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Thomas DC, Shah SK, Chawla J, Sangalli L. Medications Affecting Outcomes and Prognosis of Dental Treatment: Part 1. Dent Clin North Am 2024; 68:767-783. [PMID: 39244256 DOI: 10.1016/j.cden.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
This article gives valuable insight into the effect of selected groups of medications on dental treatment outcome and prognosis. The review emphasizes the importance of thorough medical history, which may have an impact on the prognosis of dental treatment. We discuss drugs acting on the central nervous system, gastrointestinal tract, respiratory tract, endocrine system, and bone metabolism among others. Other pertinent drugs are discussed elsewhere in this special issue.
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Affiliation(s)
- Davis C Thomas
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders and Orofacial Pain, Rutgers School of Dental Medicine, Newark, NJ, USA.
| | | | - Jitendra Chawla
- Department of Dentistry, All India Institute of Medical Sciences, Mangalagiri. Dist, Guntur, Andhra Pradesh, India
| | - Linda Sangalli
- College of Dental Medicine - Illinois, Midwestern University, 555 31st Street, Downers Grove, IL, USA
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Thomas DC, Bellani D, Piermatti J, Kodaganallur Pitchumani P. Systemic Factors Affecting Prognosis of Dental Implants. Dent Clin North Am 2024; 68:555-570. [PMID: 39244244 DOI: 10.1016/j.cden.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
Clinicians who place and restore implants are always concerned about the success and longevity of the same. There are several local and systemic factors that affect osseointegration and the health of the peri-implant tissues. In this study, we review the systemic factors that can affect implant survival, osseointegration, and long-term success. The study highlights the importance of delineating, and taking into consideration these systemic factors from the planning phase to the restorative phase of dental implants. A thorough medical history, including prescription and over-the-counter medications, is vital, as there may be numerous factors that could directly or indirectly influence the prognosis of dental implants.
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Affiliation(s)
- Davis C Thomas
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders and Orofacial Pain, Rutgers School of Dental Medicine, Newark, NJ, USA.
| | | | - Jack Piermatti
- Nova Southeastern University College of Dental Medicine, FL, USA
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Pitchumani PK, Parekh S, Rachana Hegde, Thomas DC. Systemic Factors Affecting Prognosis in Periodontics: Part II. Dent Clin North Am 2024; 68:603-617. [PMID: 39244246 DOI: 10.1016/j.cden.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
This study gives an insight into certain systemic conditions and factors such as nutrition, age, hematological disorders, hypertension, smoking, obesity, and metabolic syndrome that have a notable effect on the periodontium. The review highlights the importance of taking these factors into consideration in periodontal therapy and their impact on the prognosis of periodontal therapies. The other systemic factors are discussed in detail elsewhere in the special issue.
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Affiliation(s)
| | | | | | - Davis C Thomas
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders and Orofacial Pain, Rutgers School of Dental Medicine, Newark, NJ, USA.
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Latimer JM, Maekawa S, Shiba T, Fretwurst T, Chen M, Larsson L, Sugai JV, Kostenuik P, Mitlak B, Lanske B, Giannobile WV. Healing sequelae following tooth extraction and dental implant placement in an aged, ovariectomy model. JBMR Plus 2024; 8:ziae113. [PMID: 39347482 PMCID: PMC11427826 DOI: 10.1093/jbmrpl/ziae113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 07/26/2024] [Accepted: 08/29/2024] [Indexed: 10/01/2024] Open
Abstract
At present, a lack of consensus exists regarding the clinical impact of osteoporosis on alveolar bone metabolism during implant osseointegration. While limited preclinical and clinical evidence demonstrates a negative influence of osteoporosis on dental extraction socket healing, no preclinical studies offer data on the results of implant placement in 6-mo-old, ovariectomized (OVX) Sprague-Dawley rats. This study aimed to investigate the outcomes of dental tooth extraction socket healing and implant placement in a rodent model of osteoporosis following daily vehicle (VEH) or abaloparatide (ABL) administration. Micro-CT and histologic analysis demonstrated signs of delayed wound healing, consistent with alveolar osteitis in extraction sockets following 42 d of healing in both the VEH and ABL groups. In a semiquantitative histological analysis, the OVX-ABL group demonstrated a tendency for improved socket regeneration with a 3-fold greater rate for moderate socket healing when compared to the OVX-VEH group (43% vs 14%), however, this finding was not statistically significant (p=.11). No significant differences were observed between vehicle and test groups in terms of implant outcomes (BMD and bone volume/total volume) at 14- and 21-d post-implant placement. Abaloparatide (ABL) significantly increased BMD of the femoral shaft and intact maxillary alveolar bone sites in OVX animals, demonstrating the therapeutic potential for oral hard tissue regeneration. The present model involving estrogen-deficiency-induced bone loss demonstrated an impaired healing response to dental extraction and implant installation.
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Affiliation(s)
- Jessica M Latimer
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
| | - Shogo Maekawa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Takahiko Shiba
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Tobias Fretwurst
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
- Department of Oral and Craniomaxillofacial Surgery/Translational Implantology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg 79106, Germany
| | - Michael Chen
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
| | - Lena Larsson
- Department of Oral Biochemistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg 413 90, Sweden
| | - James V Sugai
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI 48109, United States
| | - Paul Kostenuik
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI 48109, United States
- Phylon Pharma Services, Thousand Oaks, CA 91320, United States
| | - Bruce Mitlak
- Radius Health Inc., Boston, MA 02210, United States
| | - Beate Lanske
- Radius Health Inc., Boston, MA 02210, United States
| | - William V Giannobile
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
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Kim HJ, Sung IY. Analysis of Dental Prosthetic Treatment in Patients with Cancer Aged 65 Years and Older after Expanded Health Insurance Coverage: A Retrospective Clinical Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1509. [PMID: 39336550 PMCID: PMC11433731 DOI: 10.3390/medicina60091509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Accepted: 09/14/2024] [Indexed: 09/30/2024]
Abstract
Background and Objectives: With increases in cancer incidence and the number of cancer survivors, the demand for cancer management is growing. However, studies on dental prosthetic treatment for patients with cancer are rare. We aim to investigate the dental prosthetic treatment in patients with cancer aged ≥65 years after expanded health insurance coverage. Materials and Methods: This retrospective study included patients who were treated with implants and removable dentures at Ulsan University Hospital in South Korea between June 2015 and June 2023. Data on age, sex, cancer location, comorbid systemic diseases, number of remaining teeth, dental prosthetic treatment history, type of dental prosthetic treatment, and insurance coverage status were extracted from patient medical records and panoramic radiographs. The influence of multiple variables on dental prosthetic treatment was analyzed using the Chi-square and Fisher's exact tests. Results: The study included 61 patients with cancer (32 men, 29 women; average age: 70.9 years). Among them, 56 (91.8%) had insurance coverage benefits, and 34 (55.7%) received treatments such as implants, removable partial dentures, or complete dentures for the first time. Treatment types included 37 (60.7%) cases of implant prostheses and 24 (39.3%) conventional removable dentures. No statistical differences were observed in the type of dental prosthetic treatment according to sex, age, cancer location, number of systemic diseases, and dental prosthetic treatment history (p > 0.05). Patients with <10 remaining teeth received treatment with conventional removable dentures, which was statistically significant (p < 0.001). Conclusions: Of the 61 patients, 56 (91.8%) received insurance benefits, and 34 (55.7%) underwent dental prosthetic treatment for the first time. Within the limitations of this retrospective study, the expanded health insurance coverage alleviated the unmet demand for dental prosthetic treatment. As cancer prevalence continues to increase, expanding customized health insurance coverage is crucial to meet this demand.
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Affiliation(s)
- Hyo-Jung Kim
- Department of Dentistry, Ulsan University Hospital, University of Ulsan College of Medicine, 25, Daehakbyeongwon-ro, Dong-gu, Ulsan 44033, Republic of Korea
| | - Iel-Yong Sung
- Department of Oral and Maxillofacial Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, 25, Daehakbyeongwon-ro, Dong-gu, Ulsan 44033, Republic of Korea
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Maniewicz S, Curado TFF, McKenna G, Leles CR, Müller F. Single lateral implant for mandibular overdentures as a fallback solution or a viable treatment alternative: Four case reports. J Prosthodont 2024; 33:3-9. [PMID: 38512962 DOI: 10.1111/jopr.13841] [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: 07/05/2023] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
This report of four clinical cases aims to illustrate the use of a lateral implant as a solution for implant overdentures in the mandible in different clinical situations. The first two cases describe the clinical situations of patients wearing two-implant mandibular overdentures until the failure of one of the implants, one due to implant loss and the other due to a fracture of an abutment screw, and how the conditions were managed. The third case illustrates the placement of a single implant to retain an overdenture, where a midline implant, as originally planned, was not feasible due to anatomic reasons. The final case describes the use of a lateral implant to support and retain a single-implant mandibular overdenture. The four cases demonstrate that a single lateral implant can be utilized as sole retention in cases of a failing contra-lateral implant and as an alternative to a single implant in the midline.
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Affiliation(s)
- Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | | | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Cláudio Rodrigues Leles
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Thônex, Switzerland
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Kallás MS, Guardieiro B, Henrique EA, Silva DG, Takashi DA, Marchini L. Telehealth in geriatric dentistry: A comparative analysis of concordance between virtual and in-person examinations for hospitalized older patients. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38984414 DOI: 10.1111/scd.13036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/17/2024] [Accepted: 06/19/2024] [Indexed: 07/11/2024]
Abstract
AIMS This study aims to assess the concordance between in-person clinical and virtual oral examinations among hospitalized older adults. METHODS A single examiner performed an in-person clinical examination, recorded systemic health history and oral health indices, clinically documented the Bedside Oral Exam (BOE), and captured photographs for subsequent analysis during a virtual examination. Following a 90-day washout period, a virtual examination was repeated by the same examiner and by a second examiner. Descriptive analysis and a Kappa test were used to compare proportions and evaluate the agreement between results. RESULTS Intra-examiners presented high percentage of agreement in all domains of BOE (80%-86%), with an exception for gingiva (78%). Kappa's intra-examiners presented moderate scores in saliva, mucous membrane, gingiva and teeth/dentures domains and a strong score in the tongue domain (0.839). Inter examiners presented moderate agreement in lips and gingiva, saliva, mucous membrane, and teeth/dentures domains. Inter examiners Kappa scores were weak for lips (0.395) and gingiva (0.498) domains; moderate for saliva (0.703), mucous membrane (0.769) and teeth/dentures (0.714) domains and strong for the tongue domain (0.872). CONCLUSION In this study, a moderate level of agreement was observed between clinical and virtual oral examinations among older hospitalized patients. These findings are encouraging and warrant further investigation about how teledentistry can be used to enhance oral health access to this vulnerable population.
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Affiliation(s)
- Monira Samaan Kallás
- Telehealth center, SyrianLebaneseHospital, Advanced Geriatrics Center, Sao Paulo, Brazil
| | | | | | - Deise Garrido Silva
- Telehealth center, University of São Paulo, School of Dentistry, Sao Paulo, Brazil
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Mosaddad SA, Talebi S, Keyhan SO, Fallahi HR, Darvishi M, Aghili SS, Tavahodi N, Namanloo RA, Heboyan A, Fathi A. Dental implant considerations in patients with systemic diseases: An updated comprehensive review. J Oral Rehabil 2024; 51:1250-1302. [PMID: 38570927 DOI: 10.1111/joor.13683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 10/27/2023] [Accepted: 03/02/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Various medical conditions and the drugs used to treat them have been shown to impede or complicate dental implant surgery. It is crucial to carefully monitor the medical status and potential post-operative complications of patients with systemic diseases, particularly elderly patients, to minimize the risk of health complications that may arise. AIM The purpose of this study was to review the existing evidence on the viability of dental implants in patients with systemic diseases and to provide practical recommendations to achieve the best possible results in the corresponding patient population. METHODS The information for our study was compiled using data from PubMed, Scopus, Web of Science and Google Scholar databases and searched separately for each systemic disease included in our work until October 2023. An additional manual search was also performed to increase the search sensitivity. Only English-language publications were included and assessed according to titles, abstracts and full texts. RESULTS In total, 6784 studies were found. After checking for duplicates and full-text availability, screening for the inclusion criteria and manually searching reference lists, 570 articles remained to be considered in this study. CONCLUSION In treating patients with systemic conditions, the cost-benefit analysis should consider the patient's quality of life and expected lifespan. The success of dental implants depends heavily on ensuring appropriate maintenance therapy, ideal oral hygiene standards, no smoking and avoiding other risk factors. Indications and contraindications for dental implants in cases of systemic diseases are yet to be more understood; broader and hardcore research needs to be done for a guideline foundation.
