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Onone Gialain I, Folmer Rodrigues da Silva L, Kasumi Gantier Takano M, Yagüe Ballester R, Guimarães Roscoe M, Barbosa Cruz Meira J. Peri-implant bone resorption risk of anterior maxilla narrow single implants: a finite-element analysis. Biomater Investig Dent 2022; 9:92-100. [PMID: 36325029 PMCID: PMC9621276 DOI: 10.1080/26415275.2022.2135516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Statement of the problem: Narrow implants have been recommended in high esthetic demand regions to ensure greater buccal bone thickness (BBT) and minimize soft-tissue recession due to insufficient bone support. However, a limited area of bone-implant interface can increase the risk of peri-implant bone resorption due to occlusal forces. Purpose: This article encourages the use of evidence-based finite element analysis to optimize the aesthetic outcomes in maxillary lateral incisor single-supported implant crown by accurate biomechanical planning. This study aimed to analyze the best implant dimensions that would preserve the maximum BBT and avoid peri-implant bone resorption due to occlusal forces. Materials and methods: A maxilla segment was constructed based on anthropological measurements. Four implant diameters (Ø = 3.25; 3.50; 3.75 or 4.00 mm) and two lengths (L = 10 or 13 mm) were simulated. The occlusal force parameters were defined to simulate clinical conditions. The bone resorption risk analysis was based on Frost's mechanostat theory altering the strain output to strain energy density (SED). The peri-implant bone resorption risk indexes (PIBRri) were calculated by dividing the average of the top ten SED elements of the cortical and trabecular buccal wall by the pathologic resorption limit for each bone. Results: For trabecular bone, only the model Ø4.00L13 exhibited a low PIBRri. For cortical bone, all models presented a low PIBRri, except for models Ø3.25. Conclusion: The selection of a 3.25 mm dental implant to preserve a 2 mm BBT should be avoided since it generates a high peri-implant bone resorption risk induced by occlusal overload.
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Affiliation(s)
- Ivan Onone Gialain
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
| | | | - Marlene Kasumi Gantier Takano
- “Finite element analysis in Dentistry” Course, School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
| | - Rafael Yagüe Ballester
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
| | - Marina Guimarães Roscoe
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
| | - Josete Barbosa Cruz Meira
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil,CONTACT Josete Barbosa Cruz Meira Department of Biomaterials and Oral Biology, University of São Paulo, School of Dentistry, Av. Prof. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
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Sotniczuk A, Jastrzębska A, Chlanda A, Kwiatek A, Garbacz H. How Streptococcus mutans Affects the Surface Topography and Electrochemical Behavior of Nanostructured Bulk Ti. Biomolecules 2022; 12:biom12101515. [PMID: 36291724 PMCID: PMC9599476 DOI: 10.3390/biom12101515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/07/2022] [Accepted: 10/15/2022] [Indexed: 11/19/2022] Open
Abstract
The metabolization of carbohydrates by Streptococcus mutans leads to the formation of lactic acid in the oral cavity, which can consequently accelerate the degradation of dental implants fabricated from commercially available microcrystalline Ti. Microstructure influences surface topography and hence interaction between bacteria cells and Ti surfaces. This work offers the first description of the effect of S. mutans on the surface topography and properties of nanostructured bulk Ti, which is a promising candidate for modern narrow dental implants owing to its superior mechanical strength. It was found that S. mutans incubation resulted in the slight, unexpected decrease of surface nanoroughness, which was previously developed owing to privileged oxidation in areas of closely spaced boundaries. However, despite the changes in nanoscale surface topography, bacteria incubation did not reduce the high level of protection afforded by the oxide layer formed on the nanostructured Ti surface. The results highlight the need–hitherto ignored–to consider Ti microstructure when analyzing its behavior in the presence of carbohydrate-metabolizing bacteria.
