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Scarano A, Khater AGA, Gehrke SA, Inchingolo F, Tari SR. Animal Models for Investigating Osseointegration: An Overview of Implant Research over the Last Three Decades. J Funct Biomater 2024; 15:83. [PMID: 38667540 PMCID: PMC11051165 DOI: 10.3390/jfb15040083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Dental implants and bone augmentation are among dentistry's most prevalent surgical treatments; hence, many dental implant surfaces and bone grafts have been researched to improve bone response. Such new materials were radiologically, histologically, and histomorphometrically evaluated on animals before being used on humans. As a result, several studies used animals to evaluate novel implant technologies, biocompatibility, surgical techniques, and osseointegration strategies, as preclinical research on animal models is essential to evaluate bioactive principles (on cells, compounds, and implants) that can act through multiple mechanisms and to predict animal behavior, which is difficult to predict from in vitro studies alone. In this study, we critically reviewed all research on different animal models investigating the osseointegration degree of new implant surfaces, reporting different species used in the osseointegration research over the last 30 years. Moreover, this is the first study to summarize reviews on the main animal models used in the translational research of osseointegration, including the advantages and limitations of each model and determining the ideal location for investigating osseointegration in small and large animal models. Overall, each model has advantages and disadvantages; hence, animal selection should be based on the cost of acquisition, animal care, acceptability to society, availability, tolerance to captivity, and housing convenience. Among small animal models, rabbits are an ideal model for biological observations around implants, and it is worth noting that osseointegration was discovered in the rabbit model and successfully applied to humans.
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Affiliation(s)
- Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti–Pescara, 66100 Chieti, Italy;
| | - Ahmad G. A. Khater
- Faculty of Oral and Dental Medicine, Egyptian Russian University (ERU), Badr City 11829, Egypt;
- Health Affairs Directorate, Egyptian Ministry of Health and Population, Banisuif 62511, Egypt
| | | | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Sergio Rexhep Tari
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti–Pescara, 66100 Chieti, Italy;
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Zhang Y, Luo J, Di P, Chen B, Li J, Yu Z, Lin Y. Screw-retained ceramic-veneered/monolithic zirconia partial implant-supported fixed dental prostheses: A 5 to 10-year retrospective study on survival and complications. J Prosthodont 2024; 33:221-230. [PMID: 37302066 DOI: 10.1111/jopr.13723] [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: 01/08/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
PURPOSE To assess the clinical performance of screw-retained, ceramic-veneered, monolithic zirconia partial implant-supported fixed dental prostheses (ISFDP) over 5-10 years and to evaluate implant- and prosthesis-related factors influencing treatment failure and complications. MATERIALS AND METHODS Partially edentulous patients treated with screw-retained all-ceramic ISFDPs with 2-4 prosthetic units with a documented follow-up of ≥5 years after implant loading were included in this retrospective study. The outcomes analyzed included implant/prosthesis failure and biological/technical complications. Possible risk factors were identified using the mixed effects Cox regression analysis. RESULTS A screened sample of 171 participants with 208 prostheses (95% of the restorations were splinted crowns without a pontic) supported by 451 dental implants were enrolled in this study. The mean follow-up duration after prosthesis delivery was 82.4 ±17.2 months. By the end of the follow-up period, 431 (95.57%) of the 451 implants remained functional at the implant level. At the prosthesis level, 185 (88.94%) of the 208 partial ISFDPs remained functional. Biological complications were observed in 67 implants (14.86%), and technical complications were observed in 62 ISFDPs (29.81%). Analysis revealed only emergence profiles (over-contoured) as a significant risk factor for implant failure (P<0.001) and biological complications (P<0.001). Full-coverage ceramic-veneered zirconia prostheses had a significantly greater chance of chipping (P<0.001) compared with buccal-ceramic-veneered or monolithic zirconia prostheses. CONCLUSIONS Screw-retained ceramic-veneered, monolithic partial ISFDPs have a favorable long-term survival rate. Over-contoured emergence profile is a significant risk factor associated with implant failure and biological complications. Buccal-ceramic-veneered and monolithic zirconia partial ISFDPs lower the initial prevalence of chipping compared with a full-coverage veneered design.
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Affiliation(s)
- Yifan Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Jia Luo
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Ping Di
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Bo Chen
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Jianhui Li
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Ziyang Yu
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Ye Lin
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
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Ng E, Tay JRH, Mattheos N, Bostanci N, Belibasakis GN, Seneviratne CJ. A Mapping Review of the Pathogenesis of Peri-Implantitis: The Biofilm-Mediated Inflammation and Bone Dysregulation (BIND) Hypothesis. Cells 2024; 13:315. [PMID: 38391928 PMCID: PMC10886485 DOI: 10.3390/cells13040315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
This mapping review highlights the need for a new paradigm in the understanding of peri-implantitis pathogenesis. The biofilm-mediated inflammation and bone dysregulation (BIND) hypothesis is proposed, focusing on the relationship between biofilm, inflammation, and bone biology. The close interactions between immune and bone cells are discussed, with multiple stable states likely existing between clinically observable definitions of peri-implant health and peri-implantitis. The framework presented aims to explain the transition from health to disease as a staged and incremental process, where multiple factors contribute to distinct steps towards a tipping point where disease is manifested clinically. These steps might be reached in different ways in different patients and may constitute highly individualised paths. Notably, factors affecting the underlying biology are identified in the pathogenesis of peri-implantitis, highlighting that disruptions to the host-microbe homeostasis at the implant-mucosa interface may not be the sole factor. An improved understanding of disease pathogenesis will allow for intervention on multiple levels and a personalised treatment approach. Further research areas are identified, such as the use of novel biomarkers to detect changes in macrophage polarisation and activation status, and bone turnover.
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Affiliation(s)
- Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore;
| | - John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore;
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand;
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Nagihan Bostanci
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Georgios N. Belibasakis
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Chaminda Jayampath Seneviratne
- School of Dentistry, The University of Queensland, Brisbane, QLD 4006, Australia
- School of Dentistry, Center for Oral-Facial Regeneration, Rehabilitation and Reconstruction (COR3), The University of Queensland, Brisbane, QLD 4072, Australia
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore 168938, Singapore
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Hoffmann KJ, Büsch C, Moratin J, Ristow O, Hoffmann J, Mertens C. Peri-implant health after microvascular head and neck reconstruction-A retrospective analysis. Clin Oral Implants Res 2024; 35:187-200. [PMID: 38010660 DOI: 10.1111/clr.14214] [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: 04/21/2023] [Revised: 10/04/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Prosthodontic rehabilitation after reconstruction with microvascular revascularized free flaps following ablative tumor surgery is challenging due to the altered anatomical and functional conditions. The aim of this retrospective study was to determine whether the type of graft and the type of peri-implant tissue have an effect on peri-implant inflammatory parameters and implant survival. MATERIALS AND METHODS Patients who received a free flap reconstruction with subsequent implant-prosthetic rehabilitation between 2010 and 2022 were retrospectively included. The primary outcome variable was the probing depth (PPD) at a minimum of 1 year after completion of prosthetic restoration. Predictive variables were type of free flap, emergence profile, and history of radiation. RESULTS Seventy-one patients after free flap reconstruction were included in the analysis. At a minimum of 24 months after implant insertion the primary outcome, PPD showed no clinically relevant differences between the types of free flaps used. The emergence profile through a skin island resulted in an increase in BOP compared to native mucosa in the descriptive analysis (p-value > .05). The analysis showed a 5-year implant survival of 96.2% (95% CI: 0.929-0.996) in cases without irradiation and 87.6% (95% CI: 0.810-0.948) with irradiation of the region evaluated (p-value .034). CONCLUSION Flap and associated soft tissue type had no significant effect on 5-year implant survival or peri-implant inflammatory parameters. However, the large heterogeneity of the patient population indicates that further prolonged studies are required for a more differentiated assessment of the long-term success.
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Affiliation(s)
- Korbinian Jochen Hoffmann
- Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Christopher Büsch
- Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany
| | - Julius Moratin
- Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Oliver Ristow
- Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Jürgen Hoffmann
- Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Mertens
- Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
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Hamadé L, El-Disoki S, Chrcanovic BR. Hypertension and Dental Implants: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:499. [PMID: 38256633 PMCID: PMC10816909 DOI: 10.3390/jcm13020499] [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: 12/24/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
PURPOSE The aim of the present systematic review was to investigate the influence of hypertension on the dental implant failure rate. METHODS An electronic search was undertaken in four databases, plus a manual search of journals. The I2 statistic was used to check heterogeneity and the inverse-variance method was used for the meta-analysis. The estimate of relative effect for dichotomous outcome was expressed as an odds ratio (OR). RESULTS The review included 24 publications. There were 4874 implants (257 failures) placed in hypertensive patients and 16,192 implants (809 failures) placed in normotensive patients. A pairwise meta-analysis showed that implants in hypertensive patients did not have a higher risk of failure than implants placed in normotensive patients (OR 1.100, p = 0.671). The log OR of implant failure between hypertensive and normotensive patients did not significantly change with the follow-up time (p = 0.824). CONCLUSIONS This review suggests that implants in hypertensive patients do not present higher odds of failure in comparison to normotensive patients. However, further research on this topic, with the use of more rigorous criteria to diagnose patients as being hypertensive, as well as clearer information about the pharmacological management of the condition in the patients, is recommended.
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Affiliation(s)
- Liljan Hamadé
- Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden; (L.H.); (S.E.-D.)
| | - Salma El-Disoki
- Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden; (L.H.); (S.E.-D.)
| | - Bruno Ramos Chrcanovic
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden
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Yari A, Fasih P, Alborzi S, Nikzad H, Romoozi E. Risk factors associated with early implant failure: A retrospective review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 125:101749. [PMID: 38145835 DOI: 10.1016/j.jormas.2023.101749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE The purpose of this study was to investigate the association between possible risk factors and early implant failure. PATIENTS AND METHODS This retrospective cohort study included consecutive patients receiving dental implant treatment in a four-year timeframe. Patient-related variables (age, sex, smoking, and systemic disease), local factors (area, reason for tooth extraction, and bone quality), surgical variables (bone augmentation, time of implant placement, staging, and antibiotic prophylaxis), and implant-related factors (brand, length, and diameter) were analyzed. Bivariate analyses and multivariate logistic regression model were used to determine the variables associated with early implant failure. RESULTS The study group comprised 1323 implants in 738 patients with a mean of 1.8 implants/patient of which, 53 failed in 52 patients in the early stage (before final prosthetic loading). According to the multivariate model, smoking (Odds Ratio=1.836, P=0.031), posterior maxillary region (OR=2.958, P=0.006), implantation in place of teeth extracted due to periodontal problems (OR=2.531, P=0.004), bone type IV (OR=2.881, P=0.008), implant in previously augmented site (OR=2.239, P=0.014), and immediate provisional prosthesis (OR=3.418, P=0.019) were associated with a significantly higher risk of early implant failure. Narrow implants showed a significantly higher risk of early failure in bivariate analyses (P=0.012). However, the effect was no longer significant in the multivariate model (OR=2.322, P=0.068). CONCLUSION Early implant failure would be more expected in smokers, posterior maxilla, history of periodontal problems, type IV bone, augmented bone, and immediately loaded cases.