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Affiliation(s)
- Seyed Ali Mosaddad
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
| | - Sahar Talebi
- Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seied Omid Keyhan
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
- Department of Oral & Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung, South Korea
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA
- Iface Academy, Istanbul, Turkey
| | - Hamid Reza Fallahi
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
- Department of Oral & Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung, South Korea
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA
- Iface Academy, Istanbul, Turkey
| | - Mohammad Darvishi
- Faculty of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Narges Tavahodi
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Fathi
- Department of Prosthodontics, Dental Materials Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Linn TT, Khaohoen A, Thu KM, Rungsiyakull P. Oral-Health-Related Quality of Life in Elderly Edentulous Patients with Full-Arch Rehabilitation Treatments: A Systematic Review. J Clin Med 2024; 13:3391. [PMID: 38929921 PMCID: PMC11204181 DOI: 10.3390/jcm13123391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 05/29/2024] [Accepted: 06/02/2024] [Indexed: 06/28/2024] Open
Abstract
Background: The improvement of oral-health-related quality of life (OHRQoL) with different types of prosthesis for completely edentulous jaws in the elderly population is a critical factor in clinical decision making for these vulnerable patients. This review aims to evaluate the changes in OHRQoL after treatment with different types of full-arch prostheses in the elderly edentulous population to determine the prostheses that result in the greatest improvement in OHRQoL. Materials and Methods: Clinical studies of different types of full-arch prostheses that measured the OHRQoL in edentulous patients 60 years or older were searched for in the PubMed, Embase and Scopus electronic databases, with additional hand searching to summarize the outcomes of the selected studies. Result: Among the 302 identified studies, 10 studies were selected. A total of 504 patients wearing 133 complete dentures, 372 implant overdentures and 39 fixed prostheses were assessed among the selected studies. The overall OHIP and GOHAI scores were evaluated at baseline and in the 3rd, 6th, 12th and 18th months of treatment with the respective prostheses. The improved OHRQoL with overall OHIP scores associated with conventional dentures were 9.21-12.5% from the 3rd month to 1 year after treatment, whereas those associated with implant overdentures and full-arch fixed prosthesis were 9-25.26% at 1 year and 18.53-26.79 at the 18th-month follow-up, respectively. The increased overall GOHAI scores were 21.3-25.43% for conventional dentures, 36.82-41.32% for implant overdentures and 39.48-42.83% for full-arch fixed prosthesis from the 3rd month to the 6th-month follow-up. Conclusion: In general, the improvement in OHRQoL after rehabilitation with implant overdentures declined at one year, and that with full-arch fixed prosthesis declined at the 18th-month follow-up; meanwhile, the OHRQoL associated with conventional dentures improved stably up to one year, but the implant-supported prostheses resulted in an obviously greater improvement in the OHRQoL than that obtained with conventional dentures. However, studies with longer follow-up periods are still required to evaluate the long-term clinical effectiveness.
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Affiliation(s)
- Tin Thinzar Linn
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, 239, Huay Kaew Road, Muang District, Chiang Mai 50200, Thailand; (T.T.L.); (A.K.)
| | - Angkoon Khaohoen
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, 239, Huay Kaew Road, Muang District, Chiang Mai 50200, Thailand; (T.T.L.); (A.K.)
| | - Khaing Myat Thu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR 999077, China;
| | - Pimduen Rungsiyakull
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, 239, Huay Kaew Road, Muang District, Chiang Mai 50200, Thailand; (T.T.L.); (A.K.)
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Ko YC, Lee D, Koo KT, Seol YJ, Lee YM, Lee J. A randomized controlled trial of immediate implant placement comparing hydroxyapatite nano-coated and uncoated sandblasted/acid-etched implants using a digital surgical guide. Int J Implant Dent 2024; 10:29. [PMID: 38839621 PMCID: PMC11153479 DOI: 10.1186/s40729-024-00549-8] [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: 11/09/2023] [Accepted: 05/23/2024] [Indexed: 06/07/2024] Open
Abstract
PURPOSE This study evaluated the implant stability, volumetric changes, and patient-reported outcome measures (PROMs) of hydroxyapatite (HA) nano-coated sandblasted/acid-etched (SLA) implants compared to uncoated SLA implants. METHODS Forty patients were recruited and randomly allocated to HA nano-coated SLA group (test, n = 20) and uncoated SLA group (control, n = 20) using single-blinded/block randomization. Implants were immediately placed in maxillary posterior region using a digital surgical guide. Insertion torque and implant stability quotient (ISQ) were measured at implant surgery and 1, 2, 3, and 4 months postoperatively. Intraoral scans, PROMs and soft tissue inflammation data were collected, and multivariable linear regression analysis of ISQ was performed. RESULTS In total, 48 implants (test; n = 24, control; n = 24) in 37 patients (test; n = 19, control; n = 18) were analyzed. Despite no significant between-group difference at surgery, the test group showed higher ISQ values than the control group at 2 (76.53 ± 4.17 vs. 71.32 ± 4.79, p < 0.01), 3 (77.45 ± 4.41 vs. 73.85 ± 4.69, p < 0.05), and 4 months (79.08 ± 2.96 vs. 73.43 ± 3.52, p < 0.0001) postoperatively. There were no significant differences in linear and volumetric changes, PROMs, and soft tissue inflammation analysis between two groups. The ISQ at implant surgery was influenced by age and diabetes mellitus (DM) at the implant level and DM and predicted total bone-to-implant contact area at the patient level. CONCLUSION HA nano-coated SLA implants promoted favorable immediate implants stability during early osseointegration phase compared to uncoated SLA implants, but displayed similar dimensional changes, PROMs, and soft tissue inflammation outcomes. TRIAL REGISTRATION Clinical Research Information Service (CRIS), KCT0006364. Registered 21 July 2021, https://cris.nih.go.kr/cris/search/detailSearch.do?seq=24221&search_page=L .
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Affiliation(s)
- Young-Chang Ko
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Dongseob Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Yang-Jo Seol
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Yong-Moo Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Jungwon Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Republic of Korea.
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Moraschini V, Louro RS, Son A, Calasans-Maia MD, Sartoretto SC, Shibli JA. Long-term survival and success rate of dental implants placed in reconstructed areas with extraoral autogenous bone grafts: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2024; 26:469-481. [PMID: 38450931 DOI: 10.1111/cid.13319] [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: 09/25/2023] [Revised: 01/22/2024] [Accepted: 02/22/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE To evaluate the long-term survival and success rates of implants placed in reconstructed areas using microvascularized or non-microvascularized extraoral bone grafts. MATERIALS AND METHODS An electronic search was performed in five databases and in gray literature for articles published until June, 2023. The eligibility criteria comprised observational studies (prospective or retrospective) and clinical trials, reporting survival and success rates of implants placed in extraoral bone grafts. A meta-analysis (implant failure) was categorized into subgroups based on the type of bone graft used. The risk of bias within studies was assessed using the Newcastle-Ottawa Scale. RESULTS Thirty-one studies met the inclusion criteria. The mean follow-up time was 92 months. The summary estimate of survival rate at the implant level were 94.9% (CI: 90.1%-97.4%) for non-vascularized iliac graft, 96.5% (CI: 91.4%-98.6%) for non-vascularized calvaria graft, and 92.3% (CI: 89.1%-94.6%) for vascularized fibula graft. The mean success rate and marginal bone loss (MBL) were 83.2%; 2.25 mm, 92.2%; 0.93 mm, and 87.6%; 1.49 mm, respectively. CONCLUSIONS Implants placed in areas reconstructed using extraoral autogenous bone graft have high long-term survival rates and low long-term MBLs. The data did not demonstrate clinically relevant differences in the survival, success, or MBL of grafts from different donor areas or with different vascularization. This systematic review was registered in INPLASY under number INPLASY202390004.
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Affiliation(s)
- Vittorio Moraschini
- Department of Periodontology, School of Dentistry, Veiga de Almeida University, Rio de Janeiro, Brazil
- Department of Oral Surgery, School of Dentistry, Fluminense Federal University, Rio de Janeiro, Brazil
| | - Rafael Seabra Louro
- Department of Oral Surgery, School of Dentistry, Fluminense Federal University, Rio de Janeiro, Brazil
| | - Andrea Son
- Department of Implant Dentistry, School of Dentistry, Guarulhos University, São Paulo, Brazil
| | | | | | - Jamil Awad Shibli
- Department of Implant Dentistry, School of Dentistry, Guarulhos University, São Paulo, Brazil
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Zanin F, Silva G, Mayer-Santos E, Brugnera AP, Sardop A, Brugnera A. Er:YAG Laser and Hemolasertherapy: Bone and Gingiva Gain-Case Report. Photobiomodul Photomed Laser Surg 2024; 42:493-497. [PMID: 38757706 DOI: 10.1089/pho.2023.0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
Background: Modern dentistry has increasingly valued conservative and biologically less invasive clinical practices, seeking to preserve the patients' tissues and natural dental elements. Most extractions in the dental clinic are preceded by periodontal disease that presents bone and gingival tissue loss, compromising the aesthetics as well as the support of dental elements. Objectives: The clinical approach in these cases often involves bone exertion followed by the successful installation of osseointegrated implants. Material and Methods: In this study, a case of extensive periodontal involvement and mobility of dental elements was carried out in a minimally invasive way, using the Er:YAG laser for periodontal decontamination and the hemolasertherapy technique to regenerate adjacent tissues, totaling nine weeks of treatment. Results: Clinical and radiographical improvement of tissue health and complete preservation of dental elements were observed. Conclusion: The patient underwent a follow-up appointment 2 years after the start of treatment when it was still possible to verify the stability of the clinical condition and the tissue gains obtained.
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Affiliation(s)
- Fatima Zanin
- Biophotonics Center, Brugnera and Zanin Institute, Sao Paulo, Brazil
| | | | - Eric Mayer-Santos
- Department of Restorative Dentistry, University of São Paulo (USP), Sao Paulo, Brazil
| | - Ana Paula Brugnera
- Dental Clinic, Instituto Brugnera e Zanin, Biophotonics Laser Center, Sao Paulo, Brazil
| | | | - Aldo Brugnera
- National Institute of Science and Technology INCT, Basic Optics and Applied Life Sciences FSC-USP, Instituto Brugnera e Zanin, Biophotonics Laser Center, Sao Paulo, Brazil
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13
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Orishko A, Imber JC, Roccuzzo A, Stähli A, Salvi GE. Tooth- and implant-related prognostic factors in treatment planning. Periodontol 2000 2024; 95:102-128. [PMID: 39234949 DOI: 10.1111/prd.12597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 06/21/2024] [Accepted: 07/03/2024] [Indexed: 09/06/2024]
Abstract
Following a comprehensive patient examination, including the assessment of periodontal and peri-implant diseases as well as considering the patient's needs, a pretherapeutic prognosis for each tooth and implant is given. Teeth and implants with a secure pretherapeutic prognosis require simple procedures and may be regarded as secure abutments for function and with a doubtful pretherapeutic prognosis usually need a comprehensive therapy. Such teeth and implants must be brought into the category with a secure prognosis by means of additional therapy such as endodontic, restorative, and surgical procedures. Teeth and implants with a hopeless pretherapeutic prognosis should be extracted/explanted during the initial phase of cause-related therapy (i.e., infection control). For example, teeth with vertical root fracture or unrestorable caries and implants with mobility or unrestorable malposition fall into the category of hopeless units. The primary goal of periodontal and peri-implant therapy should be to arrest disease progression. The latest consensus statement highlights that periodontitis can be successfully controlled and treated teeth can be retained for life. Nevertheless, for patients with uncontrolled contributing factors, the endpoints might not always be achievable, and low disease activity may be an acceptable therapeutic goal. Similarly, the management of peri-implantitis frequently requires surgical intervention following nonsurgical therapy due to incomplete treatment outcomes. Different surgical modalities can be effective and lead to significant improvement; however, achieving complete resolution of peri-implantitis is challenging, not always predictable, and can depend on multiple baseline factors. Therefore, this review aims at summarising available evidence on the rationale for incorporating systemic, lifestyle-related, clinical, and radiographic prognostic factors into treatment planning of patients diagnosed with periodontal and peri-implant diseases.
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Affiliation(s)
- Anastasiya Orishko
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Periodontology Unit, University College London, Eastman Dental Institute, London, UK
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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14
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Enteghad S, Shirban F, Nikbakht MH, Bagherniya M, Sahebkar A. Relationship Between Diabetes Mellitus and Periodontal/Peri-Implant Disease: A Contemporaneous Review. Int Dent J 2024; 74:426-445. [PMID: 38614881 PMCID: PMC11123523 DOI: 10.1016/j.identj.2024.03.010] [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: 08/27/2023] [Revised: 02/11/2024] [Accepted: 03/17/2024] [Indexed: 04/15/2024] Open
Abstract
The prevalence of diabetes mellitus (DM), a major chronic disease and a leading cause of death and disability around the world, is rising. According to the latest data, the global prevalence of DM has increased to 463 million (9.3% of adults) in 2019 and is estimated to reach 700 million by 2045. Periodontal disease, result of periodontium inflammation, is a common, chronic disease and has long been considered one of the complications of DM. Moreover, literature reflects a spectrum of conflicting viewpoints on the effect of diabetic conditions on the implant treatment strategies. The current review aims to update the recent epidemiologic evidence regarding the relationship between DM and periodontal/peri-implant disease, emphasising the effects of glycaemic control on the severity of these diseases and describing the pathobiological mechanisms underlying this association. This review's findings indicate a bidirectional relationship between DM and periodontal/peri-implant disease and that this relationship seems causal, implying that controlling these two diseases might help prevent each other's incidence. Additionally, the severity of periodontal/peri-implant disease is directly related to metabolic control. Although patients with diabetes can obtain implant success similar to those in systemically healthy individuals, an increased risk of peri-implantitis has been reported in DM patients. Therefore, the importance of glycaemic control and maintaining proper oral hygiene cannot be overstated.