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Affiliation(s)
- Agata Sotniczuk
- Faculty of Materials Science and Engineering, Warsaw University of Technology, 02-507 Warsaw, Poland
- Correspondence:
| | - Agnieszka Jastrzębska
- Faculty of Materials Science and Engineering, Warsaw University of Technology, 02-507 Warsaw, Poland
| | - Adrian Chlanda
- Łukasiewicz Research Network—Institute of Microelectronics and Photonics, 01-919 Warsaw, Poland
| | - Agnieszka Kwiatek
- Institute of Microbiology, Faculty of Biology, University of Warsaw, 02-096 Warsaw, Poland
| | - Halina Garbacz
- Faculty of Materials Science and Engineering, Warsaw University of Technology, 02-507 Warsaw, Poland
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Marcantonio Junior E, Sartori IADM, Vianna CP, Rocha RS, Caldas W, Trojan LC. Influence of risk factors on the long-term survival of oral rehabilitation with extra-narrow implants: a retrospective study. J Appl Oral Sci 2022; 30:e20220089. [PMID: 35920448 PMCID: PMC9365337 DOI: 10.1590/1678-7757-2022-0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/22/2022] [Indexed: 11/22/2022] Open
Abstract
Objective This study aimed to retrospectively collect clinical data to evaluate the influence of possible risk factors on the long-term success of implant treatment with extra-narrow (2.9 mm diameter) implants in a daily dental practice setting. Methodology Data were collected from records of patients who received at least one extra-narrow implant from 2012 to 2017, regarding implant survival, prosthesis survival, patient characteristics, and implant characteristics. The association between the dependent variables “implant survival”, “prosthesis survival,” and “adverse events” related to patient and implant characteristics was statistically evaluated by chi-square tests. Moreover, implant and prosthesis survival were analyzed by Kaplan-Meier survival curves. Results The sample was constituted of 58 patients (37 women and 21 men) with a mean age of 54.8 years old (SD: 12.5), followed up for up to eight years. In total, 86 extra-narrow implants were placed within this sample. Four implants were lost, resulting in an implant survival rate of 95.3%. A total of 55 prostheses were inserted and only one (1.8%) was lost, resulting in a prosthesis survival rate of 98.2%. The mean implant and prosthesis survival time was, respectively, 7.1 years and 6.3 years, according to the Kaplan-Meier survival analysis. A correlation was found between smoking and implant loss, which makes implant loss eight times more likely to occur in smokers than non-smokers. A significant association was also found between prosthesis loss and previous need of prosthesis repair. However, it was not considered clinically relevant. No association was found between the occurrence of adverse events and later implant or prosthesis loss. Conclusion High implant and prosthesis survival rates were found in the long term for treatment with extra-narrow implants. Moreover, a significant correlation between smoking and implant loss was observed.
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Thomé G, Vianna CP, Caldas W, Bernardes SR, Uhlendorf J, Cartelli CA, Trojan LC. Clinical and radiographic outcomes of maxillary lateral incisors rehabilitation using Morse taper connection extra‐narrow implants at 12‐month follow‐up: A case report. Clin Case Rep 2022; 10:e6248. [PMID: 36034604 PMCID: PMC9400033 DOI: 10.1002/ccr3.6248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/19/2022] [Accepted: 07/30/2022] [Indexed: 11/26/2022] Open
Abstract
Narrow‐diameter implants (≤3.5 mm) have been proposed to address the challenge of implant placement in cases of insufficient bone quantity, thin alveolar crest, and small cervical diameter teeth replacement The aim of this study is to report one‐year outcomes of extra‐narrow implant rehabilitation of maxillary lateral incisors, due to agenesis, in a young adult that presented sites with reduced mesiodistal and buccolingual dimensions. A 26‐year‐old male patient in need of fixed‐implant supported prostheses due to the absence of permanent maxillary lateral incisors and with limited space, was submitted to surgery to receive two 2.9 mm hybrid Morse taper connection implants with hydrophilic surfaces. Immediate loading was applied by means of insertion of provisional prostheses, which were replaced for all‐ceramic prostheses 12 months after surgery. The 1 year follow‐up showed clinical and radiographic success of extra‐narrow implant rehabilitation. Also, both regions presented good evolution of peri‐implant esthetics, as assesses using the pink esthetic score, with improvements at 4 months follow‐up and reaching high scores 12 months after surgery. Although the prosthetic rehabilitation of maxillary lateral incisors is challenging due to limited space for the insertion of implants, the clinical case suggests that the use of extra‐narrow Morse Taper implants with hybrid design and hydrophilic surface is a reliable alternative, presenting good outcomes regarding hard and soft tissue and it is a versatile solution or immediate loading procedure. Further studies are needed to confirm extra‐narrow implant predictability.