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Affiliation(s)
- Amir Yari
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran.
| | - Paniz Fasih
- Department of Prosthodontics, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran.
| | - Shahram Alborzi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hooman Nikzad
- Sub-Department of Operations and Analytics, Department of Management, Faculty of Environment, Science and Economy, University of Exeter, Exeter, UK
| | - Elahe Romoozi
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences and Department of Periodontology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Mohseni P, Soufi A, Chrcanovic BR. Clinical outcomes of zirconia implants: a systematic review and meta-analysis. Clin Oral Investig 2023; 28:15. [PMID: 38135804 PMCID: PMC10746607 DOI: 10.1007/s00784-023-05401-8] [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: 10/18/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023]
Abstract
PURPOSE To assess the clinical outcomes of zirconia dental implants based on an updated systematic literature review. METHODS An electronic search was performed in three databases, last updated in June 2023, supplemented by hand searching. The eligibility criteria were clinical studies reporting patients rehabilitated with zirconia implants. The cumulative survival rate (CSR) of implants was calculated. A meta-analysis for marginal bone loss (MBL) under different follow-up times and a meta-regression assessing the relationship between mean MBL and follow-up were done. RESULTS Twenty-five studies were included (4017 implants, 2083 patients). Seven studies had follow-up longer than 60 months. 172 implants failed, after a mean of 12.0 ± 16.1 months (min-max 0.3-86.0), of which 47 early failures, and 26 due to implant fracture, the majority in narrow-diameter implants. The 10-year CSR was 95.1%. Implants with coronal part prepared by drills presented statistically significant lower survival than non-prepared implants (p < 0.001). Two-piece implants presented lower survival than one-piece implants (p = 0.017). Implants discontinued from the market presented lower survival than the commercially available ones (p < 0.001). The difference in survival was not significant between implants in maxilla and mandible (p = 0.637). The mean MBL fluctuated between 0.632 and 2.060 mm over long periods of observation (up until 132 months). There was an estimated MBL increase of 0.005 mm per additional month of follow-up. CONCLUSION Zirconia implants present high 10-year CSR and short-term low MBL. The review was registered in PROSPERO (CRD42022342055). CLINICAL RELEVANCE The clinical outcomes observed for zirconia dental implants are very promising, although these have not yet been extensively studied as titanium alloy implants.
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Affiliation(s)
| | - Ahmad Soufi
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Bruno Ramos Chrcanovic
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Carl Gustafs Väg 34, 214 21, Malmö, Sweden.
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Uesugi T, Shimoo Y, Munakata M, Sato D, Yamaguchi K, Fujimaki M, Nakayama K, Watanabe T, Malo P. The All-on-four concept for fixed full-arch rehabilitation of the edentulous maxilla and mandible: a longitudinal study in Japanese patients with 3-17-year follow-up and analysis of risk factors for survival rate. Int J Implant Dent 2023; 9:43. [PMID: 37938479 PMCID: PMC10632321 DOI: 10.1186/s40729-023-00511-0] [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: 07/10/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023] Open
Abstract
PURPOSE Implant-supported immediately loaded fixed full-arch rehabilitation via All-on-four treatment yields good long-term results for both the maxilla and the mandible. However, the risk factors affecting long-term implant survival are unknown, and the long-term prognosis of All-on-four concept procedures in Japanese individuals has not been elucidated. We aimed to determine the cumulative implant survival rate after 3-17-year follow-up and identify the associated risk factors. METHODS We analysed 561 cases (307 maxillae, 254 mandibles) with 2364 implants (1324 maxillae, 1040 mandibles) that received All-on-four treatment. We investigated the cumulative implant- and patient-level survival rates and various risk factors for implant failure. Statistical analysis was performed using the log-rank test for differences in Kaplan-Meier curves, univariate analysis using the Chi-square test, and multivariate analysis for risk factors affecting the survival rate. RESULTS The cumulative survival rate was 94.4% by patient level and 97.4% by implant level for the maxilla, and 96.7% by patient level and 98.9% by implant for the mandible, with up to 17 years of follow-up. The maxillary survival rate at the implant level was significantly lower (p < 0.05). Furthermore, the maxillary survival rate within 24 months was significantly lower at the implant level (p < 0.01). Multivariate analysis revealed that the maxilla was the most significant risk factor (p < 0.01). CONCLUSIONS All-on-four treatment yielded high long-term survival rates in Japanese patients. However, the maxilla showed a significantly lower cumulative survival rate than the mandible, while early failure was significantly higher. Furthermore, the maxilla was a significant risk factor influencing the survival rate.
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Affiliation(s)
- Takashi Uesugi
- Malo Dental and Medical Tokyo, Fukuhara Ginza 8F, 7-8-10 Ginza, Chuo-Ku, Tokyo, 104-0061, Japan.
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo, Japan.
| | - Yoshiaki Shimoo
- Malo Dental and Medical Tokyo, Fukuhara Ginza 8F, 7-8-10 Ginza, Chuo-Ku, Tokyo, 104-0061, Japan
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | - Motohiro Munakata
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | - Daisuke Sato
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | - Kikue Yamaguchi
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | - Michiya Fujimaki
- Malo Dental and Medical Tokyo, Fukuhara Ginza 8F, 7-8-10 Ginza, Chuo-Ku, Tokyo, 104-0061, Japan
| | - Kazuhisa Nakayama
- Malo Dental and Medical Tokyo, Fukuhara Ginza 8F, 7-8-10 Ginza, Chuo-Ku, Tokyo, 104-0061, Japan
| | - Tae Watanabe
- Malo Dental and Medical Tokyo, Fukuhara Ginza 8F, 7-8-10 Ginza, Chuo-Ku, Tokyo, 104-0061, Japan
| | - Paulo Malo
- Malo Dental and Medical Tokyo, Fukuhara Ginza 8F, 7-8-10 Ginza, Chuo-Ku, Tokyo, 104-0061, Japan
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Chakraborty A, Das A, Datta P, Majumder S, Barui A, Roychowdhury A. 3D Printing of Ti-6Al-4V-Based Porous-Channel Dental Implants: Computational, Biomechanical, and Cytocompatibility Analyses. ACS APPLIED BIO MATERIALS 2023; 6:4178-4189. [PMID: 37713537 DOI: 10.1021/acsabm.3c00403] [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: 09/17/2023]
Abstract
Objective: Loosening of dental implants due to resorption of the surrounding bone is one of the challenging clinical complications in prosthetic dentistry. Generally, stiffness mismatch between an implant and its surrounding bone is one of the major factors. In order to prevent such clinical consequences, it is essential to develop implants with customized stiffness. The present study investigates the computational and experimental biomechanical responses together with cytocompatibility studies of three-dimensional (3D)-printed Ti-6Al-4V-based porous dental implants with varied stiffness properties. Methods: Additive manufacturing (direct metal laser sintering, DMLS) was utilized to create Ti-6Al-4V implants having distinct porosities and pore sizes (650 and 1000 μm), along with a nonporous (solid) implant. To validate the compression testing of the constructed implants and to probe their biomechanical response, finite element models were employed. The cytocompatibility of the implants was assessed using MG-63 cells, in vitro. Results: Both X-ray microcomputed tomography (μ-CT) and scanning electron microscopy (SEM) studies illustrated the ability of DMLS to produce implants with the designed porosities. Biomechanical analysis results revealed that the porous implants had less stiffness and were suitable for providing the appropriate peri-implant bone strain. Although all of the manufactured implants demonstrated cell adhesion and proliferation, the porous implants in particular supported better bone cell growth and extracellular matrix deposition. Conclusions: 3D-printed porous implants showed tunable stiffness properties with clinical translational potential.
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Affiliation(s)
- Arindam Chakraborty
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Shibpur, West Bengal 711103, India
| | - Ankita Das
- Center of Healthcare Science and Technology, Indian Institute of Engineering Science and Technology, Shibpur, West Bengal 711103, India
| | - Pallab Datta
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Kolkata, West Bengal 700054, India
| | - Santanu Majumder
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Shibpur, West Bengal 711103, India
| | - Ananya Barui
- Center of Healthcare Science and Technology, Indian Institute of Engineering Science and Technology, Shibpur, West Bengal 711103, India
| | - Amit Roychowdhury
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Shibpur, West Bengal 711103, India
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Sulaiman N, Fadhul F, Chrcanovic BR. Bisphosphonates and Dental Implants: A Systematic Review and Meta-Analysis. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6078. [PMID: 37763356 PMCID: PMC10532755 DOI: 10.3390/ma16186078] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/04/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023]
Abstract
The purpose of the present systematic review was to investigate the influence of bisphosphonates (BPs) on the dental implant failure rate and marginal bone loss (MBL). An electronic search was undertaken in three databases, plus a manual search of journals. Meta-analyses were performed, besides a meta-regression in order to verify how the log odds ratio (OR) was associated with follow-up time. The five- and ten-year estimated implant survivals were calculated. The review included 33 publications. Altogether, there were 1727 and 21,986 implants placed in patients taking and not taking BPs, respectively. A pairwise meta-analysis (26 studies) showed that implants in BP patients had a higher failure risk in comparison to non-BP patients (OR 1.653, p = 0.047). There was an estimated decrease of 0.004 in log OR for every additional month of follow-up, although it was not significant (p = 0.259). The global estimated implant survival in patients taking BPs after 5 and 10 years was 94.2% (95% CI, 94.0-94.4) and 90.1% (95% CI, 89.8-90.3), respectively. It was not possible to make any reliable analysis concerning MBL, as only two studies reported MBL results separated by groups. There is a 65.3% higher risk of implant failure in patients taking BPs in comparison to patients not taking this class of drugs.
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Affiliation(s)
- Nabaa Sulaiman
- Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden; (N.S.); (F.F.)
| | - Fadi Fadhul
- Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden; (N.S.); (F.F.)
| | - Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden
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Lee SJ, Alamri O, Cao H, Wang Y, Gallucci GO, Lee JD. Occlusion as a predisposing factor for peri-implant disease: A review article. Clin Implant Dent Relat Res 2023; 25:734-742. [PMID: 36373771 DOI: 10.1111/cid.13152] [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: 08/24/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 08/04/2023]
Abstract
BACKGROUND The restoration of dental implants presents a unique challenge due to the intrinsic biomechanical differences between osseointegrated implants and natural teeth, and their subsequent responses to occlusal loading. However, controversy exists regarding the role that occlusion plays in the physiology of the peri-implant complex. PURPOSE To provide an overview of the scientific literature regarding occlusion as it relates to implant dentistry and peri-implant disease. MATERIALS AND METHODS This article presents a narrative review on occlusal loading and its potential effects on the peri-implant complex, as well as some generally accepted guidelines for occlusion in implant dentistry. RESULTS AND CONCLUSIONS Although there is strong evidence linking occlusal factors to mechanical complications of dental implants, the same cannot be said regarding biological complications. There is no clear scientific evidence on the relationship between occlusal overload and peri-implant disease. However, occlusal overload may be an accelerating factor for peri-implant disease in the presence of inflammation. As the biomechanical properties of dental implants differ from that of the natural dentition, modifications to classic concepts of occlusion may be necessary when dental implants are involved. Thus, clinical recommendations are proposed which function to minimize unfavorable occlusal forces on implant restorations and reduce the associated biological and mechanical complications.