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Affiliation(s)
- Shabnam Enteghad
- School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farinaz Shirban
- Department of Orthodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
| | | | - Mohammad Bagherniya
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Anesthesia and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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15
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Baus-Domínguez M, Oliva-Ferrusola E, Maza-Solano S, Ruiz-de-León G, Serrera-Figallo MÁ, Gutiérrez-Perez JL, Torres-Lagares D, Macías-García L. Biological Response of the Peri-Implant Mucosa to Different Definitive Implant Rehabilitation Materials. Polymers (Basel) 2024; 16:1534. [PMID: 38891480 PMCID: PMC11174483 DOI: 10.3390/polym16111534] [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: 04/28/2024] [Revised: 05/23/2024] [Accepted: 05/26/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Sealing the peri-implant tissue is a determining factor for long-term implant survival. In the transmucosal region, the cervical fraction of the prosthetic crown is in contact with these tissues, so mucointegration will also be influenced by the biomaterial used for the prosthetic restoration. This study aims to compare the tissue response generated by definitive restorative materials and polymeric materials from a histological point of view. METHODS This study performed an observational prospective cohort study in which biopsies of the peri-implant mucosa were taken after placement of implant-supported prosthetic restorations made of different materials (zirconium oxide, lithium disilicate, and PMMA). RESULTS A statistically significant difference was observed in the increase in the thickness of the non-keratinized epithelium when comparing the definitive materials (zirconium oxide/lithium disilicate) vs. the provisional material (PMMA) and in the number of collagen fibers when comparing zirconium oxide and lithium disilicate. CONCLUSIONS This study found that zirconia is the material that presents the most adequate biological response of peri-implant tissues. It shows a lower intensity of inflammatory cellular content, a total normality in the number of collagen fibers (the arrangement of the fibers is normal in 90% of the cases), and vascular proliferation of connective tissue in 83% of the cases. These parameters make it a material with a predictable response. Similarly, only the following slight statistically significant differences between the definitive and provisional materials are observed, indicating that the biological response generated by the provisional material (PMMA) is not very different from that obtained with the placement of the definitive restoration.
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Affiliation(s)
- María Baus-Domínguez
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena S/N, 41009 Seville, Spain; (E.O.-F.); (S.M.-S.); (G.R.-d.-L.); (M.-Á.S.-F.); (J.-L.G.-P.); (D.T.-L.)
| | - Elena Oliva-Ferrusola
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena S/N, 41009 Seville, Spain; (E.O.-F.); (S.M.-S.); (G.R.-d.-L.); (M.-Á.S.-F.); (J.-L.G.-P.); (D.T.-L.)
| | - Serafín Maza-Solano
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena S/N, 41009 Seville, Spain; (E.O.-F.); (S.M.-S.); (G.R.-d.-L.); (M.-Á.S.-F.); (J.-L.G.-P.); (D.T.-L.)
| | - Gonzalo Ruiz-de-León
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena S/N, 41009 Seville, Spain; (E.O.-F.); (S.M.-S.); (G.R.-d.-L.); (M.-Á.S.-F.); (J.-L.G.-P.); (D.T.-L.)
| | - María-Ángeles Serrera-Figallo
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena S/N, 41009 Seville, Spain; (E.O.-F.); (S.M.-S.); (G.R.-d.-L.); (M.-Á.S.-F.); (J.-L.G.-P.); (D.T.-L.)
| | - José-Luis Gutiérrez-Perez
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena S/N, 41009 Seville, Spain; (E.O.-F.); (S.M.-S.); (G.R.-d.-L.); (M.-Á.S.-F.); (J.-L.G.-P.); (D.T.-L.)
| | - Daniel Torres-Lagares
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena S/N, 41009 Seville, Spain; (E.O.-F.); (S.M.-S.); (G.R.-d.-L.); (M.-Á.S.-F.); (J.-L.G.-P.); (D.T.-L.)
| | - Laura Macías-García
- Department of Cytology and Normal and Pathological Histology, School of Medicine, University of Seville, Av. Sánchez Pizjuán S/N, 41009 Seville, Spain
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16
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Camacho LO, Jahangiri L, Iseringhausen J, Goldstein GR. Parkinson's disease - The dentist's role as part of the healthcare team. J Prosthodont 2024. [PMID: 38689457 DOI: 10.1111/jopr.13862] [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: 01/11/2024] [Accepted: 04/11/2024] [Indexed: 05/02/2024] Open
Abstract
Parkinson's disease is a neurodegenerative disease that results in patients exhibiting uncontrolled movements, changes in saliva production, and difficulty in swallowing and speech. Understanding the staging of the disease and the available therapies allows dentists to treat these patients safely and with compassion to meet their oral health care needs for an optimal quality of life. This appraisal discusses Parkinson's disease as it relates to clinically relevant facts to manage and treat the oral health care needs of these patients in the short and long term including general dental care recommendations. Important observations related to Parkinson's disease include disease causation,; stages, pharmacologic treatment, the effects on saliva, mastication, dysphagia, and aspiration pneumonia. Dental recommendations are made for the dentate, the partially edentulous, and the completely edentulous Parkinson's patients with a focus on late-stage concerns. Optimizing dental health will help maintain the quality of life as the disease progresses. In late stages of Parkinson's disease, dental treatment should focus on keeping the patient comfortable and out of pain. While benign neglect is an often-used term, compassionate therapy in the late stages of Parkinson's disease is a more compelling term for defining the patient's needs. Since dysphagia in Parkinson's patients has been underdiagnosed, neurologists must be aware of the important part that dentists play in the early diagnosis for these patients. Early referral to a dentist is vital to mitigate the unfortunate consequence of the need for extensive dental care in late-stage patients.
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Affiliation(s)
- Liliana Ortiz Camacho
- Department of Prosthodontics, New York University College of Dentistry, New York, New York, USA
| | - Leila Jahangiri
- Department of Prosthodontics, New York University College of Dentistry, New York, New York, USA
| | - Jenna Iseringhausen
- Department of Neurology and Movement Disorders, New York University Langone Health, New York, New York, USA
| | - Gary R Goldstein
- Department of Prosthodontics, New York University College of Dentistry, New York, New York, USA
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17
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Schenk N, Bukvic H, Schimmel M, Abou-Ayash S, Enkling N. One-Piece Mini Dental Implant-Retained Mandibular Overdentures: 10-Year Clinical and Radiological Outcomes of a Non-Comparative Longitudinal Observational Study. J Funct Biomater 2024; 15:99. [PMID: 38667556 PMCID: PMC11051283 DOI: 10.3390/jfb15040099] [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: 02/27/2024] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
This study presents the first 10-year follow-up investigation of the implant survival and peri-implant outcomes of one-piece mini dental implants (MDIs) retaining mandibular implant overdentures (IODs), including marginal bone level alterations (ΔMBLs), clinical peri-implant parameters, and complications. Twenty participants with horizontally atrophied mandibles received complete dentures and four MDIs (diameter 1.8 mm) at baseline. The dentures were converted into IODs with O-ring attachments. The 10-year follow-up comprised a radiological assessment of ΔMBLs, peri-implant parameters, as well as biological and technical complications. Results from a 10-year follow-up of 14 participants showed a 100% implant survival rate for all 56 implants. The mean ΔMBL after 10 years was -1.12 ± 0.80 mm, with 49 implants classified as successful (ΔMBL < 2 mm) and 7 implants with satisfactory survival (ΔMBL 2-4 mm). Time after implant placement significantly influenced ΔMBL, with stable MBLs after 5 years. The prosthetic survival rate after 10 years was 93%. ΔMBLs were not influenced by implant position or gender but were significantly smaller in subjects older than 65 years. Conclusively, one-piece MDIs with O-ring attachments offer a reliable treatment option for horizontally atrophied mandibles after 10 years, with high implant and prosthetic survival rates, potentially benefiting from advanced age regarding peri-implant bone stability.
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Affiliation(s)
- Nicole Schenk
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (N.S.); (H.B.); (M.S.); (N.E.)
| | - Hristina Bukvic
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (N.S.); (H.B.); (M.S.); (N.E.)
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (N.S.); (H.B.); (M.S.); (N.E.)
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, 1205 Geneva, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (N.S.); (H.B.); (M.S.); (N.E.)
| | - Norbert Enkling
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (N.S.); (H.B.); (M.S.); (N.E.)
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Medical Faculty, University of Bonn, 53113 Bonn, Germany
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18
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Samara W, Moztarzadeh O, Hauer L, Babuska V. Dental Implant Placement in Medically Compromised Patients: A Literature Review. Cureus 2024; 16:e54199. [PMID: 38496195 PMCID: PMC10942790 DOI: 10.7759/cureus.54199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
As a discipline of dentistry, oral implantology deals with the diagnosis, design, insertion, restoration, and/or management of alloplastic or autogenous oral structures for the purpose of regaining contour, function, aesthetics, and speech in a partially or completely edentulous patient. The present review aims to provide the currently available knowledge about the impact of certain systemic disorders and the usage of some medications on the survival rate of dental implant therapy and to highlight the importance of patient management under these conditions. Diabetes, osteoporosis, cardiovascular diseases, and the intake of some medications can increase the risk of the failure of a dental implant. Even though there are relatively few medical contraindications to dental implant treatment, certain conditions may increase the risk of failure or complications.
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Affiliation(s)
- Walla Samara
- Department of Stomatology, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
| | - Omid Moztarzadeh
- Department of Stomatology, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
- Department of Anatomy, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
| | - Lukas Hauer
- Department of Stomatology, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
| | - Vaclav Babuska
- Department of Medical Chemistry and Biochemistry, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
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19
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石 永, 杜 书, 卢 兴, 颜 文, 刘 帆. [Construction of the Framework of a Prediagnostic Risk Assessment System for Outpatient Dental Care]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2024; 55:139-145. [PMID: 38322509 PMCID: PMC10839501 DOI: 10.12182/20240160201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Indexed: 02/08/2024]
Abstract
Objective To establish the framework of a prediagnostic risk assessment system for outpatient dental care and to provide references for ensuring patient safety and improving the quality of medical services. Methods A total of 15 medical workers in a tertiary-care stomatology hospital in Sichuan Province were selected for qualitative interviews between October 2019 and December 2019. On the basis of the results of literature analysis and the interviews, an expert consultation form for prediagnostic risk assessment system for outpatient dental care was developed. Then, consultation of 10 experts in the field of oral health care and nursing was conducted between June 2020 and December 2020. Eventually, the framework of prediagnostic risk assessment system for outpatient dental care was formulated. Results Four themes emerged from the qualitative interviews. Firstly, prediagnostic risks of dental outpatients involved mainly syncope, cardiovascular emergencies, and other emergency medical risks. Secondly, medical risks came from three sources, patients, healthcare professionals, and the environment. Thirdly, medical professionals of outpatient dental care had limited awareness of the prediagnostic medical risks of patient. Fourthly, medical professionals of outpatient dental care showed inadequate response to and management of the prediagnostic medical risks of patient. The expert consultation helped finalize the Dental Outpatient Prediagnostic Risk Assessment Questionnaire, which included 3 primary indicators (namely, general information, medical history [including history of allergy], and medication assessment), 12 secondary indicators (including patient demographics, patients' status upon admission, oral hygiene habits and special lifestyle habits, sensory disorders, special periods for female patients [ie, menstruation, pregnancy, and breastfeeding], allergy history [history of oral treatment-related allergies], past/present medical history, types of medication, route of medication administration, duration of medication administration, accuracy of medication administration, and adverse drug reactions), and 39 tertiary indicators. The effective recall rate of the expert consultation form was 100%, expert positivity was 100%, and the authority coefficient was 0.83. Kendall's harmony coefficient ranged from 0.808 to 0.839, which was statistically significant (P<0.001). Conclusion The framework of prediagnosis risk assessment system for outpatient dental care is found to be scientific and specific, but its applicability still needs further validation in clinical practice.
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Affiliation(s)
- 永乐 石
- 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院 (成都 610041)State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - 书芳 杜
- 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院 (成都 610041)State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - 兴凤 卢
- 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院 (成都 610041)State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - 文 颜
- 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院 (成都 610041)State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - 帆 刘
- 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院 (成都 610041)State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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20
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Hjortholt CO, Andersen SWM, Jensen SS, Kofod T, Gotfredsen K. Dental implant treatment in patients with cancer on high-dose antiresorptive medication: A prospective feasibility study with 2 years follow-up. Clin Oral Implants Res 2024; 35:63-76. [PMID: 37873916 DOI: 10.1111/clr.14197] [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: 05/30/2023] [Revised: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVES Dental implant treatment is considered contraindicated in patients with cancer on high-dose antiresorptive medication (HDAR). The aim of this prospective, feasibility study was to evaluate implant treatment in patients with cancer on HDAR, in terms of implant survival, implant success, and oral health-related quality of life (OHLQoL) after 2 years of loading. MATERIALS AND METHODS Implants were inserted in three groups of HDAR patients: (1) Previous tooth extraction, no medication-related osteonecrosis of the jaw (MRONJ), (2) Previous MRONJ, now healed, (3) Existing MRONJ, planned surgical resection. Implants were placed without adjunctive bone or soft tissue argumentation. Abutment operation was performed after ≥12 weeks. Prosthetic treatment was initiated ≥14 weeks. Survival and success rate were determined, and OHLQoL was analyzed with OHIP-49 and QLQ-H&N35 questionnaires. Patients were seen for 6 months, 1- and 2 years follow-up. RESULTS Twenty-two patients, 39 implants, completed the implant-based prosthetic treatment. Implant-supported crowns and overdentures were fabricated. Thirteen patients (59%) with 23 implants (59%) completed 2 years follow-up. Overall implant survival and success rate after 2 years of loading were 100% and 97.4%, respectively. OHLQoL for the patients increased in all groups after the treatment, a substantial increase was seen in group 3. Two patients developed MRONJ, but not related to the implant treatment. CONCLUSION Dental implant treatment, with high survival and success rate and increased post-treatment OHLQoL, is feasible in HDAR patients after 2 years of loading. Caution with general recommendations should be exercised.