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Affiliation(s)
- Geninho Thomé
- Department of Implantology Latin American Institute for Research and Dental Education (ILAPEO) Curitiba Brazil
| | | | | | - Sergio Rocha Bernardes
- Department of Implantology Latin American Institute for Research and Dental Education (ILAPEO) Curitiba Brazil
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Schiegnitz E, Kämmerer PW, Hellwich P, König J, Sagheb K, Al-Nawas B. Treatment concepts of horizontally deficient ridges-A retrospective study comparing narrow-diameter implants in pristine bone with standard-diameter implants in augmented bone. Clin Oral Implants Res 2021; 32:1159-1167. [PMID: 34224171 DOI: 10.1111/clr.13807] [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: 11/12/2020] [Revised: 05/12/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare clinical and radiological outcomes of narrow-diameter implants (NDI) placed in pristine bone to standard-diameter implants placed in combination with horizontal bone augmentation procedures (SDI+A) for horizontally deficient alveolar ridges. MATERIAL AND METHODS For this retrospective study, the outcome of 597 NDI (∅ 3.3 mm, 272 patients), inserted in pristine bone, were compared with 180 SDI (∅ 4.1 mm, 83 patients), inserted in combination with horizontal augmentation procedures. Oral health-related quality of life was assessed in patients available for recall. RESULTS After a mean follow-up of 37.6 ± 40 months for the NDI and of 42.4 ± 49 months for the SDI+A, survival rates were 96.1% for NDI and 95.6% for SDI+A. Cumulative 5-year and 10-year implant survival rates were 94.3% and 92.2% for the NDI group and 97.0% and 88.3% for the SDI+A group, indicating no significant difference (p = .89). According to the criteria of Buser et al., an implant success rate of 84.3% was obtained for the NDI and an implant success rate of 81.3% for the SDI+A (p = .79). Regarding oral health-related quality of life, a similar and high patient satisfaction could be observed in both groups. CONCLUSIONS NDI without augmentation procedures showed a similar clinical outcome as SDI in combination with augmentation procedures after a follow-up of more than 3 years. Therefore, NDI might be a reasonable alternative in cases of horizontal bone atrophy (no clinical trial registration as patient inclusion started 2003).
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Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Philipp Hellwich
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Jochem König
- Institute of Medical Biometry, Epidemiology and Informatics, Johannes Gutenberg-University, Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
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Meloni SM, Melis L, Xhanari E, Tallarico M, Spano G, Pisano M, Baldoni E, Cervino G, Tullio A, Lumbau AI. Three-Year Retrospective Comparative Study between Implants with Same Body-Design but Different Crest Module Configurations. Dent J (Basel) 2020; 8:dj8040135. [PMID: 33333998 PMCID: PMC7765458 DOI: 10.3390/dj8040135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/02/2020] [Accepted: 12/10/2020] [Indexed: 11/16/2022] Open
Abstract
Crest module can be defined as the portion of a two-piece implant designed to retain the prosthetic components and to allows the maintenance of the peri-implant tissues in the transition zone. AIM To evaluate the three-year after loading clinical and radiographic data, collected from patients that received a prosthetic rehabilitation on conical connection implants with partial machined collar (PMC; CC Group) and same body-designed implants, with flat-to-flat connection and groovy neck design (FC Group). MATERIALS AND METHODS A retrospective chart review of previously collected data, including documents, radiographs, and pictures of patients who received at least one implant-supported restoration on NobelReplace CC PMC or NobelReplace Tapered Groovy implants was performed. Patients with at least three years of follow-up after final loading were considered for this study. Outcomes measures were implant and prosthesis failures, any biological or technical complications, marginal bone loss. RESULTS Eight-two patients (44 women, 38 men; average age 55.6) with 152 implants were selected and divided in two groups with 77 (CC group) and 75 (FC group), respectively. Three years after final loading, one implant in CC group failed (98.7% survival rate), while no implants failed in FC group (100% survival rate). One restoration failed in CC group (98.7% survival rate) with no restoration failing in the FC one (100% survival rate). Differences were not statistically significant (p = 1.0). Three years after final loading, mean marginal bone loss was 0.22 ± 0.06 mm (95% CI 0.2-0.24) in CC group and 0.62 ± 0.30 mm (95% CI 0.52-0.72) in FC group. The difference was statistically significant (0.40 ± 0.13 mm; 95% CI 0.3-0.5; p = 0.003). CONCLUSION with the limitation of this retrospective comparative study, implants with conical connection and partial machined collar seem to achieve a trend of superior outcomes if compared with implants with flat connection and groovy collar design.