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Affiliation(s)
- Sang J Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Osamah Alamri
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Huilin Cao
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Yujun Wang
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jason D Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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12
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Mously EA. Impact of Implant Diameter on the Early Survival Rate of Dental Implants in the Saudi Population: A One-Year Retrospective Study. Cureus 2023; 15:e37765. [PMID: 37214022 PMCID: PMC10194036 DOI: 10.7759/cureus.37765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/23/2023] Open
Abstract
Introduction The use of dental implants provides a revolutionary solution to the problem of missing teeth in the oral cavity. The aim of this study was to assess the early implant survival rate in relation to implant diameter and site of placement. Methods The data were collected from 186 patients treated between January 2019 and June 2021. All the implants were evaluated and restored after three months of implant placement. The early implant survival was calculated for different implant diameters with the odds ratio (OR). Results A total of 373 implants were placed. Implants were placed in the following areas: upper posterior area (UPA), n = 123, upper anterior area (UAA), n = 49, lower posterior area (LPA), n = 184, and lower anterior area (LAA), n = 17. Implants of the following diameters were placed: 3.5 mm (n = 129), 4.3 mm (n = 166), and 5 mm (n = 78). The overall early survival rate was 97.32% after three months of placement. The highest early survival rate was at LAA (100%) and the lowest early survival rate was at UAA (95.9%). The implants 5 mm in diameter had the highest early survival rate (98.72%), while the implants 3.5 mm in diameter had the lowest early survival rate (94.57%). The ORs of the early implant survival were 4.7 [95% confidence interval (CI): 0.96-23.05)] and 4.42 (95% CI: 0.53-36.61) for the 4.3 mm and 5 mm implants, respectively, with no statistical significance. Conclusions The implants placed in the oral cavity had acceptable survival rates regardless of implant diameter or site of placement.
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Affiliation(s)
- Eihab A Mously
- Preventive Dental Sciences, College of Dentistry Taibah University, Madina, SAU
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13
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Agliardi EL, Pozzi A, Romeo D, Del Fabbro M. Clinical outcomes of full-arch immediate fixed prostheses supported by two axial and two tilted implants: A retrospective cohort study with 12-15 years of follow-up. Clin Oral Implants Res 2023; 34:351-366. [PMID: 36760035 DOI: 10.1111/clr.14047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 01/16/2023] [Accepted: 01/30/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE To retrospectively assess clinical and radiographic outcomes of immediately loaded full-arch fixed prostheses supported by axial and tilted implants up to 15 years of function. MATERIALS AND METHODS Patients with one completely edentulous arch received an immediate full-arch fixed prosthesis supported by two anterior axial and two posterior tilted implants. Definitive prosthesis consisting of a CAD-CAM titanium framework and acrylic teeth was delivered 6 months later. Patients were regularly followed to assess clinical parameters and marginal bone level (MBL) change. Multilevel regression analysis was performed to investigate factors affecting implant failure and MBL. RESULTS Six hundred ninety-two implants were placed in 72 maxillae and 101 mandibles. Seven maxillary implants (5 axial and 2 tilted) in 6 patients and 12 mandibular implants (6 axial and 6 tilted) in 5 patients failed. 15-year cumulative implant survival was 97.51% and 96.91% in maxilla and mandible, respectively (p = .64). After 10 years, the difference in MBL between axial and tilted implants was not significant in the maxilla (p = .47, 65 patients), while it was in the mandible (p < .001, 80 patients). Significant higher bone loss was reported in the mandible at both 5- and 10-year follow-up (p < .001 and p = .004, respectively). Mixed-effect multilevel linear regression evidenced a correlation between arch and bone loss at 5- and 10-year follow-up, while no correlation was found with age, gender, smoking, diabetes, and history of periodontal disease. CONCLUSION This long-term study suggests that the present technique can be considered a viable treatment modality for the immediate rehabilitation of both maxilla and mandible.
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Affiliation(s)
- Enrico Luigi Agliardi
- Advanced Oral Surgery Unit, Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Alessandro Pozzi
- Dental College of Georgia, Augusta, USA.,Private Practice in Rome, Rome, Italy
| | - Davide Romeo
- Advanced Oral Surgery Unit, Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,UOC Maxillofacial Surgery and Dentistry, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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14
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Takashima M, Arai Y, Matsuzaki N, Yamazaki Y, Nishiyama H, Nohno K. Masseter muscle cross-sectional area and late implant failure: A case-control study. Clin Implant Dent Relat Res 2023; 25:313-320. [PMID: 36726209 DOI: 10.1111/cid.13189] [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: 10/18/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Occlusal overload is considered to be one of the causes of late implant failure. However, it is unclear whether the magnitude of the patient's occlusal force is a risk factor for late implant failure. PURPOSE This case-control study aimed to clarify the association between the cross-sectional area (CSA) of the masseter muscle and late implant failure. METHODS This case-control study was limited to implant-supported fixed prostheses. We compared cases with at least one late implant failure (n = 25 patients) to controls (n = 82 patients) without implant failure. Patients were matched by age, sex, year of surgery, jaw and tooth type, and bone graft. Log-rank and Cox proportional hazard regression analyses were used to identify possible risk factors for late implant failure. RESULTS The incidence of late implant failure was significantly associated with masseter muscle CSA ≥504.5 mm2 (hazard ratio: 4.43; 95% CI: 1.82-10.79; p < 0.01). CONCLUSION Higher masseter muscle CSA increases the risk of late implant failure.
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Affiliation(s)
- Makiko Takashima
- Oral Implant and Temporomandibular Joint Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yoshiaki Arai
- Oral Implant and Temporomandibular Joint Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Nanaka Matsuzaki
- Oral Implant and Temporomandibular Joint Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yuta Yamazaki
- Oral Implant and Temporomandibular Joint Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Hideyoshi Nishiyama
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kaname Nohno
- Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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15
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Abstract
Mental health disorders, particularly depression and anxiety, affect a significant number of the global population. Several pathophysiological pathways for these disorders have been identified, including the hypothalamic-pituitary-adrenal axis, autonomic nervous system, and the immune system. In addition, life events, environmental factors, and lifestyle affect the onset, progression, and recurrence of mental health disorders. These may all overlap with periodontal and/or peri-implant disease. Mental health disorders are associated with more severe periodontal disease and, in some cases, poorer healing outcomes to nonsurgical periodontal therapy. They can result in behavior modification, such as poor oral hygiene practices, tobacco smoking, and alcohol abuse, which are also risk factors for periodontal disease and, therefore, may have a contributory effect. Stress has immunomodulatory effects regulating immune cell numbers and function, as well as proinflammatory cytokine production. Stress markers such as cortisol and catecholamines may modulate periodontal bacterial growth and the expression of virulence factors. Stress and some mental health disorders are accompanied by a low-grade chronic inflammation that may be involved in their relationship with periodontal disease and vice versa. Although the gut microbiome interacting with the central nervous system (gut-brain axis) is thought to play a significant role in mental illness, less is understood about the role of the oral microbiome. The evidence for mental health disorders on implant outcomes is lacking, but may mainly be through behaviourial changes. Through lack of compliance withoral hygiene and maintenance visits, peri-implant health can be affected. Increased smoking and risk of periodontal disease may also affect implant outcomes. Selective serotonin reuptake inhibitors have been linked with higher implant failure. They have an anabolic effect on bone, reducing turnover, which could account for the increased loss.
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Affiliation(s)
- Jake Ball
- Centre for Rural Dentistry and Oral HealthCharles Sturt UniversityOrangeNew South WalesAustralia
| | - Ivan Darby
- Periodontics, Melbourne Dental SchoolThe University of MelbourneMelbourneVictoriaAustralia
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16
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Albrektsson T, Tengvall P, Amengual-Peñafiel L, Coli P, Kotsakis G, Cochran DL. Implications of considering peri-implant bone loss a disease, a narrative review. Clin Implant Dent Relat Res 2022; 24:532-543. [PMID: 35639515 PMCID: PMC9542069 DOI: 10.1111/cid.13102] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 12/16/2022]
Abstract
Background Peri‐implantitis has been suggested to cause significant increasing proportions of implant failure with increasing time. Purpose To assess whether implant failure rates in long term studies are matching the supposed high prevalence of peri‐implantitis. Material and Methods This paper is written as a narrative review of the long‐term clinical investigations available in the literature. Results Some implant systems have seen unacceptable marginal bone loss figures with time coupled to increased implant failure rates, resulting in the withdrawal of these systems. The reasons for such mishap are generally unknown, with the exception of one system failure that was found to be due to improper clinical handling. Modern, moderately rough implant systems have functioned excellently over 10–15 years of follow up with minor problems with marginal bone loss and implant failure rates within a few per cent. Machined implants have functioned adequately over 20–30 years of follow up. Implant failures occur predominantly during the first few years after implant placement. No significant increase of implant failures has been observed thereafter over 20–30 years of follow up. Over the years of our new millennium, scientific and technical advances have allowed the discovery of numerous molecular pathways and cellular interactions between the skeletal and immune system promoting the development of the interdisciplinary field called osteoimmunology. Nowadays, this knowledge has not only allowed the emergence of new etiologic paradigms for bone disease but also a new dynamic approach on the concept of osseointegration and MBL around oral implants, re‐evaluating our older disease oriented outlook. This facilitates at the same time the emergence of translational applications with immunological perspectives, scientific approaches based on omics sciences, and the beginning of an era of personalized dental implant therapy to improve the prognosis of oral implant treatment. Conclusions Oral implant systems have been found to function with very good clinical outcome over follow‐up times of 20–30 years. Registered implant failures have occurred predominantly during the first few years after implantation, and there has been no significant increase in late failures due to peri‐implantitis.
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Affiliation(s)
- Tomas Albrektsson
- Department of Biomaterials, Institute Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Pentti Tengvall
- Department of Biomaterials, Institute Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Pierluigi Coli
- Specialist in Periodontics and Prosthodontics, Edinburgh Dental Specialists, Edinburgh, UK.,Department of Prosthetic Dentistry/Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Georgios Kotsakis
- Department of Prosthetic Dentistry/Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - David L Cochran
- Department of Periodontology, University of Texas, San Antonio, USA
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17
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Diabetes Mellitus and Dental Implants: A Systematic Review and Meta-Analysis. MATERIALS 2022; 15:ma15093227. [PMID: 35591561 PMCID: PMC9105616 DOI: 10.3390/ma15093227] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/15/2022] [Accepted: 04/28/2022] [Indexed: 01/08/2023]
Abstract
The present review aimed to evaluate the impact of diabetes mellitus on dental implant failure rates and marginal bone loss (MBL). An electronic search was undertaken in three databases, plus a manual search of journals. Meta-analyses were performed as well as meta-regressions in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. The review included 89 publications. Altogether, there were 5510 and 62,780 implants placed in diabetic and non-diabetic patients, respectively. Pairwise meta-analysis showed that implants in diabetic patients had a higher failure risk in comparison to non-diabetic patients (OR 1.777, p < 0.001). Implant failures were more likely to occur in type 1 diabetes patients than in type 2 (OR 4.477, p = 0.032). The difference in implant failure between the groups was statistically significant in the maxilla but not in the mandible. The MBL mean difference (MD) between the groups was 0.776 mm (p = 0.027), with an estimated increase of 0.032 mm in the MBL MD between groups for every additional month of follow-up (p < 0.001). There was an estimated decrease of 0.007 in OR for every additional month of follow-up (p = 0.048). In conclusion, implants in diabetic patients showed a 77.7% higher risk of failure than in non-diabetic patients.