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Affiliation(s)
- C O Hjortholt
- Department of Oral & Maxillofacial Surgery, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark
- Research Area Oral Rehabilitation, Section for Oral Health, Society and Technology, Faculty of Health and Medical Sciences, Institute of Odontology, University of Copenhagen, Copenhagen, Denmark
| | - S W M Andersen
- Department of Oral & Maxillofacial Surgery, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark
| | - S S Jensen
- Department of Oral & Maxillofacial Surgery, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark
- Research Area Oral Surgery, Section for Oral Biology and Immunopathology, Institute of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T Kofod
- Department of Oral & Maxillofacial Surgery, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark
| | - K Gotfredsen
- Research Area Oral Rehabilitation, Section for Oral Health, Society and Technology, Faculty of Health and Medical Sciences, Institute of Odontology, University of Copenhagen, Copenhagen, Denmark
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21
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Zarzar AM, Sales PHDH, Barros AWP, Arreguy IMS, Carvalho AAT, Leão JC. Effectiveness of dental implants in patients undergoing radiotherapy for head and neck cancer: An umbrella review. SPECIAL CARE IN DENTISTRY 2024; 44:40-56. [PMID: 36852979 DOI: 10.1111/scd.12840] [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: 09/12/2022] [Revised: 12/17/2022] [Accepted: 02/12/2023] [Indexed: 03/01/2023]
Abstract
OBJECTIVE The objective of this overview is to evaluate the effectiveness of dental implants placed in patients who underwent radiotherapy for the treatment of head and neck cancer, as well as to assess the methodological quality of the included systematic reviews. METHODS The study was conducted in four PubMed, Lilacs, Dare Cochrane and Google Scholar databases until July 2022, using the descriptors "Radiotherapy," "Dental implants," and "Head and Neck Cancer." RESULTS 958 studies were found in the initial search and after applying the inclusion and exclusion criteria, fifteen systematic reviews were selected to compose this overview and had their methodological quality evaluated by the AMSTAR 2 tool. RESULTS 24,996 implants in 5487 patients were evaluated with a rate of success rate of 86.2% in patients who underwent radiotherapy and 95.2% in patients who did not undergo radiotherapy. Only one of the systematic reviews was of high quality according to AMSTAR 2. CONCLUSION Oral rehabilitation with dental implants in patients with a history of head and neck cancer undergoing radiotherapy is a valid therapy. However, given the level of evidence found, further studies with better design are necessary to provide greater confidence in the clinical decision.
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Affiliation(s)
- Adriana Machado Zarzar
- Department of Prosthesis and Oral and Maxillofacial Surgery, Dental School, Federal University of Pernambuco, Recife, Brazil
| | - Pedro Henrique da Hora Sales
- Department of Prosthesis and Oral and Maxillofacial Surgery, Dental School, Federal University of Pernambuco, Recife, Brazil
| | - Ana Waleska Pessoa Barros
- Department of Prosthesis and Oral and Maxillofacial Surgery, Dental School, Federal University of Pernambuco, Recife, Brazil
| | | | | | - Jair Carneiro Leão
- Department of Clinical and Preventive Dentistry, Dental School, Federal University of Pernambuco, Recife, Brazil
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22
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Alqutaibi AY, Algabri RS, Elawady D, Ibrahim WI. Advancements in artificial intelligence algorithms for dental implant identification: A systematic review with meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00783-7. [PMID: 38158266 DOI: 10.1016/j.prosdent.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024]
Abstract
STATEMENT OF PROBLEM The evidence regarding the application of artificial intelligence (AI) in identifying dental implant systems is currently inconclusive. The available studies present varying results and methodologies, making it difficult to draw definitive conclusions. PURPOSE The purpose of this systematic review with meta-analysis was to comprehensively analyze and evaluate articles that investigate the application of AI in identifying and classifying dental implant systems. MATERIAL AND METHODS An electronic systematic review was conducted across 3 databases: MEDLINE/PubMed, Cochrane, and Scopus. Additionally, a manual search was performed. The inclusion criteria consisted of peer-reviewed studies investigating the accuracy of AI-based diagnostic tools on dental radiographs for identifying and classifying dental implant systems and comparing the results with those obtained by expert judges using manual techniques-the search strategy encompassed articles published until September 2023. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of included articles. RESULTS Twenty-two eligible articles were included in this review. These articles described the use of AI in detecting dental implants through conventional radiographs. The pooled data showed that dental implant identification had an overall accuracy of 92.56% (range 90.49% to 94.63%). Eleven studies showed a low risk of bias, 6 demonstrated some concern risk, and 5 showed a high risk of bias. CONCLUSIONS AI models using panoramic and periapical radiographs can accurately identify and categorize dental implant systems. However, additional well-conducted research is recommended to identify the most common implant systems.
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Affiliation(s)
- Ahmed Yaseen Alqutaibi
- Associate Professor, Department of Prosthodontics and Implant Dentistry, College of Dentistry, Taibah University, Al Madinah, Saudi Arabia; and Associate Professor, Department of Prosthodontics, College of Dentistry, Ibb University, Ibb, Yemen.
| | - Radhwan S Algabri
- Assistant professor, Department of Prosthodontics, Faculty of Dentistry, Ibb University, Ibb, Yemen; and Assistant professor, Department of Prosthodontics, Faculty of Dentistry, National University, Ibb, Yemen
| | - Dina Elawady
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, MSA University, 6th of October City, Egypt
| | - Wafaa Ibrahim Ibrahim
- Associate Professor, Department of Prosthodontics, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Mansoura, Egypt
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23
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Ma Y, Wang S, Wang H, Chen X, Shuai Y, Wang H, Mao Y, He F. Mesenchymal stem cells and dental implant osseointegration during aging: from mechanisms to therapy. Stem Cell Res Ther 2023; 14:382. [PMID: 38124153 PMCID: PMC10734190 DOI: 10.1186/s13287-023-03611-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
Dental implants are widely used to replace missing teeth, providing patients with unparalleled levels of effectiveness, convenience, and affordability. The biological basis for the clinical success of dental implants is osseointegration. Bone aging is a high-risk factor for the reduced osseointegration and survival rates of dental implants. In aged individuals, mesenchymal stem cells (MSCs) in the bone marrow show imbalanced differentiation with a reduction in osteogenesis and an increase in adipogenesis. This leads to impaired osseointegration and implant failure. This review focuses on the molecular mechanisms underlying the dysfunctional differentiation of aged MSCs, which primarily include autophagy, transcription factors, extracellular vesicle secretion, signaling pathways, epigenetic modifications, microRNAs, and oxidative stress. Furthermore, this review addresses the pathological changes in MSCs that affect osseointegration and discusses potential therapeutic interventions to enhance osseointegration by manipulating the mechanisms underlying MSC aging.
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Affiliation(s)
- Yang Ma
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Siyuan Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Hui Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xiaoyu Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yi Shuai
- Nanjing Jinling Hospital: East Region Military Command General Hospital, Nanjing, China
| | - Huiming Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China.
| | - Yingjie Mao
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China.
| | - Fuming He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China.
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24
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Shafaee H, Asgari R, Bardideh E, Rangrazi A, Sedigh S, Kerayechian N. The effects of low-level laser therapy and photodynamic therapy on oral health of fixed orthodontics patients. A systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2023; 44:103759. [PMID: 37604216 DOI: 10.1016/j.pdpdt.2023.103759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/23/2023] [Accepted: 08/18/2023] [Indexed: 08/23/2023]
Abstract
Objective To investigate the effect of low-level laser and photodynamic therapy on the oral health, and periodontal tissue of fixed orthodontic patients and the effect of using photobiomodulation methods compared to routine plaque removal methods and the amount of plaque in fixed orthodontic patients. Method and materials First, the title and summary of related articles were collected by using the search strategy electronic databases PUBMED, EMBASE, Cochrane's CENTRAL, Scopus, ISI and all the articles that were published from the beginning to February 2023 were evaluated. The title, abstracts and full texts of all the relevant studies were reviewed respectively, and those meeting the criteria were entered into our study. Finally, the quality of the studies was examined and the results of the studies were pooled by means of random effects inverse variance meta-analysis. Results Eighteen randomized studies, conducted between 2015 and December 2022, were selected for meta-analysis. Five studies were conducted as split-mouth, twelve as parallel-group, and one as a cross-over design. Among the studies, five examined the effects of low-level laser therapy and twelve assessed the effects of photodynamic therapy. The meta-analysis revealed that photodynamic therapy significantly reduced probing depth compared to scaling (MD=-0.2 mm, P<0.001), though the difference does not seem to be clinically significant. But no significant differences between photodynamic therapy and scaling or low-level laser therapy and control groups in terms of plaque index, or bleeding on probing, gingival crevicular fluid volume, gingival recession, clinical attachment loss, bacterial load and concentrations of inflammatory substances across multiple follow-up periods. Conclusion Moderate evidence indicates that photodynamic therapy (PDT) is comparable to conventional methods in improving oral health, as measured by periodontal indices, inflammatory proteins, bacterial colonies, and white spot lesions, making it a suitable alternative. Limited evidence suggests low-level laser therapy (LLLT) may improve oral health, particularly addressing caries, but further research is needed.
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Affiliation(s)
- Hooman Shafaee
- Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Erfan Bardideh
- Department of Orthodontics, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad blvd, Mashhad, Iran.
| | - Abdolrasoul Rangrazi
- Department of Orthodontics, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad blvd, Mashhad, Iran
| | - Sadaf Sedigh
- Student of Dentistry, University of Pittsburgh School of Dental Medicine, PA, USA
| | - Navid Kerayechian
- Department of Biomaterials and Biomimetics, New York University, New York, NY, USA
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25
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Lee D, Ko YC, Seol YJ, Koo KT, Lee YM, Lee J. Risk factors impacting the survival of implants replaced following failure: A retrospective study. Clin Implant Dent Relat Res 2023; 25:1008-1018. [PMID: 37574782 DOI: 10.1111/cid.13265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/29/2023] [Indexed: 08/15/2023]
Abstract
AIM This study aimed to investigate factors influencing the survival of replaced dental implants. MATERIALS AND METHODS Charts from 2005 to 2021 were reviewed. Replaced implants after removal for the first time were identified. Depending on their survival, the replaced group was divided into the surviving and second-removal groups. Risk factors affecting survival of replaced implants were evaluated considering clustering of multiple implants within patients. RESULTS The present study included 464 replaced implants of 370 patients, of which 429 and 35 implants were categorized into the surviving group and the second-removal group. The 5-year survival rate was 90.2 ± 0.18% in replaced implants at sites with a periodontitis history and 97.0 ± 0.15% at sites without a periodontitis history (p = 0.008). The 5-year survival rate was 89.1 ± 0.27% in replaced implants with guided bone regeneration (GBR) at first implant placement and 93.9 ± 0.14% at non-GBR (p = 0.032). The 5-year survival rate was 97.6 ± 0.13% in replaced implants with GBR and 90.3 ± 0.17% in replaced implants without GBR (p = 0.026). In the multivariable analysis adjusted for clinical variables, periodontitis history (adjusted hazard ratio [aHR] = 3.417; 95% confidence interval [CI] = 1.161-10.055), GBR at first implant placement (aHR = 2.152; 95% CI = 1.052-4.397) and non-GBR at primary implant replacement (aHR = 0.262; 95% CI = 0.088-0.778) were identified as independent risk factors for second implant removal. CONCLUSIONS Periodontitis history, GBR at first implant placement and non-GBR at primary implant replacement were identified as risk factors affecting the survival of replaced implants.
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Affiliation(s)
- Dongseob Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- National Dental Care Center for Persons With Special Needs, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Young-Chang Ko
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Yang-Jo Seol
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Ki-Tae Koo
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Yong-Moo Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Jungwon Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Republic of Korea
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26
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Bogner MS, Chambas V, Nicolas E, Faulks D, Hennequin M. Implant-supported prostheses in patients with special needs: A systematic literature review of protocols and outcomes. J Prosthet Dent 2023:S0022-3913(23)00628-5. [PMID: 37880026 DOI: 10.1016/j.prosdent.2023.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 10/27/2023]
Abstract
STATEMENT OF PROBLEM Implant-supported prostheses for individuals with special needs have been considered high-risk because of the prevalence of poor oral hygiene and parafunction in this population; however, systematic evidence on protocols and outcomes is scarce. PURPOSE The purpose of this systematic review was to summarize implant procedures and outcomes for the special needs population. MATERIAL AND METHODS A systematic literature review was conducted using PubMed, Embase, and Scopus databases in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodological framework. Data collected included patient information, location and number of implants, surgical and prosthetic procedures, behavior support techniques, postoperative follow-up, complications, and criteria for outcome assessment. Survival rates were pooled for quantitative analysis, and a separate analysis pooling data from groups of special needs patients that present similar risks was undertaken. RESULTS The qualitative analysis included 79 studies involving 759 patients and 2269 implants. The quantitative analysis included 65 studies concerning 666 patients with special needs and 1886 implants. The overall weighted implant survival rate was 95.4%, with a mean follow-up duration of 40.7 ±29.5 months. CONCLUSIONS In individuals with special needs considered suitable for implant-supported prostheses by their clinician, implant survival rates were similar to those reported in the general population. (J Prosthet Dent xxxx;xxx:xxx-xxx).