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Affiliation(s)
- Silvio Mario Meloni
- School of Dentistry, University of Sassari, 07100 Sardinia, Italy; (S.M.M.); (G.S.); (E.B.); (A.I.L.)
| | - Luca Melis
- Private Practice, 07100 Sardinia, Italy; (L.M.); (M.P.)
| | - Erta Xhanari
- Dentistry Program, Aldent University, 1022 Tirana, Albania;
| | - Marco Tallarico
- School of Dentistry, University of Sassari, 07100 Sardinia, Italy; (S.M.M.); (G.S.); (E.B.); (A.I.L.)
- Correspondence: ; Tel.: +39-3280758769
| | - Giovanni Spano
- School of Dentistry, University of Sassari, 07100 Sardinia, Italy; (S.M.M.); (G.S.); (E.B.); (A.I.L.)
| | - Milena Pisano
- Private Practice, 07100 Sardinia, Italy; (L.M.); (M.P.)
| | - Edoardo Baldoni
- School of Dentistry, University of Sassari, 07100 Sardinia, Italy; (S.M.M.); (G.S.); (E.B.); (A.I.L.)
| | | | - Antonio Tullio
- School of Dentistry, University of Perugia, 06123 Perugia, Italy;
| | - Aurea Immacolata Lumbau
- School of Dentistry, University of Sassari, 07100 Sardinia, Italy; (S.M.M.); (G.S.); (E.B.); (A.I.L.)
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Abstract
Dental implants are widely used in the field of oral restoration, but there are still problems leading to implant failures in clinical application, such as failed osseointegration, marginal bone resorption, and peri-implantitis, which restrict the success rate of dental implants and patient satisfaction. Poor osseointegration and bacterial infection are the most essential reasons resulting in implant failure. To improve the clinical outcomes of implants, many scholars devoted to modifying the surface of implants, especially to preparing different physical and chemical modifications to improve the osseointegration between alveolar bone and implant surface. Besides, the bioactive-coatings to promote the adhesion and colonization of ossteointegration-related proteins and cells also aim to improve the osseointegration. Meanwhile, improving the anti-bacterial performance of the implant surface can obstruct the adhesion and activity of bacteria, avoiding the occurrence of inflammation related to implants. Therefore, this review comprehensively investigates and summarizes the modifying or coating methods of implant surfaces, and analyzes the ossteointegration ability and anti-bacterial characteristics of emerging functional coatings in published references.
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BMP9 is a potential therapeutic agent for use in oral and maxillofacial bone tissue engineering. Biochem Soc Trans 2020; 48:1269-1285. [PMID: 32510140 DOI: 10.1042/bst20200376] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/08/2020] [Accepted: 05/15/2020] [Indexed: 02/07/2023]
Abstract
Oral and maxillofacial surgery is often challenging due to defective bone healing owing to the microbial environment of the oral cavity, the additional involvement of teeth and esthetic concerns. Insufficient bone volume as a consequence of aging and some oral and maxillofacial surgical procedures, such as tumor resection of the jaw, may further impact facial esthetics and cause the failure of certain procedures, such as oral and maxillofacial implantation. Bone morphogenetic protein (BMP) 9 (BMP9) is one of the most effective BMPs to induce the osteogenic differentiation of different stem cells. A large cross-talk network that includes the BMP9, Wnt/β, Hedgehog, EGF, TGF-β and Notch signaling pathways finely regulates osteogenesis induced by BMP9. Epigenetic control during BMP9-induced osteogenesis is mainly dependent on histone deacetylases (HDACs), microRNAs (miRNAs) and long noncoding RNAs (lncRNAs), which adds another layer of complexity. As a result, all these factors work together to orchestrate the molecular and cellular events underlying BMP9-related tissue engineering. In this review, we summarize our current understanding of the SMAD-dependent and SMAD-independent BMP9 pathways, with a particular focus on cross-talk and cross-regulation between BMP9 and other major signaling pathways in BMP9-induced osteogenesis. Furthermore, recently discovered epigenetic regulation of BMP9 pathways and the molecular and cellular basis of the application of BMP9 in tissue engineering in current oral and maxillofacial surgery and other orthopedic-related clinical settings are also discussed.
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