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18
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Stefos S, Kourtis S, Vrekoussis T, Augoulea A, Kalantaridou S. Quality of Life in Menopausal Women with Dental Restorations and Implants. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2203151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim:
This multicenter study examined the relationship, possible interactions, and intermittent effects that dental implants and prostheses can have on menopausal women’s quality of life as well as provided information regarding the possible side effects of therapeutic regimens on menopause and osteoporosis or osteopenia.
Materials and Methods:
Questionnaires consisted of selected quality of life questions based on specific and additional medical and dental (mainly prosthodontic) questions, which were administered to 100 Greek menopausal/post-menopausal women (Age: Mean Value=63,62 years old) with osteopenia or with or without osteoporosis, with dental implants and implant restorations, or conventional prosthetic restorations visiting two University Hospitals. Menopausal/post-menopausal status was judged on the basis of either secondary, definitive amenorrhoea or based on follicular stimulation hormone (FSH) values, estradiol, and clinical risk factors.
Results:
Participants had a statistically significantly better “functional” and “psychological” feeling after prosthodontic rehabilitation with and without implants. Three out of four reported that their dentist informed them of the possible implant problems that might arise from osteoporosis and its treatment (medications). Moreover, osteopenia was found to be associated with a very lower problem percentage. The bisphosphonate treatment had the highest rate (80%) of reported implant problems than non-bisphosphonate treatment (30%). The hormone replacement therapy (HRT) for menopause was reported to be more associated with problems in implant placement (19%) than in those without treatment (27.3%).
Conclusion:
The questionnaires revealed a significant improvement concerning women’s life quality and well-documented information about the problems their dental implants and restorations may cause in association with menopause and/or osteoporosis.
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King S, Klineberg I, Brennan-Speranza TC. Adipose Tissue Dysfunction: Impact on Bone and Osseointegration. Calcif Tissue Int 2022; 110:32-40. [PMID: 34374815 DOI: 10.1007/s00223-021-00899-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
Bone metabolism may be adversely affected in metabolic diseases such as obesity and metabolic syndrome, which are characterised by weight gain, due to the expansion of adipose tissue deposits. As an important regulator of energy metabolism, adipose tissues synthesise and secrete several key regulatory adipokines that influence a range of metabolic functions. This narrative review outlines the evidence for the mechanisms by which adipose tissue dysfunction may alter bone metabolism prior to the development of frank hyperglycaemia and presents the emerging evidence for the impact of diet-induced expansion of adipose tissue on implant osseointegration. Successful osseointegration requires normal bone cell function, and the expansion of adipose tissue deposits results in dysregulated adipokine production favouring an increase in pro-inflammatory adipokines, contributing to the development of a chronic inflammatory state and insulin resistance. The increase in inflammatory cytokines promotes the growth and differentiation of osteoclasts indirectly through the modulation of osteoblastic RANKL production and directly by reducing osteoclast apoptosis and increased osteoclastic expression of RANK. Conversely, the suppression of osteoblastic regulatory genes results in reduced osteoblast numbers and function contributing to compromised bone turnover. Compromised osseointegration has been established in hyperglycaemia; however, as discussed in this review, it may not be the only driver of altered bone metabolism. The incidence of metabolic disease in the community is rising, patients may present for implant treatment with undiagnosed, underlying changes to bone cell metabolism due to adipose tissue dysmetabolism.
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Affiliation(s)
- Shalinie King
- Sydney Dental School and Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Iven Klineberg
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Tara C Brennan-Speranza
- Head Skeletal Endocrine Laboratory, School of Medical Sciences and School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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20
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Smoking and Dental Implants: A Systematic Review and Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2021; 58:medicina58010039. [PMID: 35056347 PMCID: PMC8780868 DOI: 10.3390/medicina58010039] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/15/2021] [Accepted: 12/23/2021] [Indexed: 01/27/2023]
Abstract
Background and Objectives: Tobacco is today the single most preventable cause of death, being associated with countless diseases, including cancer and neurological, cardiovascular, and respiratory diseases. Smoking also brings negative consequences to oral health, potentially impairing treatment with dental implants. The present review aimed to evaluate the influence of smoking on dental implant failure rates and marginal bone loss (MBL). Materials and Methods: Electronic search was undertaken in three databases, plus a manual search of journals. Meta-analyses were performed, in addition to meta-regressions, in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. Results: The review included 292 publications. Altogether, there were 35,511 and 114,597 implants placed in smokers and in non-smokers, respectively. Pairwise meta-analysis showed that implants in smokers had a higher failure risk in comparison with non-smokers (OR 2.402, p < 0.001). The difference in implant failure between the groups was statistically significant in the maxilla (OR 2.910, p < 0.001), as well as in the mandible (OR 2.866, p < 0.001). The MBL mean difference (MD) between the groups was 0.580 mm (p < 0.001). There was an estimated decrease of 0.001 in OR (p = 0.566) and increase of 0.004 mm (p = 0.279) in the MBL MD between groups for every additional month of follow-up, although without statistical significance. Therefore, there was no clear influence of the follow-up on the effect size (OR) and on MBL MD between groups. Conclusions: Implants placed in smokers present a 140.2% higher risk of failure than implants placed in non-smokers.
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21
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Ibrahim A, Chrcanovic BR. Dental Implants Inserted in Fresh Extraction Sockets versus Healed Sites: A Systematic Review and Meta-Analysis. MATERIALS 2021; 14:ma14247903. [PMID: 34947493 PMCID: PMC8708389 DOI: 10.3390/ma14247903] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 12/24/2022]
Abstract
The present review aimed to evaluate the difference of dental implant failure rates and marginal bone loss (MBL) between implants inserted in fresh extraction sockets or healed sites. Electronic search was undertaken in three databases, plus manual search of journals, including studies randomized or not. Meta-analyses were performed besides meta-regressions, in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. The review included 163 publications. Altogether, there were 17,278 and 38,738 implants placed in fresh extraction sockets and healed sites, respectively. Pairwise meta-analyses showed that implants in sockets had a higher failure risk in comparison to healed sites: OR 1.349, all studies included; OR 2.070, only prospective non-RCTs; OR 2.487, only RCTs (all p < 0.001). The difference in implant failure between the groups was statistically significant in the maxilla (OR 1.616, p = 0.029), but not in the mandible (OR 2.192, p = 0.075). The MBL mean difference (MD) between the groups was −0.053 mm (p = 0.089). There was an estimated decrease of 0.003 in OR (p = 0.284) and an increase of 0.006 mm (p = 0.036) in the MBL MD between groups for every additional month of follow-up. In conclusion, implants placed in fresh extraction sockets present higher risk of failure than implants placed in healed sites.
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Affiliation(s)
- Adam Ibrahim
- Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden;
| | - Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden
- Correspondence:
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22
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Peri-implant parameters and bone metabolic markers among water-pipe users treated with photodynamic therapy. Photodiagnosis Photodyn Ther 2021; 37:102655. [PMID: 34852310 DOI: 10.1016/j.pdpdt.2021.102655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/19/2021] [Accepted: 11/24/2021] [Indexed: 11/20/2022]
Abstract
AIM The study aimed to evaluate the efficacy of Mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) in the treatment of peri‑implantitis among waterpipe smokers (WPS) and non-smokers with peri‑implantitis MATERIAL AND METHODS: Participants were stratified into two groups. Group 1: Subjects who smoked water pipes for the last 2 years with peri‑implant disease were treated with aPDT adjunct to MD and group 2: Participants who did not use water pipes in the last 2 years but have periimplantitis (controls) were treated with MD only. Participants were scrutinized with peri‑implantitis (PI) in one dental implant at least based on the inclusion and exclusion criteria. Using structured questionnaire information was gathered from participants. All participants underwent mechanical debridement (MD). Participants of WPS underwent antimicrobial photodynamic therapy (aPDT). Peri implant inflammatory parameters (PI, BI, PD, and CBL) were assessed in all participant at baseline, 3 months and 6 months follow-up. Periimplant sulcular fluid was collected for assessment of bone metabolic biomarkers RANK-L and OPG. For immunological and clinical peri‑implant parameters analysis of variance (ANOVA) and Kruskal-Wallis test were used. For multiple comparisons, Bonferroni post hoc test was deployed. RESULTS Clinical periodontal parameters at baseline were significantly different in the control group PI (49.8 ± 10.5), BI(46.8 ± 7.7), and PD (5.0 ± 1.8) compared to WPS PI (56.1 ± 12.0), BI (40.9 ± 8.3), and PD (5.6 ± 1.5) (p < 0.05). At 3 months follow-up after PDT, PI (19.1 ± 7.7) and PD (3.9 ± 1.4) were significantly lower in the control group compared to WPS group PI (23.5 ± 8.4) and PD (4.5 ± 1.2) (p < 0.05). Whereas, BI of control (16.3 ± 6.8) and WPS group (17.1 ± 5.3) at 3 months follow-up was comparable (p > 0.05). At six months follow up following PDT, PI (15.7 ± 5.5) and PD (3.4 ± 1.2) was significantly lower in the control group compared to participants with water piped users PI (18.6 ± 7.4) and PD (3.9 ± 1.3) (p < 0.05). No significant difference was noted in BI in both groups (p > 0.05). Participants treated with PDT adjunct to MD demonstrated significantly reduced mean RANK-L levels at both 3 and 6 months (p<0.05). CONCLUSION aPDT adjunctive to MD improved periodontal parameters i.e., plaque index, pocket depth, and crestal bone loss along with metabolic marker RANK-L in water pipe smokers compared to non piped smokers.
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Caramês JMM, Marques DNDS, Caramês GB, Francisco HCO, Vieira FA. Implant Survival in Immediately Loaded Full-Arch Rehabilitations Following an Anatomical Classification System-A Retrospective Study in 1200 Edentulous Jaws. J Clin Med 2021; 10:jcm10215167. [PMID: 34768687 PMCID: PMC8584991 DOI: 10.3390/jcm10215167] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 11/16/2022] Open
Abstract
This retrospective study analyzed implant survival of immediate implant-supported fixed complete denture (IFCD) treatment options (TOs) based on the level of alveolar atrophy (CC). Records of 882 patients receiving a total of 6042 implants at one private referral clinic between 2004 and 2020 were considered. The mean follow-up period was 3.8 ± 2.7 years. Cumulative implant survival rates (CSRs) were analyzed as a function of CCs and TOs according to Mantel-Haenszel and Mantel-Cox. Hazard risk ratios for implant loss were compared using Cox regression. Confounding factors were identified using mixed Cox regression models. The 2- and 5-year CSRs were 98.2% and 97.9%, respectively. Maxillary 2- and 5-year CSRs were lower (97.7% and 97.3%) compared to mandibular CSRs (99.8% and 98.6%) (p = 0.030 and 0.0020, respectively). The CC did not influence CSRs of IFCDs in the mandible (p = 0.1483 and 0.3014, respectively) but only in the maxilla (p = 0.0147 and 0.0111), where CSRs decreased with increasing atrophy. TOs did not statistically differ in terms of survival rate for a given level of alveolar atrophy. The adaption of IFCD treatments to the level of atrophy and patient-specific risk factors can result in high CSRs, even at different levels of bone atrophy.