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Affiliation(s)
- Marie-Sophie Bogner
- Specialist, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, Clermont-Ferrand, France.
| | - Vivien Chambas
- Specialist, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, Clermont-Ferrand, France; and Private practice, Clermont-Ferrand, France
| | - Emmanuel Nicolas
- Professor, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, Clermont-Ferrand, France; and CHU Clermont-Ferrand, Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
| | - Denise Faulks
- Specialist Consultant, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, F-63000 Clermont-Ferrand, France; and CHU Clermont-Ferrand, Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
| | - Martine Hennequin
- Professor, Centre for Research in Clinical Dentistry (CROC), University of Clermont Auvergne BP 10448, Clermont-Ferrand, France; and CHU Clermont-Ferrand, Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
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27
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Mugri MH, Sayed ME, Bhandi S, A Alaqi HA, B Alsubeaie NH, Alsubaie SH, Varadarajan S, Raj AT, Yadalam PK, Khurshid Z, Balaji TM, Patil S. Success rate of immediately loaded implants in the posterior zone. Niger J Clin Pract 2023; 26:1215-1225. [PMID: 37794532 DOI: 10.4103/njcp.njcp_884_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Dental implants are considered an ideal treatment for a missing single tooth. Immediate loading of implants can hasten the procedure, providing comfort to the patients. Recently, immediate loading of implants has gained much importance as it helps hasten the procedure and provides more comfort to patients. A previous systematic review published 5 years ago compared the success rates between immediate and conventional loading. There are several factors that influence the success rate of implants that were not discussed in detail in the previous review. Hence, the present systematic review is done to report differences in the outcomes from single implant restorations of missing teeth in the posterior region in patients who were subjected to immediate loading and conventional loading. A follow up for 1 year was done. Electronic databases of Medline, Scopus, and Web of Science were searched for publications in the English Language during May 2021. The search results yielded 306 articles, out of which 225 were excluded based on title and abstract screening. Screening of the remaining 81 full text articles yielded 14 original research articles that satisfied the predefined inclusion criteria. Meta analysis was not possible due to the heterogeneity of the data. The overall success rate of the immediate loading of a single implant is 94.31%. Implants in the maxillary region had a higher survival rate than those in the mandibular region. The age range between 18 and 80 years showed good prognosis and outcomes in older individuals. Good oral hygiene was emphasized for all patients to prevent any secondary conditions or delays in healing.
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Affiliation(s)
- M H Mugri
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - M E Sayed
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - S Bhandi
- College of Dental Medicine, Roseman University of Health Science, South Jordan, UTAH-84095, USA
| | - H A A Alaqi
- Private Practice, Jazan, Kingdom of Saudi Arabia
| | | | - S H Alsubaie
- Private Practice, Riyadh, Kingdom of Saudi Arabia
| | - S Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai, Tamil Nadu, India
| | - A T Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai, Tamil Nadu, India
| | - P K Yadalam
- Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Z Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia
| | - T M Balaji
- Department of Periodontology, Tagore Dental College and Hospital, Chennai, India
| | - S Patil
- College of Dental Medicine, Roseman University of Health Science, South Jordan, UTAH-84095, USA
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28
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Shim JS, Kim MY, An SJ, Kang ES, Choi YS. Evaluation of Implant Stability According to Implant Placement Site and Duration in Elderly Patients: A Prospective Multi-Center Cohort Study. J Clin Med 2023; 12:5087. [PMID: 37568490 PMCID: PMC10419881 DOI: 10.3390/jcm12155087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
The aim of this prospective study is to investigate implant stability and the reliability of different measuring devices according to implant placement site and duration in patients aged over 65 years. The study evaluated 60 implants (diameter: 3.5/4.0/4.5/5.0 mm and length: 8.5/10.0/11.5 mm) in 60 patients aged ≥ 65 years. The implant placement sites were divided into six evenly distributed sections (n = 10), i.e., maxillary right-posterior, A; maxillary anterior, B; maxillary left-posterior, C; mandibular right-posterior, D; mandibular anterior, E; mandibular left-posterior, F. Participants visited the hospital six times: implant surgery, 1V; stitch removal, 2V; 1-month follow-up, 3V; 2-month follow-up, 4V; before final restoration delivery, 5V; and after final restoration delivery, 6V. The implant stability was evaluated with the Osstell Mentor (ISQ), Periotest M (PTV), and Anycheck (IST). The mean values of ISQ, PTV, and IST were analyzed (α = 0.05). ISQ, PTV, and IST results of 4V and 5V were significantly higher than those of 1V (p < 0.05). The lowest ISQ results occurred in the E location at 4V and 5V (p < 0.05). In all mandibular locations, IST results of 6V were significantly higher than those of 1V, 2V, 3V, and 4V (p < 0.05). ISQ results were negatively correlated with PTV and positively correlated with IST, and PTV was negatively correlated with IST. By considering various factors affecting the stability of the implant, it is necessary to determine the appropriate implant load application time. This could help increase the implant success rate in elderly patients. And as a diagnostic device for implant stability and the evaluation of osseointegration in elderly patients, Anycheck was also able to prove its relative reliability compared to Osstell ISQ Mentor and Periotest M.
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Affiliation(s)
- Ji-Suk Shim
- Department of Dentistry, Korea University Guro Hospital, Seoul 08308, Republic of Korea
| | - Moon-Young Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan 31116, Republic of Korea
| | - Se-Jun An
- Department of Prosthodontics, College of Dentistry, Dankook University, Cheonan 31116, Republic of Korea
| | - Eun-Sung Kang
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan 31116, Republic of Korea
| | - Yu-Sung Choi
- Department of Prosthodontics, College of Dentistry, Dankook University, Cheonan 31116, Republic of Korea
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29
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Marques NP, Pérez-de-Oliveira ME, Normando AGC, Marques NCT, Epstein JB, Migliorati CA, Martelli-Júnior H, Ribeiro ACP, Rocha AC, Brandão TB, Sánchez FGV, Gueiros LAM, Lopes MA, Santos-Silva AR. Clinical outcomes of dental implants in head and neck cancer patients: An overview. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:42-53. [PMID: 36890080 DOI: 10.1016/j.oooo.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/03/2023] [Accepted: 01/17/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the clinical outcomes of dental implants (DIs) in patients with head and neck cancer (HNC) treated with radiotherapy (RT), isolated chemotherapy, or bone modifying agents (BMAs). STUDY DESIGN This study was registered in the Prospective Register of Systematic Reviews (CRD42018102772); conducted via the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist; and based on PubMed, Scopus, Embase, Cochrane Library, Web of Science, and gray literature searches. The selection of studies was performed in 2 phases by 2 independent reviewers. The risk of bias (RoB) was assessed by the Measurement Tool to Assess the Methodological Quality of Systematic Reviews 2. RESULTS Twenty systematic reviews were included in the qualitative analysis. The majority scored as having high RoB (n = 11). Primary DIs placement in the mandible of patients with HNC subjected to RT doses <50 Gy was associated with better survival rates. CONCLUSIONS The placements of DIs could be considered safe in patients with HNC in sites of alveolar bone that received RT (≤5000 Gy); however, no conclusions could be made in patients with cancer managed by chemotherapy or BMAs. Due to the heterogeneity of studies included, the recommendation for DIs placement in patients with cancer should be carefully considered. Future better controlled randomized clinical trials are required to provide enhanced clinical guidelines for best patient care.
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Affiliation(s)
- Nelson Pereira Marques
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil; Dental School, University Center of Lavras, Lavras, Minas Gerais, Brazil.
| | - Maria Eduarda Pérez-de-Oliveira
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Ana Gabriela Costa Normando
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Nádia Carolina Teixeira Marques
- Dental School, University Center of Lavras, Lavras, Minas Gerais, Brazil; School of Nursing and Pharmacy, University Center of Lavras, Lavras, Minas Gerais, Brazil
| | - Joel B Epstein
- Oral Medicine Services, CA City of Hope National Medical Center, Duarte, CA, USA
| | - Cesar A Migliorati
- Department of Oral & Maxillofacial Diagnostic Sciences, University of Florida, Gainesville, FL, USA
| | - Hercílio Martelli-Júnior
- School of Nursing and Pharmacy, University Center of Lavras, Lavras, Minas Gerais, Brazil; Primary Care Postgraduate Program, State University of Montes Claros Unimontes, Montes Claros, Minas Gerais, Brazil
| | | | - Andre Caroli Rocha
- Divisão de Odontologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Thaís Bianca Brandão
- Serviço de Odontologia Oncológica, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | | | - Luiz Alcino Monteiro Gueiros
- Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Marcio Ajudarte Lopes
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
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30
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Guabello G, Zuffetti F, Ravidà A, Deflorian M, Carta G, Saleh MHA, Serroni M, Pommer B, Watzek G, Francetti L, Testori T. Avoiding implant-related complications in medically compromised patients with or without unhealthy lifestyle/Elevated oxidative stress. Periodontol 2000 2023; 92:329-349. [PMID: 37350348 DOI: 10.1111/prd.12503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/11/2023] [Accepted: 04/26/2023] [Indexed: 06/24/2023]
Abstract
Increased human life expectancy broadens the alternatives for missing teeth and played a role in the widespread use of dental implants and related augmentation procedures for the aging population. Though, many of these patients may have one or more diseases. These systemic conditions may directly lead to surgical complications, compromise implant/bone healing, or influence long-term peri-implant health and its response to biologic nuisances. Offering patients credible expectations regarding intra- and postoperative complications and therapeutic prognosis is an ethical and legal obligation. Clear identification of potential types of adverse effects, complications, or errors is important for decision-making processes as they may be related to different local, systemic, and technical aspects. Therefore, the present review structures the underlying biological mechanisms, clinical evidence, and clinical recommendations for the most common systemic risk factors for implant-related complications.
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Affiliation(s)
- Gregorio Guabello
- Endocrinology Unit, IRCCS Galeazzi Sant'Ambrogio Hospital, Milan, Italy
| | - Francesco Zuffetti
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
| | - Andrea Ravidà
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Matteo Deflorian
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
| | - Giorgio Carta
- Argo Academy International Research Bologna, Bologna, Italy
- Private Practice, Bologna, Italy
- Lake Como Institute, Como, Italy
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Matteo Serroni
- Department of Innovative Technologies in Medicine & Dentistry, University 'G. D'Annunzio', Chieti-Pescara, Italy
| | - Bernhard Pommer
- Academy for Oral Implantology, Vienna, Austria
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Luca Francetti
- IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Tiziano Testori
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Penoni DC, Canellas JVS, Silami MANC, Sader F, Pimentel GS, Leão ATT. Osteonecrosis of the jaws in patients under osteoporosis treatment: a nine-year experience report. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:e000612. [PMID: 37252700 PMCID: PMC10665075 DOI: 10.20945/2359-3997000000612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/09/2022] [Indexed: 05/31/2023]
Abstract
Objective This study aimed to report the experience of medication-related osteonecrosis of the jaws (MRONJ) in osteoporotic patients for nine years, and their associated initiating factors. Materials and methods The numbers of invasive oral procedures (IOP) (tooth extraction, dental implant placement, and periodontal procedures) and removable prostheses performed from January 2012 to January 2021 were obtained from the digital records of a large public dental center. There were an estimated 6,742 procedures performed in patients under osteoporosis treatment. Results Two cases (0.03%) of MRONJ were registered in nine years amongst patients with osteoporosis who had dental treatment at the center. From the 1,568 tooth extractions, one patient (0.06%) developed MRONJ. There was also one case from the 2,139 removable prostheses delivered (0.05%). Conclusion The prevalence of MRONJ associated with osteoporosis treatment was very low. The protocols adopted seem to be adequate for the prevention of this complication. The findings of this study reinforce the rare frequency of MRONJ associated with dental procedures in patients submitted to the pharmacological management of osteoporosis. An integral analysis of systemic risk factors and oral preventive strategies may be considered regularly in the dental treatment of these patients.
