section Implantology & Periodontology, Department of Dentistry, Radboudumc, Philips van Leydenlaan 25, 6525 EX Nijmegen, The Netherlands.
| | - Hugo de Bruyn
- Department Periodontology & Oral Implantology, Dental School, Faculty Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
- Section Implantology & Periodontology, Department of Dentistry, Radboudumc, Philips van Leydenlaan 25, 6525 EX Nijmegen, The Netherlands.
| |
Collapse
|
50
|
Abstract
Objective: This analysis discusses common problems with systematic reviews (SRs) and presents a novel solution, the structured critical analysis (SCA) that can be incorporated into a SR or used as an alternative literature review design.Methods: A cross-sectional survey of current SRs related to interdisciplinary restorative dentistry was obtained by evaluating 100 current SRs for their self-reported methodological quality and its effect on scientific validity.Results: The preferred reporting items for systematic reviews and meta-analyses protocol (PRISMA) was used in 99/100 SRs, but only 8/100 reported a low risk of bias. High statistical heterogeneity precluding meta-analysis was found in 44/100 SRs. Only 94 paragraphs/100 SRs provided critical analysis.Discussion: Significant problems were found with current SRs that can compromise their reliability as the premier level of evidence for clinical science research. The reader must be aware of these deficiencies to correctly interpret the SR and cannot rely on the format alone.
Collapse
|