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Affiliation(s)
- João Manuel Mendez Caramês
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, 1070-064 Lisbon, Portugal; (D.N.d.S.M.); (G.B.C.); (H.C.O.F.); (F.A.V.)
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisbon, Portugal
- LIBPhys-FCT UID/FIS/04559/2013, Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal
- Correspondence: ; Tel.: +351-919727353; Fax: +351-217210989
| | - Duarte Nuno da Silva Marques
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, 1070-064 Lisbon, Portugal; (D.N.d.S.M.); (G.B.C.); (H.C.O.F.); (F.A.V.)
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisbon, Portugal
- LIBPhys-FCT UID/FIS/04559/2013, Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal
| | - Gonçalo Bartolo Caramês
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, 1070-064 Lisbon, Portugal; (D.N.d.S.M.); (G.B.C.); (H.C.O.F.); (F.A.V.)
| | - Helena Cristina Oliveira Francisco
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, 1070-064 Lisbon, Portugal; (D.N.d.S.M.); (G.B.C.); (H.C.O.F.); (F.A.V.)
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisbon, Portugal
| | - Filipe Araújo Vieira
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, 1070-064 Lisbon, Portugal; (D.N.d.S.M.); (G.B.C.); (H.C.O.F.); (F.A.V.)
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Feher B, Spandl LF, Lettner S, Ulm C, Gruber R, Kuchler U. Prediction of post-traumatic neuropathy following impacted mandibular third molar removal. J Dent 2021; 115:103838. [PMID: 34624417 DOI: 10.1016/j.jdent.2021.103838] [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: 08/25/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The extraction of impacted mandibular third molars is a common surgical procedure often associated with complications including post-traumatic neuropathy. Previous work has focused on identifying confounding factors, but a robust preoperative risk prediction model remains elusive. METHODS Using a dataset of 648 patients and 812 impacted mandibular third molars, we used least absolute shrinkage and selection operator (LASSO) to fit prediction models based on risk factors assessed at both the tooth and patient levels. In addition, we fitted multivariable logistic regression models with the Firth correction for generalized estimating equations (GEE). RESULTS The LASSO model for post-traumatic neuropathy identified distoangular impaction of ≥ 45° (odds ratio [OR] = 2.9), proximity to the inferior alveolar nerve of ≤ 3 mm (OR = 1.9), disadvantageous curving (OR = 1.4), and psychiatric conditions (OR = 2.1) as predictors [area under the receiving operator characteristic curve (AUC) = 0.75]. Among other complications analyzed, the LASSO model for bleeding identified deep embedding or full impaction (OR = 1.8), psychiatric conditions (OR = 1.3), and age (OR = 0.9) as predictors (AUC = 0.64). These associations between predictors and postoperative complications were fundamentally reinforced by the corresponding GEE models. CONCLUSIONS Our findings point to the predictability of post-traumatic neuropathy and bleeding based on tooth anatomy and patient characteristics, overall suggesting that preoperatively identifiable factors can predict the risk of adverse outcomes in the extraction of impacted mandibular third molars. CLINICAL SIGNIFICANCE Mandibular third molar extraction is both a routine procedure and a leading cause of trigeminal neuropathy. Prevention of post-traumatic neuropathy, aided by individualized preoperative risk prediction, is of high clinical relevance.
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Affiliation(s)
- Balazs Feher
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria; Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Lisa-Franziska Spandl
- Department of Dental Training, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Stefan Lettner
- Austrian Cluster for Tissue Regeneration, Vienna, Austria, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstrasse 13, 1200 Vienna, Austria; Core Facility Hard Tissue and Biomaterial Research, Karl Donath Laboratory, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Christian Ulm
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Reinhard Gruber
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstrasse 13, 1200 Vienna, Austria; Department of Periodontology, School of Dental Medicine, University of Bern, Murtenstrasse 11, 3008 Bern, Switzerland
| | - Ulrike Kuchler
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria.
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The Impact of Dental Implant Length on Failure Rates: A Systematic Review and Meta-Analysis. MATERIALS 2021; 14:ma14143972. [PMID: 34300891 PMCID: PMC8307721 DOI: 10.3390/ma14143972] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/08/2021] [Accepted: 07/13/2021] [Indexed: 12/22/2022]
Abstract
The present review aimed to evaluate the impact of implant length on failure rates between short (<10 mm) and long (≥10 mm) dental implants. An electronic search was undertaken in three databases, as well as a manual search of journals. Implant failure was the outcome evaluated. Meta-analysis was performed in addition to a meta-regression in order to verify how the risk ratio (RR) was associated with the follow-up time. The review included 353 publications. Altogether, there were 25,490 short and 159,435 long implants. Pairwise meta-analysis showed that short implants had a higher failure risk than long implants (RR 2.437, p < 0.001). There was a decrease in the probability of implant failure with longer implants when implants of different length groups were compared. A sensitivity analysis, which plotted together only studies with follow-up times of 7 years or less, resulted in an estimated increase of 0.6 in RR for every additional month of follow-up. In conclusion, short implants showed a 2.5 times higher risk of failure than long implants. Implant failure is multifactorial, and the implant length is only one of the many factors contributing to the loss of an implant. A good treatment plan and the patient’s general health should be taken into account when planning for an implant treatment.
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26
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Yang Y, Hu H, Zeng M, Chu H, Gan Z, Duan J, Rong M. The survival rates and risk factors of implants in the early stage: a retrospective study. BMC Oral Health 2021; 21:293. [PMID: 34107931 PMCID: PMC8188697 DOI: 10.1186/s12903-021-01651-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 06/03/2021] [Indexed: 12/02/2022] Open
Abstract
Background Few large-sample studies in China have focused on the early survival of dental implants. The present study aimed to report the early survival rates of implants and determine the related influencing factors. Methods All patients receiving dental implants at our institution between 2006 and 2017 were included. The endpoint of the study was early survival rates of implants, according to gender, age, maxilla/mandible, dental position, bone augmentation, bone augmentation category, immediate implant, submerged implant category, implant diameter, implant length, implant torque, and other related factors. Initially, SPSS22.0 was used for statistical analysis. The Chi-square test was used to screen all factors, and those with p < 0.05 were further introduced into a multiple logistic regression model to illustrate the risk factors for early survival rates of implants. Results In this study, we included 1078 cases (601 males and 477 females) with 2053 implants. After implantation, 1974 implants were retained, and the early survival rate was 96.15%. Patients aged 30–60 years (OR 2.392), with Class I bone quality (OR 3.689), bone augmentation (OR 1.742), immediate implantation (OR 3.509), and implant length < 10 mm (OR 2.972), were said to possess risk factors conducive to early survival rates. Conclusions The early survival rate of implants in our cohort exceeded 96%, with risk factors including age, tooth position, bone quality, implant length, bone augmentation surgery, and immediate implantation. When the above factors coexist, implant placement should be treated carefully.
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Affiliation(s)
- Yong Yang
- Department of Periodontology and Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Huiting Hu
- Department of Periodontology and Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Mianyan Zeng
- Department of Periodontology and Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Hongxing Chu
- Department of Periodontology and Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Zekun Gan
- Department of Periodontology and Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Jianmin Duan
- Department of Stomatology, General Hospital of Southern Theater of People's Liberation Army, Guangzhou, 510010, China
| | - Mingdeng Rong
- Department of Periodontology and Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China.
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Malm MO, Jemt T, Stenport VF. Patient factors related to early implant failures in the edentulous jaw: A large retrospective case-control study. Clin Implant Dent Relat Res 2021; 23:466-476. [PMID: 33999522 DOI: 10.1111/cid.13009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/14/2021] [Accepted: 04/29/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Dental implants provide anchorage for dental prostheses to restore functions for individuals with edentulous jaws. During the healing phase, proper osseointegration is required to prevent early implant failure. More knowledge is needed regarding factors related to early failure of dental implants. PURPOSE The aim of the present study was to identify possible risk factors for early implant failure, with respect to anamnestic and clinical parameters. MATERIALS AND METHODS All patients with edentulous jaws with early implant failure (n = 408) from one referral clinic were compared with a matched control group (n = 408) with no implant failure. Early implant failure was identified during the first year of prosthetic function. Matching was performed on age, gender, year of surgery, type of jaw, and type of implant surface. In addition, data on anamnestic and clinical parameters were collected. The data were analyzed with a multivariable logistic regression model using early implant failure as the binary outcome. RESULTS Five anamnestic factors were statistically significant with respect to higher probability for early implant failure: systemic disease, allergies in general, food allergies, smoking, and intake of analgesic medication. Four clinical conditions (i.e., implants in the opposing jaw, low primary stability, reduced bone volume, and healing complications) were also related to higher probability for early implant failure. CONCLUSIONS This study identified nine factors associated with early implant failure, several related to patient's general health. Further investigations are needed to fully understand the causality between the obtained variables and early implant failure.
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Affiliation(s)
- Malin Olsson Malm
- Brånemark Clinic, Public Dental Service, Region of Västra Götaland, Gothenburg, Sweden.,Department of Prosthodontics and Dental Material Science, Institute of Odontology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Torsten Jemt
- Brånemark Clinic, Public Dental Service, Region of Västra Götaland, Gothenburg, Sweden.,Department of Prosthodontics and Dental Material Science, Institute of Odontology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Victoria Franke Stenport
- Brånemark Clinic, Public Dental Service, Region of Västra Götaland, Gothenburg, Sweden.,Department of Prosthodontics and Dental Material Science, Institute of Odontology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Pillai S, Upadhyay A, Khayambashi P, Farooq I, Sabri H, Tarar M, Lee KT, Harb I, Zhou S, Wang Y, Tran SD. Dental 3D-Printing: Transferring Art from the Laboratories to the Clinics. Polymers (Basel) 2021; 13:polym13010157. [PMID: 33406617 PMCID: PMC7795531 DOI: 10.3390/polym13010157] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/14/2020] [Accepted: 12/30/2020] [Indexed: 12/13/2022] Open
Abstract
The rise of three-dimensional (3D) printing technology has changed the face of dentistry over the past decade. 3D printing is a versatile technique that allows the fabrication of fully automated, tailor-made treatment plans, thereby delivering personalized dental devices and aids to the patients. It is highly efficient, reproducible, and provides fast and accurate results in an affordable manner. With persistent efforts among dentists for refining their practice, dental clinics are now acclimatizing from conventional treatment methods to a fully digital workflow to treat their patients. Apart from its clinical success, 3D printing techniques are now employed in developing haptic simulators, precise models for dental education, including patient awareness. In this narrative review, we discuss the evolution and current trends in 3D printing applications among various areas of dentistry. We aim to focus on the process of the digital workflow used in the clinical diagnosis of different dental conditions and how they are transferred from laboratories to clinics. A brief outlook on the most recent manufacturing methods of 3D printed objects and their current and future implications are also discussed.