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Affiliation(s)
- Daniela Cia Penoni
- Departamento de Saúde, Divisão de Odontologia, Hospital Naval de Brasília, Marinha do Brasil, Brasília, DF, Brasil,
- Departamento de Clínica Odontológica, Divisão de Periodontia, Faculdade de Odontologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - João Vitor S Canellas
- INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, Delaware, United States
| | - Marcos Antonio Nunes Costa Silami
- Departamento de Clínica Odontológica, Clínica de Estomatologia e Patologia Oral, Marinha do Brasil, Odontoclínica Central da Marinha, Rio de Janeiro, RJ, Brasil
| | - Flávia Sader
- Departamento de Clínica Odontológica, Divisão de Periodontia, Marinha do Brasil, Odontoclínica Central da Marinha, Rio de Janeiro, RJ, Brasil
| | - Gonçalo Sobreira Pimentel
- Departamento de Clínica Odontológica, Divisão de Implantodontia, Marinha do Brasil, Odontoclínica Central da Marinha, Rio de Janeiro, RJ, Brasil
| | - Anna Thereza Thomé Leão
- Departamento de Clínica Odontológica, Divisão de Periodontia, Faculdade de Odontologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Baus-Domínguez M, Gómez-Díaz R, Torres-Lagares D, Gutiérrez-Pérez JL, Machuca-Portillo G, Serrera-Figallo MÁ. Retrospective Case-Control Study Genes Related to Bone Metabolism That Justify the Condition of Periodontal Disease and Failure of Dental Implants in Patients with down Syndrome. Int J Mol Sci 2023; 24:ijms24097723. [PMID: 37175429 PMCID: PMC10178122 DOI: 10.3390/ijms24097723] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/14/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
Down syndrome patients show success rates in dental implants much lower than those observed in the general population. This retrospective case-control study aimed to identify possible genes that are related to the regulation of inflammatory responses and bone metabolism related to periimplantitis and implant loss, as well as genes related to bone quality. This process involved using the functional analysis of the gene expression software Transcriptome Analysis Console (TAC version 4.0 Applied BiosystemsTM, Thermo Fisher Scientific, Waltham, MA, USA) and a search for possible candidate genes involved. The focus was placed on the 93 genes related to periodontitis, periimplantitis, bone loss, implant loss, and genes related to bone quality and regulators underlying the establishment and maintenance of osseointegration. Five genes showed statistically significant results (p < 0.05) in our comparison. Four of them, IL1B (p = 0.023), IL1RN (p = 0.048), BGLAP (p = 0.0372) and PTK2 (p = 0.0075) were down-regulated in the periodontal disease and implant rejection group, and only one was overexpressed: FOXO1A (p = 0.0552). The genes with statistically significant alterations described in this article determine that the group of Down syndrome patients with periodontal disease and implant failure is a group of patients genetically susceptible to suffering from both conditions together.
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Affiliation(s)
- María Baus-Domínguez
- Department of Dentistry, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | | | - Daniel Torres-Lagares
- Department of Dentistry, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Jose-Luis Gutiérrez-Pérez
- Oral and Maxillofacial Unit, Virgen del Rocio Hospital, 41013 Seville, Spain
- Oral Surgery Department, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
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Lemos CAA, de Oliveira AS, Faé DS, Oliveira HFFE, Del Rei Daltro Rosa CD, Bento VAA, Verri FR, Pellizzer EP. Do dental implants placed in patients with osteoporosis have higher risks of failure and marginal bone loss compared to those in healthy patients? A systematic review with meta-analysis. Clin Oral Investig 2023:10.1007/s00784-023-05005-2. [PMID: 37043030 DOI: 10.1007/s00784-023-05005-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE This systematic review and meta-analysis aimed to compare the dental implant survival rate and marginal bone loss between patients with and without osteoporosis. MATERIALS AND METHODS This systematic review was registered in PROSPERO (CRD42022356377). A systematic search was performed using five databases: MEDLINE/PubMed, Web of Science, Scopus, Embase, and ProQuest for articles published up to July 2022. Additional searches in ClinicalTrials.gov and the reference lists of included studies were performed. The eligibility criteria comprised observational studies with a direct comparison between patients with and without osteoporosis, with a minimum follow-up of 1 year and 10 implants placed in each group, which consider data analysis based on implant level, without restrictions on period or language of publication. The meta-analysis was performed using RevMan 5.4 program. Risk of bias analysis of the included studies was performed using the Newcastle-Ottawa scale (NOS). RESULTS Twelve studies met the eligibility criteria, totaling 1132 patients with a mean age range from 54 to 76.6 years. Most of the included patients were women (73.6%). A total of 3505 implants were evaluated-983 in patients with osteoporosis and 2522 in patients without osteoporosis. The meta-analysis indicated no difference in implant survival rates between patients with and without osteoporosis (OR, 1.78; 95% confidence interval [CI], 0.86-3.70; P = 0.12). However, significant bone loss was observed around dental implants placed in patients with osteoporosis (SMD, 0.71 mm; 95% CI, 0.06-0.87 mm). The NOS indicated a low risk of bias in the studies included. However, the certainty of the evidence was classified as very low and low for implant survival rates and bone loss, respectively. CONCLUSION According to the limitations of the present review, the data suggest that dental implants are a viable treatment option for the rehabilitation of patients with osteoporosis. However, clinical care by professionals is necessary to ensure the maintenance of peri-implant bone stability, as these patients may be susceptible to increased bone loss.
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Affiliation(s)
- Cleidiel Aparecido Araujo Lemos
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil.
| | - Andreza Soares de Oliveira
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Daniele Sorgatto Faé
- Postgraduate Program in Applied Health Sciences (PPGCAS), Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | | | - Cleber Davi Del Rei Daltro Rosa
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Victor Augusto Alves Bento
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Fellippo Ramos Verri
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, SP, Brazil
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Andersen SWM, Ottesen C, Gotfredsen K, Jensen SS, Kofod T, Schiodt M. Outcome of healing after dental implant placement in patients with cancer on high-dose antiresorptive medications: a prospective feasibility study. Oral Maxillofac Surg 2023; 27:89-100. [PMID: 35084584 DOI: 10.1007/s10006-022-01042-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/11/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE Implant placement in patients with cancer receiving high-dose antiresorptive medication (HDAR) is considered contraindicated. This prospective, feasibility study tested the hypothesis that dental implants can be placed in such patients by applying a staged implant placement protocol with submerged healing. METHODS Three groups of patients on HDAR were included as follows: group 1: patients who underwent tooth extraction, without the development of medication-related osteonecrosis of the jaws (MRONJ); group 2: patients with surgically treated MRONJ who had demonstrated clinical healing for at least 3 months; group 3: patients with established MRONJ who was planned for surgical resection and simultaneous implant placement. RESULTS A total of 49 implants were placed in 27 patients (group 1: 12, group 2: 7 and group 3: 8). HDAR included bisphosphonates and denosumab. The mean HDAR time was 25 months (SD: ± 18.4, range 3-68 months). An abutment operation was performed 4 months following the implant placement (SD: ± 1.9, range 3-14 months). All patients healed uneventfully. CONCLUSIONS This study demonstrated that it is feasible to insert dental implants and perform an abutment surgery in patients with cancer on HDAR, without the development of MRONJ. CLINICALTRIALS gov Identifier: NCT04741906.
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Affiliation(s)
- Sanne Werner Møller Andersen
- Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Camilla Ottesen
- Department of Oral Rehabilitation, School of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Alle 20, 2200, Copenhagen N, Denmark
| | - Klaus Gotfredsen
- Department of Oral Rehabilitation, School of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Alle 20, 2200, Copenhagen N, Denmark
| | - Simon Storgård Jensen
- Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Department of Oral Surgery, School of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Alle 20, 2200, Copenhagen N, Denmark
| | - Thomas Kofod
- Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Morten Schiodt
- Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Alle 43-45, 8200, Aarhus N, Denmark
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Alsayed H, Bukhari IA, Alsaif R, Vohra F. Efficacy of indocyanine green and methylene blue mediated-photodynamic therapy on peri-implant outcomes among diabetics with peri-implant mucositis. Photodiagnosis Photodyn Ther 2023; 42:103344. [PMID: 36841279 DOI: 10.1016/j.pdpdt.2023.103344] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND This study aimed to assess the efficacy of indocyanine green (ICG)-mediated versus methylene blue (MB)-mediated photodynamic therapy (PDT) as an adjunct to conventional mechanical debridement (MD) on the peri‑implant clinical, radiographic, microbiological, and immunological outcomes among diabetics with peri‑implant mucositis (pi-M). METHODS For this 3-month follow-up study, diabetics having pi-M were randomly divided into 3 groups: group-I (n = 20) subjects received only MD; group-II (n = 20) participants received ICG-mediated adjunct PDT; and group-III (n = 20) subjects received MB-mediated adjunct PDT. Peri-implant clinical (i.e., plaque index [PI], bleeding on probing [BOP], probing depth [PD]), radiographic (crestal bone loss [CBL]), microbiological (Fusobacterium nucleatum [F. nucleatum], Tannerella forsythia [T. forsythia], Prevotella intermedia [P. intermedia], Porphyromonas gingivalis [P. gingivalis], Aggregatibacter actinomycetemcomitans [A. actinomycetemcomitans]), and immunological (interleukin [IL]-6, IL-1β, tumor necrosis factor-alpha [TNF-α]) outcomes were assessed at baseline and 3-month follow-up. RESULTS Mean changes between baseline and 3-month follow-up in peri‑implant clinico-radiographic parameters were significantly different between control (PI: 12.42±21.80%; BOP: 12.10±19.30%; PD: 0.45±0.41 mm; CBL: 1.10±1.02 mm) and test groups (ICG-mediated PDT [PI: 26.55±25.80%; BOP: 28.77±29.24%; PD: 0.84±0.62 mm; CBL: 1.98±1.85 mm] and MB-mediated PDT [PI: 27.24±26.15%; BOP: 27.71±28.16%; PD: 0.85±0.63 mm; CBL: 1.95±1.80 mm]), however comparable differences were observed in peri‑implant PI, BOP, PD, and CBL between group-II and group-III participants (p>0.05). The proportions of T. forsythia were significantly reduced in group-II (4.78 × 104 colony-forming unit per milliliter [CFU/mL]) and group-III (4.76 × 104 CFU/mL) as compared to group-I (-4.40 × 103 CFU/mL) at 3-month follow-up (p = 0.02). No statistically significant differences were observed between the study groups regarding the proportions of the other assessed target bacterial species. For IL-6 (group-I: 210±108; group-II: 298±165; group-III: 277±121 pg/mL; p = 0.03), IL-1β (group-I: 101±95; group-II: 84±98; group-III: 86±74 pg/mL; p = 0.02), and TNF-α (group-I: 336±121; group-II: 385±210; group-III: 366±198 pg/mL; p = 0.03) peri‑implant sulcular fluid [PISF] levels, all three study groups demonstrated statistically significant reduction at 3-month follow-up. CONCLUSIONS ICG-mediated and MB-mediated adjunctive PDT showed statistically significant improvements in peri‑implant clinical, radiographic, microbiological, and immunological parameters as compared to conventional MD alone at 3-month follow-up among diabetics with pi-M. However, comparable outcomes were demonstrated by ICG-mediated and MB-mediated adjunctive PDT regarding the assessed peri‑implant parameters.
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Affiliation(s)
- Hussain Alsayed
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, P. O. Box 60169, Riyadh 11545, Saudi Arabia.
| | - Ishfaq A Bukhari
- Department of Pharmacology, Kentucky College of Osteopathic Medicine, University of Pikeville, Pikeville, KY 41501, USA
| | - Rawan Alsaif
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, P. O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, P. O. Box 60169, Riyadh 11545, Saudi Arabia.
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36
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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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An HW, Lee J, Park JW. Surface characteristics and in vitro biocompatibility of surface-modified titanium foils as a regenerative barrier membrane for guided bone regeneration. J Biomater Appl 2023; 37:1228-1242. [PMID: 36205350 DOI: 10.1177/08853282221132351] [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: 11/16/2022]
Abstract
This study evaluated surface characteristics and biocompatibility of surface-modified thin titanium (Ti) foils as a regenerative barrier membrane for future application in guided bone regeneration (GBR) surgery to augment atrophic alveolar bone. Anodic oxidation and post-heat treatment were performed to prepare various Ti foil samples. Then, the in vitro soft and hard tissue compatibility of the samples was evaluated by examining the cell responses using primary human gingival fibroblasts (HGFs) and MG63 human osteoblast-like cells. Investigated Ti foil samples showed marked differences in physicochemical surface properties. Additional 400°C heat treatment applied to the anodized Ti surface led to formation of an anatase titanium dioxide structure and well-organized nanoscale protrusions, and significantly increased surface wettability. Anodization and heat treatment enhanced the growth of HGFs and MG63 cells in Ti foil samples. Additional heat treatment for 10 and 30 min further significantly improved the response of HGFs including spreading and proliferation, and upregulated the mRNA expression of cell adhesion- and maturation-related genes as well as the osteoblast differentiation of MG63 cells. Ti foil sample with thin oxide coating obtained by a 30 min heat treatment exhibited poor clinical plasticity as a regenerative barrier membrane, which showed complete coating failure in the bending test. Our results indicate that anatase Ti oxide coating of a specific film thickness with nanoscale surface protrusion morphology and hydrophilic characteristics obtained by anodization and post-heat treatment would be an effective approach as a biocompatible Ti regenerative membrane for inducing better regeneration of both gingival tissue and bone.
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Affiliation(s)
- Hyun-Wook An
- Graduate School, 34986Kyungpook National University, Daegu, Korea.,Megagen Implant R&D Center, Daegu, Korea
| | - Jaesik Lee
- Megagen Implant R&D Center, Daegu, Korea
| | - Jin-Woo Park
- Department of Pediatric Dentistry, 65498Kyungpook National University School of Dentistry, Daegu, Korea
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Zamai RS, Corrêa MG, Ribeiro FV, Cirano FR, Casati MZ, Messora MR, Pimentel SP. Does resveratrol favor peri-implant bone repair in rats with ovariectomy-induced osteoporosis? Gene expression, counter-torque and micro-CT analysis. Braz Oral Res 2023; 37:e003. [PMID: 36700588 DOI: 10.1590/1807-3107bor-2023.vol37.0003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 11/11/2020] [Indexed: 01/27/2023] Open
Abstract
This study investigated the influence of resveratrol on peri-implant repair and its effects on bone-related markers in ovariectomy-induced osteoporosis in rats. Animals were divided into: OVX+PLAC (n = 10): ovariectomized animals treated with placebo; OVX+RESV (n = 10): OVX treated with resveratrol; OVX+PLAC+ZOL (n = 10): OVX treated with PLAC and zoledronate; OVX+RESV+ZOL (n = 10): OVX treated with RESV and ZOL; and SHOVX+PLAC (n = 10): sham ovariectomy treated with PLAC. RESV and PLAC were administrated after ovariectomy and ZOL after six weeks after OVX, until the end of experiment. One implant was inserted in each tibiae of animals 18 weeks after ovariectomy. After 4 weeks, one implant was removed for counter-torque, and peri-implant tissue was collected for mRNA quantification of several osteogenic markers by PCR. The other tibia was submitted to micro-computed tomography analysis. Reduced counter-torque values, bone-implant contact (BIC) and bone volume fraction (BV/TV), and higher bone porosity (BP) were detected in OVX+PLAC group when compared to SHOVX+PLAC (p < 0.05). OVX+RESV rats presented lower BIC, BV/TV, and trabecular number (Tb.N), and augmented BP and trabecular spacing (Tb.Sp) when compared to SHOVX+PLAC (p < 0.05). Higher Tb.N and connectivity density (Conn.Dn) and reduced Tb.Sp were observed in OVX rats treated with ZOL, independently of RESV, when compared to OVX+PLAC and OVX+RESV groups (p < 0.05), whereas the combination ZOL+RESV promoted lower BP when compared to OVT+PLAC and OVX+RESV (p < 0.05). Gene expression was not influenced by RESV (p > 0.05), whereas ZOL promoted up-regulation of BMP-2 (p<0.05). RESV did not improve peri-implant bone repair in rats with ovariectomy-induced osteoporosis.
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Affiliation(s)
- Rodrigo Soler Zamai
- Universidade Paulista - UNIP, School of Dentistry , Dental Research Division , São Paulo , SP , Brazil
| | - Monica Grazieli Corrêa
- Universidade Paulista - UNIP, School of Dentistry , Dental Research Division , São Paulo , SP , Brazil
| | - Fernanda Vieira Ribeiro
- Universidade Paulista - UNIP, School of Dentistry , Dental Research Division , São Paulo , SP , Brazil
| | - Fabiano Ribeiro Cirano
- Universidade Paulista - UNIP, School of Dentistry , Dental Research Division , São Paulo , SP , Brazil
| | - Marcio Zaffalon Casati
- Universidade Paulista - UNIP, School of Dentistry , Dental Research Division , São Paulo , SP , Brazil
| | - Michel Reis Messora
- Universidade de São Paulo - USP, Ribeirão Preto School of Dentistry , Department of Surgery and Bucco-Maxillofacial Traumatology and Periodontology , Ribeirão Preto , SP , Brazil
| | - Suzana Peres Pimentel
- Universidade de São Paulo - USP, Ribeirão Preto School of Dentistry , Department of Surgery and Bucco-Maxillofacial Traumatology and Periodontology , Ribeirão Preto , SP , Brazil
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Muniz FWMG, Fernandez MDS, Pacheco KE, Martins MW, Trevisan TC, Zatt FP, Colussi PRG. Use of dental implants among older adults of two southern Brazilian cities: A population-based cross-sectional study. SPECIAL CARE IN DENTISTRY 2023; 43:56-66. [PMID: 35666997 DOI: 10.1111/scd.12736] [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: 12/22/2021] [Revised: 03/17/2022] [Accepted: 05/13/2022] [Indexed: 01/21/2023]
Abstract
AIM To assess the prevalence and associated factors with use of dental implants among older adults. METHODS This cross-sectional study was performed with home dwelling older adults from the cities Cruz Alta and Veranópolis, Brazil. The main outcome was obtained by a clinical oral examination, considering those with at least one dental implant. Independent variables were collected by a structured questionnaire. Crude and adjusted analysis was performed by Poisson regression with robust variance estimation; results are presented in prevalence ratio (PR) and 95% confidence interval. RESULTS It was included 569 participants. The overall prevalence of using at least one dental implant was 16.7%. Higher PR for the use of dental implants was observed in white individuals (PR:5.147; 95% CI:2.033-3.034), in those with at least medium income (PR:3.202; 95% CI:1.196-5.572) and in those with access to dental care in the last 12 months (RP:1.595; 95% CI:1.087-2.340). Older adults with a medium level of education (RP:0.484; 95% CI:0.240-0.978) and those that did not use dental floss (RP:0.627; 95% CI:0.240-0.978) demonstrated a significantly lower PR for use of dental implants. CONCLUSION A substantial prevalence of use of dental implants was observed among older adults. In addition, white ones, those with a better financial situation and users of dental floss presented higher use of dental implants.
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Affiliation(s)
| | | | - Karen Eymael Pacheco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Sbricoli L, Bazzi E, Stellini E, Bacci C. Systemic Diseases and Biological Dental Implant Complications: A Narrative Review. Dent J (Basel) 2022; 11:dj11010010. [PMID: 36661547 PMCID: PMC9857470 DOI: 10.3390/dj11010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 12/30/2022] Open
Abstract
The relationship between periodontitis and such systemic disorders as diabetes, cardiovascular disease and obesity has been extensively investigated. There is less scientific evidence available, however, regarding the influence of systemic diseases on the risk of late failure of dental implant rehabilitation due to peri-implantitis. The aim of the present study was to review the literature on the role of several common systemic disorders (diabetes, obesity, cardiovascular disease, hypertension and osteoporosis) in the onset of peri-implantitis. A database search initially yielded 2787 studies of potential interest published up to 1 March 2022 (993 in PubMed; 908 in Web of Science; and 886 in Scopus). After removing 1190 duplicate articles and checking the titles, abstracts and full texts for relevance, 70 articles were selected for the present analysis. Only cohort, case-control studies and clinical case series were considered. Most of the literature concludes for no association between diabetes, cardiovascular disease, hypertension or osteoporosis and the risk of peri-implantitis. On the other hand, almost all the studies that investigated obesity as a risk factor for implant rehabilitation found a positive association between the two. Further longitudinal studies are needed to better understand the effects of systemic diseases on rehabilitation with dental implants.
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Hammouri MH, Salekh KM. Dental implants osseointegration in patients with osteoporosis. RUDN JOURNAL OF MEDICINE 2022. [DOI: 10.22363/2313-0245-2022-26-4-422-430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The successful use of surgical and medical methods of jaw bone tissue restoration has been convincingly confirmed in clinical practice. At the same time, technologies are being developed to improve the osseointegration of dental implants in patients with osteoporosis. The use of various implant coatings, as well as systemic therapy, demonstrate the emergence of new directions in the treatment of patients with partial or complete secondary edentulism with concomitant osteoporosis. This trend is relevant in modern medicine . Information was obtained from the PubMed database, using the keywords «osteoporosis» and «osseointegration» and «dental implantation» and «zoledronic acid» from 2016 to 2022. Articles were selected based on experimental work. Numerous studies have shown that bone tissue is an effective indicator of osteoporotic changes. The main changes in bone tissue in osteoporosis are emphasized - a decrease in bone volume, deterioration of the microarchitecture of the trabecular bone and processes that prevent osseointegration - loss of bone mass, a significant decrease in the percentage of contact in the implant-bone complex. Methods of dealing with the negative impact on the operation of dental implantation have been identified. In a review of studies on the systemic administration of drugs based on bisphosphonates, an increase in the osseointegration of dental implants was revealed, the systemic administration of zoledronic acid preparations significantly increased the formation of new bone, which in turn contributed to the elimination of such a negative effect of osteoporosis as bone resorption. In addition to the systemic administration of bisphosphonates, experimental studies describe the topical application of bisphosphonates in the form of various implant coatings. Topical application of bisphosphonates also contributed to increased osseointegration. Microstructured coated implants showed less marginal bone loss compared to uncoated implants. Conclusion. The use of dental implants with modified macro- and microrelief, as well as systemic drug therapy, remains the main direction of scientific research that contributes to the optimization of osseointegration of dental implants.
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Wang Z, Zhang J, Hu J, Yang G. Gene-activated titanium implants for gene delivery to enhance osseointegration. BIOMATERIALS ADVANCES 2022; 143:213176. [PMID: 36327825 DOI: 10.1016/j.bioadv.2022.213176] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/22/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Osseointegration is the direct and intimate contact between mineralized tissue and titanium implant at the bone-implant interface. Early establishment and stable maintenance of osseointegration is the key to long-term implant success. However, in patients with compromised conditions such as osteoporosis and patients beginning early load-bearing activities such as walking, lower osseointegration around titanium implants is often observed, which might result in implant early failure. Gene-activated implants show an exciting prospect of combining gene delivery and biomedical implants to solve the problems of poor osseointegration formation, overcoming the shortcomings of protein therapy, including rapid degradation and overdose adverse effects. The conception of gene-activated titanium implants is based on "gene-activated matrix" (GAM), which means scaffolds using non-viral vectors for in situ gene delivery to achieve a long-term and efficient transfection of target cells. Current preclinical studies in animal models have shown that plasmid DNA (pDNA), microRNA (miRNA), and small interference RNA (siRNA) functionalized titanium implants can enhance osseointegration with safety and efficiency, leading to the expectation of applying this technique in dental and orthopedic clinical scenarios. This review aims to comprehensively summarize fabrication strategies, current applications, and futural outlooks of gene-activated implants, emphasizing nucleic acid targets, non-viral vectors, implant surface modification techniques, nucleic acid/vector complexes loading strategies.
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Affiliation(s)
- Zhikang Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Jing Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Jinxing Hu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Guoli Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China.
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Zierden K, Wöstmann J, Wöstmann B, Rehmann P. Clinical performance of different types of dental prosthesis in patients with head and neck tumors-a retrospective cohort study. Clin Oral Investig 2022; 26:7121-7133. [PMID: 35976496 PMCID: PMC9708759 DOI: 10.1007/s00784-022-04673-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 08/09/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate how different types of dental prosthesis perform in patients with head and neck tumors. MATERIALS AND METHODS In this retrospective clinical cohort study, the impact of different patient-related factors was analyzed as influencing factors on the survival probability of dental prosthesis using Kaplan-Meier estimate. For analysis, the dental prosthesis was divided into groups: group 1 (fixed dental prosthesis), group 2 (removable dental prosthesis), group 3 (implant-supported dental prosthesis), and group 4 (prostheses anchored using wrought wire clasps and obturators). The incidental aftercare measures were also evaluated. RESULTS Two hundred seventy-nine restorations were observed (mean observation: 2.7 ± 3.0 years, max.14.8 years) out of which 49 (17.6%) had to be replaced during the observation. After 5 years, 100% of group 1 restorations, 79.9% of group 2 restorations, 91.4% of group 3 restorations, and 30% of group 4 restorations were still functional. Four hundred eighty-eight dental implants were observed, of which 77 (15.8%) failed. CONCLUSIONS Groups 1, 2, and 3 restorations showed good survival times after 5 years in function, whereas group 4 presented the worst survival times. Group 2 restorations showed the highest amount of necessary aftercare measures. CLINICAL RELEVANCE The current investigation shows that groups 1, 2, and 3 restorations should be preferred in the prosthetic treatment planning of patients with head and neck tumors. A treatment with group 4 restorations should only be considered if no other prosthetic treatment is possible or as temporary treatment.
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Affiliation(s)
- Karina Zierden
- Department of Prosthodontics, School of Dental Medicine, Justus-Liebig-University, Schlangenzahl 14, 35392, Giessen, Germany.
| | | | - Bernd Wöstmann
- Department of Prosthodontics, School of Dental Medicine, Justus-Liebig-University, Schlangenzahl 14, 35392, Giessen, Germany
| | - Peter Rehmann
- Department of Prosthodontics, School of Dental Medicine, Justus-Liebig-University, Schlangenzahl 14, 35392, Giessen, Germany
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Fischer NG, Aparicio C. Junctional epithelium and hemidesmosomes: Tape and rivets for solving the "percutaneous device dilemma" in dental and other permanent implants. Bioact Mater 2022; 18:178-198. [PMID: 35387164 PMCID: PMC8961425 DOI: 10.1016/j.bioactmat.2022.03.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/14/2022] [Accepted: 03/12/2022] [Indexed: 02/06/2023] Open
Abstract
The percutaneous device dilemma describes etiological factors, centered around the disrupted epithelial tissue surrounding non-remodelable devices, that contribute to rampant percutaneous device infection. Natural percutaneous organs, in particular their extracellular matrix mediating the "device"/epithelium interface, serve as exquisite examples to inspire longer lasting long-term percutaneous device design. For example, the tooth's imperviousness to infection is mediated by the epithelium directly surrounding it, the junctional epithelium (JE). The hallmark feature of JE is formation of hemidesmosomes, cell/matrix adhesive structures that attach surrounding oral gingiva to the tooth's enamel through a basement membrane. Here, the authors survey the multifaceted functions of the JE, emphasizing the role of the matrix, with a particular focus on hemidesmosomes and their five main components. The authors highlight the known (and unknown) effects dental implant - as a model percutaneous device - placement has on JE regeneration and synthesize this information for application to other percutaneous devices. The authors conclude with a summary of bioengineering strategies aimed at solving the percutaneous device dilemma and invigorating greater collaboration between clinicians, bioengineers, and matrix biologists.