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Affiliation(s)
- Sangeeth Pillai
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Akshaya Upadhyay
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Parisa Khayambashi
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Imran Farooq
- Faculty of Dentistry, University of Toronto, Toronto, ON M5S 1A1, Canada;
| | - Hisham Sabri
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Maryam Tarar
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Kyungjun T. Lee
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Ingrid Harb
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Stephanie Zhou
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Yifei Wang
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Simon D. Tran
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
- Correspondence: ; Tel.: +1-514-398-7203
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Block MS, Christensen BJ, Mercante DE, Chapple AG. What Factors Are Associated With Implant Failure? J Oral Maxillofac Surg 2020; 79:91-97. [PMID: 32956618 DOI: 10.1016/j.joms.2020.08.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/24/2020] [Accepted: 08/24/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Recognition of patient-specific risk factors should reduce implant failure. The purpose of this study was to identify risk factors associated with implant failure and to determine if these factors differ over time after implant placement. METHODS The investigators implemented a retrospective case-controlled study and enrolled a sample composed of patients who had 1 or more implants removed from December 1, 2007 to February 29, 2020. Risk factors were grouped into demographic, medical history, and treatment-related variables. The primary outcome variable was whether the patient's implant failed, with control patients including those without implant failure. The duration was recorded for follow-up from the time of implant placement to the last visit or implant removal. Backward variable selection was used to predict whether an implant failed within 1 year, 1 to 4 years, or after 4 years in 3 multivariable logistic regressions. RESULTS Of 224 patients in this cohort, 82 experienced an implant failure. The mean age was 58.6 ± 15.3 years, and 53.1% were females. Patients with osteoporosis had an increased risk of failure in each period. Alcohol use, smoking, depression, and penicillin allergy were all associated with an increased probability of failure within 1 or more of the periods considered. CONCLUSIONS This study has identified multiple discrete risk factors for implant failure and has demonstrated that these factors are associated with implant failure at different periods after placement.
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Affiliation(s)
- Michael S Block
- Private Practice, Metairie and Clinical Professor, Department of Oral & Maxillofacial Surgery, LSU School of Dentistry, New Orleans, LA.
| | - Brian J Christensen
- Assistant Professor, Department of Oral & Maxillofacial Surgery, LSU School of Dentistry, New Orleans, LA
| | - Don E Mercante
- Professor, Department of Biostatistics, LSU School of Public Health, New Orleans, LA
| | - Andrew G Chapple
- Assistant Professor, Department of Biostatistics, LSU School of Public Health, New Orleans, LA
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30
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Chrcanovic BR, Ghiasi P, Kisch J, Lindh L, Larsson C. Retrospective study comparing the clinical outcomes of bar-clip and ball attachment implant-supported overdentures. J Oral Sci 2020; 62:397-401. [PMID: 32848099 DOI: 10.2334/josnusd.19-0412] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The aim of this study was to compare the clinical outcomes of implant-supported overdentures (ODs) with either bar-clip or ball attachments. The implant, prosthesis failure, and technical complications were the outcomes analyzed in this retrospective clinical study conducted in a specialty clinic. Seventy-five patients with 242 implants supported by 76 ODs (36 maxillary, 40 mandibular) were included in the study and followed up for 88.8 ± 82.9 months (mean ± standard deviation). Bar-clip and ball attachments were used in 78.9% and 21.1% of the cases, respectively. Forty-three implant failures (17.8%) in 17 prostheses (17/76; 22.4%) were observed in this study. The average period of implant failure was 43.3 ± 41.0 months, and most of them were maxillary turned implants. The bar-clip system demonstrated more complications in the attachment parts compared to the ball attachment system. Poor retention of the prosthesis was similar between the two systems. Loss of implants resulted in the failure of 10 ODs in this study. ODs opposed by natural dentition or fixed prostheses presented with more complications. The Cox proportional hazards model did not show a significant effect on prosthesis failure for any of the factors. These findings indicated that patients with ODs need constant maintenance follow-ups to address the technical complications and perform prosthodontic maintenance regardless of the attachment system used.
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Affiliation(s)
| | - Peyman Ghiasi
- Department of Prosthodontics, Faculty of Odontology, Malmö University
| | - Jenö Kisch
- Department of Prosthodontics, Faculty of Odontology, Malmö University
| | - Liselott Lindh
- Department of Prosthodontics, Faculty of Odontology, Malmö University
| | - Christel Larsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University
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Feher B, Lettner S, Heinze G, Karg F, Ulm C, Gruber R, Kuchler U. An advanced prediction model for postoperative complications and early implant failure. Clin Oral Implants Res 2020; 31:928-935. [PMID: 32683718 PMCID: PMC7589383 DOI: 10.1111/clr.13636] [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: 09/13/2019] [Revised: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Risk prediction in implant dentistry presents specific challenges including the dependence of observations from patients with multiple implants and rare outcome events. The aim of this study was to use advanced statistical methods based on penalized regression to assess risk factors in implant dentistry. MATERIAL AND METHODS We conducted a retrospective study from January 2016 to November 2018 recording postoperative complications including bleeding, hematoma, local infection, and nerve damage, as well as early implant failure. We further assessed patient- and implant-related risk factors including smoking and diabetes, as well as treatment parameters including types of gaps and surgical procedures. Univariable and multivariable generalized estimating equation (GEE) models were estimated to assess predictor effects, and a prediction model was fitted using L1 penalized estimation (lasso). RESULTS In a total of 1,132 patients (mean age: 50.6 ± 16.5 years, 55.4% female) and 2,413 implants, postoperative complications occurred in 71 patients. Sixteen implants were lost prior to loading. Multivariable GEE models showed a higher risk of any complication for diabetes mellitus (p = .006) and bone augmentation (p = .039). The models further revealed a higher risk of local infection for bone augmentation (p = .003), and a higher risk of hematoma formation for diabetes mellitus (p = .007) and edentulous jaws (p = .024). The lasso model did not select any risk factors into the prediction model. CONCLUSIONS Using novel methodology well-suited to tackle the specific challenges of risk prediction in implant dentistry, we were able to reliably estimate associations of risk factors with outcomes.
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Affiliation(s)
- Balazs Feher
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Stefan Lettner
- Core Facility Hard Tissue and Biomaterial Research, Karl Donath Laboratory, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Georg Heinze
- Institute of Clinical Biometrics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Florian Karg
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Christian Ulm
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Reinhard Gruber
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria.,Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ulrike Kuchler
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
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Chrcanovic BR, Kisch J, Larsson C. Analysis of technical complications and risk factors for failure of combined tooth-implant-supported fixed dental prostheses. Clin Implant Dent Relat Res 2020; 22:523-532. [PMID: 32524744 DOI: 10.1111/cid.12927] [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] [Received: 03/05/2020] [Revised: 05/05/2020] [Accepted: 05/18/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The oral rehabilitation with fixed restorations supported by the combination of teeth and dental implants has been advocated in some cases. PURPOSE To assess the clinical outcomes of these prostheses. Fixed restorations supported by the combination of teeth and dental implants. MATERIALS AND METHODS This retrospective study included all patients treated with combined tooth-implant-supported fixed dental prostheses (FDPs) at one specialist clinic. Abutment/prosthesis failure and technical complications were the outcomes analyzed. RESULTS A total of 85 patients with 96 prostheses were included, with a mean follow-up of 10.5 years. Twenty prostheses failed. The estimated cumulative survival rate was 90.7%, 84.8%, 69.9%, and 66.2% at 5, 10, 15, and 20 years, respectively. The failure of tooth and/or implant abutments in key positions affected the survival of the prostheses. There were seven reasons for prostheses failure, with the loss of abutments exerting a significant influence. Bruxism was possibly associated with failures. Prostheses with cantilevers did not show a statistically significant higher failure rate. No group had a general higher prevalence of technical complications in comparison to the other groups. CONCLUSIONS Although combined tooth-implant-supported FDPs are an alternative treatment option, this study has found that across 20 years of service nearly 35% the prostheses may fail.
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Affiliation(s)
| | - Jenö Kisch
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Christel Larsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Loewenstein AG, Bidra AS, Balshi TJ. Management of Maxillary Cluster Implant Failures with Extra-Maxillary Implants: A Clinical Report. J Prosthodont 2020; 29:369-373. [PMID: 32304120 DOI: 10.1111/jopr.13178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/12/2020] [Accepted: 04/13/2020] [Indexed: 11/27/2022] Open
Abstract
Late cluster implant failures can be one of the most devasting outcomes of implant therapy for patients. It can have anatomic, functional, psychological and financial consequences for patients, and sometimes the loss of residual bone can preclude subsequent implant placement. Fortunately, management of cluster implant failures in the maxilla can be mitigated by using implant anchorage from remote sites like zygomatic and pterygoid regions. Few reports exist in the literature that have described the management of cluster implant failure using extra-maxillary implants such as zygomatic and pterygoid implants. This case report describes the management of a female patient with bruxism who experienced late cluster implant failure in the maxilla after 9 years of function with an overdenture. Due to the loss of residual bone, subsequent implant therapy involved the use of bilateral zygomatic, pterygoid and anterior maxillary implants, which were immediately loaded and thereafter used to support a complete arch fixed implant-supported zirconia prosthesis.
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Affiliation(s)
| | - Avinash S Bidra
- Department of Reconstructive Sciences, University of Connecticut Health Center, Farmington, Connecticut
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Chrcanovic BR, Kisch J, Larsson C. Retrospective clinical evaluation of 2‐ to 6‐unit implant‐supported fixed partial dentures: Mean follow‐up of 9 years. Clin Implant Dent Relat Res 2020; 22:201-212. [PMID: 32157812 DOI: 10.1111/cid.12889] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/10/2020] [Accepted: 01/24/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Bruno R. Chrcanovic
- Department of Prosthodontics, Faculty of OdontologyMalmö University Malmö Sweden
| | - Jenö Kisch
- Department of Prosthodontics, Faculty of OdontologyMalmö University Malmö Sweden
| | - Christel Larsson
- Department of Prosthodontics, Faculty of OdontologyMalmö University Malmö Sweden
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Torsten J. Data on implant failures will show different results depending on how patients are compiled and analyzed: A retrospective study on 3902 individual patients treated either with one single implant or implants in the edentulous upper jaw. Clin Implant Dent Relat Res 2020; 22:226-236. [DOI: 10.1111/cid.12886] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/27/2019] [Accepted: 01/21/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Jemt Torsten
- Department of Prosthetic Dentistry/Dental Materials Science, Institute of OdontologySahlgrenska Academy at Göteborg University Göteborg Sweden
- Board Certified Prosthodontist, Brånemark ClinicPublic Dental Health Service Sweden
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Successive Reimplantation of Dental Implants Into Sites of Previous Failure. J Oral Maxillofac Surg 2020; 78:375-385. [DOI: 10.1016/j.joms.2019.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/04/2019] [Accepted: 10/04/2019] [Indexed: 12/30/2022]
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Bezdjian A, Verzani Z, Thomeer HGXM, Willie B, Daniel SJ. Smoking as a risk factor for spontaneous bone anchored hearing implant extrusion: A case report and review of literature. OTOLARYNGOLOGY CASE REPORTS 2020. [DOI: 10.1016/j.xocr.2019.100140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Petrie CS, Nakatani B, Scott JM, Moniz J, Walker MP. A survey of US dental schools on predoctoral implant curricula with emphasis on diagnosing and treating implant complications. J Prosthet Dent 2020; 125:126-136. [PMID: 32063384 DOI: 10.1016/j.prosdent.2019.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 10/25/2022]
Abstract
STATEMENT OF PROBLEM Implant complications have been reported to occur at high rates and frequencies. Whether these high rates are observed in predoctoral implant programs and whether future dentists are educated to diagnose and treat implant complications is unknown. PURPOSE The purpose of this study was to analyze and report the results of a survey on US predoctoral curricula related to implant treatment and with an emphasis on diagnosing and treating implant complications. MATERIAL AND METHODS A 26-question survey was distributed to all (66) US dental schools. In addition to 3 questions regarding descriptive information about each school, 13 questions were used to calculate a curriculum composite score that was used to assess the quality of the school's implant curriculum. The remaining survey topics and number of questions included frequency of complications (2), tracking and types of complications (6), and school-reported student preparedness to identify or treat implant complications (2). A Kruskal-Wallis test was used to evaluate the relationship between the curriculum composite scores and student preparedness to diagnose and treat implant complications. RESULTS Twenty-eight schools responded to the survey for a response rate of 42.4%, and 23 schools completed the entire survey (completion rate 34.8%). Fifteen schools (65.2%) reported methods of recording implant complications, and 8 of 23 schools (34.8%) reported methods of assessing student knowledge in recognizing implant complications. Only 2 schools reported methods of assessing student preparedness to treat implant complications. Most implant complications were mechanical (64.3%), followed by biological (28.6%) and esthetic (7.1%). The prostheses associated with the most complications were implant overdentures (39.1%), followed by single crowns (34.8%) and fixed partial dentures (4.3%). A positive relational trend was observed between reported student preparedness to recognize and treat implant complications and curriculum composite scores. CONCLUSIONS Within the limitation of this survey-based study, implant curricula in US dental schools should consider improving the scope of teaching the diagnosis and treatment of implant complications. The implant complications observed at US dental schools showed similar trends to those reported in the literature.