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Affiliation(s)
- Nicholas G. Fischer
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, MN, 55455, USA
| | - Conrado Aparicio
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, MN, 55455, USA
- Division of Basic Research, Faculty of Odontology, UIC Barcelona – Universitat Internacional de Catalunya, C/. Josep Trueta s/n, 08195, Sant Cugat del Valles, Barcelona, Spain
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), C/. Baldiri Reixac 10-12, 08028, Barcelona, Spain
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Müller F, Srinivasan M, Krause K, Schimmel M. Periodontitis and peri-implantitis in elderly people experiencing institutional and hospital confinement. Periodontol 2000 2022; 90:138-145. [PMID: 35916869 PMCID: PMC9804296 DOI: 10.1111/prd.12454] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
An increasing number of elderly people retain their natural teeth into old age and further, the prevalence of endosseous implants for supporting oral prosthesis is ever increasing. These teeth and implants now present a considerable challenge in terms of maintenance, especially when patients become dependent on care. Periodontal and peri-implant diseases are more prevalent in elderly than in younger age cohorts. There are distinct differences related to the inflammatory response between periodontal and peri-implant tissues, both in young and old age. The age-related reasons for the increase in periodontal infections may be related to poor oral hygiene because of a loss of dexterity or vision, but also to immunosenescence. This term describes the aging of the immune system and the decline of its effectiveness with age. Low-grade infections, like chronic periodontitis, may cause low-grade inflammation and subsequently increase the likelihood of developing chronic diseases. In return, treatment of periodontitis may improve general health, as demonstrated for diabetes. A second mechanism illustrating how poor oral health translates into systemic disease is the risk of developing aspiration pneumonia. The treatment options in old age should be evaluated with regard to the issues of general health and maintenance. Systematic periodontal maintenance therapy, as performed in younger age cohorts, may be difficult to implement in elderly people experiencing institutional or hospital confinement because of logistics, barriers related to patients and caregivers, or cost. The scale of periodontal disease in old age represents a public health issue.
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Affiliation(s)
- Frauke Müller
- Division of Gerodontology and Removable ProsthodonticsUniversity of GenevaGenevaSwitzerland,Department of Rehabilitation and GeriatricsUniversity Hospitals of GenevaThônexSwitzerland
| | - Murali Srinivasan
- Division of Gerodontology and Removable ProsthodonticsUniversity of GenevaGenevaSwitzerland,Clinic for General, Special Care and Geriatric DentistryCenter of Dental Medicine, University of ZürichZürichSwitzerland
| | - Karl‐Heinz Krause
- Department of Pathology and ImmunologyUniversity of GenevaGenevaSwitzerland,Department of Genetic and Laboratory MedicineGeneva University HospitalsGenevaSwitzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable ProsthodonticsUniversity of GenevaGenevaSwitzerland,Department of Reconstructive Dentistry and GerodontologySchool of Dental Medicine, University of BernBernSwitzerland
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Nibali L, Gkranias N, Mainas G, Di Pino A. Periodontitis and implant complications in diabetes. Periodontol 2000 2022; 90:88-105. [PMID: 35913467 DOI: 10.1111/prd.12451] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Epidemiologic evidence indicates that periodontitis is more frequent in patients with uncontrolled diabetes mellitus than in healthy controls, suggesting that it could be considered the "sixth complication" of diabetes. Actually, diabetes mellitus and periodontitis are two extraordinarily prevalent chronic diseases that share a number of comorbidities all converging toward an increased risk of cardiovascular disease. Periodontal treatment has recently been shown to have the potential to improve the metabolic control of diabetes, although long-term studies are lacking. Uncontrolled diabetes also seems to affect the response to periodontal treatment, as well as the risk to develop peri-implant diseases. Mechanisms of associations between diabetes mellitus and periodontal disease include the release of advanced glycation end products as a result of hyperglycemia and a range of shared predisposing factors of genetic, microbial, and lifestyle nature. This review discusses the evidence for the risk of periodontal and peri-implant disease in diabetic patients and the potential role of the dental professional in the diabetes-periodontal interface.
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Affiliation(s)
- Luigi Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Nikolaos Gkranias
- Centre for Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University London (QMUL), London, UK
| | - Giuseppe Mainas
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Kim SH, Oh NS, Kim HJ. Survival Rates and Clinical Outcomes of Implant Overdentures in Old and Medically Compromised Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11571. [PMID: 36141841 PMCID: PMC9517507 DOI: 10.3390/ijerph191811571] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
Studies on the survival rate of implant overdentures in medically compromised patients are limited because most studies exclude patients with systemic diseases affecting implant prognosis. This retrospective study aimed to evaluate the survival rate and clinical outcomes of dental implants used for overdentures in medically compromised patients. A total of 20 patients (9 men, 11 women; mean age: 67.55 ± 6.84 years, range: 53-81 years) were included. Fourteen patients had more than two systemic diseases, and nine patients had more than three systemic diseases. The mean follow-up period was 39.05 months. Of the 60 implants, 2 failed, resulting in an implant survival rate of 96.6%. No statistical differences were found in implant survival rates according to sex, age, implant diameter, restored arch, or opposing dentition (p > 0.05). A significant difference in mean marginal bone loss (MBL) was noted for restoring the arch (p = 0.022) and opposing dentition (p = 0.036). Implants placed in the mandible and with opposing removable partial dentures and complete dentures showed lower mean MBL. No significant differences in implant MBL were observed in terms of age, sex, or implant diameter (p > 0.05). Favorable clinical outcomes can be expected from implant overdentures using two or four implants in edentulous patients with systemic diseases by ensuring that the patients have a sufficient healing period and regular checkups.
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Affiliation(s)
- So-Hyun Kim
- Department of Dentistry, Inha University Hospital, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea
| | - Nam-Sik Oh
- Department of Dentistry, Inha University Hospital, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea
| | - Hyo-Jung Kim
- Department of Dentistry, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwhando-ro, Dong-gu, Ulsan 44033, Korea
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McKenna GJ, Gjengedal H, Harkin J, Holland N, Moore C, Srinivasan M. EFFECT OF AUTOGENOUS BONE GRAFT SITE ON DENTAL IMPLANT SURVIVAL AND DONOR SITE COMPLICATIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2022; 22:101731. [PMID: 36162883 DOI: 10.1016/j.jebdp.2022.101731] [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: 10/06/2021] [Revised: 03/10/2022] [Accepted: 03/30/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This systematic review and meta-analysis was undertaken to answer the following focus questions: Is the implant survival in augmented bone utilizing iliac crest bone grafts the same as while using intraoral autologous bone grafts? Is the incidence of postoperative donor site complications the same when using iliac crest bone grafts as opposed to intraoral grafts? METHODS Systematic searches of electronic databases (PubMed, Embase, CENTRAL) were performed to identify studies which reported on implant survival and postoperative complications for dental implants placed in grafted partially/completely edentulous human jaws. Studies were included if: they reported on 2-piece micro-rough surface root form dental implants placed in bone-augmented completely or partially edentulous human jaws, and the jaws must have been augmented with autologous bone graft materials. Time and nature of postoperative complications must have been reported. Two investigators performed data extraction and a Cohen's unweighted kappa was calculated for inter-investigator reliability. A meta-analysis was performed for the extracted data on implant survival rate in both iliac crest grafts and intra-oral grafts. A qualitative analysis was performed on the information extracted on graft donor site complications. Quality assessment of the included studies were done using the Cochrane collaboration tool and the Newcastle-Ottawa scales. RESULTS A total of 23 studies were included in the final analysis. The calculated kappa ranged between 0.77-0.89 for the literature search and identification process. Fourteen studies were included with data on implant survival including five randomized controlled clinical trials. The meta-analysis of included studies revealed that the implant survival rate of dental implants placed in jaws augmented with iliac crest grafts was lower than those placed in jaws augmented with intra-oral bone grafts at 6-months [ICG = 95.8% IOG = 98.4%; P < .001], 12-months [ICG = 97.0%, IOG = 98.4%; P < .001], 24-months [ICG = 85.9%, IOG = 98.2%; P < .001], 60-months [ICG = 90.0%, IOG = 91.5%; P < .001], and at 120-months [ICG = 88.8%, IOG = 95.2%; P < .001] follow-up periods. Iliac crest grafts were also frequently associated with donor site complications including pain / discomfort, gait disturbance, and sensory disturbance. CONCLUSIONS This systematic review and meta-analysis demonstrates that implant survival is consistently higher in bone harvested from intraoral sites compared to iliac crest grafts. Donor site complications seemed to be a frequent finding with iliac crest grafts and mental grafts. FUNDING None. REGISTRATION The review protocol was registered with PROSPERO: International prospective register of systematic reviews (CRD42021283738).
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Affiliation(s)
- Gerald J McKenna
- Clinical Reader / Consultant in Restorative Dentistry, Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Harald Gjengedal
- Institute of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Jennifer Harkin
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Nicola Holland
- Specialty Registrar in Restorative Dentistry, Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Ciaran Moore
- Specialty Registrar in Restorative Dentistry, Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Murali Srinivasan
- Clinic of General-, Special care and Geriatric Dentistry, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Huang T, Yu Z, Yu Q, Chen Y, Jiang Z, Wang Y, Yang G. Electrochemical deposition of lithium coating on titanium implant with enhanced early stage osseointegration. J Biomed Mater Res B Appl Biomater 2022; 110:2399-2410. [PMID: 35604032 DOI: 10.1002/jbm.b.35085] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 04/19/2022] [Accepted: 04/30/2022] [Indexed: 11/10/2022]
Abstract
Recently, a large number of studies have reported that lithium (Li) displayed a positive effect on osteogenesis. However, only a few studies have investigated the Li-incorporated surfaces through electrochemical deposition. In this study, electrochemical deposition was conducted on a CHI600E electrochemical workstation. The characterization of electrochemical deposition (ECD) and ECD-Li surfaces were detected by field-emission scanning electron microscopy with energy-dispersive spectrometer. rBMSCs were cultured on two surfaces for subsequent adhesion, proliferation and live/dead assay. To evaluate the effects of Li-incorporated implants by electrochemical deposition on osseointegration in vivo, teeth extraction of two premolars and one first molar in bilateral mandible were performed on six male beagle dogs. After 3 months, ZDI and ZDI-Li implants were inserted into the bilateral mandible of each beagle dog. Micro Computed Tomography (Micro-CT) and hard tissue sectioning analysis were carried out to evaluate the osseointegration at 4- and 8-weeks post-implantation. Results showed that ECD-Li surface promoted adhesion and proliferation of BMSCs in the early stage. More importantly, through micro-CT analysis, the values of bone volume/total volume (BV/TV) (0.374 ± 0.015), bone-implant contact (BIC) (0.831 ± 0.025), and Tb.Th (0.412 ± 0.007) in ZDI-Li group was significantly higher than those of ZDI group (0.302 ± 0.009, 0.700 ± 0.023, 0.353 ± 0.001, p < .01) at 4 weeks. Similarly, ZDI-Li group manifested more bone contact with the implant surfaces at 4 weeks based on hard tissue sectioning analysis, whereas no significant difference was detected between two groups at 8 weeks. Therefore, incorporating Li into implant surface through ECD could enhance early osseointegration in vivo.
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Affiliation(s)
- Tingben Huang
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhou Yu
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Qiong Yu
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Yitong Chen
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhiwei Jiang
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Ying Wang
- Department of Oral Medicine, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Guoli Yang
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
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Mavriqi L, Lorusso F, Tartaglia G, Inchingolo F, Scarano A. Transinusal Pathway Removal of an Impacted Third Molar with an Unusual Approach: A Case Report and a Systematic Review of the Literature. Antibiotics (Basel) 2022; 11:antibiotics11050658. [PMID: 35625302 PMCID: PMC9137649 DOI: 10.3390/antibiotics11050658] [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: 04/24/2022] [Revised: 05/05/2022] [Accepted: 05/11/2022] [Indexed: 01/25/2023] Open
Abstract
Background: The purpose of the present case report was to investigate a very rare ectopic third molar removal by a trans-sinusal approach and report the study findings through a systematic review of the literature on this topic. Case presentation: A 38-year-old female patient was visited for pain at the level of the right maxillary region. No relevant medical history was reported. The CBCT tomography assessment revealed an impacted third tooth at the level of the postero-lateral maxilla. Review Methods: An electronic search was performed through Boolean indicators query on Pubmed/Medline, EMBASE, Cochrane Library databases. The clinical reports were identified and selected in order to perform a descriptive analysis. The surgical approach concerned a trans-sinusal access to the site for the ectopic tooth removal with a lateral antrostomy. No evident inflammatory alteration was associated to the ectopic tooth and a non-relevant post-operative sequelae was reported at the follow up. Results: A total of 34 scientific papers were retrieved from the database search. Only two cases reported a wait-and-see radiographical follow-up approach, while the most common treatment was surgical removal, also for asymptomatic cases. Conclusion: The third-molar ectopic tooth into the maxillary sinus is an uncommon occurrence that is beast treated by an in-chair intraoral tran-sinusal approach, with a consistent reduction of the invasivity, a mild morbidity and a successful functional outcome.
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Affiliation(s)
- Luan Mavriqi
- Faculty of Dental Medicine, Albanian University, 1023 Tirane, Albania;
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Gianluca Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20122 Milano, Italy;
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
- Department of Oral Implantology, Dental Research Division, College Ingà, UNINGÁ, Cachoeiro de Itapemirim 29312, Espirito Santo, Brazil
- Correspondence: ; Tel.: +39-087-1355-4084; Fax: +39-087-1355-4099
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