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Affiliation(s)
- Cynthia S Petrie
- Chair, Department of Restorative Clinical Sciences, Dr. George Tanaka Hawaii Professor of Restorative Dentistry, University of Missouri-Kansas City School of Dentistry, Kansas City, Mo.
| | - Bryson Nakatani
- Summer Scholar Program Participant, University of Missouri-Kansas City School of Dentistry, Kansas City, Mo
| | - JoAnna M Scott
- Assistant Professor, Biostatistician, Research and Graduate Programs, University of Missouri-Kansas City School of Dentistry, Kansas City, Mo
| | - Jessica Moniz
- Research Assistant, Research and Graduate Programs, University of Missouri-Kansas City School of Dentistry, Kansas City, Mo
| | - Mary P Walker
- Professor and Associate Dean for Research and Graduate Programs, University of Missouri-Kansas City School of Dentistry, Kansas City, Mo
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Shiraishi N, Masumoto H, Takahashi K, Tenkumo T, Anada T, Suzuki O, Ogawa T, Sasaki K. Histomorphometric assessments of peri-implant bone around Ti-Nb-Sn alloy implants with low Young's modulus. Dent Mater J 2020; 39:148-153. [PMID: 31666486 DOI: 10.4012/dmj.2018-376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Many β-Ti alloys have been developed for, and used in, medical devices because of the corrosion resistance, biocompatibility, and exceptionally low Young's modulus. The aim of the present study was to investigate the histomorphometric aspects of peri-implant bone around Ti-Nb-Sn alloy implants and compare them with those in the case of commercially pure Ti (Ti). Fluorescent morphological observations of ST-2 cells on the substrate were performed and bone morphogenesis around implants in rat femur was evaluated. There was no difference between the cell morphology on Ti and those on the Ti-Nb-Sn alloy during observation for 24 h. A comparison of the Ti-Nb-Sn alloy implant and the Ti implant showed no significant differences between the bone-to-implant contact ratios or the bone fractions. These results suggest that the biological adaptations with Ti-Nb-Sn implants during a healing period are similar to those with Ti. Ti-Nb-Sn is therefore suitable for use in dental implants.
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Affiliation(s)
- Naru Shiraishi
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Tohoku University.,Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences
| | - Hiroshi Masumoto
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University
| | - Kenta Takahashi
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Tohoku University
| | - Taichi Tenkumo
- Laboratory for Redox Regulation, Tohoku University Graduate School of Dentistry
| | - Takahisa Anada
- Institute for Materials Chemistry and Engineering, Kyushu University
| | - Osamu Suzuki
- Division of Craniofacial Function Engineering, Tohoku University Graduate School of Dentistry, Tohoku University
| | - Toru Ogawa
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Tohoku University
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Tohoku University
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Trbakovic A, Toljanic JA, Kumar VV, Thor A. Eight to eleven-year follow-up of immediately loaded implants placed in edentulous maxillae with compromised bone volume and poor bone quality: A prospective cohort study. Clin Implant Dent Relat Res 2019; 22:69-76. [PMID: 31860148 DOI: 10.1111/cid.12874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 10/26/2019] [Accepted: 11/13/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is a lack of long-term evaluations of immediately loaded implants in patients with compromised maxillary bone. PURPOSE To evaluate long-term survival and success of immediately loaded implants in subjects with poor maxillary bone quality and volume. MATERIAL AND METHODS Follow-up was performed on subjects who received six implants loaded within 24 hours with screw-retained fixed prostheses. Twenty-five subjects with limited bone (Lekholm and Zarb, quantity 3 and 4, and quality C and D) were included in the study. Nineteen participated in the radiographic examination and of these 17 participated in the clinical examination at the last visit. Evaluations of marginal bone loss were performed at 1, 3, 5, and 8-11 years. The last clinical examination included removal of the prosthesis followed by registration of: plaque, pus, pocket depth, bleeding upon probing, mobility, and percussion testing. RESULTS The mean follow-up was 9 years and 2 months (101-131 months) after surgery and showed a cumulative implant survival rate of 81.9% and success rate of 74.7%. Mean marginal bone loss was 1.29 mm (SD 2.47 mm range 0-11 mm) with a mean pocket depth of 3.1 mm (SD 2.4 mm, range 1.5-13.5 mm). 42.5% of the implants showed plaque retention and 72.2% showed bleeding on probing. CONCLUSION This nonaugmenting immediate loaded implant protocol for maxillary edentulous patients is a satisfactory solution for selected patients.
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Affiliation(s)
- Amela Trbakovic
- Department of Surgical Sciences, Plastic & Oral and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
| | - Joseph A Toljanic
- Midwestern University College of Dental Medicine-Illinois, Downers Grove, Illinois
| | - Vinay V Kumar
- Department of Surgical Sciences, Plastic & Oral and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
| | - Andreas Thor
- Department of Surgical Sciences, Plastic & Oral and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
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Chrcanovic BR, Gomez RS. Dental implants in patients with epidermolysis bullosa: a systematic review. Oral Maxillofac Surg 2019; 23:389-394. [PMID: 31659571 PMCID: PMC6841645 DOI: 10.1007/s10006-019-00802-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 09/11/2019] [Indexed: 01/08/2023]
Abstract
Purpose To integrate the available data published on patients with epidermolysis bullosa (EB) rehabilitated with dental implants, as well as to review the recommendations for EB patients receiving implants. Methods An electronic search was undertaken in February 2019 in five databases. Results Sixteen publications were included, reporting 28 patients with EB, rehabilitated with 161 dental implants. The mean ± SD patients’ age at implant surgery was 34.7 ± 12.1 years (range, 13–56). Only one implant was placed in the molar region, all other implants were placed in the incisor, canine, and premolar regions. Patients received a mean ± SD of 5.8 ± 2.8 implants (range, 2–11). Most of the patients received implant-supported fixed prostheses (fixed partial 14.3%, fixed full-arch 60.7%, overdenture 25%). Implant and prosthesis failure rates were 1.3% and 0%, respectively. The two implant failures were detected before or at the abutment connection. The mean ± SD follow-up time was of 39.2 ± 24.5 months (range, 6–111). The EB patient quality-of-life improved considerably as a result of treatment with dental implants. There is a series of dental care considerations that should be followed to smooth the implant treatment in EB patients. Conclusions The dental implant failure rate in EB patients seems to be very low, although the few cases reported in the literature were followed up for a short mean period, i.e., just a little bit longer than 3 years. More cases followed up for a long period are needed in order to be able to make a more reliable prognosis for the long-term oral rehabilitation of EB patients with dental implants.
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Affiliation(s)
- Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Carl Gustafs väg 34, SE-214 21 Malmö, Sweden
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Dental implants in patients with Sjögren’s syndrome: a case series and a systematic review. Int J Oral Maxillofac Surg 2019; 48:1250-1259. [PMID: 30827571 DOI: 10.1016/j.ijom.2019.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/15/2019] [Accepted: 02/13/2019] [Indexed: 12/29/2022]
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Kang DW, Kim SH, Choi YH, Kim YK. Repeated failure of implants at the same site: a retrospective clinical study. Maxillofac Plast Reconstr Surg 2019; 41:27. [PMID: 31355159 PMCID: PMC6616583 DOI: 10.1186/s40902-019-0209-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 06/18/2019] [Indexed: 11/10/2022] Open
Abstract
Background Implants are becoming the first choice of rehabilitation for tooth loss. Even though they have a high success rate, failures still occur for many reasons. The objective of this study is to analyze the reasons for recurring failure at the same site and the results of re-implantation. Methods Thirteen patients (11 males and 2 females, mean age 60 ± 9.9 years) who experienced implant surgery failure at the same site (same tooth extraction area) two or more times in the Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, between 2004 and 2017 were selected. The medical records on a type, sites, diameter, and length of implants; time and estimated cause of failure; and radiographs were reviewed. Data were collected and analyzed retrospectively, and the current statuses were evaluated. Results A total of 14 implants experienced failure in the same site more than two times. Twelve implants were placed in the maxilla, while 2 implants were placed in the mandible. The maxillary molar area was the most common site of failure (57.1%), followed by the mandibular molar, anterior maxilla, and premolar areas (14.3% each).The first failure occurred most commonly after prosthetic treatment (35.7%) with an average period of failure of 3.8 months after loading. Ten cases were treated as immediate re-implantation, while the other 4 were delayed re-implantation after an average of 3.9 months. The second failure occurred most commonly after prosthetic treatment (42.9%), with an average of 31 months after loading; during the healing period (42.9%); and during the ongoing prosthetic period (14.3%). In 3 cases (21.4%), the treatment plan was altered to an implant bridge, while the other 11 cases underwent another implant placement procedure (78.6%).Finally, a total of 9 implants (64.3%) survived, with an average functioning period of 60 months. Conclusions Implants can fail repeatedly at the same site due to overloading, infection, and other unspecified reasons. The age and sex of the patient and the location of implant placement seem to be associated with recurring failure. Type of implant, bone augmentation, and bone materials used are less relevant.
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Affiliation(s)
- Dong-Woo Kang
- 1Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 Korea
| | - So-Hyun Kim
- 2Department of Orthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yong-Hoon Choi
- 3Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young-Kyun Kim
- 1Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 Korea.,4Department of Dentistry & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Fabris V, Reginato VF, Smaniotto C, Bacchi A, Consani RLX. Treatment of Resorbed Mandibles with Titanium Plate and Immediate Implant-Supported Prosthesis - Case Series. Braz Dent J 2019; 30:244-251. [PMID: 31166396 DOI: 10.1590/0103-6440201902397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 01/19/2019] [Indexed: 01/06/2023] Open
Abstract
Severely resorbed mandibles with only cortical bone remaining can fracture during or after implant placement. This case series presents a technique to reduce the risk or the consequences of mandibular fracture. Seven patients with only cortical mandibular bone remaining were treated with the fixation of a titanium plate in the frontal surface previously to implant placement, during the same surgical procedure. Immediate complete-arch implant supported prosthesis were installed. Patient's systemic and local conditions that could influence implant survival were registered previously to surgery and during the follow up period. Biological and biomechanical complications were recorded. The condition of peri-implant tissues was evaluated. The follow-ups ranged from 12 to 84 months. Twenty-nine implants were placed and no implant failure or other biological complication was observed. The peri-implant tissue evaluation demonstrated most implants was surrounded by keratinized tissue (89.5%). No marginal recession (implant platform cervical to gingival margin) was observed. Probing depth was normal, ranging from 0 to 3 mm. Low scores of plaque index or bleeding on probing were recorded. Biomechanical complications evolved loosening of 4 prosthetic screws and 1 fractured. The use of a titanium plate for the fixation of severely resorbed mandibles with only cortical bone remaining was a safe treatment procedure, avoiding biological and major biomechanical complications in the treatment with immediate complete-arch implant-supported prosthesis.
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Affiliation(s)
- Vinicius Fabris
- Department of Oral Surgery, IMED - Faculdade Meridional, Passo Fundo, RS, Brazil
| | | | - Carolina Smaniotto
- Graduate Program in Dentistry, IMED - Faculdade Meridional, Passo Fundo, RS, Brazil
| | - Atais Bacchi
- Graduate Program in Dentistry, IMED - Faculdade Meridional, Passo Fundo, RS, Brazil
| | - Rafael Leonardo Xediek Consani
- Department of Prosthodontics and Periodontics, Piracicaba Dental School, UNICAMP - Universidade Estadual de Campinas, Piracicaba, SP, Brazil
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Chrcanovic BR, Kisch J, Larsson C. Retrospective clinical evaluation of implant-supported single crowns: Mean follow-up of 15 years. Clin Oral Implants Res 2019; 30:691-701. [PMID: 31066937 DOI: 10.1111/clr.13454] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To retrospectively assess the clinical outcomes of implant-supported single crowns and the supporting implants. MATERIAL AND METHODS This retrospective study included all patients treated with implant-supported single crowns at one specialist clinic. Implant and prosthesis failure, and mechanical/technical complications (ceramic fracture/chipping; crown loss of retention/mobility; crown failure/fracture; loosening/loss/fracture of prosthetic screw; and implant failure/fracture) were the outcomes analyzed. Any condition/situation that led to the removal/replacement of crowns was considered prosthesis failure. RESULTS A total of 438 patients with 567 crowns were included. Mean ± SD follow-up of 183.4 ± 69.3 months. A total of 37 implants (6.5%) and 54 crowns (9.5%) failed. If only technical problems were considered, the crown failure rate decreased to 4.1% (23/567). Most common reasons for crown failure: esthetic issue (n = 12), crown constantly mobile (n = 9), change to another type of prosthesis together with other implants (n = 8), crown fracture (n = 7), and crown in infraposition in comparison with adjacent teeth (n = 7). The odds of crown failure were shown to be statistically significantly higher for the following factors: younger patients, maxillary crowns, and screw-retained crowns. Loose prosthetic screw was much more prevalent in screw-retained than in cemented crowns. Ceramic fracture/chipping was more prevalent in screw-retained crowns, maxillae, females. Crown fracture was more prevalent in ceramic crowns, screw-retained crowns, maxillae, posterior region, females. However, these differences were statistically significant only for crown fractures in females. CONCLUSIONS The odds of crown failure were significant for some factors, but one must keep in mind that non-technical complications are as common as technical ones as reasons for the replacement of implant-supported single crowns.
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Affiliation(s)
| | - Jenö Kisch
- Faculty of Odontology, Department of Prosthodontics, Malmö University, Malmö, Sweden
| | - Christel Larsson
- Faculty of Odontology, Department of Prosthodontics, Malmö University, Malmö, Sweden
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Long-term (10-year) dental implant survival: A systematic review and sensitivity meta-analysis. J Dent 2019; 84:9-21. [PMID: 30904559 DOI: 10.1016/j.jdent.2019.03.008] [Citation(s) in RCA: 194] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 03/10/2019] [Accepted: 03/19/2019] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES To identify and appraise the most recent studies reporting dental implant survival in adults (≥18 years) using contemporary implant systems (solid screw, roughened surface) for a period of 10 years; and explore new predictors of implant survival. SOURCE MEDLINE, Scopus, and the Cochrane Central Register of Controlled trials were searched from 1997 to January 2018 to focus on contemporary implant systems. STUDY SELECTION Only prospective observational studies with at least 10 participants and 35 implants were included. The unit of study was the 'absolute survival' rate of dental implants after 10 years in the oral cavity. Study quality was assessed utilising a modified Hoy risk of bias tool for prevalence studies. A sensitivity meta-analysis was undertaken utilising a plausibly imputed model for missing data. DATA 18 studies met the inclusion criteria. The summary estimate for 10-year survival at the implant level was 96.4% (95% CI 95.2%-97.5%) and the prediction interval was 91.5%-99.4%. The sensitivity meta-analysis summary estimate of survival was 93.2% (95% CI 90.1% to 95.8%)p = 0.041 with a prediction interval of 76.6%-100%. Older age (≥ 65 years) was a significant predictor at 91.5%, p = 0.038 in the sensitivity meta-analysis. CONCLUSIONS A traditional analysis produced similar 10-year survival estimates to previous systematic reviews. A more realistic sensitivity meta-analysis accounting for loss to follow-up data and the calculation of prediction intervals demonstrated a possible doubling of the risk of implant loss in the older age groups. CLINICAL SIGNIFICANCE Improved analysis provides the clinician with better estimation of the real-world risk of implant failures so helping the clinician communicate the potential risk to patients.
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Chappuis V, Avila-Ortiz G, Araújo MG, Monje A. Medication-related dental implant failure: Systematic review and meta-analysis. Clin Oral Implants Res 2019; 29 Suppl 16:55-68. [PMID: 30328197 DOI: 10.1111/clr.13137] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The aim of this systematic review was to investigate the association between the intake of systemic medications that may affect bone metabolism and their subsequent impact on implant failures. MATERIAL AND METHODS Electronic and manual literature searches were conducted. Implant failure (IF) was the primary outcome, while biological/mechanical and the causes/timing associated with IF were set as secondary outcomes. Meta-analyses for the binary outcome IF and odds ratio were performed to investigate the association with medications. RESULTS A final selection of 17 articles was screened for qualitative assessment. As such, five studies focused on evaluating the association of implant failure and non-steroidal anti-inflammatory drugs (NSAIDs), two on selective serotonin reuptake inhibitors (SSRIs), two on proton pump inhibitors (PPIs), seven on bisphosphonates (BPs), and one on anti-hypertensives (AHTNs). For PPIs, the fixed effect model estimated a difference of IF rates of 4.3%, indicating significantly higher IF rates in the test compared to the control group (p < 0.5). Likewise, for SSRIs, the IF was shown to be significantly higher in the individuals taking SSRIs (p < 0.5) as estimated a difference of 7.5%. No subset meta-analysis could be conducted for AHTNs medications as only one study fulfilled the inclusion criteria, which revealed an increased survival rate of AHTN medication. None of the other medications yielded significance. CONCLUSIONS The present systematic review showed an association of PPIs and SSRIs with an increased implant failure rate. Hence, clinicians considering implant therapy should be aware of possible medication-related implant failures.
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Affiliation(s)
- Vivianne Chappuis
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Gustavo Avila-Ortiz
- Department of Periodontics, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Mauricio G Araújo
- Department of Dentistry, State University of Maringa, Maringa, Brazil
| | - Alberto Monje
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Hsu CM, Sun YS, Huang HH. Enhanced Cell Response to Zirconia Surface Immobilized with Type I Collagen. J Dent Res 2019; 98:556-563. [PMID: 30786812 DOI: 10.1177/0022034519828702] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Zirconia (ZrO2) dental implants provide good biocompatibility, have good corrosion resistance, and have a color that is similar to that of natural teeth. Unfortunately, ZrO2 is a bioinert material and therefore achieves osseointegration difficultly. In this study, we sought to enhance osseointegration by producing rough ZrO2 surfaces that contain hydroxyl groups (designated ZSA) through the use of sandblasting in conjunction with alkaline treatment. We immobilized type I collagen on ZSA surfaces using the natural cross-linker, procyanidin. Our results further showed that surfaces produced in ZSA-P/C featured more and steadier type I collagen than surfaces produced in ZSA-C. The ZSA-P/C also presented superior cell responses in terms of adhesion, proliferation, and mineralization of human bone marrow mesenchymal stem cells. The enhanced cell responses in the ZSA-P/C were induced through the prolonged activation of focal adhesion kinase, AKT (the phosphoinositide 3-kinase pathway), and p38 (the mitogen-activated protein kinase pathway). The simple and novel approach to immobilize type I collagen on roughened ZrO2 surfaces presented in this article can likely benefit dental implant applications.
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Affiliation(s)
- C M Hsu
- 1 Department of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Y S Sun
- 1 Department of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - H H Huang
- 1 Department of Dentistry, National Yang-Ming University, Taipei, Taiwan.,2 Institute of Oral Biology, National Yang-Ming University, Taipei, Taiwan.,3 Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan.,4 Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.,5 Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.,6 Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.,7 Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
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Tretto P, Fabris V, Cericato G, Sarkis-Onofre R, Bacchi A. Does the instrument used for the implant site preparation influence the bone–implant interface? A systematic review of clinical and animal studies. Int J Oral Maxillofac Surg 2019; 48:97-107. [DOI: 10.1016/j.ijom.2018.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/27/2018] [Accepted: 04/09/2018] [Indexed: 12/13/2022]
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Zhou N, Dong H, Zhu Y, Liu H, Zhou N, Mou Y. Analysis of implant loss risk factors especially in maxillary molar location: A retrospective study of 6977 implants in Chinese individuals. Clin Implant Dent Relat Res 2018; 21:138-144. [PMID: 30456779 DOI: 10.1111/cid.12697] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 10/04/2018] [Accepted: 10/16/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Na Zhou
- Nanjing Stomatological Hospital; Medical School of Nanjing University; Nanjing China
| | - Heng Dong
- Nanjing Stomatological Hospital; Medical School of Nanjing University; Nanjing China
| | - Yanxiang Zhu
- Nanjing Stomatological Hospital; Medical School of Nanjing University; Nanjing China
| | - Hui Liu
- Nanjing Stomatological Hospital; Medical School of Nanjing University; Nanjing China
| | - Nan Zhou
- Nanjing Stomatological Hospital; Medical School of Nanjing University; Nanjing China
| | - Yongbin Mou
- Nanjing Stomatological Hospital; Medical School of Nanjing University; Nanjing China
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